Sunday, November 28, 2004

Multiple Sclerosis Web page updated

We have updated the web page about diving with MS. The basic information is as follows:

Multiple Sclerosis

What is Multiple Sclerosis?
MS is thought to be an autoimmune disease that affects the central nervous system (CNS). The CNS consists of the brain, spinal cord, and the optic nerves. Surrounding and protecting the nerve fibers of the CNS is a fatty tissue called myelin, which helps nerve fibers conduct electrical impulses.

In MS, myelin is lost in multiple areas, leaving scar tissue called sclerosis. These damaged areas are also known as plaques or lesions. Sometimes the nerve fiber itself is damaged or broken.

Myelin not only protects nerve fibers, but makes their job possible. When myelin or the nerve fiber is destroyed or damaged, the ability of the nerves to conduct electrical impulses to and from the brain is disrupted, and this produces the various symptoms of MS.

The most common symptoms of MS include:
  • Fatigue (also called MS lassitude to differentiate it from tiredness resulting from other causes)
  • Problems with walking
  • Bowel and/or bladder disturbances
  • Visual problems
  • Changes in cognitive function, including problems with memory, attention, and problem-solving
  • Abnormal sensations such as numbness or "pins and needles"
  • Changes in sexual function
  • Pain
  • Depression and/or mood swings

Less common symptoms include:

  • Tremor
  • Incoordination
  • Speech and swallowing problems
  • Impaired hearing
For more information about MS, go to the National MS Society web page at
http://www.nationalmssociety.org/What%20is%20MS.asp

Mimics DCS

The main problem that might be seen with scuba diving with MS is that many of the symptoms of MS are similar to those of neurological DCS, such as patchy numbness, pain over peripheral nerves and fatigue. This would make it very difficult for a diving doctor to examine you and properly diagnose and treat an early case of DCS. Early diagnosis and treatment are necessary for best results with recompression treatment for neurological DCS.

No Studies

This having been said - it's going to be very difficult convincing divers not to return to diving if they had dived previously. I am not aware of any studies concerning the effects of pressure on the demyelinating effects of MS, nor am I aware of any ill effects regarding the use of certain medications for MS. If the diver is not taking drugs that alter the consciousness then there should be no problem in that area.
There are many medications used in the treatment of symptoms of multiple sclerosis. Some of theses drugs have sedation as a side effect and these should be considered when deciding if the person is 'fit to dive'. See extensive list at http://www.nationalmssociety.org/Meds_Used_in_MS3.asp .

As long as a diver is no danger to him/herself and poses no danger to his/her buddy I would have no problem allowing diving, particularly if it were done in warm waters with little stress and at no-deco depths. As far as I know, there are no pluses or minuses in regard to the effects of pressure on the demyelinating process.

You should be aware however, of the possibility of delay in diagnosis should you ever have a problem with decompression sickness. Have all neurological deficits recorded in an up-to-date fashion in the diver's log book---just in case!

Diver's Alert Network has the following to say about MS:

"
This immunologic disease occurring in young and middle-aged people is characterized by episodes of neurologic dysfunction, often separated by remission. The extent of disability is quite variable. Treatment has improved in recent years."

Fitness & Diving:

  1. There is no evidence that diving in itself has an effect on the disease. About 20 years ago an unsuccessful effort was made to treat MS with hyperbaric oxygen. Patients neither suffered nor benefited from this treatment series.
  2. Persons with MS are advised not to exercise to the point of exhaustion and to avoid becoming chilled or overheated. Diving candidates with MS should respect that advice.
  3. In each individual case, consider whether the candidate can handle the physical load and master the water skills. Diving candidates should talk to their neurologist about diving.

Tuesday, November 23, 2004

Utah Web Page Updated

Our web page containing Dive Accident facilities for the state of Utah has been updated thanks to Dr. Terri DeJohn, MD, the new Medical Director for the facility in Salt Lake City.

The Utah Hyperbaric Medicine Center

In Research Park on the Campus of The University of Utah
540 Arapeen Drive Suite 110
Salt Lake City, Utah 84108
Phone 801.582.HBOT (4268)
Fax 801.582.4269
www.utahhbot.com

Executive Director
Twyla G. Knox, RN
tknox@utahhbot.com

Director of Hyperbaric Medicine
New director of Hyperbaric Medicine is
Terri DeJohn, MD
tdejohn@utahhbot.com

Hyperbaric Program Director
Samuel L. Saur, CHT
*********************************


Pacemakers and arrhythmias web page revised

Our web page about scuba diving with pacemakers has been updated and revised. This might be more than you wanted to know about this subject - but there are many people out there that are diving with pacemakers that are not certified to withstand pressures much below 130 feet.

We have added links to some interesting articles for your research.

Enjoy!

scubadoc


Monday, November 22, 2004

Clinic and Physician added to Mexican list of chambers

We have added the following physician and hyperbaric clinic to the list for Mexico: http://scuba-doc.com/divmex.htm

Ph´s Name: David Ruvalcaba Herrera
Clinic´s contact: Clinica de Oxigenacion Hiperbarica
Location: Guadalajara , Jalisco
Adress: Luis Perez Verdia No. 165 Col Ladron de
Guevara, Guadalajara Jalisco , Mexico
Phone number: +52 (33) 3630-9606 & 3630-9607
email adress: clinicahiperbaricagdl@hotmail.com

adress : Calle Luis Perez Verdia No. 165
Col. Ladron de Guevara , Guadalajara , Jalisco ,
Mexico.

Email: clinicahiperbaricagdl@hotmail.com

Telefonos: +52 ( 33 ) 3630-9606 y 3630-9607

Multiplace chamber

Camara Multiplaza



Sunday, November 21, 2004

Reporting emails about drugs to the FDA

Here is a note from Dr. Jolie Bookspan regarding reporting receipt of email touting what you consider illegal sales of drugs.

"I offered my friend at the FDA to send the following FDA request to those with medical bulletin boards for posting, where appropriate.

Good Things,
Jolie"

**********************************


If you ever run across anything on counterfeit or black market pharmaceuticals, significant trafficking in controlled substance pharmaceuticals, or adulteration/tampering/off-label marketing of food, drugs or cosmetics please keep us in mind.

Special Agent Marc Hess
FDA/Office of Criminal Investigations
US Attorneys Office
615 Chestnut Street, #1250
Philadelphia, PA 19106
215/861-8253
marc.hess@fda.gov

Best wishes for a good Thanksgiving.

Thursday, November 18, 2004

Mexican Diving Medical Examiners added to list

The following UHMS/NOAA DMO Physicians have been added to our list of diving medical examiners, located at http://scuba-doc.com/divingexaminer.html .
  • Dr Ernesto Cuauhtemoc Sanchez Rodriguez

Director for DAN Mexico & DAN Latin America, Hospital Angeles del Pedregal Hyperbaric Unit Director, UHMS Latin American Chapter president, Current UHMS vicepresident

Camino Santa Teresa #1055

Colonia Heroes de Padierna

(52)55-55688082 fAX (52)55-55688082 EMAIL cuau@bluebottle.com

For emergencies: +1-919-684-9111 (Latin America Hotline)


  • Dr Jorge Dario Gomez Castillo

Current Fellow

Diving and Hyperbaric Unit

Prince of Wales Hospital

Sydney Australia

No current adress in Mexico.

EMAIL dario@bluebottle.com dario@bluebottle.com z3136276@student.unsw.edu.au

webpage http://www.geocities.com/g_dario2003


  • Dr Andres Alejandro Medina

EMAIL aamg_98@yahoo.com


  • Dra Renata Uribe Lopez

Camino Santa Teresa #1055

Colonia Heroes de Padierna

(52)55-55688082 fAX (52)55-55688082 EMAIL rana@yahoo.com

For emergencies: +1-919-684-9111 (Latin America Hotline)


  • Dr Alejandro Suarez Mendoza

Intensive Care

Current Fellow

Hyperbaric Medicine and Wound Care
University of Texas Health Science Center in Houston
Memorial Hermann Center for Wound Healing and Hyperbaric Medicine
Houston Texas

EMAIL mendozacruz20@hotmail.com

New web page containing Bookspan article

Dr. Jolie Bookspan has allowed us to publish another one of her articles. This is 'Detection of endogenous gas phase formation in humans at altitude'.

The abstracted material is on a web page at http://scuba-doc.com/bubbalt.html and is linked to the section on flying, diving and altitude at http://www.scuba-doc.com/flyafdv.html .

Friday, November 12, 2004

Link added to web page

The following link has been again placed on our web page:

myDiveBook.com Administrator
admin@mydivebook.com
www.mydivebook.com -- the source for online dive logs and more!

Please list us under "Diver Services"

Cheers!

Monday, November 08, 2004

New Zealand Dive Accident Facilities web page changed

For several reasons we have removed all references to individual dive accident facilities and physicians on our New Zealand web page.

All divers needing information about diving injuries will be directed to a central telephone number that will provide local information.

The central Diver Emergency Number in New Zealand:

Dial 0800 4DES 111 (0800 4337 111)




Sunday, November 07, 2004

New link to HBO facility in northeast Pennsylvania

We have added this link to our links page at the address above:

The Jenny Rose Specialized Therapy Center is located in the north east region of Pennsylvania and we hope you find the following information of interest and link us thru you web site. We provide hyperbaric oxygen therapy and conductive education.

Thank You in advance,

Sincerely,

Elaine R. Parker, Director: CHT, EMT

Phone: (570) 421-3415

Fax: (570) 421-9873

Email: support@thejennyrosecenter.com

Web: www.thejennyrosecenter.com

Friday, November 05, 2004

Physician Added to Diving Medical Examiners

We added the following physician to our web page concerning qualified diving medical examiners.


Columbia [Missouri]

Eugene R. Worth, M.D., M.Ed.

3W40 Health Sciences Center, DC005.00

1 Hospital Drive

Columbia, MO 65212

Phone: (573) 882-1488 (Hyperbaric Medicine Center)

(573) 882-4141 (24-hour University Hospital Switchboard)

DAN Referral Physician and Referral Chamber

Clinical Hyperbaric services 24/7/365

Full-time hyperbaric medicine

Board-certified: Anesthesiology

Subspecialty board eligible: Undersea and Hyperbaric Medicine
(Examination November 8, 2004)

Undersea and Hyperbaric Medical Society Member

Chair of Enduring Materials Subcommitee, UHMS CME Committee

Let me know if you are credentialed to perform 'fitness to dive evaluatons' and would like to be listed on this web site.

scubadoc

Thursday, November 04, 2004

Our forum, 'Scuba Clinic' is growing very slowly - as is to be expected. Forums rarely ever take off like 'gangbusters'. However, ours has a distinct value in that we have highly competent and knowledgeable consultants who answer questions. The forum can be accessed from the main page and by clicking on this URL:
http://scuba-doc.com/scubaclinic

Today, I added a forum to cover endocrine and metabolic questions and rearranged some of the forums in the category "Fitness to Dive". I also added a forum for Flying and altitude after diving.

You are encouraged to visit , register and participate in our free bulletin board.

scubadoc

Tuesday, November 02, 2004

We have posted a new hyperbaric chamber listing for Indiana.

Kokomo

St Joseph Hospital Wound Healing Center
1907 W. Sycamore, Suite 300
Kokomo,IN 46901
Chamber Room Phone # (765) 236-8881
Front Office phone # (765) 236-8888
Medical Director is Dr. Dawn Sabau M.D.
Safety Officer is Matthew Stewart, Hyperbaric Wound Care Technician
Wound center Manager is Dea Kent R.N
We have (2) Sechrist Model 3200 Monoplace chambers we are using for wound care. We have been operational since 9/21/2004, and are currently treating patients daily.

We have added 'blogs' to our web site - one for the newsletter, 'Ten Foot Stop' - and one general blog to provide you with news about our web site that will affect your quality viewing experience.

We will notify you here of changes on our web pages, new web pages and other activities that might be interesting.

Enjoy!

Ern Campbell, MD
scubadoc
Diving Medicine Online
http://scuba-doc.com/