Newsgroups: bit.listserv.scuba-l
Date:         Wed, 27 Jan 1993 13:16:00 EST
From:         "Reef Fish (Large Nassau Grouper)" <RFLNG@CLEMSON.BITNET>
Subject: RE: Heart Surgery and Scuba Diving

>  Doug Martin, M.D. (DOUG <"VA::DOUG"@FALCON.IUPUI.EDU>)

gave a well-reasoned medical opinion to my inquiry concerning open-heart
surgery and post-surgery scuba-diving.  THANKS.  From first/second/third
hand info I have accumulated thus far from heart surgeons, cardiac
physicians, dive-physicians, as well as several active scuba divers who
had "heart attack" (myocardial infarction), cononary artery bypass, and
aortic/pulmonary valve-replacement surgery, the overwhelming concensus
appears to be what Doug (Dr. Martin) said:

>  I believe you will find there is no definitive data on this.

Not a comforting thought, but not unlike the situation in many other
ills and practices either, relative to scuba-diving.  B-(

Doug then went on to explain why the large difference between the actual
surgeon's recommended recovery period (before resuming diving: 12 weeks)
to a particular individual, and DAN physician's recommenedation (1 year)
to the same individual is not as large as it may seem:

>    :...:                   Despite your detailed description of your
> friend's medical condition, there are many parameters that you have no
> knowledge of that may affect this decision.  His cardiovascular surgeon
> is clearly in the best position to evaluate his cardiac risk, though he
> may have limited knowledge of diving physiology.  DAN on the other hand
> has amassed considerable knowledge of diving physiology, but cannot
> possibly know all of the intricate details of your friend's condition.
> In addition, despite all of the neat studies on diving physiology in
> healthy subjects, there is very little data on patients with chronic
> medical conditions.  Until this gap in our medical knowledge is filled,
> no one can make recommendations with complete confidence.

Well put.  I take it that such divers will have to make their own subjective
evaluations in risk assessment of their own actions, in the light of meager,
available knowledge/advice ... sort of like deciding how to set your PERSONAL
margins of safety when diving with computers (or Tables, for that matter).

> Scott (S Dunbar <dunbar@BOULDER.COLORADO.EDU>)

who is not an M.D., offered sound points/advice nevertheless, e.g.,

> if your friend has drastically changed his lifestyle, that would be
> a good thing, for instance wt. loss, cessation of smoking, stress reduction,
> if he has good, then perhaps diving would be ok, but lets remember diving
> can be very strenous and stressful, so this is something else to think
> about.

No argument from me, though I suppose it's hard for the person involved to
make certain "drastic changes in lifesytyle" (including possibly giving up
or severely curtailing his diving activities) not knowing the net effect of
such changes (since ... "there is no definitive data ...").   Besides, it
reminded me of the old joke about some 90-year-old attributing his longevity
to "no smokin', no drinkin', and no foolin' with women ..." to which his
advisee inquired, "And you call that LIVING?"   :-)

> suppose you are on the island of rangaroa in the s. pacific, there would
> be no where to go to get care and the reason i bring this up is because when
> i was there a older gentleman spent too much time in the sun and passed
> out, it was not cardiac but if it was we were too far from reality
> of life.

I suppose those are the accepted risks when we travel to remote sites to
pursue our love (scuba-diving).  If I were in that gentleman's fins, I
probably would pass out (away?) with a BIG "8-)" on my face.  :-)

> good luck to your friend and i hope you enjoyed your trip, post a summary.

Thanks.  The dives with bull (C. leucas) and Caribbean reef (C. perezi)
sharks in Nassau were pulse-raising and fun|  Will do a post, soon.

-- Bob.
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