Diving with a triple fracture to zygomatic bone

[lamccarthy]

Injuries: triple fracture, left zygomatic - fracture to left eye orbit, concussion, sinus rupture.

I had an unfortunate accident on March 28th...surgery to insert 2 titanium plates to my zygomatic bone to fasten my cheek back together took place on April 7.

Question:.. I have planned to go diving in Hawaii on December 4th. My doctor said it's ok...then she said no...then she said ok..then no. Help. What is the correct answer?

I need a Diving Medicine MD's advice.

[ScubaNurse758]

Ortho isnt my specialty, so I would obviously defer to DAN on this, but I would also want to maybe have a pool session or two to see how you do clearing your sinuses and mask fit before making any final decisions. But ultimately I'd get ahold of DAN and see what they say.

[TSandM]

Issue number one is the concussion. If you are still having any symptoms related to that -- persistent headaches, confusion, memory lapses -- then I'd say no. If you haven't had any neurologic symptoms in a couple of months, then that would not be an issue.

Issue two is bone healing, which should be complete by now.

Issue three is sinus integrity and draining. What you DON'T want, with an orbital fracture, is a maxillary sinus that can't equalize and draws the orbital floor downward. (I don't know if your fracture was orbital floor or not, but those fractures are common.) I would highly recommend a pool session prior to your trip, to make sure you can equalize your sinuses.

If your brain's okay, the bones are healed and you can equalize, then from the information you have provided here, there should be no reason you can't dive. If your own physician is unsure, give her the contact information for DAN and let her give the pros the details and see what they say.

Not that anyone else should emulate me, but I went diving four weeks after my orbital floor fracture :)

[DocVikingo]

Hi Lisa,

IMHO, TSandM has covered the medical bases.

If the dive op in HI gives you a medical questionaire to complete before taking you out, and the chances are fair that it will, if you answer honestly they may want to see written clerance to SCUBA from a physician. For this reason, your doctor may wish to contact DAN Scuba Diving Medical Services (http://www.diversalertnetwork.org/medical/index.asp) and then make up her mind one way or the other. Is she cannot, or renders an opinion you are not convinced is supported by the evidence, you should seek a second opinion, preferably from a doctor with diving medicine training or experience. DAN may be of assistance in locating such a professional.

Regards,

DocVikingo

[Duke Dive Medicine]

Greetings Lisa,
Concur with TSandM and DocVikingo. Additionally, I recommend that you wait until you're medically cleared to dive before you try a pool session. Pressure is pressure, and if your sinuses are not properly vented you can injure yourself, even in the controlled environment of a swimming pool. Your location says Seattle; Virginia Mason Medical Center has a terrific hyperbaric facility with board-certified diving physicians. If your PCP isn't sure whether or not to clear you to dive, she should send you to them for a consult. If she doesn't have contact information for them, I'd be happy to provide it to her if you PM me with her email and/or phone number.
Kindest Regards,
Duke Dive Medicine