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Thread: Diving after a stroke

 


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    Diving after a stroke

    A quick question about diving after a stroke. I had a stroke on 4/12/2008 caused by a clot. In the emergency room some 10 hours later a MRI showed it was my second stroke (I thought I had one 6 months before but chalked it up to a "brain fart" because my face didn't droop ) My Dr says the first stroke was in my brain stem and should have killed me, (All symptoms were gone after two days of hard work) and my second stroke was in a very forgiving part of the brain. so forgiving that he could operate and remove 1/2 of this part of my brain and in 5 days I would have no lasting affects. My recovery from both strokes was very fast and at the moment i have a little dizzyness when I over do it and this seems to be subsiding as every day goes by. My question is are there any corrilations between diving and strokes (kicking another clot). Every Dr I've spoken with says I should be able to dive, but my famly worries.Hell I worry!!! I've made many lifestyle changes in icluding No coffee( the ONLY beverage I drank all day ) and tobacco.(kinda like closing the barn door after the horse got away...LOL)
    Please advise.

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    Quote Originally Posted by Iceguy4 View Post
    A quick question about diving after a stroke. I had a stroke on 4/12/2008 caused by a clot. In the emergency room some 10 hours later a MRI showed it was my second stroke (I thought I had one 6 months before but chalked it up to a "brain fart" because my face didn't droop ) My Dr says the first stroke was in my brain stem and should have killed me, (All symptoms were gone after two days of hard work) and my second stroke was in a very forgiving part of the brain. so forgiving that he could operate and remove 1/2 of this part of my brain and in 5 days I would have no lasting affects. My recovery from both strokes was very fast and at the moment i have a little dizzyness when I over do it and this seems to be subsiding as every day goes by. My question is are there any corrilations between diving and strokes (kicking another clot). Every Dr I've spoken with says I should be able to dive, but my famly worries.Hell I worry!!! I've made many lifestyle changes in icluding No coffee( the ONLY beverage I drank all day ) and tobacco.(kinda like closing the barn door after the horse got away...LOL)
    Please advise.


    TIA's are episodes of decreased or lost consciousness due to decreased blood flow to a portion of the brain. Occurring underwater they can lead to drowning and/or arterial gas embolism.
    Transient Ischemic Attacks are included in the list of 'Neurological Absolute Contraindications'. These include:

    History of Seizure disorder Loss or change in the level of consciousness underwater is deadly.
    After head injury, disallow diving during that period of time that the diver is at risk for seizures. The diver should be completely free of changes in the level of sensorium, symptom free and be cleared by a neurologist as being free of seizure activity.
    Intracranial tumor or aneurysm
    History of TIA (transient ischemic attacks)or CVA (Cerebral vascular accidents)
    History of spinal cord injury, disease or surgery with residual sequelae. This includes a history of having had Type II neurological DCS with permanent neurological deficits.
    A history of unexplained syncopal episodes, whether cardiovascular or neurogenic.
    Peripheral neuropathies are disqualifying. Symptoms related to peripheral neuropathy mimic neurologic decompression sickness.

    Individuals with a history of transient ischemic attack (TIA) must undergo evaluation for cerebrovascular or cardiac disease before being considered for sport diving. Often a TIA is an indication of carotid disease, intracardiac thrombus, endocarditis, or valvular heart disease. These must be ruled out before consideration for diving.

    Diver's Alert Network has the following to say about "stroke" in an article in the 'Alert Diver', May-June, 1999.
    Stroke, or loss of blood supply to the brain, causes damage to part of the brain, or bleeding from a blood vessel in the brain, which results in similar injury. Strokes come in all sizes and shapes, and the resulting disability depends on size and location of the event.
    Fitness & Diving:

    Most strokes occur in older people. The stroke itself identifies the person as one who has advanced arterial disease, thus a higher expectation of further stroke or heart attack.
    The extent of disability caused by the stroke (e.g., paralysis, vision loss) may determine fitness to dive.
    Vigorous exercise, lifting heavy weights and using the Valsalva method for ear-clearing when diving all increase arterial pressure in the head and may increase the likelihood of a recurrent hemorrhage.
    While diving in itself entails exposure to elevated partial pressures and elevated hydrostatic pressure, it does not cause stroke.
    There is certainly increased risk in diving for someone has experienced a stroke. Exceptional circumstances may exist, such as cerebral hemorrhage in a young person in whom the faulty artery has been repaired with little persisting damage. This type of recovery may permit a return to diving, with small risk. Each instance, however, requires a case-by-case decision, made with the advice of the treating physician, family and diving partners. Consulting a neurologist familiar with diving medicine is also advisable.

    There is a similar concern for significant residual symptoms.
    Any way in which I can assure that the techniques that we have developed and the values that we have taught are passed on and further refined I'm happy to do.-Thalassamania

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    Thanks for the reply Leapfrog. I read your reply several times...you must be doctor. To my knolage I havent had a TIA.
    Let me describe my symtoms. as for my first stroke I never felt anything as far as the event. one day I noticed a lil weakness on my right side, I was sluring my words and I had a hard time signing my name on the back of checks. I described the symtoms to everyone except my wife (she would make me go to the dr.) and all agreed that I had a stroke. within days all symtomes dissapeared. And besides, I looked in the mirror and my face did'nt droop, so I must be ok( just like that river in Egypt...De - Nile) my second stroke was much different. The actual event was very pronounced. some of the worst vertigo I have ever experianced. profuse sweating and projectile vomiting.I have never lost consciousness. I have never had a Seizure. My last phisical was around a year and a half ago and my blood pressure was text book and my dr. said "wow" I had just lost 130lbs from 320 to 190 a lil too fast and didn't enjoy being that lite. I would get up and do 100 pushups and 50 situps. Over the next year or so I went back up to 260lbs. At the time of my 2nt stroke my blood pressure was 263/138 and my colesterol was also high. I know medicate my high colestrol with 20 mg of SIMVASTATIN, and at this point,my high BP with 40mg LISINOPRIL in the morning and 5 mg of AMLODIPINE BESYLATE in the afternoon, and my BP is around 123/57 last night and 150/93 after reading your letter.I also take 325mg of asperin in the morning. I had a procedure that I cant spell let alone say where they stuck a device down my throat to do an ultra sound of my heart, and they checked the large arteries in my neck, and all looked real good. My dr said he felt it was caused by the thinning of my arteries at the point where they brantch off to smaller ateries. I'm seeing him today, can you think of any questions I could ask him? Also i was on heparin injections in my stomach that I stopped when I noticed they were leaving black and blue bruises the size of golf balls. could this be part of the latest heparin scare?

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    Hi. Sorry. No, not a doctor. Like a lot of people in the community, I have a "working knowledge" of Dive Medicine, most of it gleaned from Divers Alert Network and some of it from direct training and experience.

    The heparin scare certainly seems to be more than a scare, so it sounds like a good idea that you came off it.

    You really need to get a neurologist with knowledge of dive medicine to see you and advise you as well as a physician. You should contact Divers Alert Network and they will point you in the right direction.

    Hope you are able to be back in the ocean soon.
    Any way in which I can assure that the techniques that we have developed and the values that we have taught are passed on and further refined I'm happy to do.-Thalassamania

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    Reading that got me a bit scared. I did suffer a TIA 20+ years ago while working on board the Cousteau's windship Alcyone (although I was doing topside support rather than diving). Fortunately I've had no relapse in the intervening decades. Fortunately my arteries appear to be pretty clean so I may be OK.

    Appreciate leapfrog's input here.
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    DrBill, are you sure you had a TIA? Twenty years ago... How old were you and what symptoms did you experience?

    Iceguy - do you have an update on what your doctor told you?

    A stroke is a very vague term. There are three main variations of what people call a "Stroke." There are "mini-strokes," which refer to TIA's (Transient Ischemic Attack). The common term of "Stroke," which generally is a thrombotic stroke (Clot). And the worst, a hemorrhagic stroke (Brain Bleed).


    "TIA's are episodes of decreased or lost consciousness due to decreased blood flow to a portion of the brain."
    I don't know how to quote this, but this is from leapfrog. THIS IS A BAD DEFINITION


    Mini-strokes are exactly that, MINI strokes. People experience generally the same symptoms. Headache, dizziness, weakness, blurry vision etc. The key is that symptoms resolved COMPLETELY within 24 hours, there are NO residual deficits. TIA's are bad in the sense that they are in a way, a warning. "30 percent of patients have a recurrence of symptoms in 3 months, 60 percent in 6 months, and 80 percent in 1 year (Without definitive treatment)." (If you wish ask for my source I will gladly give it).

    Thrombotic strokes are obviously more serious. The severity depends on where the clot is in the brain. The symptoms are varied and include those listed above, they also include the facial droop, difficulty speaking, difficulty writing, difficulty understanding etc. If you think you are having a stroke, TIME IS BRAIN, GET TO AN ER ASAP. There are medications they can give you IF YOU GET THERE IN TIME. This medication can completely REVERSE YOUR SYMPTOMS. For the love of god get to an ER, too many people WAIT with thrombotic strokes (The most common "stroke").

    If you have had a thrombotic stroke, generally the symptoms you had during the attack are going to be residual symptoms. They can get better, they can get worse - it depends...

    A hemorrhagic stroke is bad, the worst, I will not go any farther then that.

    The TEE (Trans Esophogeal Echo) makes sense, the Carotid Doppler makes sense, but do you know the name of the procedure where he "removed half of that part of your brain." That doesn't make sense. (The MRI makes sense too).

    There are procedures you can do related to strokes. If you had a thrombotic stroke, I wouldn't expect any brain tissue to have to be removed. I am not a neurosurgeon, nor a neurologist though...

    Lastly, heparin shots LEAVE BRUISES, THIS IS NORMAL. DO NOT stop taking heparin because of local bruising at the injection site. You are taking basically a blood thinner, and stabbing it into yourself YOU ARE GOING TO BLEED/BRUISE. If your doctor has you on one heparin shot once a day, get a new doctor, heparin should be used twice a day. According to new research. Lovenox, which is a derivation of heparin, is an alternative commonly used nowadays and is a once-a-day shot. and again, YOU WILL BRUISE. :no :no :no

    I'm done, thanks

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    Nobody here can really give you good advice, because not enough is known. We don't know your age, your family history, whether you smoke, or how long you have been severely hypertensive and whether it is consistently well controlled on meds.

    You have many risk factors for stroke and heart disease -- overweight, high blood pressure, high cholesterol. You don't say if you are also diabetic, but it tends to go along with the other factors. You've had a good evaluate for treatable causes of stroke, with the echo and the carotid Doppler, and if they came up clean, then you're either dealing with some kind of hypercoagulable state, or small vessel disease (which is often associated with hypertension). There are quite a few factors and possible investigations your doctors are no doubt considering or have done to decide how high your risk of future strokes is.

    I'm not aware of anything that suggests that diving creates a hypercoagulable state, although there is some evidence for platelet activation from bubbles. Another thing to consider is that your "strokes" could possibly have been bubble-related, with a PFO, if they occurred in close proximity to dives to significant depth or of significant length. Hopefully, they were looking for this when they did the TEE.

    Since your symptoms have resolved, the prior strokes should not impact your diving. But I certainly don't know enough to tell you what your risk of having a future stroke underwater might be.
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    Hi
    first I want to thany you all for your replies I'm 51 and getting in better health every day. My doctor has cleared me to drive...and more importantly.SCUBA DIVE!!! In a book I read in the hospital it said "there is still a lot we DON"T know about stroke survivors who recover quickly" That was me...In ICU less then 24 hours after the event I was aceing the doctors tests. My problem is I'm a smart ass, and when they asked me what year it was I looked at my daughter and winked (a sign to her I was OK) and said 2007....they checked memory loss!!! Rehab was a nightmare. They labled me impulsive (yea...I've always been impulsive) I felt like asking the fat nurse that said I had impulse control problems..."how much impulse control do you have when your eating a twinky at 11.00 at night"!!! They said "the filter that use to stop me from doing risky things was damaged" They were right, but that happened when I was very young. They gave me a test I thought I failed.. They said "mr Iceguy we want you to come up with as many words as you can that start with a certain letter..now you cant use numbers, any word that would be capitalized, and no pluralizing words...your letter is S" I got 13 words in 1/2 the alloted time...1 min. and hit a brick wall. She said "ooouuu...we like to see 18 words. I left the room thinking I took a hit in my brain....NOT!!! When I gave this test to all my friends only one was able to get more words. My near genus brother started with "six"...no andy thats a number....he got only 2 words and gave up!!!

    to make a long story short, I'm back except a lil dizzyness that is getting better every day. I intend to dive this thursday to metal detect and don't intend to go any deeper then 15 feet. I'm a very conservative diver and have aborted dives in the past at the drop of a hat. As for the know-it-alls at the rehab center who said I had memory loss because I forgot their names, I say never remember names, and with the help of people like people on this board and my readings, ...with in a year, I will know more about strokes then the know-it-alls because I know it from the perspective of having two already. I am monitering everything that goes into my body and NOTHING goes in thats not good for me. I quit a 4 to 5 pack a day habbit 5 or 6 years ago, and have even quit my use of pot (Ive smoked that continusly since I was 13) I havent smoked that for a lil over 4 weeks now and am just now starting to be less of a "LIL BITCH" now. I' kinda scared that I'm gonna be one of the 41% that have another stroke in the first year. I do pray every day that if I do have another stroke that it takes me. I've seen what strokes can do(in the rebabilitation ctr) One question...will I ever be able to smoke, or eat pot again ???? Oh BTW...my spelling was always bad...Did you know Ben Franklyn was quoted as saying..."I never did think much of a fella that could only spell a word ,one way"!!!!

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