Epilepsy.... Here we go

[CAROLINA BAREFOOT]

I've been diving since I was 8, and certified when I was 12. Diving has been a determining factor in choosing a duty station, not sure how I got to Colorado though. Until a few years ago, diving had been just for me. After a cruise down to Cozumel, my wife expressed a nearly abnormal love affair with the water. All age wants to do is dive, but she is limited to snorkeling because of her epilepsy.

To the root of the question, instead of going full SCUBA, could I start her on a hookah rig? Staying at or above 20 feet, use a full face mask with communication, and limiting dive duration seems feasible to me and her doctor. Thoughts? Keep in mind that I am CLS and EMT, and have a better-than-most understanding of her condition. For goodness sake, don't bash me for asking the question, just give me advice and site some experiences of possible. If not, keep your mouth shut. Not to be a horses butt, just tired of getting flack for even broaching the subject.

God bless and hope your Easter was as awesome as mine.

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[Diver0001]

I would advise consulting a doctor with knowledge of both her condition and scuba diving. Because of her condition an instructor won't be permitted to teach her without a doctor's medical approval anyway, regardless of whether it's hookah or scuba.

I can certainly understand her love affair with water. This could turn out to be one of those things in life that just sucks no matter how you look at it. In reality there might be some things that you can do to limit the risk she's taking but if she has a severe episode under water I wouldn't fancy her chances, even if her buddy is an EMT.

R..

 

[tc]

It's going to be difficult or impossible to find anyone to certify her, I'm an instructor with the Handicapped Scuba Association and any active seizure disorder is an absolute contraindication to diving per their rules.

The potential liability for an instructor is just too great in that situation, any seizure occurring in the water has a high potential to be fatal. While a full face mask reduces the risk a little bit it's just not worth it. There is no release in the world that would cover me instructing someone that is precluded from training by agency standards.

 

[TSandM]

Well, the things that immediately pop to mind for me regarding epileptics diving would be raised oxygen tensions lowering the seizure threshold, which you are controlling by limited her depth, and the likelihood of drowning if a seizure occurs underwater, which you are limiting by using the FFM and having a dedicated buddy. Much like the HSA divers, your wife would be viewed as handicapped and requiring an attendant.

I am also assuming, because you are even contemplating this, that her seizures are relatively well-controlled on medication. It is important to realize that it will be difficult to manage a prolonged seizure or status epilepticus in the water, and the drowning risk will be higher if such an incident occurs.

I'm not sure how much being surface supplied reduces risk in this case, although being on a hookah line I guess would allow someone on the boat to drag her up if it were needed. But overall, I don't think this is a good idea unless you or someone else acts as a dedicated attendant during the dive.

 

[uncfnp]

Please keep in mind the possibility of a closed airway or laryngospasms with seizures and ascents. The FFM will not lessen this risk...

 

[CAROLINA BAREFOOT]

We are going to sit down with the doc tomorrow for a full on discussion about this. I am her dedicated partner and she would dive with no one else. At 12D AIT, we touched on the subject briefly and learned a few procedures for dealing with a subsurface seizure, but that was not epilepsy based at all.

I wonder if putting her in a hypo chamber at about 1 ATM for an extended period of time could yields a result? She has her episodes well under control with medication and a VNS implant, which with the swipe of a magnet over her implant, will stop a seizure.

Spear fishing with SCUBA gear?! Punch yourself!

---------- Post added April 22nd, 2014 at 11:58 AM ----------

Then there's the risk of an embolism. I am weighing the pros and cons, that's why I need an objective and unbiased opinion. I couldn't live with it if she for hurt and I couldn't stop it, God knows that's happened enough in combat. On the other hand, she's an adult and my wife, therefore what she wants, she gets.

Spear fishing with SCUBA gear?! Punch yourself!

 

[tc]

Not familiar with the implant you mention but check with the manufacturer on the depth rating before trying anything with increased pressure.

 

[Pedro Burrito]

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Moved from General Scuba Equipment Discussions to Diving Medicine

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[DocVikingo]

Not familiar with the implant you mention but check with the manufacturer on the depth rating before trying anything with increased pressure.

Hi TC,

VNS stands for vagus nerve stimulation (Epilepsy: Vagus Nerve Stimulation - WebMD ). It involves the implantation of a flat, round battery about the size of a silver dollar (or smaller) just under the skin of the upper chest wall. The device involves no air-containing spaces nor is it readily penetrable by water. As such, increases in ambient pressure typical of scuba should have no mechanical/electrical effect upon it.

Regards,

DocVikingo

 

[TSandM]

Laryngospasm is not a common concomitant to seizures. Having the full face mask should prevent aspiration of sea water that could induce it. Closure of the glottis is not rare but is usually brief. If she were to seize underwater, it would be important not to take her to the surface until either the seizure was over or it was abundantly clear that she was continuing to breathe relatively normally.