Update on IPE research at Duke

[Duke Dive Medicine]

Is Viagra still hideously expensive? I remember hearing something like $10/pill when it first came out; not sure if that was ever true or still is. I wonder if insurance would cover it for this purpose. That's getting a little ahead of things, I know, but just wondering how practical a solution it would be if the research shows it's effective.

It was originally developed to treat pulmonary hypertension. They only found out about the other effects during the clinical trials in the late '90s. It is an approved indication and could/should be covered by insurance. YMMV though.

Perhaps this comment would be better in its own thread...but...Ever taken Viagra? Everyone I know who has taken it, has mentioned that it gives them a flushed feeling in their face, and more sinus congestion than they had before. Seems to me that it could cause some ear and sinus squeezes that may not have happened otherwise. So could taking viagra for IPE lead to other injuries?

That's a great question and not one that has been formally investigated to my knowledge. Since it's a vasodilator it could also increase the risk of CNS O2 toxicity.

Best regards,
DDM

 

[dmaziuk]

Viagra - curse or blessing for a diver?

 

[Esprise Me]

Viagra taken before diving is very likely to increase the risk of DCS whereas taken afterwards it may be a remedy.

Fascinating. Isn't there a similar damned-if-you-do-damned-if-you-don't scenario with hydration, where too little makes you more susceptible to DCS but too much makes you more susceptible to IPE?

ETA: couldn't a vasodilator also make one more susceptible to cold water?

 

[dmaziuk]

In the case of over-hydrating triathletes, they drink enough to last them the entire distance, that's way more than a normal person would drink before a normal dive. And I believe in at least one or two cases they reportedly took blood thinners like aspirin for "feeling a bit off" before the race, too. -- But of course they are iron people, their results are probably as relevant to regular humans as studies on mice are.

 

[Esprise Me]

Right, I'm not out there rationing water like a wrestler trying to make weight. I'm just spitballing as to whether there could be some kind of link, where DCS and IPE are at opposite ends of some kind of spectrum.

 

[Duke Dive Medicine]

Of note in the Blatteau study mentioned in the DAN article that @dmaziuk linked above, the dose of sildenafil administered to the rats was 10 milligrams per kilogram. Normal human dose is 25-100 mg (the dose that Dr. Moon used in his initial study was 50 mg). I don't know that any conclusions could be drawn at this point about the effect of sildenafil on DCS in humans.

Best regards,
DDM

 

[InTheDrink]

Right. So the literature makes you more likely to have another and also fatal PE incident.

The literature isn’t that large alas.

Personally I think there are a multitude of possibilities that can give you pulmonary oedema.

CCR for sure. NPPE.

The rest I’m not sure about but it when it happens it happens fast.

Happy to take part in any study. If anyone knows about this it’s me.

 

[InTheDrink]

8 years ago and around a thousand dives since. It’s not boasting, I’ll not dive CCR again.

I *believe* it is simply putting your lungs under too much pressure. So go with the current.

I’m not a doctor have no medical training apart from DM but I’ve been there. Nothing beats experience.

I got asked to speak about it a few times and said no. Because the experience is so traumatic and people will take a pop.

But I can tell you real fast what causes it.

 

[JonG1]

Am I right in thinking the incidence rate of ipe is increasing and if so is there any indication as to why, maybe lower fitness levels?

 

[dmaziuk]

Am I right in thinking the incidence rate of ipe is increasing and if so is there any indication as to why, maybe lower fitness levels?

Or the spotlight effect? -- Now we know IPE happens and go actively looking and guess what?