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  1. Duke Dive Medicine

    Diving post ACDF spinal surgery

    Three cheers for Papaws who still jump on trampolines. Sorry this happened. Since recovery from this (and any) surgery can vary from person to person, I strongly recommend that your surgeon be front and center in the conversation. Best regards, DDM
  2. Duke Dive Medicine

    Dive Medicals

    How do you define a dive medical? Best regards, DDM
  3. Duke Dive Medicine

    Ear infection and blocked ears over 2 weeks. How to relieve?

    +1 on what @Scubagermany said. Middle ear inflammation can be extremely slow to resolve. It could be 6-8 weeks before you feel completely normal again. That said, if you go through this every year, a visit to an ENT physician might help address the root cause. Best regards, DDM
  4. Duke Dive Medicine

    Tinnitus

    I'd recommend you see an ENT physician as soon as practical. Best regards, DDM
  5. Duke Dive Medicine

    Women and DCS

    Hi @JMarc , You may be thinking of this study, but it only looked at the phase of the menstrual cycle so there's no comparison with male subjects: https://www.researchgate.net/figure/Percentage-of-women-developing-symptoms-of-DCS-during-each-week-of-the-menstrual-cycle_fig2_9007221...
  6. Duke Dive Medicine

    Info Deeply Safe Labs: A website for dive computer testing

    I stand corrected on the source. That said, I don't know that it would be possible to quantify the effect with any accuracy since the quantity of venous gas emboli varies so much from diver to diver, and from dive to dive in the same diver. Best regards, DDM
  7. Duke Dive Medicine

    Info Deeply Safe Labs: A website for dive computer testing

    Point of clarification for readers here based mostly on my own failure to thoroughly read @Deeply Safe Labs ' post #16. The right-to-left shunt described here is different than a right-to-left shunt that allows venous gas emboli to arterialize. This is an important distinction to make. What...
  8. Duke Dive Medicine

    Ear infection and blocked ears over 2 weeks. How to relieve?

    It's good to hear that you're not diving with clogged ears. Concur with @Searcaigh that you should not dive until you can easily equalize. Some people find that nasal sprays containing oxymetazoline can be of temporary benefit. If you choose to do this, ensure that you read the instructions...
  9. Duke Dive Medicine

    Cold Water Immersion And Benefits Of Scuba Diving

    There are people who say there are health benefits to cold-water plunges, but since being cold while diving comes with its own set of risks, it would not be advisable to combine the two. Best regards, DDM
  10. Duke Dive Medicine

    Info Deeply Safe Labs: A website for dive computer testing

    Great illustration!! You typically wouldn't find it until it somehow declared itself. Even then it would be a presumptive diagnosis because it's too small to see on imaging. An example might be a diver who experiences a couple of instances of sudden-onset neurological DCS, has a transthoracic...
  11. Duke Dive Medicine

    Info Deeply Safe Labs: A website for dive computer testing

    You may be referring to intrapulmonary shunting in the sense of blood in pulmonary capillaries bypassing non-functioning alveoli - your ARDS example is a good one. I would add that anatomic AV intrapulmonary shunts have been documented in healthy adults as well...
  12. Duke Dive Medicine

    Question Ulcerative Colitis and diving

    Both of these drugs are immunosuppressants, so you would be at increased risk for infection if you were exposed to a waterborne pathogen. According to the package insert, Zeposia / ozanimod can also lead to a decrease lung vital capacity, though it's not clear why this happens. Best regards, DDM
  13. Duke Dive Medicine

    Question Urostomy Help

    I think it would depend on the exact system the individual has. If there's air anywhere in the system, in theory that air could expand on ascent and lead to reflux of urine (or salt water if there's been a leak) into a pouch or other internal structure. If your surgeon is aware of the physics...
  14. Duke Dive Medicine

    Info Deeply Safe Labs: A website for dive computer testing

    I think it it is reasonable to assume good intent on the part of the OP and make allowances for English likely being a second language. There are some fine scientific minds on SB, and with that comes the opportunity to share feedback in a constructive manner. Best regards, DDM
  15. Duke Dive Medicine

    Vertigo And Tinnitus

    First, congratulations on your sobriety. That's an ongoing journey and to have done it for 30 years is admirable. Have you been able to determine a cause for your episodes of vertigo? Have you been seen by a diving physician? Depending on exactly where in Hippydom you are, there may be...
  16. Duke Dive Medicine

    Diving "Conservative" vs Nitrox

    Thanks John. I'm not 100% sure of the question but FWIW, dissolved oxygen does play a significant role in hyperbaric oxygen therapy. This was discussed in this thread. Increasing the inspired partial pressure of O2 will dissolve more O2 into the bloodstream. Breathing nitrox does just that as...
  17. Duke Dive Medicine

    Blocked Ear

    Hi @AlannaBananaB94 , Concur with @Capt Jim Wyatt , a good next step would be a timely evaluation by an ENT physician. Going only by the information you provided, a serious ear injury can't be ruled out although it's also possible that you just experienced middle ear barotrauma, which is the...
  18. Duke Dive Medicine

    Diving "Conservative" vs Nitrox

    Thanks for the add John. Not much additional to contribute; Neal Pollock and Richard Harris sum it up pretty well in the DAN article. I'm not aware of any peer-reviewed literature that compares increasing computer conservatism with breathing EAN for the same dive profile. Changing gradient...
  19. Duke Dive Medicine

    Vertigo And Tinnitus

    Hi @Eastwest , is there a question here? Best regards, DDM
  20. Duke Dive Medicine

    Question Isolated subcutaneous emphysema?

    Re the pressure of diving and its influence on subcutaneous emphysema, good question. The difference between the subq emphysema that you've seen in the ED and an event that occurs while diving is the reduction in ambient pressure on ascent, which will cause any pockets of subcutaneous air to...
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