Antioxidants and cns
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J1M1
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i have seen the link and talked to gary while i was in fla. in jan. at forty fathom
ArcticDiver
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DennisS:
Thanks Dennis. The link does go to an introductory overview. But it doesn't address the drugs and diving issue in any depth. It certainly doesn't address the rebound effect.
Lots of people I know use Low-Dose Aspirin. Many of them have been doing so for years. If this Rebound Effect is a fact then we will need to take it into consideration in planning any activity, especially diving.
Factual information?
pescador775
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Aspirin is an anti coagulant. Although not as powerful as high dose heparin, the effect is noticable. Othewise, why would the same physicians who poo-poo aspirin, a non profitable wonder drug, also, in the same breath, warn against possible internal bleeding? Aspirin has the advantage of being an anti inflammatory. It is cheap and wide available, WITHOUT PRESCRIPTION. Common sense suggests that anything which facilitates blood flow would be beneficial and a possible prophylactic against bends (oops, DCS). Experiments on rodents are not necessarily relevant. Since heparin is used as rat poison we know its effect on rodents. However, aspirin is a different matter and the relevance of aspirin experiments on rats and the effect inferred to humans may be suspect. Aspirin has been shown to be poisonous to some animals.
Anti oxidants may well moderate oxygen toxicity, again a matter of common sense but this area needs further research. There is much known about the chemistry of these substances but I'm not aware of CNS research published by a major journal. Thanks to various papers published in respected journals we know a lot more about aspirin than even 10 years ago. For one thing, it is an anti cancer drug, the list is long. Anti oxidants belong to the "health food, supplement arena, considered "fringe" by establishment medical types. However, since an article originally published in Scientific American in 1972, it has been shown that these compounds may extend the life span of rodents. Administration of Butylated Hydroxytoluene (BHT) to rats increased their life spans by 40%. This is a powerful antioxidant used to preserve foods like processed cereals. SOD is more readily available and relatively cheap. This chemical is manufactured by the human body for the explicit purpose of neutralizing oxygen radicals. The metabolic cost is significant enough that there has to be an important purpose to this synthesis, eg, protecting the cells from damage. Supplementation appears to be harmless and may be beneficial, possibly even buffering "CNS" toxicity, but I don't know not having done a literature search for this specific property.
Anti oxidants may well moderate oxygen toxicity, again a matter of common sense but this area needs further research. There is much known about the chemistry of these substances but I'm not aware of CNS research published by a major journal. Thanks to various papers published in respected journals we know a lot more about aspirin than even 10 years ago. For one thing, it is an anti cancer drug, the list is long. Anti oxidants belong to the "health food, supplement arena, considered "fringe" by establishment medical types. However, since an article originally published in Scientific American in 1972, it has been shown that these compounds may extend the life span of rodents. Administration of Butylated Hydroxytoluene (BHT) to rats increased their life spans by 40%. This is a powerful antioxidant used to preserve foods like processed cereals. SOD is more readily available and relatively cheap. This chemical is manufactured by the human body for the explicit purpose of neutralizing oxygen radicals. The metabolic cost is significant enough that there has to be an important purpose to this synthesis, eg, protecting the cells from damage. Supplementation appears to be harmless and may be beneficial, possibly even buffering "CNS" toxicity, but I don't know not having done a literature search for this specific property.
Dr Deco
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Hello pesciador and readers:
Aspirin
There are many thoughts here, and I dont want readers to come away with the wrong idea. While it is certainly true that blood thinners might help a diver because of coagulation, in tests with human divers, they have not been shown to be affective against DCS. While it might be true that it cant hurt, the fact is that some individuals can develop problems from bleeding in the stomach. Thus, while it will not help anyone, it could harm some.
A diver would do himself or herself a much better favor by avoiding those activities that promote gas bubbles formation. These are
Antioxidants
There are many substances that protect against oxygen damage. These are manufactured by the body since oxygen is poisonous and its effects must be mitigated. When we breathe increased oxygen, we overwhelm the bodys natural defense system. Certainly it is possible to take antioxidants but there is a possible trap. What is manufactured by the body within a cell (superoxide dismutase SOD, for example) threats the reactive oxygen intermediates diffusing from the mitochondria. It is not necessary true that you an ingest SOD and achieve the same effect. As a matter of fact, you cannot. SOD is a protein and is metabolized in the stomach. In fact, even if administered intravenously, it does not enter the brain (pass the blood-brain barrier). It must be microencapsulated in a lipid shell.
It certainly is an interesting concept. As always, the best treatment for a poison is simply to avoid it.
Dr Deco :doctor:
References
Aspirin
There are many thoughts here, and I dont want readers to come away with the wrong idea. While it is certainly true that blood thinners might help a diver because of coagulation, in tests with human divers, they have not been shown to be affective against DCS. While it might be true that it cant hurt, the fact is that some individuals can develop problems from bleeding in the stomach. Thus, while it will not help anyone, it could harm some.
A diver would do himself or herself a much better favor by avoiding those activities that promote gas bubbles formation. These are
- avoid heavy activity before and following a dive,
- keeping in good physical shape, and
- move around a bit between divers to activate the muscle pump and boost tissue perfusion.
Antioxidants
There are many substances that protect against oxygen damage. These are manufactured by the body since oxygen is poisonous and its effects must be mitigated. When we breathe increased oxygen, we overwhelm the bodys natural defense system. Certainly it is possible to take antioxidants but there is a possible trap. What is manufactured by the body within a cell (superoxide dismutase SOD, for example) threats the reactive oxygen intermediates diffusing from the mitochondria. It is not necessary true that you an ingest SOD and achieve the same effect. As a matter of fact, you cannot. SOD is a protein and is metabolized in the stomach. In fact, even if administered intravenously, it does not enter the brain (pass the blood-brain barrier). It must be microencapsulated in a lipid shell.
It certainly is an interesting concept. As always, the best treatment for a poison is simply to avoid it.
Dr Deco :doctor:
References
BillP
Senior Member
As mentioned in the "Attn: Please Read" sticky post at the top of this forum, board members need to exercise a degree of caution when they read "medical" posts on these forums from non-medically trained or informed folk. Pescador775 (who calls himself Pesky) is a case in point. I have gotten the impression that Pesky tries to read some about diving medicine, but truly understands very little of what he reads. Unfortunately, this little bit of half-understood knowledge seems to have led him to believe that he is a medical expert qualified to give medical advice on this board. In my experience, he lacks even the most basic knowledge of anatomy, physiology, and pharmacology and is frequently, shall we say, off-target.
For example in his first post above, I suppose Pesky might have been trying to change the subject from CNS O2 toxicity to an unrelated subject (the "bends"), but as has been so politely pointed out, Pesky seems to have missed the point of the discussion (again). I think it may be quite possible that Pesky doesn't even really understand the difference between CNS oxygen toxicity causing a "hit" (seizure) and neurological decompression sickness. Dr. Deco also pointed out Pesky's incorrect understanding about the basic physiological effects of hydration on surface tension.
Pesky also likes to promote the use of aspirin on this board periodically. While he is correct that aspirin reduces platelet adherence, which is involved in blood clotting and it reduces inflammation, which is involved in decompression illness, aspirin has not been found to improve the outcome in decompression illness, and it can have negative effects (which Pesky always fails to mention when hes promoting aspirin).
From Bove and Davis' Diving Medicine, 3rd edition:
From Edmonds, Lowry, & Pennefathers Diving and Subaquatic Medicine, 3rd edition:
From Bennett and Elliotts The Physiology and Medicine of Diving, 4th edition:
As noted above, anticoagulation with aspirin can be associated with an increased risk of bleeding. Bleeding often occurs with barotrauma. Barotrauma is the single most frequent diving injury- particularly in new divers. If you suffer a barotrauma injury to your ears, sinuses, lungs, etc., taking aspirin could potentially turn a minor event into a significant problem. Pesky knows this (because he's been told before) but he always chooses to leave this tidbit out when he's promoting his personal agenda for aspirin. Aspirin has its potential benefits, but it also has potential risk, (the risk is low, so it really is unlikely to hurt if you take aspirin and dive, but its even less likely that it will help), but as Peskys been told before, to fail to even mention potential negative effects of a course of action when you're dispensing medical advice is irresponsible.
Bottom line? Pescador775 has a lot to offer when discussing dive technique, equipment, etc. Ive learned from his posts in other sections on the board. But when reading medical "information" from ole Pesky on this board, proceed with caution. Even though he has apparently done a little reading on dive medicine issues and has learned a few big words and catch phrases, I don't believe that he truly understands just how much he really doesn't understand- yet he dispenses medical "knowledge" and advice freely and without qualification. I can only hope that one day he will come to a self-realization of his own limits and stop dispensing incomplete, incorrect, and even just downright BAD medical information and advice on this board. In the meantime, if you have the training and knowledge to follow what he says and pick out the inaccuracies, then of course feel free to read his "medical" posts with amusement. But if you don't already know the answers, I'd recommend waiting for the "corrective" posts from more knowledgeable people (that will almost surely follow) before you quote anything that he says about dive medicine.
Just my 2¢,
Bill
By the way, Pesky, aspirin and heparin work by entirely different mechanisms to affect blood clotting- a fact you seem to have completely failed to notice. And its coumadin (warfarin), yet another totally different type of anticoaglulant (about which Ill bet you know as little as you do aspirin and heparin) that is sometimes used in rat poison, not heparin.
For example in his first post above, I suppose Pesky might have been trying to change the subject from CNS O2 toxicity to an unrelated subject (the "bends"), but as has been so politely pointed out, Pesky seems to have missed the point of the discussion (again). I think it may be quite possible that Pesky doesn't even really understand the difference between CNS oxygen toxicity causing a "hit" (seizure) and neurological decompression sickness. Dr. Deco also pointed out Pesky's incorrect understanding about the basic physiological effects of hydration on surface tension.
Pesky also likes to promote the use of aspirin on this board periodically. While he is correct that aspirin reduces platelet adherence, which is involved in blood clotting and it reduces inflammation, which is involved in decompression illness, aspirin has not been found to improve the outcome in decompression illness, and it can have negative effects (which Pesky always fails to mention when hes promoting aspirin).
From Bove and Davis' Diving Medicine, 3rd edition:
From Edmonds, Lowry, & Pennefathers Diving and Subaquatic Medicine, 3rd edition:
From Bennett and Elliotts The Physiology and Medicine of Diving, 4th edition:
As noted above, anticoagulation with aspirin can be associated with an increased risk of bleeding. Bleeding often occurs with barotrauma. Barotrauma is the single most frequent diving injury- particularly in new divers. If you suffer a barotrauma injury to your ears, sinuses, lungs, etc., taking aspirin could potentially turn a minor event into a significant problem. Pesky knows this (because he's been told before) but he always chooses to leave this tidbit out when he's promoting his personal agenda for aspirin. Aspirin has its potential benefits, but it also has potential risk, (the risk is low, so it really is unlikely to hurt if you take aspirin and dive, but its even less likely that it will help), but as Peskys been told before, to fail to even mention potential negative effects of a course of action when you're dispensing medical advice is irresponsible.
Bottom line? Pescador775 has a lot to offer when discussing dive technique, equipment, etc. Ive learned from his posts in other sections on the board. But when reading medical "information" from ole Pesky on this board, proceed with caution. Even though he has apparently done a little reading on dive medicine issues and has learned a few big words and catch phrases, I don't believe that he truly understands just how much he really doesn't understand- yet he dispenses medical "knowledge" and advice freely and without qualification. I can only hope that one day he will come to a self-realization of his own limits and stop dispensing incomplete, incorrect, and even just downright BAD medical information and advice on this board. In the meantime, if you have the training and knowledge to follow what he says and pick out the inaccuracies, then of course feel free to read his "medical" posts with amusement. But if you don't already know the answers, I'd recommend waiting for the "corrective" posts from more knowledgeable people (that will almost surely follow) before you quote anything that he says about dive medicine.
Just my 2¢,
Bill
By the way, Pesky, aspirin and heparin work by entirely different mechanisms to affect blood clotting- a fact you seem to have completely failed to notice. And its coumadin (warfarin), yet another totally different type of anticoaglulant (about which Ill bet you know as little as you do aspirin and heparin) that is sometimes used in rat poison, not heparin.
pescador775
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Bill,
I stand corrected, warfarin is the 'rat poison', not heparin. Yes, I mixed up the surface tension in an earlier post, long day and all that. However, the conclusion was correct, that hydration reduces bubbles. About CNS 'hits'. Since I was treated for a serious CNS hit due to nitrogen that was a natural slant for my analysis in lieu of any clear explanation from the subject header. It was not to push an agenda.
I stand corrected, warfarin is the 'rat poison', not heparin. Yes, I mixed up the surface tension in an earlier post, long day and all that. However, the conclusion was correct, that hydration reduces bubbles. About CNS 'hits'. Since I was treated for a serious CNS hit due to nitrogen that was a natural slant for my analysis in lieu of any clear explanation from the subject header. It was not to push an agenda.
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(nt)
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I posted this on another forum back in October of last year:
http://meeting.chestjournal.org/cgi...ts=10&RESULTFORMAT=&gca=chestmtg;124/4/148S-b
Think this may be it?
DocVikingo
http://meeting.chestjournal.org/cgi...ts=10&RESULTFORMAT=&gca=chestmtg;124/4/148S-b
Think this may be it?
DocVikingo
ArcticDiver
Contributor
DocVikingo:
Yep, that appears to be the source for both articles I read.
As I think I said the information didn't seem correct from what I know of the chemistry. But, not knowing everything, I thought it deserved a follow-up to get the facts.
Oh yes, this is a good example of what we all should do when reading something in the popular press. Sometimes the information is factual and in context and helpful. More time that not it is somewhat factual, not in context and not very helpful; as is the case with the referenced article.
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