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MS and Diving

Discussion in 'Divers with Disabilities' started by mornerossouw, Jul 5, 2009.

  1. DocVikingo

    DocVikingo Senior Member

    Diving Medicine FAQs
    Multiple Sclerosis (MS)
    DAN Divers Alert Network


  2. DocVikingo

    DocVikingo Senior Member

    Hi Walter,

    Given the below examples from research studies and the most current positions of the Undersea & Hyperbaric Medical Society and the National MS Society, I would be very interested in any benefits to divers with MS from the increased pp02's related to using of nitrox.

    1. In the USA, HBOT is not recognized by Medicare as a reimbursable treatment for MS.

    2. Cochrane Database Syst Rev. 2004;(1):CD003057.

    Hyperbaric oxygen therapy for multiple sclerosis.

    Bennett M, Heard R.

    Diving and Hyperbaric Medicine, Prince of Wales Hospital, Barker St, Randwick, NSW, Australia.

    BACKGROUND: Multiple Sclerosis (MS) is a chronic, recurrent and progressive illness with no cure. On the basis of speculative pathophysiology, it has been suggested that Hyperbaric Oxygen Therapy (HBOT) may slow or reverse the progress of the disease.

    OBJECTIVES: The object of this review was to evaluate the efficacy and safety of HBOT in the treatment of MS. SEARCH STRATEGY: We searched the Cochrane MS Group trials register (July 2002), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 2, 2002), MEDLINE (January 1966 to October 2002) and the National Library of Medicine (NLM) database (July 2002), along with specialised hyperbaric resources and handsearching of relevant journals and proceedings.

    SELECTION CRITERIA: All randomised, controlled trials involving a comparison between HBOT and a sham therapy in MS were evaluated. DATA COLLECTION AND ANALYSIS: Two reviewers independently appraised all comparative trials identified, extracted data and scored them for methodological quality. MAIN RESULTS: We identified ten reports of nine trials that satisfied selection criteria (504 participants in total). Two trials produced generally positive results, while the remaining seven reported generally no evidence of a treatment effect. None of our three a priori subgroup analyses placed these two trials in the same group and were therefore unable to account for this difference. Three analyses (of 21) did indicate some benefit. For example, the mean Expanded Disability Status Scale (EDSS) at 12 months was improved in the HBOT group (group mean reduction in EDSS compared to sham -0.85 of a point, 95% confidence interval -1.28 to -0.42, P = 0.0001). Only the two generally positive trials reported on this outcome at this time (16% of the total participants in this review).

    REVIEWER'S CONCLUSIONS: We found no consistent evidence to confirm a beneficial effect of hyperbaric oxygen therapy for the treatment of multiple sclerosis and do not believe routine use is justified. The small number of analyses suggestive of benefit are isolated, difficult to ascribe with biological plausibility and would need to be confirmed in future well-designed trials. Such trials are not, in our view, justified by this review."

    3. Undersea & Hyperbaric Medical Society's position statement of September 30, 2009 to all MS patients and caregivers.
    HyperbaricLink.com - Your #1 web resource for hyperbaric oxygen therapy.

    4. "National MS Society

    Jan 27, 2009

    Complementary and Alternative Medicine
    Greater Washington Chapter

    The following is based on information from MS doctors and a clinical bulletin from the Complementary and Alternative Medicine program at the Rocky Mountain MS Center in Colorado.

    If a product claims to be a cure-all, avoid it. Questions to ask your doctor or CAM provider include: Has it been studied? What are the risks and purported benefits? Does it interfere with anything else I am taking? Lists of well-informed CAM providers can be found at www.naturopathic.org and ACAM / Browser detect in progres.

    Herbal supplements are not regulated, so the quality varies between products with some containing fillers and even contaminants. Others aren’t advisable for people with MS. Consult with a professional before you invest in a supplement regimen.

    Some CAM therapies are backed by studies or have shown promising results, while others are excessively promoted but ineffective or unsafe. Many more have yet to be studied carefully in people with MS. All should be used with caution under the guidance of a doctor or CAM provider.

    Therapies that might help MS, if used appropriately, include:

    Antioxidant vitamins, including A, C and E; and vitamin D
    A low-fat diet supplemented with fish oil
    Exercise, including swimming, cycling, yoga and tai chi
    Chiropractic therapy
    Ginkgo biloba (for cognitive function)
    Cooling therapy
    Horseback riding

    Practices that should be avoided because they are ineffective or unsafe, include:

    Bee-sting therapy
    Hyperbaric oxygen
    Dental mercury amalgam removal"


  3. Rescuediver17063

    Rescuediver17063 Instructor, Scuba

    # of Dives: 5,000 - ∞
    I have certified several people with MS, and found the most important thing is to manage their body tempeture. Cramping and fatigue, are also very important factors to monitor. The HSA, and the IAHD have several different options for training for persons with MS, and talking with the different instructors is how you will find the right fit for completing your dreams.
    Good Luck
    Welcome to HSA.com
    IAHD.ORG | Making Scuba-diving accesible for the disabled
  4. High-Gear

    High-Gear Angel Fish

    # of Dives: 50 - 99
    Location: Kansas, USA

    My wife has MS and had a little trouble getting her neurologist to sign off on the medical waiver. It appeared he was ignorant of diving, and did not want to open himself up to a lawsuit. No problems with her diving. I know as her buddy that I will have to shoulder a larger load (carrying her gear, getting her suited up quick and into the water, etc.) I don't care, its well worth it. We dive everything super conservative, and soon she will get nitrox certified and dive is almost exclusively as an aditional safety margin.

    For what it is worth, I say go for it if you are physically able!
    chillyinCanada likes this.
  5. BUZU

    BUZU Angel Fish

    # of Dives: 100 - 199
    Location: Madrid ( SPAIN )
    Hi mornerossouw,

    I suffer MS myself. I was disgnosed in jan/03 but my first symptoms go back to 1.985. Since my first crisis in 1.985 I was lucky enough to be free of any kind of problem until 2.001. From that second crisis, which left me with some movility problems, it took the doctors around 2 years to diagnose what was going wrong in me. Finally I got the devastating news. MS was the hidden hand screwing me regularly

    Anyway I qualified as a diver in 2.006 and now I am CMAS 3* and have no intention in going forward in diving grades. I feel I reached my top. And it is obviosus, I have no intenton of give up diving too while I keep enough strength to manage myself safely.

    I started medicating with Interferon in Sept/08 and it took me some time to adapt to the poisson I was injecting myself three times a week. Indeed I keep administering myself my three times a week dose tirelessly. It seems this is for life.

    So far this has been the down side. The up side is that ..... diving is one of the few things that motivates me. I enjoyed, still enjoy and hope will enjoy every one of the dives I have done and will do.

    Diving is unfortunately one of the few sports or enjoying activities I can perform in my present condition. So I will not let this fu**** dessease beat me in what I enjoy most.

    But, in the other hand, I MUST be aware of my condition and my limitations, which unfortunately are progressively building up. Even more if I think of my three kids and my wife. And if I think too of the divers I dive with.

    My humble advise is :

    a) Keep diving with caution and WITHIN your physical limits

    b) Be ABSOLUTELY aware of your condition EVERY DAY becouse your condition will vary enormously day by day following no obvious pattern. Some days you willl feel you are good for nothing and are unable to dive, even to wink your eye. Others you would feel yourself good enough to dive as any other diver.

    c) Be ABSOLUTELY cautious, even overcautious with decompression processes and bends preventing techniques. In our case, the symptoms might be easily confused with your MS. Once you start feeling strange things in you, you wont be able to know whether those come from your MS or you have the bends up over your head.

    If you want more detalied information, feel free to PM me.

    Cheers. Enjoy life. Enjoy diving.
  6. pasley

    pasley Instructor, Scuba

    # of Dives: 1,000 - 2,499
    Location: Lakewood, CA
    Bravo for you taking up SCUBA diving. Fight and keep on fighting for that is how life is lived. You have spoken well and given some excellent advice. As you have pointed out your dive decisions affect not only you, but your dive buddy and your loved ones.

    If I may offer this to extend your diving. If things progress and you continue to loose more mobility and/or strength you may want to consider becoming Handicapped SCUBA Association (HSA) certified. Then if necessary you may locate a local HSA Certified Dive Buddy. HSA Certified Dive buddies have been trained to dive with adaptive diver up to and including divers with complete quadriplegic as long as they meet the following requirements:
    1. Trained to dive in the current body. More on that below.
    2. No issues that would preclude diving such as those affecting the airway or heart. In short cleared by the doctor to do so.
    3. Able to communicate by shaking the head yes and no or some other means.

    Why do you need to re-train? You may not, but if you body undergoes significant changes from say able to move all limbs to paraplegic or quadriplegic, then you should re-train in the new body. In the case of a complete quadriplegic you would need to know how to clear your ears and mask with the assistance of your dive buddy as well as what is expected of you in the unlikely event of a CESA (exhale all the way up and spit out the regulator once you get to the surface). An instructor would determine what type of course you would need to take if any.

    HSA has instructors and dive buddies in many countries around the world. For example there are HSA trained dive buddies in Madrid Spain.

    I just offer the above as food for thought that it may be possible to continue diving with specially trained dive buddies longer than you may have previously thought possible.
  7. mauidiver57

    mauidiver57 Garibaldi

    # of Dives:
    Location: Nyssa, Oregon
    Hey all! I have MS and was diagnosed in 2008. I have been diving without any problems whatsoever. I think if you keep your core temperature relatively normal, not too hot, not too cold, then that helps alot. Suit up and get in the water, then check your gear and your buddies and dive like there is no tomorrow! Dive now, as much as you can, because you may not be able to in a few years. Who truely knows? I've been diving since '77 and I have NO plans to quit. I've talked with my Neuro Doc and she said go for it, just take your time. (Which is what diving is about anyway...take your time and see it all!) Don't stress your system and you should be good to go!

    Hope this helps those in question. :)
  8. BUZU

    BUZU Angel Fish

    # of Dives: 100 - 199
    Location: Madrid ( SPAIN )
    Hi all. Good news. Almost two years past and . . . . . . . . I AM STILL FIT FOR DIVING. Who would have told two years ago.
    Cheers mates.
    emoreira likes this.
  9. chillyinCanada

    chillyinCanada ScubaBoard Supporter Staff Member ScubaBoard Supporter

    Congrats BUZU!! Your news really cheers me up both for you and my sister! My mom also had MS but hers was the most serious non-remission type.

    Keep up the good fight! :)
  10. BUZU

    BUZU Angel Fish

    # of Dives: 100 - 199
    Location: Madrid ( SPAIN )
    Thanks a lot Chilly. You bet I'll keep fighting till my last breath. Give your mum and sister a big hug in my behalf from su ny Spain.
    chillyinCanada likes this.

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