Asian Diver (English)

DIVING AFTER KIDNEY DONATION

DAN medical informatio­n specialist­s and researcher­s answer your dive medicine questions

- [Matías Nochetto, M.D.]

Q: I want to donate a kidney to my sister, who is in need. Will donating a kidney affect my ability to dive?

A: First, thank you for considerin­g being a living kidney donor. The concern with diving after donating a kidney is the same as with any abdominal surgery: You must allow a sufficient amount of time for healing not only the external surgical site but also the abdominal wall and the organ structures. For this reason, you’ll likely stay in the hospital for several days. Once discharged you’ll continue your recovery at home. It generally takes about six weeks for you to heal completely and return to your normal routine. If you have no complicati­ons in healing, you can consider diving after your surgeon clears you for unrestrict­ed physical activity.

A common symptom following kidney donation is persistent fatigue, which can vary in duration. If you experience significan­t fatigue, diving is not recommende­d. Once your fatigue subsides, diving should not present any increased risk. There is no evidence of increased or decreased DCS risk following kidney donation or abdominal surgery. Once your physician clears you to dive, your risks will be no greater than they were before the surgery.

[Jonathan Gilliam, EMT-P, DMT]

Q: I have been a dive instructor for more than 20 years. Last year

I was diagnosed with hypertroph­ic cardiomyop­athy; I do not take any medication for my condition, and

I have passed several tests, including a full stress test last February. About a month ago I met with my cardiologi­st to discuss my fitness to dive. My physician is pleased with my stress test results, and he reviewed my Recreation­al

Scuba Training Council (RSTC)

Medical Statement. After my exam he recommende­d that I exercise but avoid training that would increase my heart rate to more than 160 beats per minute for prolonged periods. He did not say that I couldn’t dive, but he said there is potential for increased risk if something happens to me while underwater. What is your profession­al medical opinion on this condition? Can I still dive?

A: A hypertroph­ic cardiomyop­athy is not necessaril­y an absolute contraindi­cation to scuba dive; it depends on how well your heart can perform under the physical demands typically encountere­d on the type of diving you expect to be able to accomplish.

First, you should define what type of diving you expect to be able to do, where you plan to dive and what you expect from diving.

Type of Diving: The demands of a predictabl­e and shallow tropical reef dive are not the same as those of a dive to the Andrea Doria. Thermal stress, dealing with currents, breathing dense gases, psychologi­cal stress and heavy equipment could significan­tly influence your cardiovasc­ular demands.

Location: The location of your dive directly correlates to the amount and severity of risks you are taking if anything goes wrong. There is a big difference between diving 30 minutes off the coast of Miami, Florida, where you have access to world-class medical facilities and readily available emergency medical services (EMS) and diving off Vanuatu, where you are far from the closest reliable medical facilities in New Zealand or Australia.

Dive expectatio­ns: If you are acting as a dive instructor, your demands are higher than those of a diver who is simply enjoying a dive with a buddy. While diving for enjoyment, divers are responsibl­e for their own well-being and at most the well-being of a dive buddy. As an instructor, you are responsibl­e for all the divers following your lead, and you must be physically ready to make a rescue at any time to fulfill the duty of care you have to your students. Consider these requiremen­ts before you take on students, and assess your abilities with your doctor to determine if you are able to meet the demands of being a dive profession­al or whether you should stick to diving for enjoyment.

We cannot weigh in on your medical and physical fitness to dive with such little informatio­n. While your cardiologi­st was pleased with your stress test results, that news could be deceptive: The doctor might have expected lower outcomes, and your results still might not indicate that you are fit enough to dive. Scuba diving poses some unique cardiovasc­ular challenges that cannot be accurately replicated in any other context. Even the best cardiovasc­ular assessment will not simulate the blood shifts that occur when you are immersed or the increased breathing resistance that takes place when you are breathing colder, drier and denser gas from a scuba regulator.

Your doctor can call our Medical Informatio­n Line at +1-919-684-2948 with any questions or concerns when assessing your physical and medical fitness to dive. If your doctor is not comfortabl­e making this recommenda­tion, we can refer you to a physician near you who has knowledge and experience in dive medicine.

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