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Safe Diving Practices for BPPV Patients

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Benign Paroxysmal Positional Vertigo Diving Related Issues

Q: I was recently diagnosed with benign paroxysmal positional vertigo (BPPV). I’m seeing a physical therapist to resolve the vertigo and move the otoliths (crystals) out of my inner-ear canals. If my symptoms are resolved, and I am not experiencing vertigo, do you know of any pressure related issues concerning BPPV that I should be aware of while diving

A: With BPPV, diving is not recommended for anyone with this condition. Certain head and neck movements while on deck, entering and leaving the water, and during the dive may provoke another episode and result in serious injury. It’s a good idea to consider the risk of incapacitation from a sudden onset of vertigo, the danger of which increases exponentially in the underwater environment.?

Additionally, the symptoms of BPPV can resemble those seen in serious medical conditions such as DCS and lead to an inappropriate or incorrect diagnosis of an underlying condition, which may result in improper treatment. BPPV symptoms may be debilitating or incapacitating, so a diver needs to consider the risks to themselves and others around them should they require assistance.

Flying after Diving DCS Worries

Q: While on a cruise, I booked a dive excursion through one of the recommended vendors. As we finished the dive, the cruise ship was leaving port without me. We had just completed a dive to a maximum depth of 17m for 50 minutes on air, a 45-minute surface interval, and a second dive to a maximum depth of 13m for 50 minutes. The vendor and cruise line took responsibility for the mishap and booked me on a flight to meet the ship at the next port. Four hours elapsed from the end of my dives to my flight departure. I did not have any pain or symptoms during the flight, and I still feel fine. Should I be worried about decompression sickness (DCS)?

A: DAN has well-established recommendations for safe flying after diving. Based on your dive profiles, the minimum recommended surface interval before flying should have been 18 hours.

Dive tables and computer algorithms are based on theoretical models and designed for the masses. It is practically impossible to create a model to determine an individual’s risk and the factors that would make someone susceptible to DCS. Many things determine a person’s decompression stress. The shallow dives and short bottom times may have helped in your situation, but nothing guarantees a repeat outcome under the same circumstances in the future.

Upon surfacing, the nitrogen from your dives begins to leave your body tissues. Most inert gas is eliminated 24 hours after the dive, which is one of the reasons you can fly 18 hours after a dive activity. Since you have flown without experiencing symptoms in flight, and you are still symptom free a few days later, it is reasonably safe to say you will not experience DCS.

Dan World


This article was originally published in Scuba Diver ANZ #53.

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