Medical
Advice: |
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An underwater panic attack
can be a life-threatening experience. Follow these tips to keep it from
happening.
How To Beat Panic
Get proper training - Choose a course that is long enough to allow you to take your time learning dive skills, rather than one that crams everything into a week or less. It is also important to search out an instructor with whom you feel comfortable, and then identify a buddy in your dive class with whom you are similarly at ease and confident. Be fit to dive - That means not only maintaining good physical conditioning, but also resting and eating properly before a dive. It will do no good for you to be fatigued, breathing hard and metabolizing the last of a high-sugar breakfast. Diving with a cold or other illness is inviting trouble. Visualize the dive - Listen carefully to the briefing and then visualize and rehearse it in your mind before you get in the water. Ask questions if you have any - A dive leader's knowledge and experience can help dispel doubts and fears. Practice breathing - Initiate slow, full respiration well before entering the water. Check all your gear - Make sure your equipment is configured for maximum comfort and efficiency. Do a buddy check - A buddy's assurance that your gear is in place and working properly will increase your confidence. Get acclimated - Get used to the water before descending by pausing on the surface, or even snorkeling briefly. This may be especially helpful when the water is cold. Avoid task overload - Equalize your ears before entering the water and then again on the surface. Tighten your weight belt on the surface if you need to, and clear your mask shortly after submerging. This will allow you to focus on your actual descent. Descend carefully - Many divers are calmed by slowly following a descent line or natural feature of some sort, rather than free-falling through open water. Descend feet-first, deflate your BC slowly and don't hurry the process. Orient yourself - If vis is poor, use what orientation aids you have available, such as your stream of bubbles, a little water in your mask and your instruments. These can be remarkably reassuring. Pause - If you feel your heart rate increasing and experience other indicators of fear, stop your descent, try to determine what is distressing you, and attempt to remove the source of stress. Some divers find that hugging themselves is calming. Breathe - If panic strikes despite your best efforts and you feel the need to surface, try your best to remember to breathe continuously so as to avoid arterial gas embolism.
You Panicked, Now What?
Talk about it - First, discuss with an instructor what occurred. He or she will no doubt have some useful suggestions, such as additional pool sessions, descending while maintaining direct eye contact or even body contact with the instructor, or some other form of one-on-one assistance. Dive somewhere else - If you feel low water temps and limited vis are the primary issues, find a location with kinder conditions. Get help - Some people are generally more anxious than others, and this may predispose one to diver panic.
Such anxiety can be treated with systematic desensitization, an often effective technique for dealing with phobias that relies in part on progressive muscle relaxation. More traditional "talking therapies" have not proven particularly effective with irrational fears like diver panic. |
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PREVIOUS ADVICE: Diving &
Pregnancy
One of the most frequent questions people ask is regarding scuba diving while pregnant. The quick answer is … "Please don't dive" while you're pregnant.
We don't have very good data showing that hyperbaric pressure harms the fetus, and in fact, there are case records of HBO treatment of pregnant mothers with carbon monoxide poisoning without adverse effect on the fetus. However, the fetus does not have the protection of the lungs in filtering out the bubbles as does an adult. The Russians use HBO to treat high risk pregnancies and report 54/700 cases of pulmonary pathology with poorly controlled studies. Anecdotal cases reported:
1. Bangasser Survey 1978-no increased
defects Studies on pregnant sheep are particularly telling in that the sheep placenta is very similar to that of the human. These sheep studies of DCS all showed high rates of fetal death, particularly in the fetuses that had been instrumented, probably due to the bubbling that crossed into the arterial circulation via the patent foramen ovale. "The same woman who will not drink coffee or smoke during her pregnancy will want to know why she should not dive. In this litiginous society there is only one answer … "no diving while pregnant or even trying to conceive".(Dr. Maida Taylor). No major studies prove it unsafe but the hazards are there. Presently, every HBO treatment chamber does not allow female personnel who are pregnant to act as tenders. Since diving is an entirely elective activity for 99% of all women divers, the obvious choice would seem to be not to dive. If one has been inadvertently diving while early in her gestation, there is no good data which would justify an abortion.
Diving in Very Early Pregnancy
If you are planning a perfect holiday for diving, sun and you really want to try and conceive on the first three days of your ten day holiday, what do you do about the possibility of damaging the embryo? Bottom line - you should probably go ahead and completely enjoy your dive trip. The reasons are multiple. First, a normal couple, actively trying to achieve a pregnancy, actually is successful only once in three or four months of trying to conceive - so the odds are that you won't get pregnant on this trip (although it's certainly not unlikely). Second, the embryo does not actually attach to the wall of the uterus for about seven days, receiving its nourishment from fluids secreted by the Fallopian tube and uterus. Even though attachment to the wall of the uterus occurs about a week after ovulation, it is later in pregnancy (at least another week to ten days) before there is any effective maternal-placental blood circulation. The major theory for the cause of fetal malformations associated with diving concerns the possibility of transfer of intra-vascular bubbles from mother to fetus. As there is no effective circulation in the earliest stages of pregnancy we are considering, this is possible cause is not a concern. Third, many thousands of women have been diving unknowingly at the same early stage of pregnancy you might be in - there is no evidence of an increase in miscarriages or other problems in these women who have been diving around the time of conception. In fact, before pregnant women were advised not to dive, several studies looked at women who dived throughout pregnancy. Although we no longer recommend diving during a recognized pregnancy, there is no solid scientific data to prove that diving is dangerous to the fetus. Finally, the very early embryo is still composed of cells which have not yet undergone differentiation - that is, one cell isn't destined to be the heart, another the left arm, etc. If any single cell is damaged at this very early stage of pregnancy, other cells can "step in" to form the needed structures. Only later, after differentiation, will damage to a single cell likely result in an abnormality.
Martin M. Quigley, MD
Uncomplicated vaginal delivery
Cesarean section delivery
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Bangasser SA Medical Profile of the Woman Scuba Diver in NAUI proc 10th Int Conf on Underwater Ed Colton, CA NAUI 1978 p31-40 Bolton M Scuba Diving and Fetal Well-being: a survey of 208 women Undersea Biomed 1980, 7: 183-89 Fife WP, Fife CE Women in Diving, NAUI Int Conf Proc on Underwater Ed, Mar 1991, p 80-88 Turner G, Unsworth I Intrauterine Bends? Lancet 1982, 1: 905 |