ST101921%BROWNVM.BITNET@mvs.oac.ucla.edu (Jack Rozel) (02/08/91)
I'm sorry that it took me so long to post my final comments on the subjects of
Scuba Diving, HIV, AZT, and Alternobaric Pharmaology. I've had all sorts of
other junk going on...
First, a (relatively important) comment and correction: While (919) 684-8111
is the Divers Alert Network phone number, it is also, more specifically, their
_EMERGENCY_ number. For the sakes of their blood pressure, please use their
Non-Emergency information number (9-5 EST): 919 684 2948
And now, on to my responses to various postings:
<2913> The initial question: The short answer is that while there have been
some studies about the effects of AZT under hyperbaric-atmospheric (high
pressure air), the studies have been case follow ups, and thus the scale of
these studies are miniscule (say, n<15)
<2915> This posting brings up three important things, the first of which (the
DAN phone number) I already covered.
The second issue is diving with reduced lung capacity. This is a very
relative thing: there are some ABSOLUTE CONTRAINDICATIONS in regards to pulm-
onary function, and some RELATIVE CONTRAINDICATIONS. Absolute contraindica-
tions include a history of COPD (Chronic Obstructive Pulmonary Disease), severe
pneumonia, and any history of spontaneous or traumatic pneumothorax (collapsed
lung). Relative contraindications are primarily a history of excessive smoking
(especially marijuana becasue of it's high tar content, but normal tobacco, to
o).
The third is mental confusion. Diving is an intense and potentially
dangerous activity. Any person with any type of altered mental status shouldn'
t dive. Especially, as Jack Hamilton said, those with confusion problems.
If anyone on AZT is having mental complications as a result of the medication,
diving is not recomended. As far as narcotics in general are concerned (alco-
hol, codeine, high potency analgesics, as well as any psychoactive drugs),
any mind altering substance's effect will almost certianly be amplified into
narcosis (inebriation-like mental status). The already present Inert Gas
(nitrogen) Narcosis is a major obstacle for dives deeper than 80-100 feet.
Complications from psychoactive pharmaceuticals could lower the narcosis
ceiling to 20-40 feet.
<2916> Macgyver mentioned that he didn't think that diving involved too much
pressure. It does, but because the pressure is in euqilibrium (hopefully)
it's effects are more subtle. To use a less subtle example to demonstrate
the degree of pressure, consider this: when you are 33 feet-saltwater deep,
you are under about two atmospheres (or 29.4 pounds per square inch). This
is only an increase of one atmosphere (14.696 psi); an example of non equalized
pressure of this type would be to take a fifteen pund object, say a small type
writer, and to balance it on a one-square inche segment of your skin, a little
more that the size of a quarter. It's a lot of pressure, and it accumulates qu
ickly and can cause physiological complications galore, not the least of which
is an altered metabolism from the high oxygen concentrations.
Incidentally, as far as depths are concerned: sport diving limits
recomend a maximum depth of 100-130 feet. Hyperbaric chambers are usually
limited to about the equivalent of 50 feet. (However, walk-in chambers,
especially those used in treating barotrauma, routinely go to depth-equivalents
of 165 feet. Duke University's F. G. Hall alternobaric lab has chambers that
go to several thousand feet.)
<2921> I said it before and I'll say it again: any dive master, instructor, or
rescue diver who does not routinely carry and use a pocket mask is not only
taking a (minimal) risk of infecting themselves with HIV (more likely, it would
be something like hepatitis) , but they are not using a tool which greatly
simplifies resuscitation efforts. Don't keep it in your first aid kit, keep it
in your pocket (it's small enough, and BCD pockets are useless for anything
else, anyhow).
<2930> Rob Bernardo says that most bacterial infections potency isn't affected
by HIV; I don't know myself, so I'll assume that that is true.
However, beware of wound infections: There are hundreds of sharp dirty
things underwater just waiting to gash and infect careless divers. I can't
say how much of this falls under bacterial infections and how much doesn't,
but wounds that can be expected are coral burns and cuts (even superficial woun
ds take months to heal completely), urchin spines (the spines are occasionaly
venemous and ALWAYS very sharp and very brittle; people who are already on
something like cyclosporine could have trouble dealing with resultant infect
ions), and others. (I once dove with a guy who got a nasty infection from a
crocodile bite, but you're more likely to get chomped by a pit bull than a croc
. . .)
That's about all I can say at this point, because as someone else said (it's
in my notes, here, somewhere, but it's 3:45 am and I don't want to look for it)
the jury is still out on AZT and alternobarics. Who knows? A month from now
they could find out that Hyperbarics considerably augment AZT function. . .
I'll relay any knew information on this no the net.
And, as I mentioned last time, I am an underwater operations consultant in
my free time. AIDS Awareness and fighting discrimination are pretty good
pro bono causes; if I can be of any help to any of you (as far as networking
in undersea medicine, or case research on alternobarics, AZT, and diving)
please Email, or write, or something...
Until next time:
Jack Rozel <st101921@BROWNVM.bitnet>
POB 3088 Brown University : No
Providence, Rhode Island : Quotes.
USA 02912 : (Sorry)