General Category > AN Issues

One Year Post-Op and Personal Decisions on Returning to SCUBA Diving

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Nine5:
Hey Cary,

I'm curious to know what was the surgical detail they checked?  It'd be great if you could share that after your next visit.  I'm assuming you had microsurgery rather than CK?  Which surgical approach did you have?

caryawilson:
I need to return to my surgeon so I'll ask. I've been a little lazy in traveling back to Hopkins but I should go in the next six weeks.

I had modified retro. I can only imagine it's the process they used to close the skull (guessing). Since I had a 5cm hole that needed to be closed, after surgery, the procedure they used would determine if it would after hold up to the pressure at deeper depths. (I would imagine pushing in the "patch" would be a unique diving experience)

Keep in mind he is ok with me diving up to 1 atmosphere (33 feet)

Seahorse:
Thank you for your post, Nine5.  My husband is just recovering from trans lab surgery for a 2.8cm, and we have quizzed our surgeons on the diving issue, both ENT and Neuro are agreed that there is no clinical reason why he should not dive once fully fit.  He has hardly any balance issues after surgery, he has been feeling dizzy for years and had adjusted already to that particular problem prior to even knowing about the AN.  In fact, his balance and dizziness have been always been fine underwater, much better than on land!

He had a go at equalizing a few days after his op., and felt the sensation of it.  He intends to do what you did and try a gentle descent to 5m when he is fully healed, and take things from there.

What is a worry is your thinking on CSF leaks, particularly as hubby is now back in hospital after two weeks to have a drain fitted as a result of a sudden very runny nose, but the neuro thinks that all will be well once the drain stops the pressure from fluid preventing things from healing  The neuro did not mention any increased risk of CSF leaks with scuba.

What is another concern is getting travel insurance for hubby post op., we would like a holiday in a few months time if he feels OK, and also DAN insurance if and when he resumes diving.  Nine5, have you arranged dive insurance? I would really appreciate hearing of any experiences regarding this.

 

caryawilson:
I met my neurosurgeon and asked him on the factors that affect diving.  It appears the main issue is on how the hole that was cut into your skull was closed.  It appears this is based on the doctors experience and the medical companies recommendation on the material that was used to close the hole.

It appears Hopkins has recently started using bone cement (Hydroset).  One reason is they believe this has a greater chance to reduce post operative headaches.  I'm now almost 2 years after surgery and Dr. Lim is comfortable with me diving up to 2 atmospheres (66 feet).  I told him, I wanted to go 3-4 atmospheres.  It sounds like, I'm outside the standard recommendations.  He doesn't see any reason I can't go deeper, but he told me that I will need to see how I feel and take it slow.   Also, in future years the bone will continue to slowly close the hole.

So, it appears I'm good with 2 atmospheres.

Now, the previous method, they would use a screen / plate, that was placed over the hole.  I understand they don't recommend this for more than 1 atmosphere... ever.

In summary, the bone cement is better than the screen and the plate.   We are in a little uncharted waters here, and 1 atmosphere is easy, and there are more concerns on the deeper you go.

Does this help??

caryawilson:
Small update.  I'm  in the Maldives, and my girlfriend mistakenly mentioned my brain surgery.  The resort called the doctor to approve my diving.  The onsite Doctor said that after a tumor removal, the brain will have a large air pocket, and this would make me ineligible to dive.  In fact, this is NOT true.  I have MRIs that have confirmed, I do NOT have an air pocket.  However, it appears the resort has a policy not to allow a person with a previous brain surgery to dive.   So while they may believe in the "air pocket" issue, they were NOT willing to hear any medical evidence or discussion from my surgeon.   This appears to be more about liability than medical facts.

In summary. I'm in the Maldives and I'm NOT permitted to dive.  So my advice.  When travelling, be careful how much you inform the staff regarding your AN treatment.  Get clearance from your surgeon.

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