![]() Remember that there is always some degree of DCS risk any time you dive, so take measures to minimize that risk. While you may or may not be at a greater risk for DCS after surgery, it is prudent to refrain from diving until you have completely healed and your surgeon has released you for unrestricted, rigorous activity. ![]() The pathophysiology of referred pain from laparoscopic procedures is quite different from the way DCS may cause shoulder pain while scuba diving. Many factors can lead to DCS, including overall fitness to dive, general health, hydration status and thermal status. Trapped CO 2 can irritate the phrenic nerve and cause shoulder pain, and movement may help release the gas. Residual effects of a pneumoperitoneum and CO 2 retention resolve within seven days in 96 percent of the patients who undergo this procedure. The diaphragm and shoulder thus share the same nerve path. The phrenic nerve originates from the same level of the cervical spine (neck) as the nerves that provide sensation to the shoulders and descends downward between the lungs to the diaphragm. Shoulder pain is a common side effect of a pneumoperitoneum. Another benefit is that you can rapidly clear CO 2 from your body as a natural byproduct of respiration. CO 2 is the preferred gas in laparoscopic surgery due to its high solubility in the blood and its resistance to combustion, which is particularly important with the presence of electrosurgical equipment. To expand their view, surgeons often use gas to create a space called a pneumoperitoneum. Since this seems similar to decompression sickness (DCS), should I be concerned about future dive trips?ĭuring laparoscopic surgery, surgeons insert tubes with lighted cameras and surgical instruments to repair the hernia with minimal intervention. Pain medicine has not been working, so my doctor suggested walking to get rid of the excess gas. One of the side effects is shoulder pain on my left side, which my doctor said was due to the CO 2 permeating the tissue. I recently had a hiatal hernia repaired with laparoscopic surgery, during which the surgeon used CO 2 to inflate my abdominal cavity. Should you continue to push yourself, your heart may race, and you can experience an elevated breathing rate, panic or even hypoxia (insufficient oxygen) and pass out. With COPD, shortness of breath during exertion doesn’t mean you are out of shape it means you cannot rid your body of CO 2 and replace it with the oxygen needed to meet the demand of your exertion. You may also have to walk in full gear along a boat deck after an exhausting dive. Reduced exercise tolerance is also common for those with COPD and poses risks for diving. There can be strenuous activity involved with managing currents, swimming on the surface in choppy seas or pulling yourself and your wet, heavy gear up a ladder and onto an unsteady boat. Some people with COPD retain carbon dioxide (CO 2), which creates a risk of CO 2 toxicity at depth. ![]() The bubbles that cause an AGE may lodge in the lungs, heart or brain and result in a pulmonary embolism, heart attack or stroke, respectively. A rupture leads to air escaping the lungs and potentially entering arterial circulation, which can cause an arterial gas embolism (AGE), or the chest, resulting in a life-threatening pneumothorax. The balloon filled with air at depth expands during ascension, which teaches the importance of never holding your breath while diving. If your lungs cannot quickly expel all the air, it creates a situation similar to partially holding your breath while diving since the trapped air will expand, possibly to the point of rupturing your lungs. The volume of gas is inversely proportional to its absolute pressure, which your open-water instructor probably demonstrated to you using a balloon. It expands, but the walls do not actively force out the air. Any air remaining in the alveoli creates a much higher potential for pulmonary barotrauma. Unfortunately, COPD is a contraindication to diving for several reasons. With COPD, there are abnormal enlargements of the air spaces in the lungs and destruction of the air sac (alveoli) walls, reducing their elasticity. The alveolar walls are normally elastic like a balloon. A balloon expands when you breathe into it, but the walls are ready to recoil and expel the air, which is how normal alveoli function. With reduced elasticity, it is more like breathing into a plastic bag. I get short of breath when I exercise, but I still swim for about an hour three times a week, including a 75-foot (23-meter) underwater swim with fins. How will COPD affect my diving? I was diagnosed with chronic obstructive pulmonary disease (COPD) last summer. DAN® medical information specialists and researchers answer your dive medicine questions.
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