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SamM3124
07-09-2015, 04:10 PM
Ladies and Gents,

Wondering if you can help, my partner has been diagnosed with Narcolepsy with Catalepsy symptoms. For those who don't know Narcolepsy is, in a nut shell, when someone just is always tired and falls asleep (there is a lot more too it but in a nutshell that's the laymans explanation) Cataplepsy is a loss of muscle strength brought on by different things depending on the person. In relation to my better half her cataplepsy is brought on by laughter. For example, if she is standing and you make her laugh too much, there is a risk she'll drop to the floor. Having said that it's only when you make her laugh a lot.

Both of these are medicated using stimulants that are similar to those used in children with ADHD or ADD. These medications make her stay awake and she always knows when she is going to fall asleep and doesn't 'just nod off' she normally knows when she is going to require a nap etc. These medicines do not assist the catalepsy however, I do not feel that this should be an issue unless the marine life are going to start telling knock knock jokes!

My question would be in relation to her narcolepsy, will she be allowed to dive if she times it correctly and has had her medication and if she limits her depth? Or if she wears a full face mask?

Regards,
Sam

Tel
07-09-2015, 04:28 PM
The one and only stock awnser possible is to seek an authorative decision from a diving
doctor as she will definatley need a diving medical anyway.

Usually that's a medical referee, but might be worth looking around for a medical
referee that might have more knowledge of the condition.

From a layman's POV pressure/increase of Nitrogen and the way that diving tends
to affect the senses, may mean that the warning she gets now, might not happen
or happen too late, so this would be of extreme concern.

It might be that you can get away with benign dives at very shallow depth in
warm-clear waters, but before any of that will need to seek actual medical advice.

http://cpanet.co.uk/downloads/medical-referees-uk.pdf

Turbanator
07-09-2015, 04:44 PM
It might be that you can get away with benign dives at very shallow depth in
warm-clear waters, but before any of that will need to seek actual medical advice.



I can't find it now, but I'm sure that I remember that if a Doc puts a depth limit on a medical (PADI at least), that it's as good as a "No" for training. Still looking for it though.

BTS
07-09-2015, 05:31 PM
Regardless of whether medically she can dive or not why risk it FFM or not?... Seems a crazy thought IMO....

Tel
07-09-2015, 05:40 PM
Regardless of whether medically she can dive or not why risk it FFM or not?... Seems a crazy thought IMO....


Had a similar one a few years ago when someone who wanted to learn asked about
severe migraine. When asked how severe, the reply was, "well I pass out sometimes".

Asking if he got any warning, the awnser was yes "about 30mins before".

Seemed pretty unconcerned when explained this woud be just about when he would be
at the worse part of a dive and as unconcerned when told migraine might indicate a PFO.

He walked out in a huff when the fee for a medical refferee was mentioned.

SamM3124
07-09-2015, 06:03 PM
Guys,

I appreciate your feedback - just for clarification when I say she falls asleep its not the case of she just goes, its a gradual thing like when any one gets tired. Just the difference is it's quicker for her to become tired then anyone else.

The reason I'm asking is that she wants to live as normal as a life as she can and she would like to try Scuba - not suggesting for a second going to 30m etc just a nice shallow try dive sort of thing.

Thanks for all your help.
Sam

BTS
07-09-2015, 06:22 PM
Scuba isn't part of a normal life 😆

I appreciate people.dont want to feel something is holding them back but I'm confident narcolepsy and diving are not suitable bed fellows. We all live within our limitations regardless of if they have labels or not.

The only way forward is to get a diving medical referee to speak with her. Try a call to the DDRC....

gobfish1
07-09-2015, 06:26 PM
FFM and stick a mattress on her back she will be fine, :shagger

:x:

Garf
07-09-2015, 08:04 PM
So this person falls asleep quickly and uncontrollably, and may experience hallucinations?

Diving doesn't seem dangerous enough, have they thought about Russian Roulette?

There is no way in hell I would accept them on a class, medical clearance or not.

G

Dive dog
07-09-2015, 08:11 PM
I have a video somewhere of my wife laughing through her regs at a scallop swimming away from her.

Ihsaan
07-09-2015, 08:55 PM
Narcolepsy isn't an automatic ban on driving if controlled so it may be possible to dive.

Tunicates
07-09-2015, 09:31 PM
At least in a car you can slow the fuck down and stop within a matter of seconds. On a dive......no, I'm with Garf on this.

If she's really really stuck on the idea of diving then why not think about sky-diving? No need to worry at all there - the ground will always catch you.

But this is the internet. She needs to ask a diving doctor. Try the London Diving Chamber who will be able to have a chat and give a much more definite response.

Ihsaan
07-09-2015, 09:43 PM
And driving carries more risk of harm to others from a medical condition than diving.

londonsean69
07-09-2015, 10:39 PM
I can't find it now, but I'm sure that I remember that if a Doc puts a depth limit on a medical (PADI at least), that it's as good as a "No" for training. Still looking for it though.

I remember reading that, it's from around 2006-2007 training bulletins IIRC.

Edit - Found it :) 2007 :D



Conditional Medicals
Q: Can I accept a medical form when the physician gives approval for the person to dive with a depth limitation?
A: No. The medical form must not impose any restrictions on the diver. The physician gives approval by marking the box on
the form next to the statement “I find no medical conditions that I consider incompatible with diving.” If the doctor
adds a comment that the diver must not exceed a certain depth, it becomes a “conditional” medical and, therefore, is
unacceptable.

No idea if this is still the current rules from PADI though.

Paulo
08-09-2015, 06:25 AM
So PADI can enforce (too early to think of a different term) depth limits but a doc cannot?

Divemouse
08-09-2015, 06:31 AM
Really? I used to have a medically imposed 20m on my form when I started with BSAC and it was never a problem for training.

LearnerDiver
08-09-2015, 06:38 AM
Same here. I was initially limited to pool only when I started with BSAC

londonsean69
08-09-2015, 07:20 AM
So PADI can enforce (too early to think of a different term) depth limits but a doc cannot?

PADI can choose whether to accept someone for training or not - ATEOTD it's PADI's standards that PADI instructors (should be) are teaching to. To stay within standards, you must use their paperwork, and their paperwork is a yes or no when it comes to fitness to dive.

Please note: This was for PADI Europe, I remembered it from my time teaching in Lanzarote. PADI International (who cover the UK) may well be different, I'm sure the training dept would tell you immediately.


Really? I used to have a medically imposed 20m on my form when I started with BSAC and it was never a problem for training.
According to that training bulleting (granted, it's old and may well be out of date) PADI want either;

Fit (no restrictions)
Not fit


For them, not fit includes any specific restrictions regarding depth.


Same here. I was initially limited to pool only when I started with BSAC

Fair enough, but that is BSAC, not PADI.

BTS
08-09-2015, 07:40 AM
No one can impose a depth limit but one can be recommended. At the end of the day once in the water if you choose to go to 30 and your medic has recommended 25 who, other than yourself, is going to stop you....

Turbanator
08-09-2015, 07:41 AM
This applied to training, not already trained divers. If you were trained, but later had a depth limit imposed, perhaps as a result of a bend, then you would be expected to dive to that limit, often using nitrox.

Human nature being what it is, I've had people ask whether that's the actual depth or an EAD.

ATEOTD, there's no dive police. If you choose to put yourself at extra risk diving with a prior known medical condition that is considered to be contraindicative to diving, you won't find someone waiting to slap cuffs on you when you get out of the water.

Similarly, no one has the right to force an instructor to train them. Even with an OK from a GP, I'm not sure I would take the student in the OP on.

Sent from my C6903 using Tapatalk

Ian_6301
08-09-2015, 07:56 AM
OK, so this is not what you want to hear and I've been a bit blunt (not as blunt as some on this thread) but I'm phrasing it so that there's no confusion, because I really really don't want anyone to get hurt.

I floated this one past Mrs Me at breakfast. She is a Royal Navy GP and has done the big boys' diving medicine course at INM. Twice.

She laughed. And said "No" pretty firmly.

Taking a risk based approach, If I were the one marking the homework, I'd want to see medical evidence that there is no connection between narcosis and narcolepsy, then I'd want a staged introduction, perhaps some dry dives in a chamber. Then I'd want a fully briefed and drilled procedure for a mild and a major episode underwater (individually risk assessed). At this point, I'd contemplate letting her begin training, but one episode in the water and I'd want a complete halt and re-assess.

Looking at that lot objectively, the medical evidence is going to be impossible. No ethics committee anywhere is going to authorise an in water trial. There is also no commercial application for such research, so there is likely to be no funding. Finally, "proving that something is safe" is an extremely vague concept. You'd need to understand statistics and medical trials to get a proper understanding of it and there are folks on here who do that for a living and can explain much better than I could. But basically, you'd need a large enough sample that it DID contain a number of episodes in order to have a certain degree of confidence about frequency. If you just repeated an experiment 100 times and all the results were negative, you absolutely can't say that "the probability of a positive result is less than 1/100"! Unless you are a government minister. But that's a whole other story.

Too many unknowns, unquantified probability of incident, potential severity of outcome severe (1-5 fatalities once you consider buddies etc attempting a rescue), no controls in place / controls suggested with little or no evidence for reduction in outcome (FFM). On ANYONE's risk scoring system, that's a big fat red.

No-one is going to touch this with a 50' pole from a commercial outfit, because the risk assessment will be impossible to justify.

BSAC have a "Healthy" appetite for risk in diving and have history in providing diving for the differently able (think that's the current PC term?). Can't say I agree with a lot of their decisions, but there it is.

jturner
09-09-2015, 12:45 PM
Ladies and Gents,

Wondering if you can help, my partner has been diagnosed with Narcolepsy with Catalepsy symptoms. For those who don't know Narcolepsy is, in a nut shell, when someone just is always tired and falls asleep (there is a lot more too it but in a nutshell that's the laymans explanation) Cataplepsy is a loss of muscle strength brought on by different things depending on the person. In relation to my better half her cataplepsy is brought on by laughter. For example, if she is standing and you make her laugh too much, there is a risk she'll drop to the floor. Having said that it's only when you make her laugh a lot.

Both of these are medicated using stimulants that are similar to those used in children with ADHD or ADD. These medications make her stay awake and she always knows when she is going to fall asleep and doesn't 'just nod off' she normally knows when she is going to require a nap etc. These medicines do not assist the catalepsy however, I do not feel that this should be an issue unless the marine life are going to start telling knock knock jokes!

My question would be in relation to her narcolepsy, will she be allowed to dive if she times it correctly and has had her medication and if she limits her depth? Or if she wears a full face mask?

Regards,
Sam

FWIW, I suggest you consult a diving doctor for starters but based on the description you have provided, I would have grave reservations personally if I was to be taking the class. Basing a strategy for safety (with the risk of serious or potentially life-threatening accident) purely on careful timing and the hope that the catalepsy doesn't occur, doesn't sound all that clever to me to be honest...

Tim Digger
15-09-2015, 01:29 PM
This is in a grey area and must be assessed fully by a diving physician with full access to all previous medical investigations and opinions. A difficulty with this condition is in semantics. I would define sleep as an altered state of consciousness from which the person can be roused to full conscious activity by minimal stimulation and with retention of protective reflexes. Unconsciousness is where there is usually loss of normal reflex activity (airway control etc) and from which the person cannot be roused even with extreme stimuli (pain). It may well be that there are shades of grey in the narcolepsy area but a significant problem will be finding a dive doc with sufficient knowledge of an uncommon condition to give a meaningful opinion. If I had been faced with certifying this individual fit to dive. I would be advising firmly against taking up SCUBA although my knowledge of the condition is necessarily limited. As others have indicated there are plenty of other dangerous sports that do not have a vital and immediate need for full consciousness.

SamM3124
20-10-2015, 11:16 PM
Ladies and gents,

Thanks for all the advice and input - it is appreciated.

She only wanted to try a session in a pool to experience SCUBA and not do a course etc, I do take on all the comments and suggestions.

Thank you all greatly.

Sam

Cheeky Monkey
22-10-2015, 09:11 PM
Meh, think of some of the people you see dragged about by the tank valve on Red Sea try dives - they'd be easier to handle if they were asleep !

BenL
22-10-2015, 10:32 PM
Ladies and Gents,

Wondering if you can help, my partner has been diagnosed with Narcolepsy with Catalepsy symptoms. For those who don't know Narcolepsy is, in a nut shell, when someone just is always tired and falls asleep (there is a lot more too it but in a nutshell that's the laymans explanation) Cataplepsy is a loss of muscle strength brought on by different things depending on the person. In relation to my better half her cataplepsy is brought on by laughter. For example, if she is standing and you make her laugh too much, there is a risk she'll drop to the floor. Having said that it's only when you make her laugh a lot.

Both of these are medicated using stimulants that are similar to those used in children with ADHD or ADD. These medications make her stay awake and she always knows when she is going to fall asleep and doesn't 'just nod off' she normally knows when she is going to require a nap etc. These medicines do not assist the catalepsy however, I do not feel that this should be an issue unless the marine life are going to start telling knock knock jokes!

My question would be in relation to her narcolepsy, will she be allowed to dive if she times it correctly and has had her medication and if she limits her depth? Or if she wears a full face mask?

Regards,
Sam

Cataplepsy is a new one on me - didn't know such a thing existed. But I do know narcolepsy can be managed; a good friend of mine has the condition and he's a consultant ENT surgeon.

As others have advised, contact a diving doctor.

There's one near you: http://m.midlandsdivingchamber.co.uk

Who knows? They may be interested in researching this.

bubbleless
23-10-2015, 01:08 AM
I didn't say this and wouldn't do this, hire a pool and let her have a go.....

yassin3
08-01-2020, 07:50 AM
I'd say that narcolepsy affects my life on 3 different levels:

the symptoms and co-morbidities of narcolepsy,

the consequences of living with these symptoms on more or less every aspect of my life (social, professional, economical etc.),

the long-term psychological impact of these consequences.

Learning to live with the symptoms is not easy (especially since these symptoms are often evolving over time, most of them worsening, new ones appearing), but it's possible. It usually takes a few years. To be honest, the worst with this disease isn't the symptoms. It is how the rest of the world deals with us, from denial to mockery and rejection.

I have a typical type 1 narcolepsy (https://sleep-land.com/narcolepsy-diagnosis-criteria-and-treatment/), so the list of symptoms is a pretty long one:

constant fatigue, like always feeling like it's 3 a.m. after two days and nights with no sleep at all, which is like a chronic state of extreme sleep deprivation.

sleep "attacks", which are not as sudden as in movies but get overwhelming in a matter of minutes, so it's better to just give up and take a nap, whatever i'm doing and wherever i am.

"brain fog", my brain decides to stop working and i can't execute even very simple tasks, feeling (being) totally stupid for a while.

memory issues: losses, especially short-term and prospective memory, but also having "fake" memories, of events that never happened.

cataplexy, which is a loss of muscle tone that goes from nodding to totally collapsing on the floor. It is the most misunderstood and misrepresented symptom. I never lose consciousness and it usually goes away after a few seconds. Cataplexy is triggered by particular emotions or actions and makes many activities impossible for me, like practical jokes, theater, playing sports involving fast-moving objects, playing drums, or simply laughing without looking weird.

hypnagogic and hypnopompic hallucinations, i-e when waking or falling asleep

sleep paralysis, pretty terrifying experiences that go way beyond having nightmares

disrupted night sleep. Ever since i've developed narcolepsy (i was 19 y.o.) i've never been able to sleep more than 2 hours consecutively.

acting out dreams, often confused with "restless legs", screaming and kicking things around while sleeping.

impossibility to feel certain emotions like some forms of joy or anger. This symptom is very difficult to describe, but it's been proven that orexin/hypocretin is involved in processing emotions.

obesity, due to excessive stocking of brown fats

anosmia = loss of sense of smell ...

The list goes on. Now it's time for a nap ;)