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  1. #21
    Grumpy Git, Not Old Yet...
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    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.
    DISCLAIMER: If you don't understand this shit, ask a grown up, preferably someone with deep pockets, who your widow/kids can sue. Don't trust people on the internet with your life, your credit card details or your naked selfies! This advice may contain, or indeed be written by someone who is (clinically), nuts.

  2. #22
    Established TDF Member
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    Quote Originally Posted by SamM3124 View Post
    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...

  3. #23
    Prior Member Tim Digger's Avatar
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    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.
    Evolution is great at solving problems. It's the methods that concern me.
    Tim Digger

  4. #24
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    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

  5. #25
    Cancelled Account
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    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 !

  6. #26
    Gimme a medal BenL's Avatar
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    Quote Originally Posted by SamM3124 View Post
    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.
    I don't want to get technical or anything, but alcohol IS a solution

  7. #27
    Established TDF Member bubbleless's Avatar
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    I didn't say this and wouldn't do this, hire a pool and let her have a go.....

  8. #28
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    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, 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


 
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