Late summer, 2010 and I had just started teaching Confined Water sessions after a few weeks off with a strained shoulder muscle.
I had three students on this new course.
The following post is my observations and understandings, and my research on training and diving with a person who has multiple sclerosis.
It has taken me a little longer than I expected to write this – it is easy to note your observations and actions but not so easy to explain them in a way that hopefully does the person, and their attitude, justice.

Before I proceed, please understand and be assured that I am not medically trained – this is not a medical opinion and by all means, please consult a medical professional for advice regarding scuba diving and multiple sclerosis.

All the information I have gleaned is from the internet, the Hyperbaric Unit at the Devonport Naval Base and her doctor is quoted as such.
Jasmine waited a year after her diagnosis – to ensure she was symptom free – before receiving the final medical clearance to start a scuba diving course.

Firstly, I knew hardly anything at all about Multiple Sclerosis.  Basically nothing at all.

I went online and read the definitions of MS.

MS is a disorder of the central nervous system (CNS) which includes the brain, spinal cord and optic nerves.

The CNS is responsible for our conscious and unconscious functioning, including movement and the response to sensations such as sight, touch and hearing. It directs these functions by sending its instructions in the form of electrical impulses to the appropriate sites along nerve fibres.

Nerve fibres are coated in a protective insulating covering called the myelin sheath—this serves a very similar function to the coating around electrical wires. Myelin is important in speeding electrical conduction along nerve fibres and in insulating nerve fibres from one another.

The term multiple sclerosis refers to multiple areas of scarring (sclerosis) scattered throughout the brain and spinal cord. These scars are the result of healing patches of inflammation that are the basic cause of damage to nerve fibres and of the suddenly appearing symptoms that are referred to as an attack, exacerbation or relapse.

Patches of inflammation heal spontaneously over several weeks or months when symptoms may resolve completely or residual impairment may result, if they do not.

The inflammation causes damage particularly to the insulating myelin sheath covering nerve fibres, but also damages the nerve fibres (axons) themselves.

In MS, the typical damage is often referred to as “demyelination”. The nature of the symptoms and their severity depends partly on the site of the patch of inflammation (or lesion) and partly on its nature and intensity.

The course of MS varies widely from person to person. Some people will only ever experience mild symptoms over their lifetime while others will have relapses followed by incomplete remission when disability may worsen in a stepwise fashion with each relapse experienced. A number of people experience slowly progressive, worsening of disability over many months or years. There is uncertainty how much of this progressive process is due to low-grade inflammation and how much to loss of previously damaged nerve fibres.

Source : The Multiple Sclerosis Society of New Zealand

Jasmine had talked to quite a few dive shops in her local area – most said that they could not train her, the others not so sure , and one even saying that she should have kept it quiet.
I could not believe this when I heard it!  Firstly, Jasmine had waited a whole year – until she had been symptom free – until she had the Medical Statement completed, and secondly, MS symptoms can be so similar to DCS, why would a reputable dive shop want this to not be disclosed to both Instructors and Buddies?
Global Dive said we would train her.  And that meant that we would train her properly – with all the information that we had available.

I then went to see if I could find some information on how and what effects scuba diving has on MS and what effects MS has on scuba diving.
I had read the letter that Jasmine’s doctor had sent along with her required Medical Statement.

There is no evidence that diving in itself has an effect on the disease.

  • About 20 years ago an unsuccessful effort was made to treat MS with hyperbaric oxygen. Patients neither suffered nor benefited from this treatment series.
  • Persons with MS are advised not to exercise to the point of exhaustion and to avoid becoming chilled or overheated. Diving candidates with MS should respect that advice.
  • In each individual case, consider whether the candidate can handle the physical load and master the water skills. Diving candidates should talk to their neurologist about diving.

Source : Divers Alert Network

And the accompanying letter from her doctor was quite concise :

The above named has taken a full Entry Level SCUBA Dive Medial to AS 4005.1 and is considered fit to dive with the following rider.

Dive Instructors and Buddy Divers should be aware of her history of multiple sclerosis.

This is not a contra-indication to compressed gas, SCUBA and surface supplied breathing apparatus diving or even breath hold diving but represents a potential threat in that the symptoms and signs of multiple sclerosis and optic neuritis are very similar to decompression sickness and arterial gas embolism.  Any neurological symptoms within 24 hours of surfacing from a dive must be considered dysbaric and managed by referral for therapeutic decompression.
Multiple sclerosis would not cause a sudden underwater problem.

Multiple sclerosis is often a relapsing condition but the diagnosis in her personal case is not well established and it is probable there will be no recurrences.  If there are, she should not dive for a year following resolution of symptoms.

The plan was to teach Jasmine to scuba dive – and to train her along with her husband, who was a certified Rescue Diver.
While of course, training the other two students who were signed up to the course along with her.

The first pool session went well.
Swims and floats (treading water) were relatively easy for everybody and the water keeps everyone nice and cool.
When the time came to start putting equipment together, Jasmines fingers were a little shaky which only caused a problem with attaching the low pressure inflator hose to the BCD.
Showing her how to do this by using her leg as a stabliser for her fingers holding the pinch clip so she could insert the BCD attachment, and then detaching it and letting her do it herself sorted that little problem out easily.

For the second pool session, we were completing deep water entries.
This was a little more difficult so we looked at seated entries – and later at gearing up in the water when it was too deep to stand.

My observations here are mainly around heat and muscle strength.
Getting geared up and moving into the water is quite imperative.  If a diver with MS gets too hot, they can feel “woolly” or start to feel something similar to pins and needles – especially in the fingers (from what I understand).
Looking at ways to lessen the time spent standing around in full scuba gear is really important.

For the Open Water dives, we headed up north and did a day at Matheson Bay.
The weather report was fabulous however when we arrived, there was a little easterly swell that should have dropped off. We geared up and headed down to the beach. Once in the water, the swell was a little stronger than I expected however everyone agreed we could head out. Open Water Dive One is an underwater tour – no skills, just looking. The visibility was pretty yuck so after 45 mins, we came back in.

Trying to get the girls up the beach was difficult. Difficult and not enjoyable.
During our surface interval, the girls made it pretty clear that they didn’t want to do Dive Two there – which was not a problem (we can complete three training dives in a day) so we decided to complete Two, Three and Four in Lake Pupuke the following day.

The next day went really well.
The only issue – not even a big issue – was the weight of the equipment that Jasmine was wearing and by the end of the day she was (we all were) pretty tired. A very very successful course!

It just goes to show, we humans are amazing creatures.
We can spend days talking ourselves out of being able to do and achieve all sorts of things. But when we really put our minds to it, we can talk ourselves into those same things in a matter of minutes.

Great attitudes, the support of our friends and family and a willingness to succeed means that we can all accomplish anything that we set our sights on.

“You cannot plough a field by turning it over in your mind” ….. Author Unknown.

For more information :

[fb_like]


Check out the grins Discover Scuba Crew Devil in Dive Mistress Team Tara descends to the HMNZS Waikato / Photograph by Andrew Simpson Scuba Certified Signs in the Heavens Open Water Skills - Alternate Air Ascent Open Water Skills - Fin Pivot Specialty Instructor Ratings The Zen Master

Related Posts