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January 2013    Download the Entire Issue (PDF) Available to the Public Vol. 28, No. 1   RSS Feed for Undercurrent Issues
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Post-Op Diving

how you can suit up after major medical work

from the January, 2013 issue of Undercurrent   Subscribe Now

In fall 2010, at age 52, Undercurrent subscriber Karin Doggett (Richmond, VA) found out she needed rotator cuff surgery. "I had six anchors installed and was told that it was important to let this heal properly. The recovery changed my lifestyle significantly -- I was in physical therapy for six months. Healing may continue for several years, and a re-injury may not be repairable. Due to all that, I've not dived since. I miss it very much and want to get back in the water soon."

I , too, had rotator cuff surgery -- probably from those 78-mile-per-hour fastballs I threw in high school and college -- and was wondering how that would affect my diving. I wasn't so much worried about how I would do once in the water (though a long overhand crawl would be impossible), but I was concerned about whether I'd be able to lift tanks, haul dive gear and be able to get in and out of the water. Turns out, with today's valet diving, it's not so difficult.

In our recent monthly e-newsletter, I asked Undercurrent readers to describe how their surgical experiences have changed their diving routines. Many of them wrote back, detailing their surgeries and recovery experiences. The good news: Their replies show that divers can definitely return to the sport, but you must work hard to regain dive-ready fitness.

Talk to Your Doctor

If you are about to go under the scalpel, let the surgeon know beforehand that you're a diver, says Edward McDevitt, an orthopedic surgeon in Annapolis, MD, who served as chief of orthopedics and sports medicine at the U.S. Naval Academy. "A lot of surgeons are athletic, many are divers, so they know what needs to be done to dive again after surgery."

Ed Heimiller (Streamwood, IL), has had four major surgeries in the past 12 years, returning to diving within six months after each one. "I have detailed discussions with the doctors prior to the operations to let them know about my active lifestyle, and to find out what limitations I would have afterwards."

Speak up even if you suddenly need an emergency operation, like Mike Masson (Santa Barbara, CA) did. "As they were wheeling me into the operating room for an emergency appendectomy, I asked the surgeon, 'What approach are you going to use? Will I be able to lift 50 pounds over my head in three weeks?' 'Why?' he asked. 'Because that's when I'm going on the dive trip of my lifetime, my scuba rig weighs 50 pounds, and I am going, no matter how this surgery turns out.' The doc turned to the surgeon-in-training and said, 'I guess we'd better use a laparascopic approach.' They did, leaving only three Band-Aids, and the next morning I raised my scuba tank over my head."

Take Time to Heal

Before you dive, your repair will need to be sufficiently healed. For some operations, there will be a limit before you can even fly, because blood clots may be a concern. Bruce Bander (Calgary, AB) says his surgeon's concerns about his arm weren't about whether he could re-injure himself if not healed. "Dive equipment is heavy, and you're playing with all that gear on an unpredictable ocean and a moving boat, so he recommended against my diving until the sutured tendon had more months to heal. His view was that if something unexpected happened, I would instinctively use the bad arm to help someone, grab equipment or catch myself on a boat and end up tearing the sutures."

The type of diving, plus depths and temperatures, also make a difference. Peter Milburn, who has run Dive Cayman Ltd. in Grand Cayman since the early 70s, contacted Divers Alert Network (DAN) after a major surgery, "and they told me to not do anything too deep for at least six months. I followed that advice and had no problems."

Mike Nelson (Ft. Myers, FL) was told by his doctor to stay out of the water for four to six weeks after a hand operation. "His concerns were germs and bacteria getting in before the incision fully healed, and any stress caused before my hand was back in shape. I didn't go back in for nearly eight weeks until I felt I could hang onto the boat ladder with one hand in case the other one slipped."

After having both rotator cuffs repaired, Robert Getz (Everett, WA) was allowed to dive after four months, but only in warm water. "I had to wait until a full six months to dive in Puget Sound. My surgeon's reasoning was that the diminished restriction in a 3- or 5-mm wetsuit versus what's involved with a drysuit and the heavier gear made it all right."

Bill Shepherd (Satellite Beach, FL) was cleared to dive three months after heart surgery, so long as he didn't go deeper than 100 feet and didn't do too many dives without rest. "Four months after surgery, I was in Palau and did 18 dives over six days, none deeper than 94 feet. I experienced no problems, and have been doing 45 to 60 dives a year since then."

Get (Back) into Shape

Surgeons recommend a post-op rehabilitation program, which can be the difference between finning over reefs or being stranded in pain on the boat. On its website, DAN says, "When you're able to perform your exercise and daily living activities with full weight-bearing and no difficulties -- such as pain, swelling or stiffness -- diving would probably be allowed. There isn't much difference between the physical demand placed on joints during a gym workout and during scuba diving. As long as the area in your body has an adequate blood flow to help with the offgassing of nitrogen, a problem is unlikely."

Fred Turoff (Philadelphia, PA) has had three shoulder and heel surgeries in the past seven years, but took Indonesia dive trips after each one. "I always allow four to five months of rehab and complete return to function. I live an active lifestyle, eat well, and know how to push myself for physical conditioning. Plus I'm 65, and realize I heal slower than I used to. So I give my body time to make necessary repairs and adjustments."

McDevitt, the orthopedic surgeon, says the recovery timeframe depends on the surgery, your age and what shape you're in. "You're never the same after surgery, so you have to work hard to get back to 100 percent." He tells his post-op patients to use the pool to do laps and jog along the bottom. "It's a great, easy way to use all the muscles. I had one patient who did that and was diving the Caribbean 10 days later." Dave Bridenbaugh (Cincinnati, OH) says water work was a big part of his therapy after knee replacement. Swimming and kicking proved to be beneficial, and actually sped up the healing process."

Many readers say their rehab was hard -- literally blood, sweat and tears -- but essential. Greg Liebman (Round Lake Park, IL) needed six months of therapy after shoulder surgery last March. "The first few weeks were excruciating and demoralizing. I really doubted the wisdom of the surgery -- I had already learned to compensate by using my other shoulder for everything, like one-handed pulls up the dive ladder. I continued going to regular therapy twice a week for almost four months, then just weekly the last two. I did all the home exercises, and I didn't do anything stupid to impede my progress. They promised me I'd be diving in September, and I was -- the Philippines -- and had absolutely no trouble with tanks, ladders or anything else. Just follow the rules, do your exercises, and all will be well."

Sydney Youngerman-Cole (Boise, ID) had back surgery in October 2010, subsequently losing the use of her right leg, but returned to diving the following March. "I was only able to do this because of an extensive physical therapy routine that had me working in a pool, exercising on machines and doing a lot of yoga. The whole experience made me physically stronger."

If you do feel yourself lagging on therapy, wanting to skip the exercise, Wayne Davis (Fort Collins, CO), who had bilateral knee replacement, says to ask yourself this question: If the other guy in the water was me, what would I like his physical state to be? "If that is not you, don't put anyone else in danger."

Take It Easy

On your first dives, play it safe. McDevitt adds, "Follow the tables carefully, stay at 30 feet or so until you feel comfortable. And don't cheat yourself." Jim Harris (Austin, TX), who started diving 10 months after a motorcycle accident, recommends doing an easy, familiar dive first. He started with the lakes around his hometown. "It helped that there was no pressure to stay in the water, like there might have been on a Cozumel boat dive, and it's easy to abort a shore lake dive if you're uncomfortable."

Forget your ego and ask for help. Wuni Ryschkewitsch (Gainseville, FL) has no trouble asking dive buddies for help after knee and hip replacements. "I was back in the water within six weeks of my hip replacement. I was afraid to carry my tank on my back down steep embankments and rocky water entries, so I asked my buddy to take my tank to the water, and I put it on there. I took off my tank in the water, and had my buddy pick it up and take it up the bank."

Use the steps, or sit instead of stand to start dives, says Donna J. Wilson (Venice, IL), who had rotator cuff surgery. "For my first dive in Bonaire, I stayed away from the giant stride, because that can really jar your shoulder. On boat dives, I sat on the back platform and just went face forward into the water. On shore dives, I went off the steps on the pier, and didn't do shore dives that required walking out of the surf."

After back surgery last year, Mel McCombie (New Haven, CT) always dons and doffs her tank in the water, "so as to never climb up carrying the weight." That really cuts the stress.

Ask the crew for help -- that's what you're paying for. Greg Yarnik (Palatine, IL) says his wife, who had major surgery on her leg, can't walk with her dive gear on. "So we meet with staff in advance to discuss a plan where she does an entry from the rear of the boat after the divemaster brings her gear, which she dons in the seated position and then does a body roll off the end. We tip accordingly for the extra TLC she requires, and have yet to encounter any dive operation that didn't do right by her."

Nigel Haines (Sussex, England) recommends telling the travel agents who book your trips "of medical issues so they can forewarn the dive operators, and you'll get the appropriate assistance you may require."

The best way to ensure pain-free dive trips? Go by liveaboard, says Sharon Greenspan (Mcdonough, GA). Eight months after surgery, she took "a nice, cushy liveaboard in Indonesia, so there was little need to haul anything much heavier than my camera/strobe rig. No problem with backroll entries, and the tenders had ladders so I didn't have to body-flop into the boat."

Don't Fear Setbacks

photo by Dave ReubushAs with any type of injury, there's still risk while diving. "Shoulder surgery may seem mild but when you're in a bad current, your mask is getting ripped off and you're trying to hang on, it feels like your body is being pulled apart on a rack," says Judy Foester (Milbrook, NJ). "So my advice is to stay away from places with ripping currents. "

Scott Patterson (Sacramento, CA) went diving at Catalina Island three months after back surgery, and says, "While trying to exit the stairway at the casino, a big surge grabbed me while I held the rail and yanked me back. I just lay in the water screaming and couldn't do anything to stop the pain. People tried to help, but there was nothing they could do. After three more attempts, the pain eventually went away enough for me to get out. I tried again a few months later, on a dive boat in the same area. I still had pain, but the crew made all the difference. No giant strides, a crew member put my gear on me on the swim platform and I gently slid in. These things take a lot longer than you think to heal."

To end on an upbeat note, I'll leave you with a story that shows you're never too old to recover and dive again. We all love Gladys Howard, the owner of Pirates Point Resort at Little Cayman, and she wrote to tell me what happened after she was diagnosed with cancer in October 2011. "After I had completed all the chemo and radiation, I ended up with blood clots in my legs and in my filter that I had put in prior to surgery for knee replacement. I was determined to go diving on my 80th birthday on August 9th, and I indeed did make a dive to 80 feet on the Great Wall in Bloody Bay. Martha Steinhagen, my super dive instructor, stuck to me as if she was my twin, but I had no problems. I did the dive with a 63 nitrox tank, and stayed down for 63 minutes!" And here's her picture (above; Gladys is on the left) to prove it.

-- Ben Davison

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