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RESEARCH, EDUCATION & MEDICINE
hot water. Most of these toxins are
thermolabile, meaning they can be
broken down with heat. Hot-water
immersion is an important part of
first aid; the water should be around
110°F to most effectively relieve
symptoms. Water that is too hot may
harm healthy tissue, so always test the
temperature on yourself first if treating
someone else — local skin reactions
may alter an injured person’s ability to
discern if water is too hot.
It is important to note that some
species have very persistent pigments,
and those black dots in your skin may
actually be pigment rather than actual
spines. In most cases it is easier to
assess whether or not spines are still
present once the initial swelling has
resolved. The decision about whether
or not to remove spines should
depend on several factors: location,
pain with movement, joint or tendon
involvement, signs of infection and
allergic reactions. The same way an
egg is much stronger if you squeeze it
from top to bottom but fragile if you
squeeze it from the sides, sea urchin
spines can be really hard at the time
of penetration but awfully fragile
when you try to remove them. In
some cases localization by X-ray may
guide extraction efforts.
Foreign bodies such as spine
fragments can cause reactive
granulomas, which are roughly
spherical masses of immune cells
that encapsulate foreign bodies. This
is a normal immune response that
attempts to wall off substances that
are perceived as foreign until the
granuloma can either digest them or
eliminate them with drainage of pus
through an opening in the skin. This
can take anywhere from a few days
to several months.
Prevention is the goal. Before
your next dive consider strategies
like improved buoyancy control. If
your diving skills are rusty or you
think an update would help, consult
your local dive shop about buoyancy
specialty training.
Q:
I have inflammatory
bowel disease and
wonder if I should go on
a dive trip.
A:
Inflammatory bowel disease
(IBD) is a chronic condition
that causes inflammation
and sometimes ulceration of the
bowel. The two most common forms
are ulcerative colitis and Crohn’s
disease. As the name implies,
ulcerative colitis is limited to the
colon. Crohn’s disease, on the other
hand, can involve any segment of the
gastrointestinal (GI) tract, from the
mouth to the anus. Some individuals
are genetically predisposed to IBD;
those affected are also at increased
risk of GI cancer.
Ulcerative colitis and Crohn’s
disease also have several non-GI
manifestations, which include
arthritis, iritis and episcleritis
(inflammation of the eyes), skin
lesions, sclerosing cholangitis and
pericholangitis (inflammation of the
bile ducts and surrounding tissues).
Systemic symptoms are common
in IBD and include fever, sweats,
malaise and joint pain.
Commonly affecting people
in the 20- to 40-year age group,
IBD complications include
anemia (low iron), electrolyte
imbalance, impaired nutrient and
fluid absorption, liver disease and
dehydration. Mild cases with only
occasional symptoms may be treated
with medication, but severe cases
may involve surgical removal of the
affected bowel.
Most people with IBD have
a good understanding of their
condition and their physical
capabilities. Diving is only
recommended if the condition is in
remission or if symptoms are mild
52
|
WINTER 2012
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www.DAN.org/lifeline
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50-53_MedicalLine_Winter2012.indd 52
12/21/11