{"id":22182,"date":"2022-06-14T15:00:36","date_gmt":"2022-06-14T19:00:36","guid":{"rendered":"https:\/\/world.dan.org\/?post_type=dan_alert_diver&p=22182"},"modified":"2023-05-18T16:27:59","modified_gmt":"2023-05-18T20:27:59","slug":"bells-palsy-and-surgery","status":"publish","type":"dan_alert_diver","link":"https:\/\/world.dan.org\/fr\/alert-diver\/article\/bells-palsy-and-surgery\/","title":{"rendered":"Paralysie de Bell et chirurgie"},"content":{"rendered":"
\n
\"Les<\/figure>\n<\/div>\n\n\n

I have developed Bell\u2019s palsy. Due to its internal effects, are there any reasons I should not dive? I understand the risks of its external effects \u2014 such as not being able to blink in a mask-clearing situation and not having full control of the regulator in my mouth \u2014 but could diving cause anything to happen internally that would worsen the condition? <\/span><\/strong><\/p>\n\n\n\n

There is no evidence suggesting that diving worsens the effects of Bell\u2019s palsy, and no studies show adverse effects. The main concern is that facial droop, eye twitching or inability to close your eye, facial numbness or paralysis, drooling, pain around your jaw or behind the ear, and a headache could all accompany Bell\u2019s palsy. These symptoms compromise dive safety by not allowing you to securely close your mouth around a regulator, increasing the risk of aspirating seawater, and causing eye irritation. Anything that diverts your attention from diving is a safety risk.\u00a0Signs and symptoms of Bell\u2019s palsy can also mimic a stroke or decompression sickness, making it very difficult for a physician to make an accurate diagnosis should something happen while diving.<\/p>\n\n\n\n

L'une des solutions consiste \u00e0 adopter des comportements conservateurs tels que plonger bien en de\u00e7\u00e0 de votre limite de non-d\u00e9compression, plonger au nitrox enrichi en r\u00e9glant votre ordinateur sur l'air, allonger vos paliers de s\u00e9curit\u00e9 et vous limiter \u00e0 une ou deux plong\u00e9es par jour avec un jour de repos entre les jours de plong\u00e9e. Ces approches peuvent \u00eatre b\u00e9n\u00e9fiques pour r\u00e9duire votre stress de d\u00e9compression. <\/p>\n\n\n\n

Si tous vos sympt\u00f4mes ont disparu, la plong\u00e9e ne devrait pas poser de probl\u00e8me. Si les sympt\u00f4mes persistent, m\u00eame s'ils sont l\u00e9gers, vous devez reporter la plong\u00e9e jusqu'\u00e0 ce que vous soyez compl\u00e8tement asymptomatique. <\/p>\n\n\n\n

\u2014 Anne Strysniewicz, AEMT, DMT<\/em><\/p>\n\n\n\n

<\/div>\n\n\n
\n
\"d\u00e9congestionnant<\/figure>\n<\/div>\n\n\n

Je plonge au nitrox et je me demande si je peux utiliser du Sudafed et du Claritin en toute s\u00e9curit\u00e9 pendant la plong\u00e9e. <\/span><\/strong><\/p>\n\n\n\n

There are two significant issues with using Sudafed (pseudoephedrine) while diving.\u00a0Research shows a theoretical risk of oxygen toxicity with Sudafed while diving with higher partial pressures of oxygen. Pseudoephedrine was not tested specifically, but it is a sympathomimetic \u2014 a drug that produces effects similar to those the sympathetic nervous system produces \u2014 so we might infer from other drugs in that category that it has a similar effect. In addition, our current understanding of the mechanisms that cause oxygen convulsions would predict that sympathomimetic drugs might enhance susceptibility to oxygen convulsions.<\/p>\n\n\n\n

Compte tenu des r\u00e9sultats de cette \u00e9tude, nous pouvons dire qu'il peut y avoir un risque accru de toxicit\u00e9 de l'oxyg\u00e8ne, mais cela n'est pas probable dans les limites de la plong\u00e9e r\u00e9cr\u00e9ative.<\/p>\n\n\n\n

L'autre probl\u00e8me du Sudafed est qu'il a une demi-vie relativement courte, ce qui signifie que ses effets s'estompent rapidement et que votre congestion peut r\u00e9appara\u00eetre brusquement lorsque le m\u00e9dicament s'estompe. Ce changement rapide peut cr\u00e9er les conditions d'une compression invers\u00e9e. Le probl\u00e8me est qu'il est difficile d'\u00e9galiser si les probl\u00e8mes surviennent pendant la remont\u00e9e. Si votre congestion r\u00e9appara\u00eet au cours d'une plong\u00e9e, il est possible que votre retour \u00e0 la surface provoque un barotraumatisme important. <\/p>\n\n\n\n

Sudafed est un d\u00e9congestionnant, tandis que Claritin (loratadine) est un antihistaminique et peut ne pas offrir les m\u00eames avantages en mati\u00e8re d'\u00e9galisation. Claritin-D est une combinaison des deux m\u00e9dicaments et peut fournir des avantages d'\u00e9galisation dans une pr\u00e9paration de plus longue dur\u00e9e avec une tendance r\u00e9duite \u00e0 s'estomper. Vous pouvez demander \u00e0 votre m\u00e9decin de vous proposer d'autres options pour lutter contre la congestion. Si vous avez toujours besoin de d\u00e9congestionnants en raison de probl\u00e8mes d'\u00e9galisation, vous pouvez consulter un oto-rhino-laryngologiste. <\/p>\n\n\n\n

- Ben Strelnick, NREMT, W-EMT<\/em><\/p>\n\n\n\n

<\/div>\n\n\n\n

Lors d'une croisi\u00e8re, j'ai r\u00e9serv\u00e9 une excursion de plong\u00e9e aupr\u00e8s de l'un des fournisseurs recommand\u00e9s. Alors que nous terminions la plong\u00e9e, le bateau de croisi\u00e8re quittait le port sans moi. Nous venions d'effectuer une plong\u00e9e \u00e0 une profondeur maximale de 55 pieds pendant 50 minutes \u00e0 l'air, un intervalle de 45 minutes en surface et une deuxi\u00e8me plong\u00e9e \u00e0 une profondeur maximale de 43 pieds pendant 50 minutes. Le vendeur et la compagnie de croisi\u00e8re ont assum\u00e9 la responsabilit\u00e9 de la m\u00e9saventure et m'ont r\u00e9serv\u00e9 un vol pour rejoindre le navire au port suivant. Quatre heures se sont \u00e9coul\u00e9es entre la fin de mes plong\u00e9es et le d\u00e9part de mon vol. Je n'ai ressenti aucune douleur ni aucun sympt\u00f4me pendant le vol et je me sens toujours bien. Apr\u00e8s avoir entendu mon histoire, un instructeur de plong\u00e9e local m'a dit que je n'aurais pas d\u00fb prendre l'avion sans un intervalle de surface plus long. Dois-je m'inqui\u00e9ter de la maladie des caissons (DCS) ? <\/span> <\/strong><\/p>\n\n\n\n

DAN a des recommandations bien \u00e9tablies pour la s\u00e9curit\u00e9 des vols apr\u00e8s la plong\u00e9e, bas\u00e9es sur notre atelier de 2002 sur les vols apr\u00e8s la plong\u00e9e r\u00e9cr\u00e9ative. Sur la base de vos profils de plong\u00e9e, l'intervalle de surface minimum recommand\u00e9 avant le vol aurait d\u00fb \u00eatre de 18 heures.<\/p>\n\n\n\n

Dive tables and computer algorithms are based on theoretical models and designed for the masses. It is practically impossible to create a model to determine an individual\u2019s risk and the factors that would make someone susceptible to DCS. Many things determine a person\u2019s decompression stress. The shallow dives and short bottom times may have helped in your situation, but nothing guarantees a repeat outcome under the same circumstances in the future.  <\/p>\n\n\n\n

En remontant \u00e0 la surface, l'azote de vos plong\u00e9es commence \u00e0 quitter les tissus de votre corps. La plupart des gaz inertes sont \u00e9limin\u00e9s 24 heures apr\u00e8s la plong\u00e9e, c'est l'une des raisons pour lesquelles vous pouvez voler 18 heures apr\u00e8s une activit\u00e9 de plong\u00e9e. Il est rare qu'une personne souffre de DCS plus de 24 heures apr\u00e8s une plong\u00e9e.<\/p>\n\n\n\n

\u00c9tant donn\u00e9 que vous \u00eates rentr\u00e9 chez vous sans avoir ressenti de sympt\u00f4mes en vol et que vous n'avez toujours pas de sympt\u00f4mes quelques jours plus tard, on peut raisonnablement affirmer que vous ne souffrirez pas de DCS. <\/p>\n\n\n\n

\u2014 Robert Soncini, NR-P, DMT<\/em><\/p>\n\n\n\n

<\/div>\n\n\n
\n
\"fusion<\/figure>\n<\/div>\n\n\n

Je dois subir une fusion cervicale et une discectomie. Quand pourrai-je replonger apr\u00e8s l'op\u00e9ration ?<\/span><\/strong><\/p>\n\n\n\n

There are several considerations to discuss with your surgeon. After surgery, the minimum benchmarks to meet are to be released by your physician for full and unrestricted activity, including contact sports, and then add an additional convalescent period equal to at least half of your healing time. If your doctor releases you for unrestricted activity after eight weeks, for example, your total waiting period would be 12 weeks. That extra time will help you regain the physical fitness and aerobic capacity you lose from atrophy during your recuperation. Once you\u2019re back into a regular exercise routine after the waiting period, you can discuss a return to diving with your doctor. <\/p>\n\n\n\n

Diving typically requires you to perform certain physical demands that you may want to discuss with your orthopedic surgeon. You need to be able to carry weights around and walk while fully geared. Your dive preparation might require significant weight on your shoulders. Boarding a boat after diving means you need to climb a ladder fully geared. Shore dives could pose an additional risk, with the difficulty of navigating surge and uneven surfaces such as river rocks and iron shore. If you are in a leadership position, you\u2019ll also need to be ready to help others with their gear and keep them safe by whatever means necessary,\u00a0so your physician will need to feel comfortable that you will be up to the task.<\/p>\n\n\n\n

Il existe un risque accru de DCS chez les personnes ayant d\u00e9j\u00e0 subi des l\u00e9sions de la colonne vert\u00e9brale, y compris une intervention chirurgicale. Le fait d'ajouter \u00e0 votre plong\u00e9e autant de comportements conservateurs que possible contribuera \u00e0 att\u00e9nuer ce risque, mais rien ne l'\u00e9liminera. Des comportements tels que la plong\u00e9e au nitrox en utilisant des tables \u00e0 air, la limitation du nombre de plong\u00e9es par jour, la limitation du nombre de jours de plong\u00e9e cons\u00e9cutifs et l'augmentation des paliers de s\u00e9curit\u00e9 et des intervalles de surface sont des changements faciles \u00e0 mettre en \u0153uvre.<\/p>\n\n\n\n

\u2014 Lana P. Sorrell, MBA, EMT, DMT<\/em><\/p>\n\n\n\n

<\/div>\n\n\n
\n
\"vertige<\/figure>\n<\/div>\n\n\n

I was recently diagnosed with benign paroxysmal positional vertigo (BPPV). I\u2019m seeing a physical therapist to\u00a0resolve the vertigo and move the otoliths (crystals) out of my inner-ear canals. If my symptoms are resolved, and I am not experiencing vertigo, do you know of any pressure-related issues concerning BPPV that I should be aware of while diving?<\/span><\/strong><\/p>\n\n\n\n

with BPPV, diving is not recommended for anyone with this condition.\u00a0Certain head and neck movements while on deck, entering and leaving the water, and during the dive may provoke another episode and result in serious injury. It\u2019s a good idea to consider the risk of incapacitation from a sudden onset of vertigo, the danger of which increases exponentially in the underwater environment.<\/p>\n\n\n\n

En outre, les sympt\u00f4mes du VPPB peuvent ressembler \u00e0 ceux observ\u00e9s dans des conditions m\u00e9dicales graves telles que le syndrome de Down et conduire \u00e0 un diagnostic inappropri\u00e9 ou erron\u00e9 d'une condition sous-jacente, ce qui peut entra\u00eener un traitement inappropri\u00e9. Les sympt\u00f4mes du VPPB peuvent \u00eatre d\u00e9bilitants ou incapacitants, de sorte qu'un plongeur doit prendre en compte les risques pour lui-m\u00eame et pour les personnes qui l'entourent s'il a besoin d'assistance. <\/p>\n\n\n\n

Avant de plonger, un m\u00e9decin form\u00e9 \u00e0 la m\u00e9decine de plong\u00e9e doit \u00e9valuer votre \u00e9tat et vous expliquer soigneusement les risques.<\/p>\n\n\n\n

 \u2014 Anne Strysniewicz, AEMT, DMT<\/em><\/p>\n\n\n\n

\u00a9 Alert Diver<\/em> - Q2 2022<\/p>","protected":false},"excerpt":{"rendered":"

Les sp\u00e9cialistes de l'information m\u00e9dicale et les chercheurs de DAN\u00ae r\u00e9pondent \u00e0 vos questions sur la m\u00e9decine de plong\u00e9e. \"J'ai d\u00e9velopp\u00e9 une paralysie de Bell. En raison de ses effets internes, y a-t-il des raisons pour lesquelles je ne devrais pas plonger ? Je comprends les risques li\u00e9s aux effets externes de la paralysie de Bell, mais la plong\u00e9e peut-elle provoquer...\"<\/p>","protected":false},"featured_media":22183,"template":"","dan_alert_diver_categories":[90],"dan_alert_diver_issues":[479],"class_list":["post-22182","dan_alert_diver","type-dan_alert_diver","status-publish","has-post-thumbnail","hentry","dan_alert_diver_categories-dan-mission","dan_alert_diver_issues-q2-2022"],"acf":[],"yoast_head":"\nBell\u2019s Palsy and Surgery - DAN World<\/title>\n<meta name=\"description\" content=\"DAN\u00ae MEDICAL INFORMATION SPECIALISTS and researchers answer your dive medicine questions.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/world.dan.org\/fr\/alert-diver\/article\/bells-palsy-and-surgery\/\" \/>\n<meta property=\"og:locale\" content=\"fr_CA\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Bell\u2019s Palsy and Surgery\" \/>\n<meta property=\"og:description\" content=\"DAN\u00ae MEDICAL INFORMATION SPECIALISTS and researchers answer your dive medicine questions. \u201cI have developed Bell\u2019s palsy. 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