Name: DAMJAN Surname: PEKLAR Date of birth (d.m.y.): 29. 12. 1968 Place of residence: Nova vas 87, 2281 Markovci, Slovenia Citizenship: Slovenian Formal education: Degree in Economics Marital status: In relationship, father of a daughter Driving license A+B Level of SCI Injury: Below 9th thoracic vertebra (Th 9 – paraplegia)
Introduction During Reha CARE Dűsseldorf in 1999 he saw demonstration of diving for disabled. The same year he made his first dive in his friend’s back yard swimming pool. In 2000 he starts PADI diving course, but he quit because of the operation.
CMAS P* In 2003 he started CMAS adapted diving course as a member of second group of divers with SCI. Course was organized by Plavalni klub Slovenske Konjice, member of Slovenian Diving Federation – SPZ. Course was experimental project approved by SPZ and lead by Branko RAVNAK under supervision of Andrej Brodaric CMAS M**** (HRV/CRO/M4/0027).
CMAS P** In May 2007 he finished P**, but SPZ canceled the issuance of C-card. The card was subsequently issued by IAHD Adriatic in 2008 when IAHD Adriatic became member of CMAS TC.
CMAS P*** In 2009 he finished P*** course as a first among divers with SCI in Adriatic region. Since 2007 he was instructor assistant in all courses for divers with SCI.
CMAS M* The Instructor course M* started in 2010 and it was lead by Ivica Cukusic (CRO) and Branko Ravnak (SLO) both instructors of IAHD Adriatic. Course was finished in April 2011 and certification should be performed during CMAS GA in Rome, by president of technical committee Mr. Kevin O’Shaughnessy.
Diving locations Slovenia: Piran, Fiesa, Bled … Croatia: Murter, Jezera, Kornati, Kaprije, Zirje, Rijeka, Kostrena, Rovinj, Biograd n.m., Sibenik, Silo, City of Krk, Cres, Klimno, Dubrovnik, Mlini pri Dubrovniku, Cavtat … Italy: Isola del Giglio, Porto Santo Stefano, Monte Argentario
Best wrecks(max. depths are for wrecks not for dives) Peltastis: Klimno, Croatia, max. depth 33 m Taranto: Dubrovnik, Croatia, max. depth 60 m Elhawi star: Rijeka, Croatia, max. depth 42 m Sigrid: Rijeka, Croatia, max. depth 25 m Lina: Island Cres, Croatia, max. depth 55 m
Boat leader’s license of competence for sea and inland navigation
When and why did you begin to dive? I began to dive because of great desire to get to know the underwater world. I wished to dive long before the injury in 1990 but then because of lack of time and resources I couldn’t. What fascinates me about diving is the “weightlessness” of the movement in the water.
In 1999, at the Reha Care fair in Dusseldorf I saw a presentation of diving for disabled persons and then my desire for diving rose again. I started a PADI course in Maribor in 2000, but I had to interrupt it because of a surgery. In 2003 I joined the second diving course for people with spinal cord injuries organized by swimming club of Slovenske Konjice which is a co-founder of IAHD Adriatic.
What do you like in diving? In course for CMAS one star and other categories I liked the theory, rules and skills you need for safe and good dive. Everything we learned at that time was new and interesting. I like this expertise and knowledge and mastering of the underwater movement. Every dive since then brought me more and more confidence in myself.
What does diving contribute to your life? How do you feel yourself underwater? With every dive I see and feel the beauty of the underwater world. Underwater movement is for me a kind of new universe. Diving affects me also in a physiological way as after every dive I almost don’t have spasms any more, which often limit my everyday living.
What does your great achievement means to you? The acknowledgement of my CMAS one star instructor category means to me a big personal satisfaction. For me and for other disabled divers it also means a confirmation, that with hard and systematic work we can be equal to all recreational divers. The only assistance we need is the help with carrying the equipment to the place of the dive. This licence brings also the responsibility, which, if I tell the truth, also scares me a little bit. My instructor category is not just acknowledgement to me, but to all of us who invested in this our work, time and patience.
Can you tell us something about your CMAS one star instructor course? Well it’s funny you would probably expect that we did some extra exercises but I have to disappoint you. I was a member of a group of three candidates together with Alenka Fidler and Matjaz Paj they are both able bodied. Our instructors were Ivica Cukusic and Branko Ravnak and you can believe me they didn’t have no mercy. For me it was fun because I was diving with Alenka and Matjaz for last few years and both of them are excellent divers that know our needs. Theoretical part was most demanded because our instructors insisted that everything should be by the book. Micro lectures were sometimes real nightmare for all of us. All together we have been working for more than six months.
Are you aware of the fact that you are first licensed one star instructor with SCI (Spinal Cord Injury) in history of CMAS? Yes I do and you can believe me that this is a great victory for all divers with SCI. You have to know that world of disabled divers is really small. As far as I know beside me at the moment out there is only one person with SCI that is diving instructor. That is Fraser Bathgate from Great Britain but he has different licence, he is not a CMAS Instructor. He is more mobile and he actually doesn’t teach disabled.
You want to say that CMAS gave you the opportunity that you can teach equals? That’s exactly what I’m saying. But CMAS didn’t gave that only to me but to all the other disabled divers (among them SCI divers are the most demanded). Ten years ago none of us could imagine that he can become instructor. When I started my CMAS one star course we have been learning together with our instructor Branko Ravnak. He learned from us about our disability and we learned from him everything about diving. Knowledge sharing trough practical experience made us unique. Today we can learn and transfer methods faster than anyone that we know and all we need is minimum assistance of able bodied.
How long do you need to finish CMAS one star course for someone with SCI? Today we finish the basic skills in three weeks most of them in the pool after that the candidate is ready to dive in open water. To become complete one star diver he has to dive for at least two years after he finishes his exam. Then he can approach for second star. It is also important that candidate is totally independent which means that he or she has to drive the car.
You said “she”, you want to tell us that among SCI divers there are women? Of course there are. We are endangered by female population with SCI. In first group back in 2002 there was Barbara (she just became mother of a son few weeks ago). She was the first woman with SCI that started diving all around. She was diving on wrecks (Peltastis, Taranto) and elsewhere and she is the first that she reached the depth limit in diving with compressed air. Today we have three girls from Croatia and Slovenia that are capable to dive with compressed air in almost all conditions.
What conditions you have in mind? We don’t have money to go to Bonaire or to other fancy destinations with warm water like HSA and other disabled divers does. We dive mostly in Adriatic Sea which is most of the time unfriendly (cold water, wind …). Anyway we deal with that and we dive normally from March until November. We use wet suits made by measure and other standard equipment which allows us to dive to 40 meters inside safety curve. Ten years ago they said to us that we can dive in warm environment and only to 15 meters. When we asked why no one could explain. Since 2002 we collect data and carefully observe everything and that is how we reach the maximum depth for compressed air. In 2007 prof. Dujic with his group made with us a study: “Venus gas bubble formation and decompression risk after scuba diving in persons with chronic spinal cord injury and able bodied controls”. In that study they proved that diving with compressed air is not less dangerous for individuals with SCI than to other able bodied divers. That was first great victory.
What was the second one? Without doubt being a member of CMAS family. Further on the fact that we expand our activities trough Adriatic region and that we survived in those messy times. Today we have excellent SCI divers in Slovenia, Croatia and Serbia. They are composing the network which guaranties that activities won’t stop. We are proud on our research work and appearance on EUBS and other scientific events worldwide. I have to mention that everything wouldn’t be realized without a team of our able bodied friends and mentors from all over the world.
Who are they? First of all there is IAHD Advisory board that is supporting and supervising our activities. Great names like prof. Gosovic, prof. Sagalevich, prof. Dujic, Dr. Denoble and Msc. Hocevar are guarantee that our work is honest and correct. Followed by president of CMAS Mr. Ferrero and president of CMAS TC, Mr. O’Shaughnessy, both of them trust us and in the end approved my certification which made my burdon even bigger. In the end all my friends handicapped and able bodied from Adriatic region which are expecting that we won’t stop and that after me there will be more disabled divers and instructors.
What is your message to other disabled people and to the diver society? Everyone who is not afraid of the water or closed spaces should at least once in his life try to peak in the underwater world and take a “walk” in a different way.
The PADI Course Director Training Course is a 10 day program involving skill evaluations, grading evaluations,confined water teaching presentations, open water teaching presentations, and classroom presentations, as well a number of presentations by the PADI Staff members on Marketing, the psychology of evaluation and Project AWARE.
Mark’s achievement in gaining the PADI Course Director rating makes him the first wheelchair user to attain this, it was confirmed by the PADI staff.“Hopefully”, Mark says, “it will help highlight the fact that a wheelchair user can get to the top in diving and additionally highlight the benefits of diving for someone with a spinal injury’.
After having the accident which left him paralysed from the waist down two months following his PADI Instructor examination Mark has thrown himself back into the diving world and teaching and worked his way up the PADI Instructional ladder to reach this goal. The rating of Course Director qualifies Mark not just to teach people how to dive but the also conduct Instructor Development Courses where candidates are taught to be diving instructors.
Карьера Mark Slingo (по данным Linkedin)
PADI Course Director Buccaneer Diving 2013 In charge of professional development programs conducting the PADI Instructor and continuing education programs. Other duties include webmaster, marketing and overseeing internship programs, and coordinating international events and symposiums.
ProTrainer Disabled Divers International (DDI) 2010 Offering DDI Instructor and Divemaster pro trading courses to learn to work with handicapped divers and the full range of DDI programs for disabled people to experience and get certified as scuba divers
Designer,Managing Director, Administrator, WebDesigner The Divernet, Self Employed, Thailand & Kenya Январь 2011 г. –настоящее время (4 года 2 месяца) Creator of The Divernet social network for scuba divers to enact with each other and share diving experiences as well as let divers know of new developments in the diving world and provide a portal for dive businesses to market their products to a target audience. Freelance contractor building websites, ecommerce sites, CRMs, SMS communication systems and social networks for businesses in South East Asia and East Africa.
PADI Course Director West Coast Divers, Freelance, Thailand Март 2008г. – Сентябрь 2013 г. (5 лет 7 месяцев) Running PADI IDCs withOcean Geo Divers in Phuket, conducting DDI Instructor training with Scuba CatDiving in Phuket and teaching PADI courses. Responsible for coordinating dive centre activities and teaching IDCs, student level and handicapped instructor courses. In addition running the full dive career internships offered by West Coast through my website http://www.phuketschoolofscuba.com and running the Instructor teams at the dive school.
PADI Course Director, General Manager Divers Lodge, Египет Март 2009г. – Ноябрь 2009 г. (9 месяцев) Responsible for coordinating dive centre activities and teaching IDCs, student level and handicapped instructor courses. In addition marketing the diver courses through web campaigns and UK based agents and web design.
MasterInstructor Mermaids Dive Center,Таиланд Август 2004г. – Апрель 2008 г. (3 года 9 месяцев) Worked first as Divemaster involving close customer interaction running Dive Boats for 20-30people/day and then from December ‘04 teaching clients to scuba dive and Oct’04 as a specialist Handicapped diver’s instructor (IAHD) and Instructor Trainer.This is in addition to marketing and logistical work.
I became a complete T8 paraplegic in 1980 as the result of a motor vehicle accident.
I started diving with my brother when we were both at university in 1985. Sydney is blessed with great diving and we spent years diving around Sydney, the caves in Mt Gambier, the Great Barrier Reef, Lord Howe Island, Fiji, Bass Strait, California and New Mexico.
In 1995 I took my 10 metre sloop Moonpenny from Sydney to the Solomon Islands where I spent 3 months enjoying fabulous diving with my wife Katharine and Anthony Michaels.
In 1987 Alan and I went looking for shipwrecks around Sydney. We found the SS Duckenfield in 24 metres north of Long Reef, for which we received an Historic Shipwrecks Award from the New South Wales Government. At this time we identified and dived the wreck of the light cruiser HMAS Encounter in 70 metres off Bondi.
I spent a lot of time in the early nineties diving the SS Catterthun in 62 metres near Seal Rocks NSW with photographer Mark Spencer . That project was funded by Australian Geographic and resulted in the publication of an article in the Australian Geographic Magazine.
Scuba Diving For Paraplegics
By Neil McLennan Copyright Neil R McLennan. Source
This manual is designed to assist paraplegics adapt themselves to standard SCUBA diving techniques. It is designed to be used in conjunction with a standard diving manual such as PADI’s Open Water Diving Manual. Using the techniques in this manual, the paraplegic should be able to dive at least as well as an able-bodied fin swimmer.
I have written it to apply to all paraplegics, whether or not they have good balance or not. As long as you have good hand and arm function, then this manual is for you.
My personal diving philosophy is to be adventurous. You may prefer to be more conservative and not dive off rocks or over 80 feet. I have included all the techniques I have used and you can pick those that suit you.
Remember that diving is a great social sport. It is a great way to make friends and through them, increase and improve your diving.
DOING A COURSE ПРОЙДИТЕ ОБУЧЕНИЕ
Paraplegics should be able to complete a standard diving course such as PADI Openwater Diver. Paraplegia should not medically contraindicate diving. You can do the course with not really any more assistance on the course than able bodied students. When choosing a course you may prefer to pay little more to do a course that has boat dives rather than shore dives as access will be easier. You can also hire a personal instructor to cater the course specifically to you.
Disclaimer: Warning SCUBA DIVING and SNORKELLING are dangerous activities. Whilst I have tried to give safe advice it should not be used by someone who has not been trained by a recognised training agency.
You will be required to swim 400m unassisted without stopping to be a SCUBA diver. In reality, modern SCUBA gear is so good many able-bodied students can’t even do that but they still dive. However, you should practise to become a good swimmer so you can swim rings around able-bodied swimmers on the bottom.
This is the stroke you will always use when under the water. On the surface it is fairly tiring because you have to lift your head out of the water to breathe. Underwater, if you are floating horizontally, it is a serene feeling breast stroking across the ocean floor. With fingers outstretched and almost touching about 8″ in front of your chin and elbows at shoulder height, move your forearms out until your arms are straight. Hands should be slightly cupped with thumbs on the lower side. Then, pull your elbows in towards your hips relaxing your hands and bringing them back in front of your chin. This stroke gives a lot of power and good rotational control (when you don’t use your legs there is nothing to stop your rolling over – -so you must control this with your arms). This stroke can be extended once the arms are straight by moving the whole arm down towards your hips and then drawing your hands up to your chest and back to your chin.If you don’t need the power of a full stroke then it can be reduced by bringing up only to shoulder height with the elbows, about 90 degrees. The arms are then straightened and brought down to the hips.
The fastest and most efficient stroke, it took me years to bee able to do it. It is not necessary to be able to freestyle as it is an impossible stroke in SCUBA gear. It is very useful, though, in the ocean where there is any surf or current to swim against. To freestyle your legs must float on the surface when you are face down. Most likely your knees will hang down like mine and you will need to wear some flotation. You can wear a wetsuit on your legs or use a float with straps attached. Once you have enough flotation to float your knees on the surface the swimming technique is the same as for an able-bodied swimmer without kicking.
This style will allow you to generate enough speed to swim out through the surf to boats and be able to catch waves bodysurfing. Remember to attach the flotation securely for surf conditions. Backward sculling through the surf when you lose your float results in a heavy duty wash and spin cycle.
I find a mm sleeveless triathlon suit works well in the ocean. The suit has the advantage of keeping you warm. In the pool, I normally wear just a float as it is easier to put on.
The stroke is the same as regular freestyling except that you don’t kick. In the ocean, waves will cause you to roll. You can control this by modifying your stroke by straightening your arm. A straighter arm provides more lateral stability but less forward thrust.
Backward Scull На спине двумя руками
This is the easiest stroke, only useful for surface swimming. Because it is done on your back, breathing is very easy and you can stop anytime and rest without having to tread water. Start off by lying on your back and move your arms out about 45 degrees with elbows slightly bent and hands facing down; then, move your arms towards your hips keeping them fairly straight with your hands almost facing up. Be careful because it is easy to run into things with your head.
Forward Scull Вперед двумя руками
This stroke is also useful while SCUBA diving where there is limited room to move your arms or for fine adjustments and hovering. This stroke is normally done while swimming face down. Hands are held just behind the buttocks and with fingers spread. The whole arm is rotated moving the hand through about 190 degrees. Start with the thumbs pointing at the tank and with your arms bent about 15 degrees; rotate your whole arm and hand to push against the water.
Bodysurfing Преодоление прибоя
This is a useful skill if you will be around water. You must be able to freestyle so I assume you are wearing a flotation device of same sort. This is important because it allows you to rest.
Go out through the small reformed wave as quickly as possible diving under them and grabbing the sand if they are big. Keep swimming until you are just outside the breakers. Here you are relatively safe. Watch the break of the wave and position yourself so that you are just out from where the wave starts to foam.
Start swimming for the beach, try to get in 3 strokes before you get on the wave. Keep swimming until you are up then get at least one arm out in front of you. You should be able to ride it for at least 10 metres.
The arm out in front will protect your head if you get dumped and acts as an aquaplane on the face of the wave. If you see a wave coming you want to avoid, swim at it. If you get caught in a rolling whitewater, relax and wait until you see some light. You won’t get held down for more than a few seconds. Choose a safe beach. Beware of dumping waves and avoid rocky bottoms.
CLIMBING AND CRAWLING КАРАБКАЯСЬ И ПОЛЗКОМ
Maximising your mobility will allow you to be virtually totally independent as a SCUBA diver. Two techniques often overlooked by paras are Crawling and Climbing. Both of these require a reasonable level of fitness, but most importantly it requires lightness. Your power-to-weight ratio is critical when you no longer have a wheelchair holding you up.
Skin protection Защитите себя
You must protect your coccyx and issual tuberosities as a priority because they will always get pressure on them. These can be safeguarded by wearing good protection (think of feet in a shoe) and using the sidearm crawl. This is preferable to the two-handed backwards crawl, as you can see where you are going, takes all of your weight on your hip away from the pressure areas and doesn’t require good balance
If you cannot get a lift across a beach then your only option is to crawl. Taking your time you can go quite a long way. Crawling is really useful on boats, allowing you to get to everything and be very independent.
The sidearm crawl is performed by assuming the position in fig xx. The arms lift and pull the body towards the straight arm. Then the other arm pulls the feet up to the hip. It does not matter if you cannot generate much lift on a beach because you can drag through the sand. This crawl gives good balance so you can be fairly controlled as you raise and lower your bottom off the ground.
The two handed backwards crawl requires a big lift with the arms every movement. That then leads to a big drop back to the ground. This is not good for the backside, is very tiring and you cannot see what you are about to sit on. It also requires more balance to do this crawl.
You must protect your coccyx and issual tuberosities as a priority because they will always get pressure on them. These can be safeguarded by wearing good protection ( think of feet in a shoe ) and using the sidearm crawl. This is preferable to the two handed backwards crawl, as you can see where you are going, takes all of your weight on your hip away from the pressure areas and doesn’t require good balance.
Aim to be strong enough to be able to climb up a vertical rope or pole that you can get a good grip on. You should be able to hang by one hand easily for at least 30 seconds. If you can do this, combined with your crawling, you will be able to go virtually anywhere. This skill may sound difficult but I think that any paraplegic who is not over weight should be able to do at least about 12 mm in diameter to give adequate grip.
SNORKELLING ПЛАВАНИЕ С ТРУБКОЙ
More physically demanding than SCUBA diving but often easier because heavy gear doesn’t have to be lugged to the shore. It’s a good idea to wear a wetsuit when snorkelling. It protects your skin from sunburn and rocks and of course keeps you warm but also allows you to float easily if you get tired.
The first problem is where to leave your wheelchair especially if you are solo.
Water access without boat–beaches Вход в воду без лодки – пляжи
Generally, a wheelchair will roll through soft sand downhill if it is wheel stood. If the tide is out then the wheelchair will roll pretty well once you are onto the wet sand. Letting the pressure down makes a big difference. Leave the wheelchair above the height the water will reach before you get out. An unattended wheelchair on a beach always looks like a suicide. Once I swam out to my boat at night. When I swam back a policeman was waiting for me–two women I thought were watching my muscles as I got in thought I was going to drown and called the police–Fortunately, he was a big one and gave me a push up the beach.
Twice my chair has been stolen by kids–later recovered once by the cops and once by my girlfriend who tracked the runts down until they squealed where it was. Another time, I was surfing at Bond for about 1 ½ hour. An ambulance came down to the beach and the lifeguards were actively patrolling the beach. I figured one of the tourist had drowned. When I got out the ambulance came slowly down the promenade with I presumed–a dead one. They stopped next to me as I shepherded some Japanese tourists out of their way and said they had been looking for me–I was the dead guy!
So, when you leave your wheelchair, lock it up if possible and leave a note on your chair saying when you’ll be back. If the beach is all flat soft sand, you may as well leave the chair on the harder soil and crawl the whole way.
Crawl to swimmable depth and away you go. When you return if your wheelchair is still there, push up to the soft sand until you get bogged. Get out an crawl, pulling your wheelchair after you. Take your time, it’s hard work.
A 4WD is a great way to get onto the beach and other places. Be prepared to get it sandy as it is impossible to get the sand off you before you get off the beach. If there is an outside shower at the beach, roll right in the wheelchair and you to get the sand off.
Off Rocks По камням
Not easy but can be done. It depends on the terrain whether you can get your wheelchair across it–otherwise, you will have to crawl. Remember the tide can make it a lot harder to get out. If you went in at high tide then the water level may have fallen one metre or more when you go to get out. If you went in one hour before high tide then you could get out at the highest water. You can calculate the tide times easily by looking in the local paper, Time your entry to go in just after a swell has come by. When getting out, swim close to the rocks avoiding breaking waves. Make a quick pull for the rocks on the top of a wave not the bottom, grab as high up as you can on the rocks and lie prone as the wave recedes and you are left high and dry. When the next wave comes in, pull yourself up higher–good luck. Do not try to do this in an area exposed to the wind or swell. I have done this numerous times, you will need to wear a full 5 mm wetsuit and gloves for this. Use the protection of jutting rocks and lee shores for rock hops.
In the water В воде
With just a mask and snorkel and no wetsuit, you will be slightly buoyant with your head in the water. When you put your mask on, make sure there is no hair hanging into it and that it sits smoothly on your face; spit in it and rub around the inside lenses to stop fogging; then rinse in salt water. I find the easiest way to put it on with poor balance is to sit upright and lean forward on my elbows for balance and then using both hands pull the mask onto my face. Then, I run my fingers around the edges to make sure no hair is in the way. Choose a snorkel that is wide enough to allow you to expel the air rapidly enough to clear water from the snorkel. If you have reduced trunk muscles (T12 and above) then a narrow snorkel will overcome your reduced breathing strength.
Before going in the water you must be able to hold your nose and pop both your ears by trying to blow into your nose. This is called the Val Salva manoeuvre and although a strange name and manoeuvre, it is essential that this be done when you go underwater. It increases the air pressure inside your ears to compensate for the increasing water pressure. Don’t dive underwater unless you can do this comfortably.
Lying face down in the water and breathing comfortably, take a big breath, reach forward and pull your head under the water. Pointing your head straight down, pull strongly towards the bottom. The key to getting to the bottom is to dive vertically creating as little drag as possible, putting most of your effort into the first two metres.. Perform the Valsalva manoeuvre, ideally your mask will be snug enough on your nostril to allow you to Valsalva without holding your nose.
Start off snorkelling in the pool Get good at this sport before you SCUBA dive and then the rest will be easy. When you snorkel in the ocean pay attention to the current and then swim AGAINST it. For a paraplegic, this is the most important rule. If you get down current, getting back may not happen.
When surfacing, give some good pulls for the surface. Pushing off the bottom gives you a good boost. Tilt your head back slowly and breathe out just before you break the surface. This will clear your snorkel easily. If water remains a sharp blow should clear it. Otherwise, get a narrower snorkel. You an achieve 10 metres with practice. When you snorkel, be as quiet as possible i.e. don’t break the surface with your hands as this will scare the fish.
A fast way to the bottom is to pull yourself down the anchor line or a fish trap or a wharf pier etc. If you are wearing a wetsuit , leave your weightbelt behind when pulling yourself down a line. When you let go, a slight stroke with your arms will rocket you upwards. Additionally, a good push off the bottom will speed you upwards.
The really quick way down is to grasp a weight and let it go to the bottom. The hard point is getting the weight back up. You can tie the weight to a pulley attached to a boat or a float or pull it straight in from a boat.
When I am snorkelling without a wetsuit I prefer to wear a couple of pounds of weight to overcome my buoyancy. Weight belts are standard items at dive shops–just make sure it has a quick release buckle.
Whether the water temperature requires one or not, a wetsuit is great for protecting your skin. You can crawl and crash over objects that would otherwise leave you lacerated. It’s a good idea to wear one always when you are in a boat to protect you. Whenever you are swimming, a wetsuit will let you stop and rest and swim faster.
There are two different types of suits, the overall style and the jacket and long johns For general swimming, I prefer a 7 mm sleeveless. Overall, it gives flotation, is streamlined and allows good arm movement.
For diving, I prefer long johns and jacket. The advantage is that the jacket can be removed easily while you are in the boat and the long johns will still provide protection to your bottom and legs. In the tropics you can dive in just long john. I like to have an attached hood on my jacket as it is much warmer and protects your head from rocks. Get flies put in your long johns. Women can get flies running left right inside the crotch. Wetsuits come in different thicknesses. In the seat, at least 5 mm is needed to protect your behind .
To put your wetsuit on it is best to stay in your wheelchair. Put one leg into the pants and pull it up over the knee (It makes it easier if your leg can spasm out straight when you pull it up.) Then pull the cuff over your heel and put the other leg in, pull it up over the knee, and then the cuff. Leave both feet off the foot plate and pull the pants up as high as you can. Lift up quickly and pull the top part of the pants up under your bottom. Now you should be able to pull them up all the way.
For climbing around on boats and anything else for that matter, I use a pair of wetsuit shorts with a zip down each thigh and closed cell padding in the seat. If I am going to be bouncing around a lot I put a low profile Roho in the seat. The two zips allow the pants to be easily removed and put on. The fly obviously is important. Putting a Roho in the shorts not only gives great protection but will also provide an environment for healing cuts on your coccyx. It is a real shame to be on an overnight or extended dive trip and have to curtail your activities due to a minor cut. I have found injuries to my coccyx are like skinned knees and elbows and can be managed while still being active.
An example of the protective nature of the neoprene wetsuit is when I was diving the Duckenfield near Sydney with my twin brother Alan. We were using a petrol powered compressor to pump air to the diver via an air line (called a Hookah) As we had just found this wreck we were diving it at night so no one would find its location. Alan was under the water and I was monitoring the compressor. I began to smell burning rubber. Concerned that my brother’s air may become contaminated, I quickly searched for the cause. I looked around unable to find it and then noticed my foot was under the exhaust pipe and my neoprene bootie was burning. I pulled my foot away and put it in the ocean. Then I gently took the bootie off my foot and was amazed to see no injury. Only the outer casing had burnt and the water in the neoprene had stopped my skin from burning.
The long johns are also good protection for crawling activities. I have crawled through several caves which would have lacerated bare skin. Because the long johns are secured over the shoulder and are a tight fit they will not be pulled off by drag as one crawls along. Wearing the wet suit shorts is also a good lifesaving measure as it allows you to float in the water and to freestyle.
POSTURAL DIURESIS МОЖНО ВЫЙТИ?
This is a major problem for paraplegics. When you are under the water, the water pressure exerts equal pressure over your entire body. Therefore, fluid cannot pool in your legs as it will when you sit in your wheelchair. The body will excrete any pooled fluid through the bladder once you submerge. In a one-hour dive, my experience is that you may excrete half a litre. If you are unable to void your bladder under the water then you are very likely to distend your bladder as this pooled fluid is excreted. To avoid this you need to void your bladder before diving and immediately afterwards and restrict your fluids beforehand.
In short dives say 20 minutes, this is not a great problem. For long dives over one hour, it becomes hard to avoid. If you have a bladder which empties spontaneously, then this will not be a problem, the only drawback will be your wetsuit will smell when you take it off. If you use intermittent catheterisation, you will need to catheterise before and after diving, hence the importance of putting a fly in your suit.
I have found diuresis to be a problem on deep dives with long bottom times. When I was diving the Catterthun in 60 metres, our bottom times were 25 minutes. We would then be required to do 60 minutes of decompression: two minutes at 18 metres 3 minutes at 15 metres, 5 minutes at 12 metres, 9 minutes at 9 metres 15 minutes, at 6 metres and 25 minutes at 3 metres. This was about 1 ½ hours under the water and meant a lot f fluid was excreted As a result, I suffered bladder distention. I have tried to restrict my bottom times since then.
WEIGHT BELTS ГРУЗОВЫЕ РЕМНИ
When you wear a wetsuit you will need to wear extra weight to overcome the buoyancy of the suit. This is done by wearing a belt of lead weights around your waist. In the event of an emergency, it must have a quick release buckle so you can make a rapid ascent., it must have a quick release buckle so you can make a rapid ascent.
For optimum swimming potential, it is important not to wear too much weight. You should try to adopt a prone position in the water. Many paraplegics adopt a standing position underwater because they use gear designed for persons using fins swimmers who adopt a standing position by wearing extra weight to overcome the upward thrust of their fins. Once they start swimming, their fin thrust will put them in the prone position. However, a paraplegic if naturally floating in the standing position will stay in the standing position once he starts swimming. The standing position causes a lot of drag and the prone position carries the least.
Putting on the belt Затянем ремень
For paraplegics, the worst part of weight belts is that they are easy to lose. Because our thighs are skinny, and our hips are very slim and don’t give the belt much to rest upon. Therefore, they tend to slip off over the hips. It is difficult to get them tight while sitting up so I put the weight belt on by lying down and doing it up tight when I exhale.
Several different types of buckles are available. The clasp type requires threading the belt through the buckle which is difficult if your balance isn’t good. I prefer the old fashioned wire buckle style as it can be done up easily.
As soon as you get into the water check that your weight belt is secure. The amount of weight to wear depends on the buoyancy of your suit and the buoyancy of your body. You may find like me that 2 or 3 pounds of weight helps me when I am snorkelling without a wetsuit. With a full 7mm suit, I would wear 18 pounds.
Also available are elasticized belts which are easier to keep on because they can be put on with more tension.
Losing your weight belt Если теряем грузовой пояс
If it falls off while diving let all the air out of your BC, exhale and swim down as hard as you can and grab the weight belt on the bottom. To put it on, put the buckle in your left hand and while lying on your back bring it u to the back of your waist. Then, grab the free end with your right hand. Maintain the position on your back as you do it up.
If it falls off while you are on the surface drop a weighted line as soon as possible where you lost it. Depending on the depth you or your buddy can snorkel or SCUBA for it by following the line.
SPEARFISHING ПОДВОДНАЯ ОХОТА
I have successfully spearfished as a paraplegic. It can be very fun especially if you are hungry. It is a good activity when camping on dive trips or on sailing trips. I have found a pneumatic gear to be the easiest to use because they are shorter and easier to aim and to load. A rubber powered gun is hard to load as it requires two hands and the butt must be firmly held against the hip which is hard if you can’t brace with trunk muscles.
A fin swimmer will swim with the gun extended in his hand ready to shoot any fish that comes in front of him. If you swim with your hands you cannot do this. My technique is to tie the gun to my weight belt with the safety catch on, then dive down to my desired depth, then point my gun in front of me with one hand and with the other, rotate myself 360 degrees and shoot any fish that comes to view.
It is important to make the gun easy to detach. Once I had it tied to my jacket and while I was under the water the gun became caught under a rock. I was unable to surface and was fortunate to break the string holding the gun. Of course, the same could happen if you speared a big fish and the gun was attached to the spear.
The spear is attached to the gun with a retractable cord. The gun is tied to a rope which runs through a loop attached to your weight belt and then onto a red buoy. This buoy acts to warn boats of your presence and by attacking a stainless steel spike on a lanyard to the buoy, you store your fish on the buoy. It’s good to keep dead fish away from you in case of sharks.
When you spear a fish, you can let go of your gun if the fish is pulling hard and recover it when the fish tires by pulling on the buoy line.
SCUBA DIVING ДАЙВИНГ
This sport is totally dependent upon man-made equipment. Firstly, let’s go through the equipment and I will discuss how paraplegia will affect how you will use it. The following are the standard SCUBA gear:
Air is compressed to about 200 times regular air pressure dried and pumped into an air tank. It give you a finite amount of air for breathing depending on how deep you are and how hard you are breathing.
Tanks come in different sizes. Different designs of tanks can hold greater pressures; therefore, the physical size of tanks does not indicate the amount of air that they hold. The tank is the hardest item to carry above and below the water, so it is best to use a tank that is no bigger than necessary
New high pressure steel (370 bar) tanks are the most compact but require special screw in regulator fittings (DIN fittings) and many dive stores cannot fill them. Aluminium 63 tanks are easy to carry and get filled but hold 30% less than a 90. It is up to you the tank you select. They should last for 100,000 fills and cost about $200 each (less, second hand) so it is a good idea to have two, say a 63 or 72 and a 90.If you are diving out of your own boat, you will find it much easier to lift a 63 in than a 90.
Carrying the tank in the wheelchair is not that hard. I grab the tank by the valve and pull it between my knees and sit it on the footplates or leg strap. If it is only a small tank, it can be laid on your lap. I prefer not to have protective shrouds or boots on the tanks as it makes dragging it up over the legs or wheelchair very hard on the skin.
Buoyancy Compensators (BC) Компенсатор плавучести
The BCs principal function is to increase and decrease your buoyancy so you can float at different depths. Additionally, it secures the tank to your back and has pockets for storing things.
The modern BC has breakaway clips on the chest and provides much greater stability than the old horse collar and non breakaway jacket designs. It is important to have as much of the buoyancy in the jacket located near the main weight area, ie the weight belt.
BC’s come in different sizes. Make sure yours is a snug fit when all the straps are done up. Different jackets have different amounts of buoyancy I always look for one with minimum drag-no bulky pockets. It is important to achieve a snug fit. If the tank can slide around on your back it makes swimming much harder.
The KEY TO SWIMMING EASILY IS TANK PLACEMENT. For most paraplegics, I have dived with, they position their BC’s high on their tanks. This emulates the fin swimmers who position their tanks there to weight their legs to overcome the upward thrust of their legs. When they do this, they end up swimming standing up. In the end, they really only do a vertical dive using their BC, as swimming horizontally becomes exhausting
If you are swimming without fins, then you are better adopting a slightly head-down position as you will receive a slight upward thrust from your arms. Additionally having a slightly head down attitude will lift your legs clear of obstructions when pulling yourself along the bottom.
This body attitude is simply attained by moving your BC up and down your tank. With a 90, I like to place the top of my BC in line with the start of the curve on the tank. With a 72 or 63, I put it halfway along the tank.
Your BC should have clips on the chest so it can breakaway easily This makes the BC very easy to get off and easy to put on. It was especially useful for me once when I was diving with Amghad. After a spectacular dive to 160 feet at the Cape Byron Pinnacle, we decompressed and then surfaced in a 4-knot (very strong) current. Hanging on to the side of the anchored inflatable, with water flowing around us like a river, Amghad removed his tank and we pushed it into the boat. he had become very tired decompressing and was washed away. Now I was on my own wondering how I would get in, when I inflated my brand new BC and with one hand, released the should clips and the BC tank and erg went racing away 3 miles out to sea. Without that weight I as able to jump in the boat and after half an hour hacking through the anchor line with some old pliers. Poor Amghad had grabbed the mermaid line and wrapped around his hand. Half an hour of that had worn the skin away where the rope had been. Following the current, I found my tank half a mile away.
Another advantage of having a low placement on your tank is that the regulator hoses and tank valve are very easy to reach over your head. I have never had any problem hitting my head on the tank valve although able body people say it happens to them. I think as paraplegics we don’t stand up with our tanks on our backs, which is when this may happen.
For low drag, I think it is best to use a regulator with the yoke at 90 degree to the first stage. This setup leaves the hoses close to your shoulders rather than packing over your head like in an in line mode.
With that exception, I don’t believe a paraplegic needs anything special in a regulator. As they are expensive and durable, you ought to buy a good quality balanced regulator as they give superior performance at all depths.
Gauges are normally mounted in a console attached to the HP line. This works well for the pressure gauge. I normally have my depth gauge there as well. However, because it is difficult to look at the console without ceasing to swim, it can be hard to regularly monitor your depth gauge or compass. Therefore, sometimes, I will wear them on my right arm so that I can easily monitor them while controlling my ascent/descent with my left hand. I like to put my high pressure hose through my left BC sleeve and then under the BC waist strap. This makes the console easy to find and reduces drag.
It would be nice to have a compass mounted on your mask or chest so that you could monitor it as you swim. However, I have never done this. I take a bearing on an object and then swim at it and then take another bearing.
These are really useful but not specifically for paraplegics. Get one if you can afford it–preferably one which goes down further than 70 metres–why not!
They are great as your hand are very prone to hitting sharp rocks as you pull through the water with your hands. You will often pull yourself along a shipwreck or wall in a current and gloves make it much less painful.
A close fitting neoprene glove is the best a they have the least drag but wear out fast and are expensive. As your gear depends on finger movements (BC buttons, grabbing hoses, purging regs), you need a glove that does afford some sensitivity.
I have tried webbed gloves for extra propulsion without success. Unlike the legs, arms do not have a lot of excess power to drive a pair of fins. I found that my arms couldn’t handle the extra force generated by the webbed gloves. Additionally, I found that they reduced the sensitivity and movement of my fingers in manipulating my equipment, taking longer to adjust my gear and therefore slowing down my swimming.
Knives are always lost fairly rapidly so I have given up wearing them. When I do wear one, I normally put it on my arm or BC rather than ankle as the ankle is hard to reach readily.
Fins (Flippers) are superfluous for a paraplegic
GETTING IN ЗАХОД В ВОДУ
I will assume you will be diving out of a boat and that you already have your wetsuit on. Put your weightbelt on, you may have to lie down to do this. Sit at the doorway or on the side of the boat and put on your tank. If you loosen your shoulder straps on your BC first it will be easiest to put on. Put some air is in the BC (with your mouth, to conserve air) Hold a line attached to the boat and roll in. Holding the line means you can’t get washed away especially if you have a gear problem. Ideally, you can run the mermaid line from the anchor line so you can pull yourself along it to the anchor line.
As soon as you get in check that your weight belt is tight and then tighten your BC straps.
If it is too rough to do your straps up easily on the surface go in with just your arms through the BC and the straps undone. Do them up when you get to the bottom. It can be difficult getting straps done up with poor balance as you try to hang on with one hand.
It is often easier, especially if you are on your own to throw your tank in and then put it on. Slide a rope attached to the boat, through the arm of the BC and put the tank in the water holding onto the end of the rope. Jump in yourself, then position the BC (with some air in it) so that the tank valve is pointing downwards at about 40 degrees and the BC is between you and the tank. The hoses should be hanging clear of the BC, then put the reg in your mouth. Put your arms through the holes, taking the rope back through the hole but holding it so you stay connected to the boat. Push your head down under the water until you have the BC on your back. Once you have done this, allow yourself to roll on your back and relax as you do up all your straps.
If there is no rope from the anchor line getting past the boat can be the hardest part of the dive if there is current or waves. You can either swim hard pull yourself along the boat and submerge and swim underwater. I don’t recommend the latter as you don’t know where you will end up. In a boat up to 25 feet long it is practical to place both hands on the gunwale and ‘walk” hand over hand to the anchor line. Otherwise, you may be able to pull yourself along the rubbing strakes along the side of the boat. If all else fails, generally you can submerge and pull yourself along the vessel’s keel.
When you get to the anchor line, clear your ears and let the air out of your BC and pull yourself down the anchor line. You should be weighted so that with your BC deflated, you will sink when you exhale.
You should be able to clear your ears by blowing into your mask (with practice). This will leave your hands free for swimming. The advantage of descending down the anchor line is that it is physically easy and fast, you can’t get lost, you arrive at the dive site and you can check the anchor will not pull out. Another advantage is that if you have trouble clearing your ears, you can stop rapidly.
If it is impractical to go down the anchor line be careful because you cannot stop quickly to clear your ears, you must use your BC to stop if you have to use your arms for some problem.
When close to the bottom, hold onto the anchor line, clear of the bottom. Tighten all your straps and weight belt, check your air an depth and current direction. Inflate your BC until you feel yourself become slightly buoyant.
Plan your dive to take you up current so that you know you will make it back to the anchor (or at least to the boat).
If SCUBA diving off the shore, get your buddy to take your tank out to safe water and then snorkel out to it.
ON THE BOTTOM НА ДНЕ
Before you get in, tell your buddy not to swim right next to you or you will hit him in the head as you swim.
When SCUBA diving, you should be weighted so that you can easily swim in any orientation. You should never have to swim really hard. When you feel tired stop and have a rest. You will waste air working flat out.
If the bottom is flat look for a crack in the rock to follow. It will most likely lead you to a wall you can then follow. Wherever you go, look back regularly and try to remember what it looks like. Underwater navigation is the key to speed. Everything tends to look the same. If you can navigate well you will beat everyone back to the boat.
If the bottom is featureless sand or kelp, swim straight up current and count the number of strokes you make. When you come back if you take an equal number of strokes, you will gone too far as you have the current behind you. If you reduce the stroke number by 30%, you should be near the anchor.
Swimming along a slope is fairly easy, keep the slope on one side when you swim out and then on the other as you swim back.
Walls, of course, are easy to navigate on.
Shipwrecks can be very easy if they are intact. If they are broken up then you may be faced with swimming across sand to another part of the wreck. I often drag my knees through the sand to leave a trail
Keep an eye on your air and turn around before you get to 50%. Keep an eye on your buddy if he is behind you by tilting your head right down and looking back under our waist. Also, you can roll on your back to look at your buddy. In this way, you don’t have to stop swimming just to keep an eye on them
When current is present on the bottom you may not be able to swim against it. Swim as hard as you can and grab the bottom. Pull yourself along it taking advantage of any rises, boulders or walls that will block the current. it is also easier if you traverse back and forth against the current. This traversing can be done up and down against a wall as well.
Where there is no current but surge from passing swells, you can use its force to give you a big lift. When you feel a contrary motion, hang on to the bottom. Before the surge comes behind you, start pushing off the rock and swim hard. You will be surprised how far you will go with little effort. It is a great activity around swim throughs where you can hold the rocks wen the surge is against you and then give a big push through the swim through. You can gauge when the surge will change direction by watching the kelp swaying.
SURFACING ПОДЪЕМ НА ПОВЕРХНОСТЬ
If you make it, back to the anchor surfacing is easy. If you can’t find it you will have to do a blue water ascent. With enough air in your BC, use your arms to swim up. Remember to look at your watch before you leave. Come up at the speed of your smallest bubbles, venting your BC regularly. Use your hands to spin around so you can watch your buddies. As you get near the surface listen and look for boats to avoid. If your ascent becomes to great with all your BC air dumped use your hands palm up to push against the water.
On surfacing inflate your BC and look for the boat. Use your snorkel and swim towards the front of the boat. If it is rough , you can swim on SCUBA under the water when you have taken a bearing on the boat.
NIGHT DIVING НОЧНОЕ ПОГРУЖЕНИЕ
A beautiful experience, the only special equipment needed is a torch. As you can’t hold it still and swim you need to attach it to your head. It is best to get a caving helmet and attach 2 or 3 torches with wire ties. If you are lazy, you can just push the torch under your hood as or even tape it to your mask strap. There are also several proprietary products available now for putting a lighting source on your head.
My craziest night dive was on a wreck in 50 metres. My two mates, Mike and Mal, went in first. I would mind the boat while they wen in and then go down 18 minutes later when they should be coming up. I never saw them as I went down and pondered in my narcotic state where they were. After leaving the bottom, I was sitting decompressing when Michael appeared out of the black void. On the surface, he explained that having lost the anchor line, he surfaced and swam for the boat, skipping his deco. Mal stayed under doing his deco drifting with the current. We searched for Mal for 3 hours when fearing the worst, headed back home. And that was where he was. In only 40 minutes, he had swum 1 ½ miles ashore, run 400 metres to my house, and was having a cup of tea.
BUDDY BREATHING ДЫХАНИЕ С НАПАРНИКОМ
This skill is becoming much less important now that octopus regulators are so common. For the paraplegic, it is impossible to swim while your hands are busy using the second stage. I have found the best procedure is for the paraplegic to grasp the buddy’s BC firmly and control the second stage, moving it between the buddy and himself. Then, the buddy is free to swim the couple to safety.
DEEP DIVING ГЛУБОКИЕ ПОГРУЖЕНИЯ
The problems of diving over 30 metres are:
Nitrogen narcosis doesn’t present any unique problems for the paraplegic. It can be very dangerous or very enjoyable. The best way to avoid it is to get a lot of experience at depth and to visit a deep dive site several times before straying far from the anchor.
Finding the anchor is essential as decompression stops must be performed near the surface. If you aren’t hanging on to the anchor line, you will be washed away by the current and it will be hard to maintain the correct depth.
The only real problem for the paraplegic in deep diving is carrying the twin tanks, which are often essential to supply enough air at depth. I have never been able to move twin tanks out of the water. I always rely on my buddy to shift them around and then I put them on in the water. Swimming with them is not hard. The tanks must be moved forward as with a single tank to provide a prone swimming position.
I have never suffered from decompression sickness in over 500 dives, many of which were over 50 metres. As well most were done to US Navy tables which have greater bottom times than the sport diving tables now in use. From my observation paraplegia does not cause any noticeable increase in decompression sickness. It is possible that a paraplegic could suffer a bend in the legs which he could not feel, but the consequences of that in someone who cannot walk anyway would not be very severe. I think that it is unlikely that a paraplegic would get bent in the legs without bent in his arms, because the relatively slow flow of blood in paralysed legs would have a much slower exchange of dissolved nitrogen to the leg tissues than in the arms.
Very often, it is easier for everyone if a mate gives you a lift. There is the piggy back, the come to me and the fireman’s chair. The latter is the best–less strain on the lifters and less strain on you. Come to me is comfortable for you but requires a strong lifter. Piggy back is a powerful life but it is difficult to achieve from the squatting position and can be hard to spread your legs apart. Quite uncomfortable for the passenger, too.
If somebody offers you a hand, I will generally accept it except if it is something I do all the time and my doing it keeps me fit, like pushing up a ill. I will also ask if I need a hand. Normally, that hand is offered well before I ask for it.
By far, the easiest boat to use for a paraplegic is an inflatable on a trailer. They have no sharp edges, are extremely seaworthy and are very easy to get in and out of. At a suitable ramp, they can be driven on and off the trailer. When travelling in an inflatable, sit up on the middle of the pontoon. You will not bounce out of the boat but up and down. As long as you can hold onto the lifelines along the side you should be able to hang on even with a rough ride. Many people stand up to absorb the shock of a speed boat bouncing across the chop. As you have to sit, sit at the back of the boat because it tends to remain steady while the front of the boat bounces around a lot.
Aluminium and fibreglass boats need to be much bigger to carry the load and be as seaworthy as an inflatable. They have lots of hard edges that can injure a paraplegic when it gets choppy. The most likely injury is to the coccyx from the edge of a seat. This can’t happen in an inflatable because the seats curve away from the coccyx. I would recommend a 14 foot inflatable, with a 25 hp motor.
To get into the boat, at the ramp it is often easiest to board the boat while it is still on the trailer. Then the wheelchair can be put in the car. If you are needed to back the trailer, then after you’ve parked the car you may get your buddy to lock it in the car or take it with you in the boat.
At most wharves there are steps you can ‘”roll” down or you can get out and climb down. Sometimes, the boat is sitting at a wall with a big drop. I like to go hand over hand down the mooring line. Or you can jump in somewhere else and swim around.
Getting out Выход в воду
These diagrams show a couple of ways to get into the boat. This is a very important skill if you want to be independent. Take your weight belt off first and put it in the boat. Take it off with one hand while you hold on with the other. Then take your tank off and attach it to a lanyard hanging from the boat. Many able bodied divers have difficulty getting back in so a paraplegic will also. Look at the boat and see where it is easiest to get in. One tip is to get some of the people in the boat to go to the side you want to get in on so that the boat lists in that direction.
Driving the boat Управление лодкой
Most boat are set up to be driven by hands only. So long as your can sit at the wheel or tiller driving it shouldn’t be a problem. An advantage of inflatables is that you can rapidly slide along the pontoon to the front of the vessel. In an aluminium or fibreglass boat, seats normally run across the boat requiring lots of climbing.
I can easily pull start a 1993 Mariner 40 twin but a 1987 Mariner 15 is too hard. Before you buy a motor make sure it is geared to be easy to pull start.
In every person’s life there comes a time that we face the “…but”. The word, stuck in the middle of a sentence which was started with positivity, usually concludes with negativity. “I am sure you can do it, but…”. “I have no doubt that you think you can, but…”. It’s that moment when the belief of others doesn’t align with your beliefs. Getting my Rescue Diver was one of those buts.
If this site hasn’t made it obvious, I am a Quadriplegic. A Quad Diver. I have full use of my arms, limited finger functionality and no leg function. I have passed my Open Water, Nitrox, CPR/1st Aid, and Advanced Open Water (Ultimately, my end goal Master Diver). I have read every book about diving (medical, fiction and non-fiction). And others would consider my state of mind as borderline diving-obsessive.
There were two reasons I wanted my Rescue Diver during this scuba-obsessed journey:
it is a major step to becoming a Master Diver. Without RD, I could never be a MD
I believe that, even if I physically can’t do something, at least knowing makes me one step closer to preparedness. As I have said in this blog before, if I can’t be the strongest, I want to be the smartest.
So I started asking some dive shops if they would certify me as a Rescue Diver. Over and over it was a no.
from Torsten’s instagram
“HSA divers can’t get their RD”. huh? Where is that a rule? I understand that Quadriplegic Rescue Divers don’t exist much (at all), but such a quick dismissal without thought wasn’t ok. Why not let me try and fail? Try and fail like many-a-“pedestrians” (yes that’s what I call you functioning legged folk). If I (or they) am capable, then I/they will pass. If I fail, at least I will be mentally prepared in an emergency. Again, make me strong mentally or physically or both. But saying no right away isn’t smart.
What these nay-sayers get caught up on are the tasks. They were taught to complete a task a specific way. What they aren’t thinking about is that the method is irrelevant. The outcome is. Being creative to figure out new ways of accomplishing said outcome, and then perfecting that way, is the important part.
Larry Mack, the Instructor who has been with me since day one of my diving life, was the only person to say yes to my request for Rescue Diver. Under one condition: I must complete everything without exception (not even being “creative” with the 900 yard swim – read: doing 450 yards!). He would only certify me if he would feel comfortable diving with me as competent Rescue Diver. If I can’t fulfill the tasks, then he won’t pass me. But to be clear, his reply had nothing to do with my chair.
Below I describe the tasks Larry and I did, and modified, based on my capabilities. This should demonstrate that this IS possible with some modifications (and a Dive Master who has patience!) When appropriate there is a video time mark corresponding to the video above.
Surface Swim w/ mask, fins & snorkel (900 yards) – holy pain in the arms. After this 900 yard swim (mind you no legs to help here) I figured that would be the hardest part of the day. Ha. Nope.
Tired Diver Tows: Do-Si-Do, Octopus Pull, Fin Push & Tank Strap Pull – We got creative here. The only objective here: tow someone to safety on the surface. Towing a person to safety is easier with functional legs for power while you use your hands to hold a person. I physically can not do that. So, the three methods we found worked best:
One arm tow – I wrapped my left hand (which has less function than my right hand) in the BCD strap above his tank. With my right, I did a back stroke. (11 seconds)
Octo in Mouth – I took his Octopus hose and put it in my mouth. That freed up both hands to do a normal back stroke. Because Larry’s BCD keeps him buoyant, pulling him is simple. Thus, this one seemed fastest and easiest. (18 seconds)
Push – In an alternate way of doing the standard fin push (having the fatigued diver’s fins against your shoulders while doing a front kick) I placed the diver’s fin/leg across my shoulders while I swam backwards.
Strap – If you know you need to go for a while, remove one of the BCD Velcro straps (the Cressi Travel Light has one for packing purposes), tie it around a strap on their BCD and to your chest strap. Again, this leaves your hands free to stroke. Make sure you do this only when the rescued diver is calm as you two are now attached.
Panicky Diver on Surface – A panicky diver, above or below, will usually do what they can to save themselves. This means jeopardizing your safety for their own. Thus, it is the rescuers job to calm them down by talking to them (lucky for me I have a Barry White – like voice), stay far enough away until you know you can help them without compromising your own safety and, when in position, shock them out of their panicked state. As one approaches, tell them to calm down. Abled-bodied divers will then swim under the diver out of the panicked grasp and surface behind them to take control. In my case, I needed to swim around them. Once I had their tank, I could briefly pull down to dunk their head under water which gave Larry a quick shock (29 seconds). Think of this as a slap in the face when you want someone to get their wits about them without causing harm. See here. It works.
Panicky Diver Underwater – This was a fun exercise. Again, a panicked diver will do what it takes to save themselves. This means ripping your mask off, wrestling with you and ultimately taking your regulator. Larry, without warning, pushed up his own mask (a common reaction when someone is scared) gave me the out-of-air sign and darted at me before I could give him my Octo. We tussled on the platform until I could get my Octo in his mouth, calm him down, and safely ascend with our right arms locked together (go to 1:55 in the video, two Dive Masters thought we were actually fighting and came to help!). There wasn’t much adaptation I needed to do here other than staying calm and making sure I am safe, then helping the distressed diver (biggest rule to remember which took me a moment to adhere to: save yourself first. If you aren’t safe, how can you save them?). As we ascended together, it satisfied the Octopus Sharing (stationary & ascent to surface, 30 feet) drill. (See here a clear example)
Rescue Unconscious Diver Underwater – This task requires the RD to assess the situation, act and ascend. In this case, Larry laid face down on the platform. I approached, tapped him on the back (you never know if someone is inspecting a coral or something small), noticed he wasn’t responding and turned him over. The next step was getting him safely (read: not just inflating his BCD and watching him rocket up) to the surface. I released his weights, shot two puffs of air into his BCD via his inflator and maneuvered his body into a headlock position. By having one arm under his chin I naturally opened his windpipe allowing air to push out of his lung as we ascend (without this he could get a ruptured lung). This also frees up my other arm to stroke upward. As you stroke upward, the air in his BCD increases making it easier to push. (Note, it’s easier to deal with venting one BCD, so if you can, remove the air from your BCD and use the rescued BCD to ascend). (2:44 in video)
Remove & Replace Weights Underwater – This one sucked for no other reason than: I didn’t know my needs and my equipment’s capabilities. First, I removed my weight and drop them on the platform. As you would assume, I started ascending (after all, weight is the reason you stay down). Without legs to kick, retrieving the weight was difficult (Difficult. NOT impossible. See minute 1:17). I then began to replace the integrated weight into the pocket. I tried sideways. Standing. On my back. Everyway. The problem: the weights need to lock into fastex clips inside the pockets. Long story short, this is not the BCD for someone with limited finger functionality as it is difficult to clip in inside of the weight pocket. Instead, I am purchasing a BCD that has easier integration systems (read: either external Fastex clips or Velcro). Either way, it worked. I just prefer it to be easier. To repeat, this is not a factor of if someone can do it, but rather what is the right equipment they need.
Remove & Replace Mask (switching equipment with buddy) & Remove & Replace Mask (swimming 10 yards w/o mask) – In this drill I had to remove my mask, drop it, swim, find it and replace it. The second task involved Larry giving me his mask (and he taking mine) and then clearing the mask of all the water. Nothing really different here as it pertains to HSA. With my limited finger functionality I use the palms of both hands to tip the mask while I exhale through my nose. If there is only a little water, I place my palm on the top of the mask and exhale (note: get a low volume mask. Makes clearing a hell of a lot easier) (43 seconds)
Remove & Replace BCD– This one scared me. Larry motioned for me to doff all gear which included my weights. This means a very fast ascent to the surface (at 30 ft below). It helped that Larry made me practice this three times on the surface as I now knew all the clips and the process in which they should be fastened (I was somewhat annoyed that he made me do it 3 times on the surface. It was during this that I knew why he made me). You’ll see (3:37) that I was in such a zone/concentration that I didn’t even see or feel Larry trying to help me. Had I “listened” to Larry I would have realized that flipping on my back to don my gear would have made life a lot easier. This exercise is important. Imagine you find yourself stuck in a wreck or somewhere tight, need to get through a doorway and don your equipment when you pass through. Again, nothing here different.
Emergency Swimming Ascent – The last exercise was a fast ascent in case of emergency. The process is to dump your weights and sprint to the surface. However, as you ascend, let out a huge scream. This prevents you from holding your breath and getting lung expansion (a higher percentage of diving accidents stem from ruptured lungs than Decompression Sickness – aka The Bends). Again, nothing different for an HSAer here. Just the ability to dump weights and swim.(5:16)
Don’t take this entry as permission for anyone and everyone to get their Rescue Diver. It is not easy. The take away is that we should encourage everyone to be as safe as possible, learn as much as they can about SCUBA and above all, give them a chance.
Torsten and Maggie Gross (from Torsten’s instagram)
My name is Torsten Gross and I started this to journal my experience so other divers can understand the perspectives of an HSA diver (Handicapped SCUBA Association – those who Dive Without Fins!), noting all the small nuances that are important to us and the best locations (but the site is for scuba divers that are handicapped and non-handicapped alike). While searching for dive locations it became apparent that Tripadvisor, review sites, dive shop websites, et al, don’t have the detail and imagery that are most important to HSA divers. Leaving certain questions unanswered until one gets to the location is not comforting. Hopefully these logs will help.
I live with my wife Maggie in NYC, both work in advertising as strategists and have an awesome Australian Cattle Dog named Rye. I love parenthesis (my attempt to be the David Foster Wallace of (*)) and use them unpredictably. Maggie is a self-proclaimed vacation-diver (only if it’s warm), I am an obsessed diver (even my bathtub will do).
Diving Certifications for Torsten & Maggie:
Torsten: (C6 Quadriplegic)
Handicapped Scuba Association (HSA Level A) Open Water Certification in 2011 with Scuba Network of Long Island
SDI Nitrox Certification in 2012 with Scuba Network of Long Island
CPR/1st Aide certification in 2012 with TriState CPR Training
NAUI HSA Advanced in 2012 with Scuba Network of Long Island
NAUI Rescue Diver in 2013 with Larry Mack
Maggie: (No Disability)
YMCA Open Water certification in 2007 at Florida State University
YMCA Advanced certification in 2007 at Florida State University
SDI Nitrox certification in 2012 with Scuba Network of Long Island
CPR/1st Aide certification in 2012 with TriState CPR Training
Rescue Diver in 2012 with Scuba Network of Long Island
SSI Handicapped Scuba Association (HSA) Buddy Diver in 2012 with Scuba Network of Long Island
Six severely disabled men were selected for their swimming ability and physiological suitability for diving. Four paraplegics – T4, Тб, T12, and L3, and two double leg amputees, one with both legs amputated above the knee, one with one above and one below. The three high lesion paraplegics and the more severe double amputee were normally mobile only in wheelchairs. Medical history and present physical status is presented for all trainees. A daily report is given of a five-day acquaintance diving course during which the trainees completed all the normal scuba pool training schedule as required by the Confederation Mondiale des Activites Subaquatiques and the British Sub Aqua Club. The course concluded with trainees diving in the open sea. It is concluded that self-contained diving training is an excellent rehabilitatory activity for disabled people with the following limitations: no paraplegic should dive in the sea with a lesion above T5; no paraplegic whose injury was caused by bends should dive at all; no disabled diver should undertake decompression dives. Certain general limitations should be applied to weather conditions, etc. Recommendations are made for further training courses, and for supervision of disabled people in diving schools and clubs.
DIVING TRAINING FOR THE SERIOUSLY DISABLED
Since the 1940s it has been recognised that sports offer to disabled people a unique opportunity to improve their health, enjoy themselves, and achieve social participation and acceptance. Since the inception of the Stoke Mandeville games by Sir Ludwig Guttman in 1948 this aspect of rehabilitation has received public recognition all over the world.
Because of the institutional background of hospital life, and the need to supervise many subjects with few instructors, it is natural that emphasis has usually been on team games and competitive games. These games have also, in western culture, been granted great respect, so that disabled people acquired social integration by playing such games, and particularly by winning. Less attention has been paid to the more solitary sports, characterised in the extreme by the rugged individualist climbing Mount Everest. This class of sports included skiing, canoeing, sailing, mountain climbing, diving, pony trekking, camping, camping, caving or pot-holing, parachuting, flying, hang-gliding, gliding, etc. They are sometimes described as ‘adventure’ sports or ‘risk’ sports.
In view of the risk entailed in most of these activities, and the outdoor mobile nature which makes supervision difficult, it may seem perverse to encourage people to take part who have already suffered severe injury or disability at least once. However, there is a good case to be made, and this will be put forward fully at the end of this paper. At this point it is sufficient to say that there is a psychological difference between team competitive games and adventure sports, and that people who are attracted to one are often not attracted to the other. Thus, granted that sports have rehabilitative value, adventure sports reach a new section of the disabled population. The risk element is no higher than with able-bodied people since the essential art of learning these activities is to learn how to maintain the risk within acceptable limits by modifying the techniques and restricting the task attempted.
DEFINITION OF THE PROBLEM
Swimming has long been recognised as a sport of enormous value, though usually restricted to a pool, and we only know of a few examples of seriously disabled people who attempt long distance swims in the open sea.
Several individuals have taught themselves SCUBA diving, but there has been little formal attempt to define standards of diving instruction and diving qualifications so that disabled people may acquire safe diving training.
The United States army has run several courses in Hawaii for soldiers with single and double leg amputations, and we have been informed by an instructor in Guam of a diver who learnt to dive although he had one arm amputated at the shoulder, and the other at the wrist.
At this point we should define what we mean by a seriously disabled person, and what degree of self-sufficiency is aimed at in training. In the context of diving, the amputation of one leg is not serious, because many people can swim well with one leg. There are problems in walking about wearing the equipment, but they are not medical or physiological problems, nor peculiar to diving. The absence of a hand or arm is more serious, since a diver frequently has to adjust his equipment while underwater. However, the problem is one which can be solved by careful supervision and instruction by a good diving instructor, who must judge the safety of the pupil. There is no special medical problem.
The class of disability which we are considering is typified by double leg amputation or paraplegic spinal lesion. The precise limitations of safe diving will be discussed below, but it is obvious that any injury which affects the subject’s respiration, sinus, heart, etc. immediately debars him from open water diving.
It is important also to define the competence in diving which we intend the subject to acquire. In 1966 Mr Pritchard in Kenya showed that diving was possible even for a cervical lesion. He dived accompanied by two friends who lifted him into the water, fitted his aqualung, and towed him about underwater. This has enormous psychological value for the individual who enjoys the underwater world, but does not constitute safe diving at an independent level. In the late 60s and early 70s several individual paraplegics found that it was possible to dive, particularly R Head of London, England, who was an active diver for many years with a partial T10 lesion.
The level of competence which we are seeking to achieve is as follows:- the subject is passed as medically fit to dive so that his companions do not have to worry about him. He drives himself to the dive site, looks after his own diving equipment, but may need assistance getting into a boat, and getting his scuba gear fitted in the water. Once dressed he can swim unaided, dive, adjust his equipment, perform all the normal safety exercises, swim in the company of a buddy diver, monitor the progress of the dive, control his ascent, and swim to the boat on the surface. At the boat he will probably require further assistance to remove his equipment and to get back on board. In the event of becoming separated from the boat he could inflate his lifejacket and survive for many hours. This level of independence ensures a high degree of safety, and permits the disabled person to join in diving groups of able-bodied people, to enjoy underwater observation, photography, natural history, or underwater science and research.
MEDICAL AND PHYSIOLOGICAL REQUIREMENTS FOR SUBJECTS
In July 1974 six disabled men were selected from the Israel Defence Forces wounded soldiers rehabilitation programme. The criteria of the medical examination used were the same as those demanded for any person who is to join a diving course. (References: Bennett and Elliott, Miles, CMAS, NAUI, MAC, etc) . In addition each case was examined separately taking into consideration the causes of the injury, and the results of the criterion for uninjured people necessitates a completely normal physiological system, central nervous system, ear nose and throat, and sinuses. In short, the potential diver should be very fit.
The examination included a precise medical history (anamnesia) plus a description of the present physical status, as well as the character of the applicant as far as it could possibly be judged. With regard to disabled divers, all the factors mentioned above were taken into consideration, plus the eight following special points:
The respiratory system should be completely normal. All the respiratory muscles should be under control, and the spinal lesion not above T5, preferably not above T8.
It is of extreme importance that the skin condition of a paraplegic is proper without any injury, kobitus (pressure sores). For amputees, the scars should be completely healed or perfect, meaning at least three months after amputations.
The paraplegic should not have any urinary tract infection, and should have full control of urine and bowel movements, with or without artificial aids.
Fullest consideration should be given to the personality of the disabled person: he should show self-discipline, with a full knowledge of his own abilities and disabilities. He should be of steady character with the capability of withstanding anxiety and withstanding anxiety and panic. He should also be of a co-operative nature, accepting orders from his superiors without resentment.
He should be an excellent swimmer, participating regularly in intensive swimming, including sea swimming.
He should pass physical tests and exercises concerned in preparation for the course, and if necessary undergo special physio-therapeutical training.
If he is a paraplegic, his disability should not have been caused by a spinal bend (discussion below), nor by arterio-vascular malformation, nor by transverse myelitis.
It should be pointed out to persons with partial spinal lesions, from whatever cause, that there is a possibility that diving might make the lesion complete. There is no record of this ever having happened other than with bends cases, but it is a possibility. There are several cases of people with partial traumatological lesions diving with no ill effects.
Description OF COURSE CANDIDATES
CASE A Date of birth: 1947 Date of injury: 28 February 1969 Injury: Gun-shot wound penetrating the right upper thorax, lung, and lamina of the fourth thoracic vertebra, with laceration of nerve roots on the right side and contusion of the spinal cord. Status after treatments State after decompression lamenectomy at level T4-5 (27 February 1969). The bullet during penetration caused intra parenchimal haemorrhage in the upper apex of the right lung and haemopneumothorax, and was operated. A week after operation all X-rays were within normal limits. The patient remained a paraplegic T4. Medical history: Before the injury there is nothing to say, and Case A was always healthy. Present physical status: Except for the result of the injury is without pathological finding. Lung and heart within normal limits. Note: As a result of the high injury it was decided that this person was not fit for sea diving, but he was allowed to participate in the exercises in the swimming pool with full guidance. This was in order to define more precisely the realistic limits for disabled divers. Case A performed most of the exercises correctly, but it was clear that short bursts of intense exercise caused a difficulty in breathing. This was because he was breathing only with the diaphragm.
CASE В Date of birth: 4 September 1945 Date of injury: 21 July 1970 Type of injury: Gun-shot wound of the chest. Bilateral haemopneumothorax with fracture of sixth rib and scapular. Paraplegia Тб. Treatment: The penetrating wound back left shoulder, and exit wound in the right shoulder. Suction applied twice and after 4 days of tracheotomy, his condition was improved. He was left paraplegic with sensory level of T.6. X-ray of chest and heart within normal limits. Medical history: According to the check sheet the anamnesia excluded any illness past or present. Present physical status: Blood pressure 70/110. 60 seconds later – 70. Ears, eustachian tubes, sinus and pharynx, within normal limits. Chest, good expansion, good alveolar breathing on both lungs. Heart – rate 70, regular sinus rhythm, within normal limits. Chest x-ray – normal. State of fractured rib 6th right, slight thickening of pleura in that region. Paraplegic with sensory level at Тб. Skin on legs healthy without any pressure sores. Good blood supply to the extremities. Conclusion: Case В passed the acquaintance course successfully performing all the exercises to the satisfaction of the instructors, including one dive to 7 metres in the open sea.
CASE C Date of birth: 1947 Date of injury: 27 August 1970 Type of injury: Gun-shot wound entered right side of the back vertebra T12, passed through the spleen and came out through the left side of the body. Treatment: Had a splenectomy. Status after treatment: Paraplegic with sensory level L2. Has had several urinary tract infections, but left the hospital in a good condition. Medical History: According to the check-up sheet the artamnesia excludes any illness in the past. After the injury always healthy, only occasional urinary tract infection. Present Physical Status: Blood pressure – 110/70 Pulse – 60, 80, 70, 60. Ears, eustachian tube, ear drum, pharynx, within normal limits. Chest – good expansion, alveolar breathing with both lungs. Heart – regular sinus rhythm within normal limits. Neurological – paraplegia with sensory level L2. No sense of position, no sense of vibration, no reflexes in leg, stomach reflex within normal limits, lower epigastrium reflex absent, no feeling in the genital area, no feeling in the sphincters. Chest X-ray – without pathological findings. Conclusions: Case C passed the acquaintance course successfully, performing all the exercises to the satisfaction of the instructors, including one dive to a depth of metres in the open sea.
CASE D Date of birth: 2 November 1947 Date of injury: 10 June 1967 Type of injury: Compression of cauda equina at level III, IV. Treatment: Decompression laminectomy. Status after treatment: Lesion L3-5. State post haemothorax right side, state after rupture of liver (laparotomy). Medical history: According to the medical sheet there was no illness before the injury. After the injury there was paralysis below the knees. Present physical status: Blood pressure – 130/8. Pulse – 80, 100, 80. Ears, sinus, nose, eustachian tube, pharynx, without pathological finds. Chest – good expansion, alveolar breathing in both lungs. Heart – Sinus rhythm regular 80. Within normal limits. Chest X-ray – without pathological finding, lung and heart. Neurological – paralysis below the knees. With control of sphincters. Conclusions: Case D passed the acquaintance course successfully and performed all the exercises to the satisfaction of the instructors, including one dive to a depth of 7 metres in the open sea.
CASE E Date of birth: 20 October 1945 Date of injury: August 1969 Type of injury and treatment: Amputation above knee right. Rupture and fracture of right hand. Amputation of left foot. Medical history: Medical record sheet shows always healthy. Present physical status: Blood pressure – 110/70. Pulse – 60, 80, 60. Ears, nose, eustachian tube, sinus, pharynx, without pathological finding. Chest – without pathological finding. Chest x-ray – Lungs and heart without pathological finding. A small metal fragment 0.5 cms x 0.5 cms below rib 10 on left side. All scars have healed perfectly and are dry. Conclusions: Case E passed the acquaintance course successfully performing all the exercises to the satisfaction of the instructors, and made one dive to a depth of 7 metres at sea.
CASE F Date of birth:1947 Date of injury: October 1973 Injury and treatment: Both legs amputated above the knee. Medical History and Present physical status: Healthy. Conclusions: Case F passed the acquaintance course successfully performing all the exercises to the satisfaction of the instructors, including one dive to a depth of 7 metres in the sea.
PHYSIOTHERAPY AND PHYSICAL TRAINING
Medical examination shows whether people have disabling conditions which would prevent them from diving, but even if they are medically suitable they may not be fit in the sportsman’s sense of being in training. Diving does require quick reflexes and physical exertion, and fitness is therefore essential. Subjects for a diving course should be able to pull down with 1/8 -1/5 their body weight on each hand at full arm extension sideways. They should swim regularly, and lead an active life, involving frequent transfers in and out of wheel chairs, or walking on crutches.
If the normal level of physical activity of the subject, and his present physical condition, do not satisfy a physiotherapist or physical training instructor that he is fit to dive, then a course of exercises should be attended for several weeks prior to commencing diving training. This course would involve at least an hour of swimming daily, with bar exercises, walking on callipers, and exercises with weights, punchbags, etc.
DESCRIPTION OF THE DIVING COURSE, JULY 1974
Right: Mediterranean Diving Center, Sidna Ali Beach, Hertzlia, Opening 1971. Left: Dive Center 1972 photo by Howard Rosenstein
The six subjects mentioned above were selected by the Israel War Veterans Disabled Rehabilitation organisation, and the medical examinations carried out by Yehuda Melamed and Dan Harel. The course ran from July 11-16th, based at Tivon, a small town near Haifa, Israel. A staff of diving instructors, swimming instructors, and physiotherapists was assembled. The essential point is that every disabled subject was accompanied by a diving instructor when in the water in the training pool, and by two instructors, when in the sea. The visibility in the pool was about 3.0 metres, and there was no attempt to run an underwater class, with one instructor supervising several pupils.
The subjects gathered at the Tivon swimming pool a week before the course and were tested for swimming ability. They purchased masks and snorkels, and practised swimming with them in the pool.
It was originally planned that the course should be full-time during the day, allowing a total of 6 hours for lectures and pool sessions each day. Some of the course pupils had to continue studies and exams in the mornings, and thus the timetable was rescheduled to run from 15.00 to 19.00 or later each day. The pupils thus had a very heavy day’s work. Four days of pool exercises and theoretical lectures were followed by one day for diving in the open sea at Akko. Pupils drove themselves to and from the pool and lecture areas, changed into swimming trunks themselves, and in most cases could get in and out of the pool without assistance.
The course syllabus was based on the British Sub-Aqua Club 3rd and 2nd Class standards, and the training methods of the Israel Underwater Federation.
DAY 1 – Demonstration by disabled instructor (NCF) of the following exercises in the pool: (a) Fitting mask and snorkel on pool side and entering water
(b) Fitting mask and snorkel while swimming
(c) Duck-dive to 3 metre depth
(d) Swim 20 metres underwater
(e) 3 rolls forward underwater on one breath
(f) 3 rolls backwards underwater on one breath
(g) Breathing through snorkel without mask, face down in the water
(h) Fitting scuba set while hanging on side of pool
(i) Adjusting buoyancy with air-inflatable life-jacket (ABLJ)
(j) Removing and replacing mask and scuba mouthpiece underwater
(k) Removing weight belt, mask, and scuba underwater, and free ascent
The pupils then swam 180 metres each on the surface, at a steady pace. The T4 Case A was considerably slower than the others, though the swim was not timed.
The pupils then demonstrated breath-holding and confidence in the water by lying face down floating on the surface for as long as possible. Times, without hyperventilation, were as follows: Case A – 35 secs Case В – 1 min 42 secs Case C – 1 min 35 secs; Case D – 1 min 20 secs; Case E – no test; Case F – 28 secs.
Pupils hung on the side of the pool and breathed through snorkel without wearing a mask for one minute. All adapted successfully with the exception of Case A, who had to continue practising. All pupils then swam 20-30 metres submerged on a single breath, with times varying from 20-40 seconds.
Pupils then demonstrated forward and backward rolls underwater equipped only with mask and snorkel. All pupils achieved 3 rolls on one breath, with the exception of Case A who could only do two. It was clear that, although very competent and self- possessed in the water, this exercise required greater breath control and inhalation than could be achieved using the diaphragm alone.
Pupils then practised fitting mask and snorkel while swimming or floating in the pool. For a paraplegic, or double amputee without fins, this is much more difficult than it sounds, since the act of raising the hands out of the water causes the body and the head to sink. The most effective technique was as follows: the pupil duck-dived to 3 metres and picked up the mask and snorkel from the bottom. The snorkel was then tucked into the side of the swimming trunks while the mask was fitted. Since the head and the mouth sank into the water during mask fitting, breath-holding was required, and the mask was inevitably full of water. As soon as the mask was sealed the pupil breathed through his mouth, swimming with one hand, while he recovered his snorkel. The snorkel was fitted while breathholding again, and then the mask could be cleared of water by inhaling through the snorkel and exhaling into the mask. Most pupils made several attempts before succeeding in this test, and Case A found it very difficult because of his difficulty in preventing inhalation through the nose.
During this pool session pupils were in the water for nearly two hours, most of that time being actively devoted to exercises, and part of it hanging on the side. Because of the effort involved getting in and out of the pool, pupils tended to keep this to a minimum. Several pupils scratched or grazed their legs, in spite of frequent warnings. In subsequent sessions all paraplegic pupils wore elastic athletic bandages around their knees, and a canvas pad was arranged on the side of the pool in the corner.
Lectures before and after the pool session included the following topics: Mobility for the disabled diver; physics of diving; liquid laws (Boyle’s Law, Charles’ Law, Dalton’s Law, Henry’s Law); outline of the physiology of diving; respiratory system; dangers of hyperventilation and incorrect breathing.
DAY 2: The pupils spent 25 minutes in the pool repeating the exercises learnt on Day 1. To test confidence and sense of direction, all pupils then swam one length on the surface with the mask completely blacked out.
This was followed by a 45 minute lecture at the pool-side on the following subjects, with demonstrations: adjustment of ABLJ, filling and fitting ABLJ cylinder, buoyancy adjustment while diving, breath control, principle of breathing regulator, fitting regulator to tank, testing tank pressure, importance of exhaling during ascent, hand signals.
The pupils all filled their own ABLJ cylinders from their scuba tanks, and entered the water for their first exercises with scuba equipment. In each case the pupil entered the pool at the corner wearing mask, snorkel, and ABLJ. The scuba set was lowered beside the pupil as he hung on the rail, and the instructor helped the pupil to fit the set and adjust the harness. With an inflated ABLJ the pupil could fit the scuba gear without help. Two or three pupils were in the pool at a time, each with an instructor. The pupils dived to rehearse hand signals, and then performed the following tests: two lengths of the 30 metre pool submerged on scuba; rolls and loops to demonstrate attitude control; buoyancy control by breathing; clearing the mask of water.
Performance was very variable. Case A was good on swimming and hand signals, but could not clear mask; Case В was so confident that he took off his mask completely several times and exchanged masks with his instructor while submerged; Cases С, C and E performed well; Case F was confident and successful, but had difficulty in maintaining a balanced attitude in the water.
Each pupil was submerged for 20-30 minutes on scuba. Although they wore ABLJs they were not permitted to adjust buoyancy themselves for the first day, to avoid the danger of over-inflation and rapid ascent. The instructor adjusted the buoyancy as needed.
There were no lectures on this day.
Dive Training at Wingate Institute 1974 (Mediterranean, Israel) photos by Howard Rosenstein
DAY 3: In the pool training all pupils dived first to rehearse the lesson of the previous day. After assembling and donning their ABLJ and scuba gear they performed the following tests: rolls forward and backwards; remove and replace regulator mouthpiece; remove and replace mask underwater. Pupil A was submerged for 16 minutes but could not succeed in mask clearing; the other pupils completed the tests in times as follows: В – 16 minutes, C – 9 minutes, D 9 minutes and E – 14 minutes. Pupil F had extreme difficulty in getting his attitude trim balanced, and worked closely with an instructor attaching weights on various positions on the torso until stability was gained. This was achieved by fitting weights to the ABLJ at the upper chest level. Pupil F was submerged for 18 minutes.
A pool-side lecture and demonstration was then given on the following topics: operation of the ABLJ, control of ascents, effect of wearing a diving suit, effect of pressure on buoyancy of suit and ABLJ, effects of work, cold, and depth on rate of air consumption, variations in breathing resistance with depth and tank pressure. There was a demonstration of the correct order of donning equipment.
All pupils then dived with their instructors in the pool and carried out the following exercises: submerge and share the scuba mouthpiece breathing alternately with the instructor for several minutes; swim one length submerged, surface, change to snorkel, and swim one length on the surface; swim one length underwater with a blacked- out face mask. All pupils completed these tests successfully.
In the evening there was a lecture on the following topics: physiology under pressure; effects of the various gas laws as they apply to the gas spaces of the body; Dalton’s Law and the various kinds of gas poisoning, oxygen, nitrogen narcosis, carbon monoxide, carbon dioxide, and hydrocarbon gases.
This was followed by a lecture on mobility for disabled people on diving expeditions, including methods of crossing rough ground, negotiating steps, camping, and living rough.
DAY 4: The course gathered at the pool to practise the advanced exercises of fitting and removing complete scuba gear while submerged, and life-saving. It was explained that removing scuba gear underwater was possibly useful in certain kinds of emergency, and that donning equipment underwater was relevant to changing sets for prolonged decompression, etc. However, it was made clear that the principle reasons for these tests was to show complete control of the equipment by the pupil, and complete confidence underwater.
For removing equipment the pupils were instructed to proceed as follows: sit on the bottom, remove weight belt and place it across the legs, unfasten scuba harness and slip off one shoulder strap, swing tank round and slip off the other shoulder strap, pull tank down beside diver and lay it on the bottom so that the regulator is close to the diver, remove mask and snorkel and place them on the bottom, start to turn off the tank pillar-valve, take one large breath and close the tank completely, ascend slowly exhaling all the time.
For fitting equipment underwater all the gear was thrown into 2-3 metre depth with the tank pillar-valve turned on, and the regulator mouthpiece tucked under the weight belt to prevent free venting. The pupils were instructed to proceed as follows: swim down, pick up mouthpiece and start breathing, take weight belt off tank and place across legs while sitting on the bottom, pick up mask, fit and clear it, pick up tank, slip one arm through harness, swing tank round behind back or over the head, put other arm through harness, faster waist buckle, fit weight belt, swim one length submerged, surface slowly.
It was explained that the second exercise was much more difficult than the first. Pupils must compete the first exercise to qualify for a sea dive, but would not be disqualified if they failed to complete the second. For paraplegics with no control of their waist muscles it should be appreciated that both exercises require an extremely acute sense of balance, and continuous slight hand movements to prevent the diver falling over. NCF then gave a demonstration of fitting the equipment underwater using the technique as instructed.
The pupils then carried out exercises as follows:
A – Had not achieved sufficient control to attempt these tests. Was given intensive instruction in breath control, balance, and mask clearing. Improved rapidly.
В – Removed equipment swiftly and calmly. Had trouble with balance during fitting equipment, and instructor held legs down to improve stability. Completed both tests.
C – as for B, but could have completed exercise without help
D – as for В
E – both exercises completed quickly and calmly without any help
F – both exercises completed quickly and calmly without any help
Pupils В – F were very enthusiastic about these tests, and carried them out several times in order to improve their efficiency. The instructors then demonstrated lifesaving with each pupil in turn, bringing them to the surface and towing them one length of the pool. The pupils were shown that they could assist a diver in difficulty by releasing his weight belt and/or inflating his ABLJ, but these exercises were not practised.
In the evening there was a lecture on the following topics: structure and function of the sinus, ear, eustachian tube, ear-drum; circulation and respiration, function of alveoli, risks of embolism and blocked alveoli, dangers of heat loss and exhaustion; dive planning.
This was followed by a lecture on methods suitable for disabled people getting from the shore onto diving boats, in and out of the sea from various kinds of beach and foreshore, and from boats into the sea and out again.
Left: Sidna Ali Diving Center 1971 (Mediterranean, Israel). Right: David the fisherman takes divers photos by Howard Rosenstein
DAY 5: The class and instructors met at the quay-side in the harbour of Akko at 07:15. The early hour was chosen to try and avoid the wind which gets up during the day. After careful consultation and discussion YM and NCF had decided that it was not safe for A’ to dive in the sea with scuba tanks. While he undoubtedly had excellent mental and emotional adaptation to diving, the height of the lesion at T4 made diving dangerous anywhere except in a pool under supervision. At 07:50 the first pair of pupils, В and F boarded the 8 metre diving boat, accompanied by diving instructors, a doctor (YM) and physiotherapists and observers. In a water depth of 8 metres the boat was anchored, the pupils lowered themselves over the side, and the instructors helped them to fit scuba gear in the water. Each pupil dived in the company of two instructors, and the visibility was less than 3 metres. They were submerged for 20 minutes, and then returned to the boat. F was able to get from the boat into the water and out again unassisted, but В required assistance.
The boat returned to shore, and the personnel were exchanged so that the other four course members could put to sea. Pupils C and E carried out the same dive as the first pair, in a slight wind with a half metre swell. Pupil D dived last, by which time, nearly 1000, there was a strong breeze and waves of about 1.0 metre. Pupil A snorkelled safely for about half an hour, but did not dive.
On July 22nd 1974 pupils A, C, D and E gave a demonstration of diving at Beith Halochem Sports Centre for the Disabled, near Tel Aviv. The pool was 50 metres long with excellent clear water, and the demonstration was documented with underwater photographs and underwater television. An audience of several hundred watched the demonstration at the pool, and the participants were presented with certificates recording their achievements.
Effectiveness of the course
The course described above was designed as an acquaintance course to demonstrate that seriously disabled people could master the techniques of scuba diving in safety, and to establish the best methods of diving and instruction. The progress of the course has been presented in detail since authorities wishing to follow or improve upon this example will naturally be very cautious, not to say sceptical, and it is therefore important to provide exact evidence of the progress of a group pupils. The question of further training will be discussed below.
Maximum degree of injury permissible
This problem has already been discussed in the section on medical criteria, but is considered here from the point of view of safety on a dive in the open sea, rather than from a purely physiological standpoint. It has been demonstrated clearly that T4 paraplegic lesion prevents diving in the open sea. Whilst pupil A showed the greatest courage, self-control, and competence in the water, the loss of respiratory muscles was critical. In contrast, pupil В with а Т6 lesion was completely safe. This confirms the theoretical prediction that T5 is the highest lesion which can be permitted diving in the present definition. Any pupil with a lesion above T8 should be scrutinised especially carefully.
The most serious problems of safety related to attitude control in the water, and the restrictions resulting from the hands being required both for propulsion and adjustment of equipment. The paraplegics had good attitude control when swimming, though the feet tended to float up a bit, but had some problems with the advanced pool tests because of the lack of waist muscle control. Conversely, the double amputee with both legs off above the knee had difficulty in controlling the attitude when swimming with scuba, but had no difficulty when swimming with scuba, but had no difficulty when sitting on the floor of the pool. Pupil F found it necessary to attach weights at waist level to attain a good swimming attitude with tanks.
A special danger for paraplegics is that they do not know the position of their legs unless they look at them. This is quite difficult while wearing mask and scuba, and so there is the risk that their feet or knees will collide with rocks, coral, or wreckage. If complete suit covering is worn there is no risk of abrasion or cuts, but in the absence of a suit, extreme care must be maintained.
Special consideration has been given to the situation of paraplegic lesions, or other types of paralysis, arising from bends. The conclusion quite simply is that a person who acquired a paralysing disability as a result of bends should not dive again, and this applies to a spinal or cerebral bend even if a cure is achieved through recompression treatment.
Discussion with Dr HV Hempleman and Dr HL Frankel produced the following evidence. A spinal bend damages the spinal card as a result of interrupted or reduced blood supply. Recompression treatment, or the restoration of blood flow. However, there is no means of knowing whether the capillaries have truly been restored to their normal efficiency. Neurological tests of reflexes etc. will confirm that the spinal cord is functioning adequately at normal atmospheric pleasure, but there is no means of discovering whether the blood supply would remain adequate under extreme stress, pressure, or unusual respiratory conditions, other than by exposing the subject to risk in those conditions.
The recent cases can be quoted to illustrate the risk. Subject X was diving in the Channel Islands, acquired a bend, and was brought to Stoke Mandeville Hospital paralysed after recompression treatment which failed to bring any improvement. After ten weeks of complete rest and care X began to recover sensation and muscle control in the lower part of his body, and eventually walked out of hospital completely fit. A few months later X was swimming in a pool, and attempted to swim a length underwater whilst holding his breath. He was paralysed again and was returned to hospital. After a further few weeks he recovered sufficient strength in his legs to walk with the aid of a stick, but four years later he still walked with a serious limp, and required a stick for support.
Subject Y was diving daily to 35 metres in the North Sea, and acquired a bend which paralysed him from the waist down. He was treated immediately with recompression, and apparently recovered completely. Several weeks later he returned to diving with scuba, and two months later was diving at 25 metres on a no-stop dive. After ascent he was paralysed again, from the lower chest down. Recompression treatment failed to produce complete alleviation of symptoms, and for several months he experienced numbness in the legs, headaches, and abnormal reflexes a year later there were still slight residual symptoms.
These cases demonstrate that inadequate decompression causing spinal damage can result in a condition which is undetectable by neurological examination, but which is extremely dangerous. Quite apart from the fact that a person who has suffered one Type II bend may be prone to such bends, the first exposure, whether partially or totally cured or not, may have left damage at a higher spinal level with no neurological symptoms. Upon a second exposure the subject may be very seriously injured.
Optimum Training Schedule
The course at Tivon/Akko was designed as an intensive acquaintance course. It was successful because the pupils had been selected as having exceptional aptitude, in spite of their disabilities, and there was a large team of skilled instructors. There were doubts on the first day as to whether the course members could stand the pace of two hours in the water and two hours lectures as the second half of a working day. In practice the pupils showed increasing enthusiasm and no adverse effects. However, the course was excessively intensive, and people with less innate aptitude are capable of becoming competent divers. In general an introductory course should be more gradual and less intensive.
An optimum introductory course, with a view to subsequent continuous diving training, might consist of 5-10 trainees, supervised by a doctor, 2-3 physiotherapist/swimming instructors, and 3-5 diving instructors.
The course would last 3-5 full days, including 2 hours of lectures, demonstrations, films, technical displays, etc for each hour actually spent in the pool. There should be ample opportunity for reading and studying, discussion with the instructors, and trainees to form a single social group. Each disabled trainee has special difficulties and problems arising from his injury, and the instructors will be learning how to cope with this, as much as is the trainee. This requires the instructors to understand and identify themselves with the trainees to a very high degree.
Optimum follow-up and progressive training When the standards of training for disabled divers have become well established it may be possible, and preferable, for trainees to join diving clubs or diving schools immediately after their medical selection, and receive training from qualified diving instructors in the usual way. In the mean time it is preferable that severely disabled people in the categories considered here should receive initial training at special short courses supervised by doctors and physiotherapists. Such courses could be established in many countries by co-operation of national sports diving organisations such as NAUI, BSAC, FFSSEM, and the veterans administration, and disabled sports organisations.
Disabled divers should not dive with each other. After receiving initial training, the trainee should join an active diving club or diving school. Training in these organisations is usually carried out on a part-time basis over many weeks or a few months, and this is ideal for the disabled person. By diving regularly with members of the club or school the disabled diver will acquire a group of friends and fellow divers who know his capabilities and limitations when diving at sea, and this will provide maximum safety.
Disabled divers should as far as possible complete all the established training exercises as laid down by the Confederation Mondiale des Activites Subaquatique, and be granted the appropriate certificates. The CMAS standards of training should only be reduced or modified to allow for restricted depth and sea conditions, as discussed below, and in respect of life-saving, since the disabled diver can give very little assistance to others. The disabled diver who acquires sufficient sea experience to become qualified should receive a certificate or log book endorsement stating clearly the limiting conditions within which he may dive safely. He should receive an annual medical check to ensure that it is safe to continue diving.
Performance limitations and dive planning
It is hoped that the present article will be used by diving clubs and disabled sports organisations to help them assess the suitability of disabled diving trainees, and to plan diving trips including disabled people. It is important therefore to try and visualise the full performance envelope of a disabled diver, showing the weak points, and the means of compensation.
Table 1 is a very subjective attempt to estimate the relative level of competence which may be shown by a disabled diver compared with an average trained sports diver. The figure of 100 is taken to represent the normal competence, safety level, etc for the average sports diver.
Paraplegics may tend to get cold more quickly than able-bodied divers, and should wear additional protection. This will vary between individuals very much. If a paraplegic becomes very cold during diving, do not try to warm him up with a very hot bath, as this may cause burns. The hottest bath that is safe is about 40°C.
BASIC RULES FOR SEA DIVING BY DISABLED PEOPLE
The following rules are based on six years of disabled diving experience by one of the authors (NCF) and the conclusions from the course in Israel.
Obey all usual diving regulations and medical regulations concerning diving.
Your safety factor is always lower than for an able-bodied diver.
The dive begins when you leave home and ends when you get back home safely.
NEVER DIVE ALONE.
ALWAYS DIVE WITH TWO ABLE-BODIED EXPERIENCED DIVERS CLOSE TO YOU IN THE WATER; THAT IS WITHIN 5 METRES OR VISIBILITY RANGE WHICHEVER IS THE SMALLER. THERE MUST BE AT LEAST ONE DIVER IN THE COVER BOAT AND A BOATMAN.
Always plan and survey your entry into and exit from the water with the people who will be helping you.
Make sure that your diving companions know your limitations in terms of diving safety, and general medical care.
You cannot use your hands to adjust your equipment or carry out work while you are swimming. Avoid situations which require both at once.
Never dive in a current stronger than you can swim against for a long time.
Avoid abrasions and cuts from reefs and rocks. Do not touch corals.
Do not make dives requiring decompressions stops.
Never go under overhangs.
Never go inside caves or wrecks.
Never dive at night.
Never dive in visibility less than 3 metres. It is impossible for your companions to stay sufficiently close to you to give rapid help in these conditions.
Never dive in waves of more than 2 m (?) or a strong wind.
Plan all diving operations with multiple redundant safety measures and fail-safe procedures.
VALUE OF DIVING FOR DISABLED PEOPLE
It has long been recognised that swimming is an ideal sport for disabled people, since it enables them to discard all artificial aids to mobility and to obtain a maximum level of exercise enjoyably. While swimming gives the disabled person free mobility in two dimensions, diving gives the third dimension. The disabled diver can swim, rise, or descend, roll and turn in any attitude, with no special equipment other than conventional diving gear.
As pointed out at the beginning of this article, risk sports, or adventure sports, appeal to a different mental and emotional character than do team competitive sports. Team competitive sports require superlative performance within the limits of arbitrary man-made rules; the goal is competitive victory over the opponent. It is most unlikely that the disabled person will be able to compete with able-bodied people because he would always be beaten. Adventure sports are not competitive, although they can be made so in some cases, and the goal is to use skill, judgement, and strength to live with and overcome a natural environmental situation: the air, the sea, a sheer cliff, a glacier.
Quite apart from the satisfaction of mastering a difficult technique, a dangerous environment, and obtaining enjoyable physical exercise, diving – in common with some other adventure sports – requires intense group cohesion, loyalty, and mutual trust. A solitary diver is always unsafe, whether disabled or not, and divers learn to depend on each others’ skill and ability for their physical safety. This applies to planning, equipment maintenance, and training, as much as to actual co-operation during buddy dives. Involvement in the overall planning and preparation for dives means that the disabled person should become completely integrated into the team. Even in cases where a person is so severely disabled that it is not safe to dive at sea, it is possible the sufficient enjoyment and exercise may be obtained in a pool to justify the effort.
The paper on the Israeli paraplegic divers was first presented at the Diving Officers Conference of the British Sub-Aqua Club in 1974. The paper by Culp and Lobel first appeared in Sea Frontier, the bi-monthly magazine of the International Oceanographic Foundation. Our thanks are due to these organisations for help in allowing republication.
BRITISH SUB-AQUA CLUB DIVING OFFICERS CONFERENCE Guidance for Branch Diving Officers on the Possibility of Diving Training for Disabled People 6 November 1974
Early in 1974 there was a meeting between the Minister for Sport and the Minister for the Disabled, as a result of which the Sports Council has set up a number of liaison groups between sporting bodies and various groups representing disabled people. The aim of this scheme is to permit disabled people to join normal sports clubs, and to participate in outdoor activities. Reg Vallintine represented the BS-AC at the first few meetings until, about midsummer 1974, I was appointed the official BS-AC representative on the Sports Council Committee for Water Sports for the Disabled.
In spite of the strict necessity for medical fitness in diving, it has long been apparent that a person with quite a serious injury, say one leg amputated above the knee, could become quite a competent diver, other things being equal. Several more seriously injured people have taught themselves to dive, and in about 1968 Bob Head, a paraplegic with both legs almost completely paralysed, joined London Branch. Keith Nicholson was then Diving Officer, and he decided to accept Bob for training, using his experience of diving safety to judge what could and could not be safely attempted by a person with this disability. Bob became a competent and keen diver, with many sea dives to his credit, though he has recently cut back on his diving in order to take up flying aircraft!
In 1969 I became paralysed from the waist down as a result of a car accident, a condition known medically as paraplegia. From 1970-73 I worked slowly and steadily at exploring the full possibilities for disabled diving, sticking as closely as possible to the full BS-AC training schedule and tests. In 1974, as a result of negotiations by BS-AC Vice President Alex Flinder, I compiled a diving training course for seriously disabled men. The attached report is a preliminary version of a paper which I have written together with Dr Yehuda Melamed, which we hope will be published soon in the journal Undersea Biomedical Research.
The policy of the BS-AC is to encourage branches to accept disabled members for diving training wherever possible, entirely at the discretion of the Branch Diving Officer. The attached report should demonstrate that disabled people can be safe divers, and active branch members, provided that the proper medical precautions and checks are made first. If a seriously disabled person comes to you and wants to learn to dive, give him a copy of this paper, and ask him to take it to his GP, and your branch diving doctor, so that the doctor can establish the basic feasibility of the person taking up diving. Once that has been done it is up to you, the DO, to decide if the candidate is suitable. To put it in its most direct terms, if a man is going to make a safe diver in a disabled condition, he would have been a very good diver when he was completely fit.
There is no reason why a disabled diver should be a passenger in the branch, and you can always clobber him for equipment maintenance, treasurer, social organisation, fund raising, editor of the Branch newsletter, etc.
If half the branches of the BS-AC enrolled one disabled person each and taught him or her to dive, that would be a fantastic achievement. Please write to me if you have any questions.
NSW Branch Scientific Meeting – 5 March 1977
The members who attended this meeting were treated to an interesting and varied program, the result is large part of the determined efforts of Dr Chris Lowry. The setting was the Old Stone Building lecture room at the Prince of Wales Hospital. This choice of venue loses nothing from its proximity to a pleasant and historic hostelry and is commended for future meetings.
The first speaker was Dr Doug Walker, who tried to persuade the audience that a fresh look was needed in the realm of Medical Standards. He instanced the cases of applicants with histories of asthma, diabetes, spinal Bends or even traumatic paraplegia. Individual consideration rather than inflexible rules were advocated. The fallibility of the resting ECG in predicting future coronary thrombosis was noted, quoting aviation medicals in Australia over a recent 10 year period. The overwhelming importance of good training and correct diving routine as the most important safety factor was stressed. Next Dr Bart McKenzie spoke on sinus barotrauma, mentioning that 25% of cases were associated with ascent and warning that facial numbness could result from antral reaction effecting the nerve directly and need not indicate a CNS lesion. The diagnosis naturally considerably effects therapy!
We were privileged to hear Dr Yeo describe the recent work at the RNSH Spinal Unit, using sheep, concerning the use of НР0 to reduce the damage after spinal injury. The results justify further work and in fact some patients have received treatment. It was suggested that possible repeated treatments would be even better than a single one, the mode of the initial sheep experiments. The supposed reason for benefit from НР0 was by helping tissues near to the primary damage retain viability despite the bruising and reduced circulation. That НР0 can itself produce toxic effects was mentioned by one member. It was noted that in the elderly a central cord lesion could very easily follow a minor fall. It was suggested that any casualty where cord damage was suspected should be given mask oxygen therapy from the earliest time seen and transported with continued oxygen.
Professor Colebatch was our second “special”. He described his recent work on divers who had suffered pulmonary barotrauma not due to apparent failure of ascent techniques. He related the damage to the abnormal elastic forces in the lungs of such people, an abnormality not effecting routine tests of respiratory function. Both Professor Colebatch and a member of the audience described the occurrence of pulmonary barotrauma in people attempting too vigorously to excel at ventilatory tests! The damage occurs, logically but possible unexpectedly, on the INSPIRATORY effort phase. Cases where the barotrauma occurred associated with ascent technique failure have been shown to have normal elastic forces in their lungs.
Mr John Pennyfather gently but firmly let us see that the problems of diving at altitude were complex: we could see why those in need of advice came to him. In
answer to a query about flying after diving he gave two instances worth serious consideration. The first concerned a saturation diver in the USA who suffered Decompression Sickness five days after surfacing, due to taking a plane trip. In the other instance, five RAN divers went on a bus tour in the Canary isles, to an altitude of 7,000 feet, after diving that day and the one previously: they suffered
“bends” also. As he said, there appeared to be little basis for the accepted rule of 12 hour delay between a dive and flying. One possibility is that ascent from sea level merely makes apparent the subclinical decompression problem in such people. Once more we must accept the limited safety given by our present level of understanding of decompression problems.
Dr John Knight brought us back from the clouds to the practical dangers of entering cold water. In one instance in Victoria an experienced diver only survived his entry because his demand valve was already in his mouth; the sudden cold-reflex inhibition of control of respiration made it quite impossible for him to take voluntary action. Had he needed to surface in order to take a breath he would inevitably have drowned. Dr Knight also reminded the audience that body core temperature continued to fall for perhaps half an hour after removal from the water, and full return to a normal core temperature could require two hours or more. Heat loss in water is delayed in onset but not changed in ultimate extent by normal wet suits, heat loss being greater in the active than the static: the fact that 71% of the human body is within 2.5 cms of the skin surface makes the peripheral vasoconstriction important in heat conservation.
The final talk was by our President, Dr Ian Unsworth. Two case histories were presented to indicate that HPO therapy can be beneficial even after a delay of several hours from the incident of cerebral air embolism. Neither of these cases were initially recognised as being examples of this condition, and in neither case was the necessity for HPO as a primary mode of treatment recognised immediately. The first case was associated with an anaesthetic incident, the second with a childhood misadventure. Despite a delay in initiating HPO of 20 hours, the recovery was ultimately complete in the first case. Naturally diagnosis is easier in retrospect than under clinical stress but the existence of a hyperbaric facility makes diagnosis important.
The meeting was a success. The report is full so that the many who almost came will gain some benefit also.
I’m 32 years of age, and was left quadriplegic 11 years ago due to an unforeseen accident that occurred during a training exercise at the Police Academy located in Cairo, Egypt, which is where I studied during my university years.
I found my purpose of life (Coaching, Inspiring, Motivating and Helping People ) after I had that accident.
Since then, I’ve developed a lot of mixed emotions regarding my condition, but today I stand tall and happy, relieved that I was given another chance to enjoy life, and to be able to breathe. Due to that feeling, I was inspired to try to help others, especially those who are unaware of the potential ability they may have.
Many individuals have an abundance of opportunity, yet they lack the mindset to realize it and act on it. They are strong-willed; however need a shoulder to lean on, a push, motivation and a hand-shake every now and then, regardless of their condition. It is my desire to illuminate the lives of others so they might acknowledge and live out their own greatness.
I’ve the unending ability to see possibility and excel in the midst of any circumstance so I facilitate transformation and focus strongly in the areas of self-discovery, self-development, and self-love because I believe that it is not until we truly know, love, and accept who we are that we can give true love and acceptance to others.
I also believe that the key to achieving lifelong health, wealth, happiness and peace involves “self acceptance” plus setting small, measurable, and attainable goals along the way.
During the past few years I have taken part in various activities, despite my lack of hand and leg movement. These activities include swimming, horseback riding, sand boarding and scuba diving and to become world’s first quadriplegic who demonstrates these activities in form of motivational documentary.
And I still intend on taking part in various other activities.
I have had the honor of speaking at; World Meditation Day, International Breast Cancer Awareness Day, British university in Egypt, Arab for Science and Technology Academy, Police Academy, World Rotary Youth Day, Egypreneur Forum (Entrepreneurs Network) and being a guest on Radio and TV stations.
Certifications and Education:
I hold a Bachelor’s of Police-Science and laws .
I hold a Diploma of Self-Actualization-Psychology
I’m a Certified Coach from the American Board of NLP
I’m a Certified Meta Coach from the Meta-Coach Foundation
I’m a Certified Resolve Coach from Transformations International
I’m a Certified Strategic Intervention Coach from the Robbins-Madanes Center.
Часто в общении с инструкторами по дайвингу возникает вопрос о том, можно ли инструктору, не имеющему специальной подготовки, работать с дайверами с ограниченными возможностями здоровья. Многие инструктора сомневаются, в том, что их статус позволяет им обучать таких дайверов, не будет ли к ним претензий со стороны “родной” ассоциации, не станет ли это нарушением стандартов обучения.
Приведу выдержку из Справочника по методике обучения PADI, самой массовой ассоциации, занимающейся обучению дайвингу и подготовкой инструкторов.
Инструктор PADI Светлана Чертенкова (Томск) и Евгений Бурмистров на курсе Open water diver
Teaching Techniques – General Considerations
Some student divers have physical challenges that interferes with their ability to perform certain motor skills. Although meeting some skill performance requirements may be difficult, adaptive techniques and reasonable accommodations can be made to help individuals with physical challenges master dive skills and enjoy diving.
The overall approach is to invite anyone interested in scuba diving into a program, as long as there is a desire and the person can meet the medical screening guidelines established by the industry and leading physicians knowledgeable in dive medicine. With medical clearance, you can train people with a wide variety of challenges by focusing on their desire to dive, rather than on any disability they may have.
While the standards themselves can’t be compromised, a variety of techniques can be used to help divers meet a performance requirement. Look for reasonable and creative ways to meet the standards.
Also consider the options available in the PADI System. If a student diver is unable to meet all Open Water Diver course performance requirements, the individual may be able to earn a PADI Scuba Diver rating. Discover Scuba Diving programs may a good option for continued participation – giving someone with challenges a closely-supervised, conservative diving experience. e PADI Seal Team program easily adapts to adult participants with physical challenges, the elderly and others who require a closely-controlled experience that ful lls the desire to have fun underwater. You can help people learn to cope with limitations and better use the full extent of their abilities by establishing reasonable, and achievable goals. You have the options you need to introduce scuba to all who seek it out.
Инструктор PADI Jona Lou и Евгений Бурмистров (травма позвоночника, параплегия) на курсе AOWD
In many areas there are laws that protect people with disabilities from discrimination. If you choose not to teach people with special challenges, your policies should not unfairly exclude people from participating in snorkeling or diving activities.
As with every course, make sure all costs and services are clearly communicated to student divers before the course begins. If you anticipate that student divers may need extra sessions, specialized equipment, a sign language translator or other additional service make sure everything is clearly written out and agreed to in advance. Your service policy should be distributed and agreed to by all student divers in all courses, equally.
If you welcome people with physical challenges into your courses, you have a responsibility to inform them about general diving risks as well as special considerations they may have based on their capabilities. Make sure everyone enrolled in your courses knows that participation will not result in certi cation unless all performance requirements are met.
You’ll find that most of the time you can accommodate divers with disabilities in your regularly scheduled courses. However, you may consider creating a special training package that includes all the extras an individual may need.
Инструктор PADI Дмитрий Князев и OWD Alex Trilap
People with injuries at high levels of the spine may have an impaired body thermoregulation and are more susceptible to hypothermia and heat exhaustion. On a warm day, help individuals avoid overheating by having adequate shade, water spray bottles or moist towels and fans available. To avoid chilling problems, make sure divers have a correct tting exposure suit, even in tropical climates. Always try to enter the water and begin activities as soon as possible.
Reduced circulation caused by some physical impairments decreases healing ability, so that even minor bumps and scrapes could take months to heal, or worse, lead to hospitalization. Make sure divers with physical challenges always wear protective clothing, such as exposure suits, tennis shoes, booties, heavy pants, etc. in and around the pool, beach and on dive boats. When possible, pad pool sides and boat swim steps to provide further protection.
While standard dive equipment may work for many people, sometimes minor modifications are necessary to compensate for physical impairments. For example, amputees can benefit for removing the unnecessary part of a wet suit and resealing it for warmth and protection. Divers with limited or no leg mobility can use webbed gloves for more efficient swimming. Divers with no right or left arm use may switch clips, gauges and hoses around for better access with their usable arm. Divers with poor vision may benefit from a magnifying glass attached to a mask for gauge reading.
People with limited or no use of their legs may not be able to stand in shallow water. During con ned water sessions provide reasonable accommodations such as blocks, step stools or plastic chair for stability.
Инструктор PADI Дмитрий Князев и Марина Куликова (травма позвоночника, параплегия) на открытой воде курса OWD
Participants with limited mobility may need assistance when entering and exiting pools, con ned water or open water sites. Use certified assistants to position wheelchairs, canes or crutches for easier entries and exits, and provide necessary lifting or steadying.
Make sure you and your certified assistants use proper lifting techniques. Remind assistants to adopt a stable position with their feet apart – one leg slightly forward to maintain balance and create a stable base for lifting. Be prepared to move their feet for stability if necessary, and keep their backs straight, maintaining a natural curve, and not twist their bodies when lifting. No one should lift or handle more than can be managed easily, and ask for help if needed.