Archive for May, 2011

Some of my readers are going to be unhappy with this article.  But issues like this is why I started this blog.  Getting this posted on the official Florida Sea Base website would be, well, let’s call it, “unlikely”.  But it is an important issue and should be shared with our participants.  I have discussed this at length with the Florida Sea Base Health Advisor.  It is disappointing that many doctors will unknowingly approve persons for scuba diving without having an adequate understanding of hyperbaric effects of various medical conditions and medications.

Almost every year we find ourselves facing new medical issues and scuba diving.  For 2011 the issues are hemophiliacs and persons using blood thinners.  (I have combined these two issues because they are so closely related.)  Most MDs should recognize that these conditions are not compatible with scuba diving.  However, we have had several medical forms signed-off by doctors clearing hemophiliacs and participants using blood thinners for scuba diving.  The Florida Sea Base Health Advisor (an MD with a sub-specialty in hyperbaric medicine) will deny such requests.  Here is just some of the data available that supports the idea that people should not scuba dive while taking blood thinners.

From PubMed Health:

“PubMed Health is a consumer health Web site produced by the National Center for Biotechnology Information (NCBI), a division of the National Library of Medicine (NLM) at the National Institutes of Health (NIH). PubMed Health provides up-to-date information on diseases, conditions, injuries, drugs, supplements, treatment options, and healthy living, with a special focus on comparative effectiveness research from institutions around the world.”

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000634/

“Warning …

“Warfarin may cause severe bleeding that can be life-threatening and even cause death.

“Warfarin prevents blood from clotting so it may take longer than usual for you to stop bleeding if you are cut or injured. Avoid activities or sports that have a high risk of causing injury.”

What side effects can this medication cause?

Warfarin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • gas
  • change in the way things taste
  • tiredness
  • pale skin
  • loss of hair
  • feeling cold or having chills

If you experience any of the following symptoms, or those listed in the IMPORTANT WARNING section, call your doctor immediately:

  • hives
  • rash
  • itching
  • difficulty breathing or swallowing
  • swelling of the face, throat, tongue, lips, or eyes
  • hoarseness
  • chest pain or pressure
  • swelling of the hands, feet, ankles, or lower legs
  • fever
  • infection
  • nausea
  • vomiting
  • diarrhea
  • loss of appetite
  • pain in the upper right part of the stomach
  • yellowing of the skin or eyes
  • flu-like symptoms
  • joint or muscle pain
  • difficultly in moving any part of your body
  • feelings of numbness, tingling, pricking, burning, or creeping on the skin
  • painful erection of the penis that lasts for hours
  • ***BOLDED SYMPTOMS ARE ALSO SYMPTOMS OF DECOMPRESSION ILLNESS***sw

The following brand names are from RxNorm, a standardized nomenclature for clinical drugs produced by the National Library of Medicine:

Brand names

  • Coumadin
  • Jantoven
  • Marfarin”

From Divers Alert Network:

http://www.dan.org/medical/articles/article.asp?articleid=79

Anticoagulants

A diver who has been prescribed an anticoagulant, e.g., Coumadin® or Warfarin®, should be warned of the potential for bleeding: excessive bleeding can occur from even a seemingly benign ear or sinus barotrauma. There is a potential risk that, if decompression illness occurs, it may then cause significant bleeding in the brain or spinal cord.

From Assessment of Diving Medical Fitness for Scuba Divers and Instructors, by Peter B. Bennett, Frans J. Cronje, Ernest S. Campbell

PAGE 99 BLEEDING DISORDERS

“Other causes of bleeding disorders include: … Medicines, such as aspirin, heparin, Warfarin, and drugs used to break up blood clots.”

“Risks to divers include barotrauma damage to air filled spaces such as the sinuses, ears, or lungs from the bleeding that can occur in these organs, and the decrease in oxygen carrying capacity of the bleeder with anemia.  These individuals should be advised not to dive.”

Since symptoms for hemophilia is very similar to those listed above, the rational is the same.  In the old days most of the training agencies were more direct.  Bennett, et. al., hit the nail on the head.  “These individuals should be advised not to dive”.

Coumadin, Jantoven, Marfarin, Warfarin, and all other brand names of blood thinners have not been tested for safety under increased hyperbaric pressure (as in scuba diving).  While a person may experience no side effects at sea level, side effects may be magnified by the increased pressures of diving.  Several of these side effects mimic decompression illness and can exacerbate treatment.  Bruising injuries (such as getting smacked by the boarding ladder) are common on dive boats.  Sinus squeezes and ear barotraumas are frequent in scuba diving, especially for new divers and persons who dive infrequently.  These conditions can be a serious risk for hemophiliacs and persons on blood thinners.  Barotrauma to the lungs, spinal cord or brain could be fatal to anyone, but again, the danger is significantly higher for persons with bleeding disorders.

If you are using a prescription blood thinner, that medication has been deemed medically necessary by your doctor and you should NOT discontinue your medicine in order to participate in recreational scuba diving.  If you are on a preventative regime of low dose aspirin, you should ask you doctor if it is “medically necessary” or if it would be okay to suspend the aspirin therapy during diving.  Remember that it may take 72 hours or longer to flush the aspirin from your system.

As far back as I can remember, hemophilia and the use of blood thinners have been contraindicates for scuba diving.  This is NOT new.  What is new is the number of doctors who seem to be unaware of the issues and who approve persons for diving when they are at such an increased risk of injury.

Capt. Steve
Aboard S/V Escape

Above and beyond all else that I have to say today, I want to say “thank you” to current and former military personnel who have defended my freedom.  God bless you all.

Our first Sea Exploring crew of the summer season arrived Sunday.  They will be aboard the Schooner Jolly II Rover for the week.  Four Coral Reef Sailing crews also arrived at the Florida Sea Base yesterday.  They went out on Sprindrift, Wandering Star, Conchy and Dutch Love.  Five Scuba Adventure crews and one Scuba Certification crew checked in.  The 2011 summer season has begun in earnest at the Florida Sea Base.

The wind started out at 11 knots yesterday morning but built to near 20 knots by dinner time.  Otherwise the weather was great.  The wind is forecasted to stay near 20 knots from the East for the next several days.  That is going to make conditions very dicey for the divers and borderline for the sailors.  But a forecast is only that and hopefully conditions will improve very soon.

Captains Rich and Carol rode their bikes to Key West yesterday.  Sailing Commissioner Stephanie Mansburger did a great job during Capt. Rich’s absence.  Scuba Commissioner Laura Kuras lead the scuba staff through last minute preparations yesterday morning and through our first crew arrivals of the summer yesterday afternoon.

Time to head out for the 0730 staff meeting.  Have a great Memorial Day.  If you get a chance, say “thank you” to a soldier, sailor, marine or coastie.  They certainly deserve much more.

Capt. Steve
Aboard S/V Escape

Saturday was the last official day of staff training despite the fact that the 2011 Florida Sea Base summer season opened on Friday.  The scuba staff spent the morning in the classroom with the Florida Sea Base health advisor learning about medical issues as they relate to scuba diving.  They spent the afternoon diving and practicing rescue scenarios.  The next time they perform a rescue it will be the real deal.

No one has had a day off yet.  Evolving from training to operation will now allow for some time off.  Capt. Rich (who I worry about the most due to his work load and stress level) is scheduled to be off today.  He is thinking about riding his bike 74 miles down to Key West.  Tim took yesterday afternoon and this morning off.  The seasonal staff members are doing extremely well.  They will start a cycle of days off this week.

One Scuba Liveaboard crew (Schooner Conch Pearl) and three Coral Reef Sailing crews (Misty Shoals, Jewel of Athena, and Juan Cadiz) arrived yesterday.  No crews were in for shore leave and no crews returned to Sea Base for their luau.

This may sound stupid, but the sun was BRIGHT yesterday.  We get a lot of sun through most of the year; but yesterday the sun seemed exceptionally bright.  Maybe I need more sleep.  The weather was very threatening in the late afternoon so I moved my car out so it might get a Keys car wash.  But the rain didn’t happen.

Last night recently certified Scuba Instructor Brian Sevald led an Emergency First Response course (CPR and First Aid) for some of the staff members.  Capt. Alex Bergstedt and I assisted.

That’s it for this morning.  Have a great day.

Capt. Steve
Aboard S/V Escape

 

We are in the home stretch for the 2011 summer staff training at the Florida Sea Base.  On Friday the scuba staff focused on the care and maintenance of scuba equipment in the morning and went diving (and mostly practiced more rescue scenarios) in the afternoon.

While all of this great training is going on, we are also having to prepare for our annual camp “visitation” that will take place in about two weeks.  It used to be called what it really is, an inspection, but the kinder, gentler BSA decided visitation sounded nicer.  We welcome the dedicated volunteers and professional Scouters who make the visitation happen.  And we sincerely appreciate having fresh eyes review our programs and policies.  These annual inspections (I mean visitations) have lead to many improvements in the quality of our programs.  And we have had, and will continue to draw, some people with serious inspection skills, such as two Admirals, the CEO of AT&T, MDs, PhDs, attorneys, BSA professionals, subject matter experts from all walks of life, members of the BSA Health and Safety Committee, etc.

One Scuba Liveaboard crew returned to base yesterday for their luau.  One Scuba Liveaboard crew and four Coral Reef Sailing crews arrived to begin their adventures.  Dr. Ellen was swamped but handled it (as always) with a pleasantness and professionalism beyond my level of comprehension.  Theresa Wells received the Scuba Liveaboard crew.  They will be aboard S/V Endeavour with Capt. Kelly and S/V Silent Harmony with Capt. Mike.  The Coral Reef Sailing crews are aboard S/Vs Midnight Dragon, Silver Crow, Siesta and Chanticleer with Captains Jim, George, Ed and Scott, respectively.

Here’s our forecast from the National Weather Service:

Saturday: A chance of showers and thunderstorms. Mostly sunny, with a high near 89. East wind around 5 mph. Chance of precipitation is 30%.
Saturday Night: A chance of showers and thunderstorms. Mostly cloudy, with a low around 78. East wind around 10 mph. Chance of precipitation is 30%.
Sunday: A chance of showers and thunderstorms. Mostly sunny, with a high near 89. East wind around 15 mph. Chance of precipitation is 30%.
Sunday Night: A chance of showers and thunderstorms. Partly cloudy, with a low around 78. East wind around 15 mph. Chance of precipitation is 30%.
Memorial Day: A slight chance of showers and thunderstorms. Mostly sunny, with a high near 89. Chance of precipitation is 20%.
Monday Night: A slight chance of showers and thunderstorms. Partly cloudy, with a low around 78. Chance of precipitation is 20%.
Tuesday: A slight chance of showers and thunderstorms. Mostly sunny and breezy, with a high near 89. Chance of precipitation is 20%.
Tuesday Night: A slight chance of showers and thunderstorms. Mostly cloudy, with a low around 78. Chance of precipitation is 20%.
Wednesday: A slight chance of showers and thunderstorms. Mostly cloudy, with a high near 89. Chance of precipitation is 20%.
Wednesday Night: A slight chance of showers and thunderstorms. Mostly cloudy, with a low around 78. Chance of precipitation is 20%.
Thursday: A slight chance of showers and thunderstorms. Partly sunny, with a high near 89. Chance of precipitation is 20%.
Thursday Night: A slight chance of showers and thunderstorms. Partly cloudy, with a low around 78. Chance of precipitation is 20%.
Friday: A slight chance of showers and thunderstorms. Mostly sunny, with a high near 89. Chance of precipitation is 20%.
Point Forecast: Marathon FL [Similar City Names]
24.72°N 81.07°W (Elev. 7 ft)
Visit your local NWS office at: http://www.weather.gov/keywest

I hope you have a safe and enjoyable weekend.

Capt. Steve
Aboard S/V Escape

Thursday was Mr. Rob Kolb’s day to address the combined staffs from the Florida Sea Base and the Brinton Environmental Center.  The meeting was hosted at our facility again this year.  Almost every year we discuss having this part of training at the Brinton Center, but it never happens.  I’m sure that a part of the reason is because most of the guest speakers are from the Upper Keys and the 50 mile drive to Brinton may be asking too much of them.  A representative from Bank of America made a pitch about why the staff members should open an account with them.  Former FSB staff member and now Deputy Director of the Florida Keys National Marine Sanctuary, Mary Tagliarini, and former FSB staff member and now Florida Wildlife Commission Lieutenant Liz Reisz made presentations plus the local blood bank was on site taking donations.  For the third year in a row we set a new record for the number of blood and platelet donations made by the Florida Sea Base / Brinton Environment Center staff members.  Most of the full time FSB staff members were also assigned topics for the day’s meeting.  Training concluded early and Mr. Kolb took the staff to see the newest Pirates of the Caribbean movie followed by dinner back at base.

This coming weekend is Memorial Day and the big opening weekend for this summer’s participants.  The chance of rain has been increased to 30% for today through Monday.  The Colorado State University releases an update to their 2011 hurricane forecast on 01 June.  I hope to put together a post on 02 June addressing that topic – stay tuned.

Jim Aspell sent in the following comment:

Steve,

I just wanted to tell you how much I enjoy your blog. Our Troop 146 from West Hartford, CT does the coral reef trip every two years and we always have a great time. I personally was on base in 2010 and did a week with Harman on Dutch Love. Our second crew that year did the week with Ed on Siesta and had an equaly great time (although a little more on island time than we were with Harman., lol) I enjoyed myself so much I came back here and bought an O’Day Mariner and have begun to dream of the cruising life :)

We will be back in April 2012 for another week of sailing on the reefs. What a great program! I understand the reasons the program changed (fuel endurance/morality) but our only wish is that the Coral Reef program still did the Key West run.

You should post a bicture of Escape on your blog!

YIS

Jim

Thanks for the kind words Jim.  I understand your sentiments about Key West.  The “Key West Day” has been removed from all programs except Sea Exploring (which may happen in 2012 or 2013), Open Oceans Adventure (which starts and ends in Key West), Order of the Arrow Oceans Adventure (OA members only), Keys Adventure and maybe the Florida Fishing Adventure (I stay confused about whether they go or not).  As you can see, there are some programs still visiting Key West.  To be clear, here are the programs that DO NOT visit Key West as part of the itinerary: Coral Reef Sailing (Jim’s favorite), Eco Adventure, Scuba Adventure, Scuba Certification, Scuba Liveaboard, Out Island Adventure, and (as noted above) maybe the Florida Fishing Adventure.

Fuel and concerns over the lack of proper adult supervision of the kids while in Key West were considerations in removing Key West from these programs.  However, what drove the changes were two other factors. First was YEARS of Coral Reef Sailing participant critiques complaining that they did not get to sail enough due to the “forced march” to Key West.  The boats were forced to average around 5 knots to make the trip.  Sometimes the wind doesn’t cooperate with a set schedule so a lot of motoring was required to insure timely arrival at Key West and to return to the Florida Sea Base.  So we decided to model the program after our very successful Bahamas Sailing program and remove the destination.  Now, wind is the only determining factor.  The crew can literally go where the wind carries them from day to day and we are seeing a LOT more sailing and (as pointed out by Jim) a reduction in fuel purchases.

The second reason was also based on participant critiques; the scuba crews wanted more dives.  So we removed Key West from the itinerary and replaced that day with another day of diving.  Accomplishing this required the purchase of another $300,000 dive boat (so there went the savings from the Coral Reef Sailing fuel reduction).

Finally, the Risk Management folks in Dallas felt that transporting kids on US 1 was the most dangerous thing we did.  Obviously that didn’t affect Coral Reef Sailing going to Key West, but the other crews were taken by school bus or vans.  We had a perfect safety record, but it was likely a matter of time until we had a catastrophe.

Again, thanks for the comment Jim.  What we are suggesting for those who really want a day in Key West is to come a day early or stay a day late and add the Key West day to your Tour Plan.  Key West is a GREAT place to visit.  But the trip needs to be planned and supervised.  Key West can be a positive experience for Scouts when state parks, museums and Scout appropriate sites are scheduled.  But without adult supervision there are inappropriate opportunities for the kids (and adults).  And speaking of adults, while very rare, it was very infuriating to be called in the middle of the night to drive an hour and a half to Key West to liberate adult Scouters from the local police because the leaders were holed up at Sloppy Joe’s (or one of the other 650 bars in Key West) while the kids roamed Duval Street without supervision.  As we know, all it takes is one numb-skull to ruin an otherwise great opportunity.

Ok, off the soap-box.  Here’s a photo of S/V Escape at Morgans Bluff, Andros Island, Bahamas.

Click to enlarge.

Yesterday was my dad’s 79th birthday.  I love you, Dad.  As with many Eagle Scouts, my award should have gone to my dad; he worked harder guiding me along than I did.  I remember him hiking with serious blisters and the torturous bike ride from Fort Worth to Burkburnett, Texas in the grueling heat of the Texas summer on single speed bikes with camping gear and rations for the weekend.  There were many other sacrifices on his part, but those were the two most painful that I recall.

Have a great day.

Capt. Steve
Aboard S/V Escape

We are more than half way through this summer’s staff training.  Yesterday morning was dedicated to van driver training.  Almost everyone on staff will be required to drive a van load of participants somewhere this summer.  Many of the staff have never driven anything as large as a one ton, 12 passenger van so our insurance carrier requires several hours of training.  After lunch the scuba staff worked on boat mate training, including how the systems on the boats work, safe boarding techniques for the participants, safe loading techniques for the dive gear, how to safety depart and return to dock, cleaning the vessel, common knots used on the vessels, etc.  After dinner the staff went to Alligator Reef to learn how we conduct night dives.

The knot tying is one of my pet-peeves.  Most of our staff are Eagle Scouts.  It is sad that many of them don’t know, or have forgotten, how to tie a bowline, clove hitch, and two half-hitches.  In medieval times (when I was a Scout) these were fundamentals.  It is also critical for them to know how to tie a cleat hitch but I can understand their lack of experience with that knot.  These four knots are critical when handling boats and can be the difference between safe operation and docking of the vessel and significant property damage or personal injury, especially when operating in dicy conditions.

The success to the night dive is preparation.  I’m always comparing this place to Disney Land and the “secrets” that go on behind the scenes is what makes the “magic” for our participants.  The night dive at the Florida Sea Base is the first night dive for most of our scuba participants.  Step one is classroom preparation where the participants are taught proper etiquette and procedures for safely and effectively using the flashlight (it’s harder than it sounds).  The divers are now challenged with carrying something in their hand while diving, not blinding the other divers with their light, and using the light for signaling each other.  They have to control the light, control their buoyancy and BC, equalize their ears, and communicate.  Four or five hands would be enough; two handed this process is a bit of a ballet.  Another issue is fear of the dark water and the “monsters” that lurk below.  So we start our night dive right at sunset so there is some ambient light and the darkness happens gradually and with less of a shock factor.  The divemaster is responsible for herding the eight cats (participants) in his/her crew through this experience and insuring their safety and comfort.  This is no easy task and very difficult for ADD challenged staff.  Attention to detail and focus for an hour is essential.  There is also the equipment preparation: batteries, bulbs, lanyards for the flashlights, tank marker lights and strobes (used as underwater markers).

Once again it was a productive day.  No overcast skies yesterday morning.  It was very sunny all day.  Summer is here!

Capt. Steve
Aboard S/V Escape

Another great day of summer staff training has been completed at the Florida Sea Base.  Yesterday morning the scuba staff went diving and practiced rescue scenarios.  After lunch they attended compressor training and mandatory HazMat training.  In the late afternoon they worked on luau ceremonies and did a walking tour of the base.

I was on and off the base yesterday.  I left early for my follow-up with the surgeon.  (Everything is healing nicely.)  Then rushed back to the base to make the HazMat presentation.  The manager of Bauer Compressors – Miami called and said one (out of four) scuba compressors had arrived for the scuba liveaboard program.  He agreed to meet me half way with the compressor so I headed back to the mainland.  I returned to Sea Base right around dinner time.  I don’t have a clue as to what was accomplished by the sailing, food service or ranger staff members, but I’m sure they had a very productive day.

The weather was overcast and threatening rain again yesterday morning but cleared up and we didn’t get any rain.  Our afternoon highs are running around 90 and the overnight lows are about 80.  The water temperature at Molasses Reef was 81.7º yesterday.

As I mentioned previously, our first crew of the summer was a Scuba Liveaboard crew that arrived on 21 May.  This Friday we will have 4 Coral Reef Sailing and one Scuba Liveaboard crew arriving and at that point the flood gate will be open and we will have a record setting attendance for the remainder of our 2011 program season.  The first Sea Explorers arrive on 29 May, Eco Adventure kicks off on 02 June, the Open Oceans Adventure (this is the first year for this program) starts on 10 June, and the Order of the Arrow Oceans Adventure starts on 15 June.

Capt. Steve
Aboard S/V Escape

Today was very productive and the staff is progressing well.  This morning started with a staff meeting, flags and breakfast.  Next the staff went swimming (BSA Swimmer’s Test) before breaking for lunch.  After lunch the scuba staff worked on scuba skills review, rescue skills, and providing emergency oxygen.  Flags and dinner followed AND, due to the hustle displayed during the day, the scuba staff had the evening off.  In between the routine items of flags and meals, the sailing staff completed their swim review, learned how to teach the Snorkel BSA program, did some small boat sailing and I think I saw some kayaking going on as well.

The ranger staff spent much of the day on vehicle maintenance.  The food service staff went swimming this morning with the scuba staff and spent the rest of the day on meal preparation and internal training.  Overall a very productive day.

The weather was overcast and somewhat threatening early but it did not rain.  We have a 20% chance of rain through Memorial Day.

I will be absent from this morning’s training due to a follow-up appointment with the surgeon.  I am optimistic that he will give me good news.  I hope you have a good day as well.

Capt. Steve
Aboard S/V Escape

Sunday was a full day of staff training, starting at 0730 and ending at 1730 with a 45 minute lunch break.  The facilities staff and galley staff joined us for much of the day.  We also completed all US Coast Guard drug testing for the sailing and scuba staff.  After training, the staff lowered the colors and enjoyed Mexican food for dinner.

We were indoors all day but the weather was nice; no sign of that 10% chance of rain so far.

This morning will start with a short staff meeting, flags ceremony and breakfast.  Then we will do swim tests and scuba reviews for the scuba staff.

22May

Productive Day

in Scuba  •  0 comments

While several departments allowed their staff to sleep in and take the day off, the Scuba staff met at 09:00 and worked hard until mid-afternoon.  Repairs were made in the scuba pool area that I have been promised by the facilities department would be completed two years ago.  The scuba area is ready for participants and the scuba staff is becoming a fine tuned machine.

We also had our first Scuba Liveaboard crew arrive today.  Yes, staff training has not started but crews are arriving.  There is no explanation that I can make here that won’t get me in trouble.  So I will say Dr. Ellen checked the crew in, Captains Denny and Holly are ready aboard the Schooner Conch Pearl and Scuba Instructors Sargon Smith and Megan Ware are packed and ready to roll.  The crew completed their check-in, swim review and scuba review yesterday.  This morning they will have breakfast, load vans and a trailer with personal effects, scuba gear, fishing gear and provisions and head off to meet up with the Pearl.

Our summer staff training starts at 07:30 this morning and will conclude whenever we get through – likely after dinner tonight.  It is the first day of a week of long days and serious fun.

The weather is a little iffy for the week with a 10% chance of rain through Monday night and a 20% chance of rain for the remainder of the forecast period.  So we will look at that as an 80 to 90% chance on no rain.

On a personal note, my 12 year old granddaughter, Juliet, won the Bonnie look-alike contest yesterday at the Bonnie and Clyde Festival in Gibsland, Louisiana (near Shreveport).  I don’t have a photo yet but will post one later if I can.

That’s it for this morning.  It’s going to be a long day of rules, paperwork, and uniforming – all of the fun stuff.

Capt. Steve
Aboard S/V Escape