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>>>"The Diver: A recently certified 25-year-old woman had just returned >>>from her first weekend dive vatcation in Mexico. She takes mild >>>medication for anxiety and smokes a pack of cigarettes daily. She's >>>in good physical shape but isn't involved in a regular exercise >>>program." >> I'm not hip enough yet to the subtleties of diving medicine to comment meaningfully (I wear wings not dolphins), but in the aviation community as a flight surgeon (where I can comment), we've measured the effects of just *ONE* cigarette as being the equivalent of an ascent to 10,000 feet in reduction of O2 pick-up. NATOPS (Naval Aviation Training and Ops standards) require O2 masks in tactical aircraft at this altitude! Simple guy that I am, I figure that if smoking cuts down your O2 absorption at sea level, it *CAN'T* be any better for you at depth! (and may be even worse). The "anxiety" meds alluded to could refer to almost anything. For various reasons, the metabolism of some drugs at depth (and at altitude) can get real tricky and unpredicable. While I'm coming to understand that tourist based diving is a big business (hence a motive to down play its hazards) there is such a thing as being too chavalier about the medical status and conditioning from a safety standpoint. While I just joined DAN a couple of days ago as a personal show of support to my newfound community (I've not seen the Alert journal yet and have not read this comment in it's entirety) I hope that this is not typical of the general hyperbaric and dive medical community (and just an unfortunate choice of words). The juxtapositioning of "cigarette smoking" and any activity as intimately intertwined with breathing physiology as diving, is an oxymoron. I really should just keep my mouth shut read a few issues before commenting further. But, "good shape" is a relative term and should be used guardingly when refering to a smoking diver with obviously reduced lung reserves. It's a no-brainer...you smoke...you have reduced lung reserves (the pulmonary docs have decades of plesmographic readings to prove it. (not to mention the carbon monoxide that irreversibly ties up the hemoglobin and further reduces the O2 carrying capacity. As physicians (formally trained as diving medical officers or not) we have to set good examples for our patients (or my new diving friends in this case). I'm sure DAN was not condoning smoking and diving (but it does show you have to be careful in your choice of words!) Sorry, I'm preaching to the choir....will someone help me down now from this box? Robb Wolov CDR Robert B. Wolov, MC, (FS), USNR Department of Orthopedic Pathology Armed Forces Institute of Pathology Washington, DC 20306-6000 wolov@hi*.co* (preferred) wolov@em*.af*.os*.mi*
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