Diving and medications don't always go well together and sometimes extra precautions need to be taken. Blood thinners are one such medication and divers, whether newbies or old pros, who are taking them, need to know what that means in terms of their health and safety. The first thing to know about blood thinners is that there are two types of them: anticoagulants and platelet inhibitors. The most common anticoagulant is called Coumadin and a common platelet inhibitor is Plavix. Each of these will directly or indirectly affect divers as they participate in the very sport they love, so let's take a look at Coumadin first.
Coumadin is a blood thinner that prevents the blood from clotting. Blood clotting is actually a crucial response that our body has to protect itself. If our blood didn't clot, then even a minor injury would cause death because the blood would not stop flowing. However, there are some conditions in which inhibiting the ability of the blood to clot is necessary, conditions such as atrial fibrillation, certain types of illness, and conditions of the veins such as phlebitis. This drug works by inhibiting vitamin K, which is the vitamin that is responsible for the creation of one of the clotting factors called prothrombin. Since vitamin K levels can change easily in a person, due to diet, bacteria levels in the gut, and other factors, the clotting of someone on Coumadin must be closely monitored, especially for the first few weeks and months, in order to ensure that the right level of clotting is maintained.
When it comes to diving, the inability of the blood to clot can cause problems. However, there are many people who take Coumadin and still dive successfully. Despite this, there are some things to be aware of. While there is still some clotting ability in the blood when a person is taking Coumadin, it takes longer to clot and if there is injury while underwater, the diver is at a much higher risk for significant blood loss. Ear and sinus squeeze can both cause injuries and if a person taking Coumadin experiences either of these, then they can have significant bleeding and are at risk of ear or sinus infection. A person who is taking Coumadin also has a higher risk of pulmonary barotrauma. However, there are many people who have atrial fibrillation, artificial heart valves, an abnormal heartbeat, and phlebitis who take Coumadin and dive regularly without complications. If you must take Coumadin or a similar drug, then consult with your doctor and as long as your blood is tested monthly and you are continuously monitored you should be able to dive without complications.
Now, for the platelet inhibitors such as Plavix. These medications also work to reduce the clotting ability of the blood, but this time by inhibiting the action of the platelets. People who have had a stent implanted in their coronary artery should take Plavix. The concerns of diving while taking platelet inhibitors such as Plavix are the same as those for anticoagulants such as Coumadin. Consistent and long-term monitoring of blood by a doctor is required.
Having said the above about the risks of diving while taking blood thinners, there is also the issue of why the blood thinners are required in the first place. In most cases, the illness that caused the need for blood thinners is either gone or, if it is a medical condition, it is well managed and under control. However, it is important to monitor the condition, especially if it is related to the heart. You should consult with your doctor to ensure that you are physically fit to dive and that your heart can withstand the exercise load required of divers by taking a heart stress test.
Those diving while taking Coumadin or Plavix must be sure to avoid diving when they are ill, have their blood clotting time monitored regularly and carefully, completely avoid ear and sinus squeezes, and ensure they are on a diet that will not adversely affect the drug Coumadin. The key is to balance the effects of the medication so that there is just the right amount of clotting; not too much or not too little. Once this is all under control, divers can enjoy recreational diving to their heart's content, knowing they are doing so with the greatest amount of safety possible.