If you are considering taking up diving and have a spina bifida congenital defect, unless you are learning in a specialized program you are taking a great risk. There are certain things that need to be addressed before any decision can be made, such as:

1. The extent of usage of your lower extremities; how much numbness of your legs and whether or not you have any “autonomic” instability. This means things like postural hypotension, blood pressure changes and ability to react to cold water immersion.

2. All of your neurological deficits should be carefully documented so that a diving physician will have this information available in case of an accident.

3. If you have good circulation, a shunt should not be a problem since there is no air involved and there should be no pressure differentials from the changes in pressures of diving.

4. The main problem that I can see is that you must consider your buddy–and it might be a good idea to dive with an extra buddy to help manage your equipment,and entries and exits from the boat and water.

5. If you have an open wound you must be aware of the increased risk of infection from pathogens in the seawater.

Dr. Chris Edge feels that these people can dive with a disabled diving group and that none of their problems are insurmountable. Shunts generally pose no problem as they are mostly closed off by adulthood.

Dr. Nick McIver feels that one falls back on the theoretical risks mentioned, although he does not know of proven cases of previous spinal cord problems that have led on to unmerited DCI. The UK Scuba diving medical standards refer to need for careful individual assessment: The numbers at risk must be small, and so risk not quantifiable, although he knows of one paraplegic who dives and the Israelis have run courses for paraplegics.

Otherwise one relies on the usual caution in assessing spinal cord problems:

1. Physical capacity to dive.

2. Safety in water for diver and buddy.

3. Risk of diving with symptoms and signs that could mimic DCI needing treatment.

4. Possible loss of functional reserve should Neurological DCI supervene.

5. Detailed assessment ant tailored diving care and instruction.

6. Doubts over existing pathology- is there any compromise in spinal cord circulation?

7. Spinal DCI has arisen in sports divers who observed safe diving practices, and no-stop dives. Dr Michael Swash of London (Neuro physiologist) cautions about risking a second insult to an already-damaged spinal cord.

The Australian Sports Diving Standards require an intact normally-functioning CNS apart from documented minor local (and not general) abnormality.

Here is more information that you can get from some associations for Disabled divers: American Association of Challenged Divers, John Ellerbock, P.O.Box 501405 San Diego, CA 92150-1405: (619) 597-8978

Eels on Wheels Adaptive Scuba Club, Scott Ogren, 1126 Corona Drive, Austin, TX, 78723; (512)335-5227

Handicapped Scuba Association, Jim Gatacre or Michelle Galler, 1104 El Prado, San Clemente, CA,92672; (714) 498-6128, (610)692-7824 (Julia), 303-933-4864 (Michelle)

Moray Wheels; Adaptive Scuba Association–Rusty Murray, P.O.Box 1660 GMF, Boston, MA 02205; 603-598-4292

National Instructors Association for Divers with Disabilities-(NIADD), Dorothy Strout, P.O.Box 11-22-23, Campbell, CA 95011: 408-379-6536

Open Waters, Paul A. Rollins, Project Coordinator or Steven Tremblay, Project Director, c/o Alpha One/Open Waters, Center for Independent Living, 127 Main St., South Portland, ME 04106;800 640-7200 vox or TTY, or 207 767-2189

Zero Gravity Diving Center, Bill Demmons, P.O.Box 2893, South Portland, ME, 04116; 207- 773-3483 (office)

Further Reading Jill Robinson and Dale Fox: Scuba Diving With Disabilities, 1987 Leisure Press, Champagne, Ill.