Dr. Bookspan Inducted to Hall of Honor - National Organization of Underwater Instructors, NAUI

It was my honor to be notified recently that I was inducted into the Hall of Honor of the largest non-profit scuba diver training organization in the world.

The award is for my work as a scuba instructor, teaching divers and diving leaders, as a diving and hyperbaric medical researcher finding safer diving practices, advising committees determining policies, running hyperbaric medical conferences, writing diving textbooks, and other contributions.

The National Association of Underwater Instructors (NAUI) trains recreational and technical scuba divers from novice through instructor. Their motto is Safety Through Education.

This year, two people were inducted. I was honored along with my old friend and colleague Henry Veix, former physical education director at West Point Military Academy.

My colleague Peter Oliver accepted the NAUI Hall of Honor award in my name and expressed my thanks.





Related Fitness Fixer:

• A NAUI project I worked on - New First Aid Training
• Some of my underwater adventures - The Mermaid Stories
• My work that makes strong brave men cry - Extending The Envelope - Military and Civilian and Extremes, Survival, Injuries, Faster Higher Stronger - Fitness Fixer
  
• Good books on understanding diving medicine and physiology - DrBookspan.com/books
  

Fitness Fixer for Smarter SCUBA diving:

• Three Common Swimming and SCUBA Myths in the News Again
• Diver Down Flags - Boating, Swimming, SCUBA Safer and Smarter
• Respiratory Muscle Training for Swimming, Diving, and Running
• Lower Back Pain From Swimming and SCUBA
• Hyperbaric and Aquatic Medicine On Travel
  

Random Fitness Fixer:

• Fast Fitness - Grip Strength and Endurance

Labels: award, education, hyperbaric, scuba

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Working In An Underwater Lab

I am a scientist in human physiology. I study how the body works in extremes of environments. I lived on mountains and underwater. I slept outdoors in snow to study cold adaptation. I spun pilots in centrifuges until their faces looked like shar pei puppies. I make grown men cry.

Readers asked for stories of when I lived the extremes myself.


Here is a story when I worked and lived in an underwater lab.

I didn't have a camera then, and have few photos from those years, so at right is a photo of an underwater lab found on the Internet using a search of the terms "underwater lab."

You live many meters underwater in a metal structure that keeps out the water. It is an air pocket the size of a big room and the air you breathe is under pressure equal to the surrounding water depth. Since you live there for days, or weeks, the lab has a kitchen. Cooking and using the bathroom in the higher pressure is for another story.

To get to the lab you need to dive down underwater. You can wear scuba gear or use a long surface supplied hose. Occasionally a reporter would come visit the facility and want to stay in the underwater lab for a day to get a story. We, the staff, would teach them enough to use the air supply safely to get them down and back up after their stay, and transport their sometimes large and unwieldy suitcases for them in watertight containers.

One day, another staff member and I helped a reporter dive down to the lab, helped her inside, all nice and dry, and left here there to set up her typewriter (this was a long time ago before laptops and wireless devices). We returned to the surface and put the air hoses away. Shortly later, we decided to free dive back down to check on her.

We took a deep breath, held our breath and dived
down down down

We thumped on the big tempered glass portholes trying to get her attention.

thump thump!
(holding breath)

thump thump thump!
(holding breath longer)

thump!
longer... oooooooh!

She noticed us. She was delighted to see two mer-people swimming in the blue depths outside. She waived at us gaily. We hovered swimming weightlessly outside in the blue, holding our breath.

She raised her two hands, making a camera gesture.
She clicked a finger in air and then pointed it to tell us - "Wait!"

Through the porthole we watched her pawing around for her suitcase to find her camera.
(still holding our breath, outside in the deep blue water)

She looked and looked. She scattered clothes and bags.

The other staff and I used a swallowing technique to extend breath-hold time -uuuuuuuuuuuMH

Finally, a camera waved at the view port.

She positioned the camera to take our photo.

(Still holding our breath waiting, waiting).

She held up the camera .... She leaned back, ... She stopped and oriented the camera the other way, ..... She leaned to the side

She gestured WAIT!! She gestured, "I have to get it just right! Just a moment longer just WAIT."


She got the photo. We saw the flash bounce off the glass, knowing the photo would never come out. She didn't seem fazed.

She held up one finger and pantomimed through the glass - "Wait - one more!"





Related Fun Fitness Fixer:

• Living Under The Sea (includes the exploding toilet story)
• The Mermaid Stories
• How To Stay Underwater For A Month
  
• Indiana Jones Rocket Sled
• Space Walks
• Extending The Envelope - Military and Civilian
• Do Military Chants Help Running? - The Jody Calls

Random Fun Fitness Fixer:

• FDA Orders Suicide Risk Warning for Common Back Pain and Migraine Drugs, and Others

Labels: aerospace, breath-hold diving, cold, hyperbaric, military fitness, scuba, swimming

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Are You Always Colder With Exercise In Cold Water?

It is winter in the northern hemisphere. Outdoor swimming and boating waters range from chilly to frozen. A widespread assumption is that exercise in cold water always makes you colder. Some scuba diving textbooks assert that cold water will cause heat loss and therefore you will always chill in cold water. Some survival protocols may say you must never try to swim to safety if you find yourself unexpectedly in cold water. Are these true?

Although you lose a high amount of body heat to moving water, it is also true that you gain heat from being alive and from moving. The more heat you can generate, the more it is likely to meet or exceed the amount you lose. Losing heat by itself does not mean that you are chilling. If you generate more than you lose, you do not chill, you can stay warm when swimming and diving, even overheat. If not, of course, you can get very cold.

In general, it is easier to chill than overheat in cold water. However, in some cases, you can generate enough heat through exercise to match or surpass the heat you lose, even moreso if you are well insulated with muscle and fat. Swimmers doing laps in pools and divers sweating into their masks during hard finning against currents can tell you that. During Desert Storm, some divers in the Persian Gulf needed to wear ice vests for heat extraction to prevent overheating.


Many factors are involved including your fitness (ability to exercise hard enough to make enough heat), your build, your clothing, medicines you may be taking, how far it is to safety, your health, how warm you were when you started, the weather, water current and conditions. You can have net loss and gain back and forth during the same swim. Much to know.

When I competed in swimming, we swam miles each day. In winter, after finishing pool training, I walked home, hair still dripping. A fun thing was to see how fast it would freeze. When I'd pat the top of my head, the frozen hair crackled humorously. You could hold locks out to freeze in shapes. Teammates and I experimented informally, running various speeds to see if the wind froze the hair more or our rising body heat could melt it. Some of us were able to generate a literal head of steam. Most of my training was pool swimming (wimpy) but I have tried ice swimming in no more than a bathing suit. My family were Russian Ice swimmers and my Grandfather was the oldest member of the Iceberg club, who swam in the ocean every day, including New Year's Day. I am trying to find any photos that may have been taken. I know the club and my Grandfather were pictured in an issue of Strength and Health magazine.

In my military work in cold survival, we used computer models to compare heat loss in critically cold water scenarios for downed pilots and combat swimmers, to our real experiments putting volunteers in cold water with lots of forced convection - waves, wind, overhead spray, and my little toy wind-up sharks and penguins. You can become incapacitated by cold before becoming hypothermic. You can die from cold incapacitation in the water without ever reaching a hypothermic state. In informal conversation, the terms hypothermia and chilling are often used interchangeably, but that is not correct, and they are not the same. I made t-shirts for "my guys" the military volunteers in each extreme experimental protocol. The cold immersion trial shirts were inspired by the verse "Many are called but few are chosen" to become, "Many are cold but few are frozen."

More On Surviving Cold:

• Sixteen Miles of Cold Water
• Getting Fitter in 50 Degrees
• Beware of Hype in Training Methods
• Do You Lose Most Of Your Heat Through Your Head?
• Swimming and Pulmonary Edema Part I
• Japanese Ama Divers - Cold, Clothing, and Children

Healthy Swimming and Scuba:

• Diver Down Flags - Boating, Swimming, SCUBA Safer and Smarter
• Better Stretches for Swimming - Cook Strait Update
• Lower Back Pain From Swimming and SCUBA
• Nutrition for Endurance Swim Training

Random Fitness Fixer:

• Inspiring Update from Jill - Celiac, Knees, Fasciitis, and Restoring Happy Life

Labels: cold, military fitness, myths, scuba, swimming

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Diver Down Flags - Boating, Swimming, SCUBA Safer and Smarter

My father, some of my brothers, and I loved swimming together in a cold river in the northern United States. We enjoyed fun discussions treading water at the turn-around points. One day, a speedboat left the boating lanes and came at us. I stared dumbly at the fast-approaching boat, because why would anyone run right over you when he could plainly see you? Everyone knew that people swim in the water. The prow churned the water right over us. We corkscrewed underwater like five clams in a row snapping shut, to clear the propellers. It is an acoustics fact that words attempted underwater are distorted. Humor columnist Dave Barry once wrote that anything said underwater sounds like "b-mmoogle" but Dad's blue stream was pretty clear through the roil of bubbles

We listened underwater until the propeller sound deepened, showing it was going away. We surfaced, and looked, and saw the boat turn around and head straight back for us. I thought it might be checking if we were all right, but Dad pushed all our heads back under. The boat smashed the water directly overhead again. Maybe the boat came to "finish us" but with the benefit of the doubt, maybe he just wasn't looking where we he was going again.

We dodged trouble. We are divers and have and use diver down flags. Boats not observing them is another problem. Every year, boats hit swimmers and scuba divers, and injure, disfigure, dismember, and kill them. Know your flags and prevent tragedies:

The Diver Down flag has a red background with diagonal white bar. It is notice to boaters that scuba divers are in the area and to keep clear. It was designed in the late 1950's so that boaters would not suddenly find themselves running over divers surfacing in their path. The "Diver-Down Flag" may be attached to a floating surface buoy and dragged around by a diving group if they will be ranging far from the entry point, or used as a stationary line for descents and ascents. It may also be flown by a boat used for divers. Some states prohibit flying the diver-down flag if divers are not in the water at the time. In that case, the dive boat will (is supposed to) raise the flag during dive activity then lower after all divers and swimmers are back onboard

Labels: injury, scuba, swimming

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The Mermaid Stories

"Are you a real mermaid?" asked 6-year-old Claire. Readers have been asking about skin and scuba diving, training for triathlon swims and breath hold diving, getting in shape for beach lifeguarding, science of swimming, Navy undersea maneuvers, and many aquatic adventures. Then, at a gathering I attended, the young granddaughter of a friend asked a question.

For the next two weeks or so, I will post Fitness Fixer answers to some of these from the road to teach at the Wilderness Medical conference in Colorado USA. Here is the first story.

It was her birthday. She wore a mermaid costume, and held her gifts of assorted mermaid dolls and toys. Claire loved mermaids. My mother, a Russian circus teacher, came to her party as a surprise and was teaching everyone to juggle scarves. Through the moving scarves, looking like sea waves, one of the mothers pointed my way and said, "Claire, look, that's the lady who lived under the sea - she's a mermaid!"

Claire edged over. She asked, "Are you a REAL mermaid?"

I thought before answering: I had devoted years of research career studying the human body diving deep underwater. I had lived days at a time inside research chambers simulating high and low pressure conditions. I had lived in actual undersea vessels on the sea floor called habitats. I helped test and pilot small submarines. But these were living in air pockets, breathing air. I thought a bit more. I had been a competition swimmer, training 5-7 miles every day, but that was in a pool. The longest I swam at once was 20 miles. Not as much as I imagined a real mermaid could easily swim. I had done open water swims across lakes and in rivers and harbors. I did ice swimming in winter. But that is still just swimming. I am a scuba instructor, who taught students and led trips far underwater. I had my scuba students and dive trip participants dress in costumes and sports clothes and we did underwater tennis, ballroom dancing, drove pedal cars and bicycles underwater, held umbrellas, and did underwater karate. But still, we breathed air from tanks or surface supply hoses, or did long breath hold dives from the surface. I worked with one of the greats in diving medicine who had worked developing liquid breathing long before the movie "The Abyss." I had put myself through school lifeguarding and teaching swimming at a city pool. I had guarded beachfronts, and competed in lifeguard contests, running the beach in a small red swimsuit and red rescue tube, body-paddling a rescue board over crashing waves to dive down and lift a human to the surface like stories of sea-dolphins, or maybe mermaids, buoying drowning sailors. I had lived in Japan and got to study the legendary diving women, spending long deep dives in hazy green cool waters, appearing briefly at the surface with seaweed decorating my long hair. I ate algae and sweet sea grasses. I love the water. I feel at home in the water. Then I spoke, "No."

Claire crinkled her small nose and stomped away. "NOT a REAL mermaid!"

I turned to my friend and asked, "Should I have lied to your child?" She said, "Tell the real stories."


Coming Next - The AmaSan Japanese Diving Women

Previous Mermaid Stories:

• Living Under The Sea
• Nutrition for Endurance Swim Training
• Hyperbaric and Aquatic Medicine On Travel
• Train Exercise is Exercise Training
• Three Common Swimming and SCUBA Myths in the News Again

Next Two Weeks:

• Get Certified, Learn With Fitness Fixer Personally In Colorado USA in July

Stories of Previous Year's Journeys to this Conference:

• The Coming Two Weeks
• Fitness Fixer Index

Labels: breath-hold diving, hyperbaric, movie/media fitness, scuba, swimming

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Helium Speech - An Astronaut Calls the President of the United States

When you take a breath from a helium balloon and speak, your voice rises humorously. What happens when an astronaut does the equivalent and calls the President of the United States?

In 1965, Sealab II replaced Sealab I, 62 meters (200 feet) down on the ocean floor (photo at left). Sealab II was sometimes called the “Tiltin' Hilton" because of the slope of the site. Teams of "aquanauts" lived and slept inside, dry, breathing air pressurized to that depth. The Sealab project was under command of Dr. George Bond, Captain, U.S. Navy Medical Corps, affectionately called "Papa Topside."

NASA Astronaut Scott Carpenter (photo right) spent a record 30 days in Sealab II. After spending that much time at that depth, specific protocols of changing the breathing mixture and the pressure are needed to avoid problems from the dissolved gas that was absorbed while breathing the air at SeaLab pressure. Commander Carpenter did that inside a special decompression chamber, while breathing an air mixture containing helium. Yesterday's post How To Stay Underwater For A Month explains.

Helium changes heat transfer both inside and outside your body, and changes how fast sound can travel. Sound travels faster through helium than through air. That is the "Donald Duck" effect. People who inhale helium from a balloon and speak on the exhale have a distinctive humorous voice change. Funny voice is temporary, lasting only as long as helium is passing the vocal apparatus. (Helium can't support life. Don’t continuously breathe balloon or other helium source to get a few laughs talking funny.)

I had heard from my Navy friends that an old recording existed of Commander Carpenter trying to phone President Johnson for a formality of congratulations while still inside the recovery chamber breathing the helium mix.

Recently, my colleague Dr. Derrick Pitts, Director of the Fels Planetarium at the Franklin Institute in Philadelphia, and I were talking about space and underwater habitats. He told me that the recording of Commander Carpenter had been found, restored, and was available through NPR National Public Radio.


The description lists the event as 1964, but I think it would have been 1965. It doesn't matter. Enjoy the recording.


Over this summer, I hope to write you some interesting stories about decompression, scuba, space research, cool people involved, and my work living under the sea. Until then, here are related stories:

• Space Walks
• Indiana Jones Rocket Sled
• Exercise and Medicine Underwater and at High Pressure
• Exercise and Fitness in Decompression Sickness Risk
• How To Stay Underwater For A Month
• Collapsing Astronaut Gives Healthy Reminder
• Altitude Sickness, Viagra, and Bubbles on Flights
• Altitude Sickness on Flights
• Living Under The Sea

Labels: aerospace, altitude, breathing, hyperbaric, movie/media fitness, scuba

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How To Stay Underwater For A Month

Human beings have gotten all the way to the moon, but can't get far under the sea. In space we can wear special suits to decrease effects of pressure change and deliver air to breathe, but (in brief) the farther you go down underwater, the more these same conditions constantly change in difficult ways.

For ordinary scuba diving, divers wear a tank of regular air. A compressor squeezes ordinary filtered air into the tank, so that several times more air fits. For more time underwater than a tank allows, a diver can breathe from a special long hose from the surface. How far you can go depends on the length of the hose and the power to compress the air to the right pressure. With other specific training, you can wear a rebreather. A rebreather scrubs and reuses exhaled air instead of losing the exhale into the water (shortest description). In all these cases, the deeper and the longer you stay, the more nitrogen in the air you breathe dissolves all over your body.

When a diver starts back to the surface, pressure reduces all the way up, letting nitrogen back out. You need to come up slowly enough and not have stayed too long to be able to go directly to the surface without the nitrogen forming bubbles inside your body, part of the diving injury called decompression sickness or The Bends. Decompression sickness, and bubble formation, transit, and medical effects was a passion of my career work in physiology for many years. Still is.

On deeper dives, it works better to breathe less nitrogen. You can't substitute more oxygen at deep depths, because oxygen becomes increasingly toxic. You need a gas that doesn't make as much trouble during each depth and time. One choice is helium to replace some or all nitrogen, and part of the oxygen.

If you have lots of dissolved nitrogen or helium or other gases chosen for a long and/or deep dive, you need to stop on the way up, called a decompression stop. Where and when and for how long to stop is interesting, and the subject of research and arguments (discussions) among scientist and divers. Different Navies and commercial companies use different protocols, some known well, some closely guarded as company secrets.

For extreme depth diving for research, commercial work like oil drilling, mining, and communications, military surveillance, espionage, and "proprietary commercial interests," divers can spend time on "deco" stops, but for long dives, many stops are needed, some more than 10 hours. Doesn't work to do that, then go back to work the next day and repeat. One solution is to stay down inside the rig or habitat or other enclosure designed for that. I wrote a little of my work doing that in Living Under The Sea.

At each depth, you can only absorb a certain amount of gas. After that, no more fits. It doesn't matter how long you stay past a certain point, you have the same decompression obligation on the way up. Staying down until you are full of gas is called saturation diving. You can stay down a week or a month, then decompress once. Decompression can be done in the water, but there are problems of cold, darkness, bathroom needs, and gas supply. Another solution is inside a vehicle designed for that purpose. The decompression vehicle can be raised and removed from the water, and the divers inside slowly decompress safely. It was also experimented, to drag divers straight to the surface and throw them as fast as possible into a surface chamber to quickly compress them back to pressures at depth, then slowly release according to algorithms people back then decided were right. Tragically, some regular scuba divers heard about these two kinds of "surface decompression" and thinking it meant the water surface, managed to publish articles in diving magazines, and give lectures at dive shows, with that misinformation being widely repeated, that one could come straight to the surface after deep dives and float around in an inner tube and read dirty magazines, as the guys in the special recompression chambers did to pass the couple days they'd spend.

You wouldn't turn inside out from the huge pressure differential produced, as depicted in some science fiction movies, but it might kill you as effectively. That is a sample of what happens when reporters don't read what scientists write in their research articles, just repeat some sentences taken out of context, conclusions in the abstracts, or what someone else wrote.

Tomorrow - a fun story about NASA Astronaut Scott Carpenter in 1965. He lived 30 days underwater in SEALAB II, in the US Navy’s Man-in the-Sea Project off the coast of California. Commander Carpenter was breathing a helium mix during his surface decompression in a chamber. In tomorrow's post, hear a recording of what happens when he makes a pre-arranged phone call while breathing helium in the chamber to President Lyndon Johnson - Helium Speech - An Astronaut Calls the President of the United States.

Related stories:

• Space Walks
• Indiana Jones Rocket Sled
• Exercise and Medicine Underwater and at High Pressure
• Exercise and Fitness in Decompression Sickness Risk
• Living Under The Sea

Labels: aerospace, breathing, hyperbaric, injury, myths, scuba

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Who We Read - Using Fitness Fixer for More

Beside your Fitness Fixer post each day, what else is here for information and fun?

Down the right-hand column of your screen are several categories of links:

1. First is "Health Expert Updates" where you can subscribe and have each new Fitness Fixer post sent to you free.


2. Under "Health Expert Updates" is "Recent Posts." Recent Posts lists the ten Fitness Fixer posts before the one you are reading in the main screen. If you are reading an older post, you will not see current posts.
   


3. Under "Recent Posts" come the "Archives." Clicking an archive link gives all posts from that month. I have been writing Fitness Fixer since 2006, so there are many months in the archives. Archives may not look interesting, but a month of posts at t time lets you quickly skim for short interesting reads. Try one.


4. Under the Archives is "Who We Read." Here is where I can share with you sites I personally use:

• Bonkers Institute, in the guise of comedy and with a deft hand, exposes serious medical scams. I introduced it in the post Technical Difficulties.


• New Scientist generally has a variety of well-done and interesting science articles





• Scuba Doc is a massive wealth of scuba medical and technical information, put together by my dear colleague and friend Dr. Ern Campbell, MD, FACS. "Scubadoc's Diving Medicine Online" has an open Scuba Clinic Forum where you can find many diving questions and answers by topic, and interact with other divers and interested people. The Tenfootstop Weblog is a lovely helpful scuba blog. The FAQ is a considerable collection of scuba answers. The "Site Map and Table of Contents" gives a huge list of articles.


• TruthOrFiction calls itself "Your Email Reality Check" by checking veracity of "rumors, inspirational stories, virus warnings, hoaxes, scams, humorous tales, pleas for help, urban legends, prayer requests, calls to action, and other forwarded emails."

Any time you want to see the most recent Fitness Fixer post, click the blue underlined "Fitness Fixer" link under the Healthline.com menus, to the left of my name. It is (so far) always just above the title of the top post in the main screen.

Labels: education, scuba

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Subjects Invited for Immersion Pulmonary Edema Study

Duke University contacted me regarding Swimming and Pulmonary Edema.

They are recruiting experimental subjects who have experienced immersion pulmonary edema to participate in studies to investigate causes of this condition. The studies concentrate on effects of cold-water facial and body immersion on pulmonary arterial pressure and pulmonary arterial wedge pressure. It will also analyze subjects' DNA to see if people who have experienced immersion pulmonary edema (IPE) may have a genetic predisposition.

DNA Analysis Study
Subjects over 18 years old who have experienced immersion pulmonary edema are needed to donate a small amount of blood for this DNA analysis. This will involve one blood draw and a review of past medical records. Subjects will be paid $50 for participation in this part of the study.

Immersion and Exercise Study
A small group of subjects will be studied more extensively to investigate the effect of cold water immersion on pulmonary arterial and pulmonary arterial wedge pressures. Subjects will exercise underwater on a cycle ergometer (bicycle) modified for use in a pool inside a hyperbaric chamber. Subjects will be monitored with arterial and pulmonary artery catheters.

Subjects must come to the laboratory about 3 hours before the immersion and exercise study for a physical exam, an exercise test, orientation, and scheduling for the experimental day. The experimental day (about 8 hours) takes place at least three days later.

Subjects involved in the immersion and exercise part of the study will be paid up to $350 for participation.

Subjects undergoing immersion and exercise must be 18-40 years of age, physically fit (regularly exercise at least twice a week), and have no physical impairment that would prevent them from participation.

Immersion Pulmonary Edema
Immersion pulmonary edema is a sudden accumulation of excessive fluid in the lung air spaces during swimming or diving. It is characterized by cough, shortness of breath, decreased blood oxygen levels, and coughing up blood. This condition has caused death. Its cause is unknown, but it can occur in swimmers and divers who are usually young and healthy, including military recruits. It may occur in swimmers or divers who have experienced similar conditions before without any problems.

To Participate Contact:
For more information, please contact Dionne Peacher at IPEdivestudy@notes.duke.edu or 919-668-0001.


Related Related Fitness Fixer:

• Swimming and Pulmonary Edema Part I
• Swimming and Pulmonary Edema Part II
• Sinus and Head Colds
• Regular Exercise Reduces Cold and Flu Incidence
• Sixteen Miles of Cold Water
  
  

Labels: education, pulmonary edema/oedema, scuba, swimming

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Living Under The Sea

Since I was small, I wanted to be a scientist. I wanted to study physiology under the sea. I wanted to live underwater, and for a time, I did. This is how I found out about exploding toilets.

I grew up to be a scientist in extreme physiology - the science of surviving extremes of heat and cold, mountain top and underwater, high and low air and water pressure, exercise and nutritional and pharmacologic tinkering, altitude, g-forces, injury, and other things extreme.

One of the laboratories where I worked was tethered to the bottom of the ocean at a moderate depth. It was a small metal building with air inside. You could not see it from the surface. If you went by in a boat, or drove by the highway, you would see only the sea. We wanted to order a pizza and give the lab address and see the delivery person pull up to nothing but water and try to find us at the bottom of the sea. Even scientists can be funny sometimes.

To live in the lab, we swam down in scuba gear, entered through a small hatch in the bottom, and dried off, or just walked around in a towel. Then we stayed dry while working and sleeping inside. We walked around normally and breathed the air normally, day after day. When it was time to go to work outside in the ocean, we put on scuba gear or surface-supplied hoses, and swam down through the bottom hatch. The hatch did not need to stay closed. We could look down to see fish swimming, even sit on the lab floor and dangle our feet in the water through the hatch, without flooding the lab. How does this work? See the drawing at right of an elementary science demonstration:

1. Hold a glass upside down over a bowl of water.
2. Push the upside down glass straight down into the water.
3. Water doesn't enter the glass. Water rises in the glass a small amount because air is squeezed by water pressure. As long as you don't tilt the glass too much, the rest of the water stays out.

It works pretty much the same way in an underwater laboratory, summarized in a child's science homework at right. Water stays out and air stays in with everything dry inside, as long as a sea monster doesn't come and knock the lab sideways.

The deeper the lab, the more the air is squeezed and the higher the air pressure. If you bring something full of air down to the lab, it might squash flat by arrival. One of the scientists had a CD-player that I brought down for him in a transfer pot. We opened the pot to find the case bowed inward, so tightly suctioned from inside that it couldn't open.

When transferring gear back up from the lab to the surface, air expands as water pressure decreases. Water-tight cameras had to be transferred open, or they might pop on the way up.

This same "pressure-volume" gas-law relationship applied to the marine toilet, a rectangular plastic box with a screw cap lid. When coming up, air expands. From only 33 feet of seawater (10 meters) to the surface, air volume will double because water pressure is decreased by half. Unless you fill the toilet box completely with water (or other liquids and solids), all gas inside will expand on the way up. It was a test for new interns to see if they understood gas laws to prevent the toilet from expanding enough to explode. Good to understand Boyle's Gas Law.


Related posts on better health and improving fitness in extremes:

• G-forces- Indiana Jones Rocket Sled
• Space Walks
• Three Common Swimming and SCUBA Myths in the News Again
• Respiratory Muscle Training for Swimming, Diving, and Running
• Exercise and Fitness in Decompression Sickness Risk
• Exercise and Medicine Underwater and at High Pressure
• Sixteen Miles of Cold Water
• Altitude Sickness on Flights
• Altitude Sickness, Viagra, and Bubbles on Flights
• Collapsing Astronaut Gives Healthy Reminder
• Forensic Anthropology and Bone Density

Labels: hyperbaric, military fitness, scuba

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Three Common Swimming and SCUBA Myths in the News Again

On Monday July 7, a news show Troubled Waters featured a story of two scuba divers who floated 19 hours overnight after they and their dive boat did not connect after a dive on the Great Barrier Reef in Australia.

In their television interview, the two divers told various points of the situation. Three of the concerns were common myths often repeated in scuba training.

1. They mentioned they experienced signs of hypothermia. Technically, not any chilling is hypothermia. Being uncomfortably cold does not mean you have hypothermia. Shivering and teeth chattering does not mean you have hypothermia. You can even become incapacitated by cold before becoming hypothermic. In informal conversation, the two terms of hypothermia and chilling are often used interchangeably.

2. The woman of the pair stated she had read in a book, which had a section about progression of hypothermia, that exercise is not good and can be counterproductive. They were worried that body movement would, "send blood to the muscles away from your core, and your organs" and for that reason, make them colder.

I have read the book they mention. It is a book of wonderful stories and great writing, interesting medicine, but the physiology is frequently off. As a physiologist, I notice these things. When I teach medical students in their classes, I often see that they do not want to learn physiology, they only want to learn what medicine to give and where to cut. I tell them that without understanding the reasons for how the body resulted in the situation in the first place, they will only repeat the mistakes of their teachers by giving medicines and cutting.

Back to the shivering divers floating all night, waiting for rescue. It is not always the case that exercise in the cold must only make you colder. Exercise in cold water can generate enough heat to match or surpass the large thermal drain, depending on water temperature, work load, duration of exposure, your body composition, what you are wearing, and other factors. It is true that exercise in cold water increases heat loss, but it is an important point that it does not mean that you will always cool. Whether you stay comfortable or get cold depends how much heat you keep and how much you lose. If you generate more heat than you lose, you will be warmer than when you started. When I worked on cold water immersion for the Navy, we studied body cooling in pilots downed in cold water, and how long they could survive (all volunteers, really they loved my studies). We also studied divers. Some divers sent for underwater missions during the Gulf War were overheating underwater and had to wear ice vests with their scuba gear.

3. The last myth is a popular one. I am a scuba instructor and have heard this one repeated often. The two divers mentioned that the woman of the pair was menstruating and that there were sharks in the water. The woman said, "I'm shark bait is what I'm thinking." Diver researcher Dr. Carl Edmonds found that Australia's shark attack tracking system reported nine times more shark attacks on men, even though there was an even number of male and female swimmers.

Menstrual blood does not attract sharks. Neither does menstrual blood attract grizzly bears during camping trips, cause wine to sour as stated in ancient religious writings, or cause wings to snap off airplanes, as pilots insisted in the 1920's. The term man-eating shark, for now, remains.

I explain these myths and more about swimming and diving physiology, underwater and in heat and cold, in the book Diving Physiology in Plain English.

Related Fitness Fixer:

• Do You Lose Most Of Your Heat Through Your Head?
• Fitness Myths - How Many Legs Does a Dog Have If You Call the Tail a Leg?
• Time of Death From Body Temperature?
• Beware of Hype in Training Methods
• Lower Back Pain From Swimming and SCUBA - Parts I and II
• Exercise and Fitness in Decompression Sickness Risk
• Getting Fitter in 50 Degrees
• Gluteal Muscles Myth - Shaking The Dog's Paw

Labels: cold, menstruation, myths, scuba, swimming

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Stop Lower Back Pain From Swimming and SCUBA Part II

Yesterday's post explained the most common hidden cause of lower backache after swimming and scuba diving. Swimmers and divers who get this chronic pain are often misdiagnosed with SI (sacroiliac) joint dysfunction, arthritis, disc injury or various "catch-all" terms for back pain with unknown origin. Scans may show damage to the facet joints, which can occur from spinal overarching. Injections and surgeries and various anti-inflammatories are often prescribed. No shots, medicines, or surgeries are needed. You do not need physical therapy or strengthening programs. All you need to do is stop overarching and maintain neutral spine when walking, running, swimming, and diving. It is easy, and is a healthy and normal spine position. You do not tighten any muscles to do it. It is just learning a normal posture.

Check yourself to see if you stand in hyperlordosis:

1. Stand up and look sideways in a mirror. Your belt should be level, as in the left drawing of neutral spine. The side seam in dress or trousers should be vertical from leg to waist, as in left drawing, not tilted forward at the hip (middle drawing).
   
   
2. Back up slowly and gently into a wall. If your backside touches first, it may be an indicator that you lean forward at the hip. If your upper back touches first, it often is a good indicator that you lean the upper body backward (right drawing).
   
   
3. Stand with your back against a wall, with heels, hips, upper back and back of your head touching. There should be a small space between your lower back and the wall, but not a large space. Then raise both arms overhead to touch fingers to the wall behind you to simulate swimming with arms outstretched. See if the lumbar curve increases. You should be able to stand with the back of your head touching the wall without increasing your normal curve, and be able to raise your arms without increasing it.

If you have a large space between lower back and the wall, try this:

1. Press the lower back toward the wall to feel how to decrease the space. There is a short movie of this on Fast Fitness - How to Feel Change to Neutral Spine.
   
2. If you can't figure how to do that, put your hands on your hips, thumbs facing the back, and roll your hip under so that your thumbs come downward in back.
3. Feel the large space between lower back and the wall become a smaller space.

Lower back pain that is caused by hyperlordosis should ease right away. Learn how to easily, gently do this while walking, running, swimming, or whatever you do. This is done without tightening or clenching any muscles.

Keep the good new neutral spine when you walk away from the wall, and all the time. Apply it to when you are swimming and scuba diving.

Muscle Use is Not Automatic
The muscles that hold neutral spine are your abdominal muscles. They do not do this automatically, which is why strengthening programs do little to stop back pain. Someone may have strong abs but stand and swim in arched posture, with continuing lower back pain.

Heavy scuba tanks don't make you arch your back or have bad posture. Not using your ab muscles to counter the pull, and allowing your back to arch is the problem.

When you are standing up wearing tanks, straighten your body against the pull of the load and maintain neutral spine. Do not tighten your abs, just move your pelvis. If you notice yourself arching while wearing tanks, straighten your body as if starting to do a crunch but don't curl forward. Only straighten to neutral spine. Don't tuck so much that you lean back or push your hips forward.

No More Lower Back Pain From Overarching
Transfer this neutral spine skill to your daily life for carrying gear, putting cargo up on racks, heavy packages on counters, and whenever you lift and reach. Use neutral spine when standing, walking, running, reaching overhead, swimming, and scuba diving.


Related Fitness Fixer:

• Prevent Back Surgery
• What Does It Look Like to Not Use Abdominal Muscles?
• What is Neutral Spine and Why Does Sticking Out In Back Harm?
• Aren't You Supposed To Stick Your Behind Out to Sit Down or Do Squats?
• Innovation in Abdominal Muscles

Labels: facet joints, lordosis, lower back, neutral spine, scuba, swimming

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Lower Back Pain From Swimming and SCUBA

Lifting and carrying heavy dive gear with good lifting mechanics is good and functional exercise. With bad lifting habits, it is a common and obvious cause of lower back pain in scuba divers. A second major cause of lower back pain after SCUBA and swimming is often overlooked and can occur after scuba diving and after swimming laps with no gear lifting.

Hyperlordosis
When swimming or finning face down and horizontally through the water, many divers allow their lower back to increase in arch. They look like they are face down in a hammock - shown by the figurine below:


A small inward curve belongs in the lower back. When you allow the normal inward curve, (normal lordosis) to increase, it becomes hyperlordosis or overarching (swayback).

For most people, hyperlordosis is most common when upright, such as standing, walking, and running. Swimmers and divers who allow their back to overarch when swimming face down often notice the pain after swims and dives:


How Hyperlordosis Causes Lower Back Pain
Hyperlordosis pinches the joints of the vertebrae called facets and the surrounding soft tissue. When swimming and diving in hyperlordosis, the fulcrum of the kick becomes the facets instead of the muscles of the abs and hip. When standing upright with a hyperlordotic lower spine instead of neutral spine, the weight of the upper body presses down on the overly pinched-backward lower back. Running in hyperlordosis causes more of the banging and pressing.

People with lower back pain from hyperlordosis usually feel they need to bend over forward, or sit, or raise one leg to relieve it. Often nothing shows up on x-rays and scans. Eventually, hyperlordosis can damage structures enough to show. Until then it just aches a great deal.

The cause of this kind of pain is often unrecognized and people may be told they have a condition called sacroiliac, or SI joint dysfunction, or nonspecific back pain, or other names.

Next - Part II, How to Stop Lower Back Pain From Swimming and SCUBA tells how to recognize it and what to do

Labels: facet joints, lordosis, lower back, neutral spine, scuba, swimming

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Hyperbaric and Aquatic Medicine On Travel

For the next 2 weeks we will be away attending the annual meeting of the Undersea and Hyperbaric Medical Society (UHMS). The post Exercise and Medicine Underwater and at High Pressure tells about the UHMS, the fun people, and the meeting. My friends and colleagues who attend are scientists and flight surgeons, SEAL team captains and commercial divers, submarine and aircraft personnel from navies of many countries. As we like to say, the rest have paying jobs.

I won't have computer access to see comments. Healthline will be changing format for answering reader comments and requests. Before you write with questions, check the hundreds of Fitness Fixer posts already here and all the replies already given to comments. If you still want more, click this post which gives a list of labels. Clicking a label will give all posts on that topic.

I will be posting as always, even on the road. Posts to come while I am away will cover swimming and other topics. Here are posts that cover some of the subjects we study at the meeting:

• Does Hyperbaric Treatment Help Muscle Injuries?
• Does Hyperbaric Treatment Heal Sprains?
• Does Hyperbaric Oxygen Help Exercise Ability?
• Exercise and Fitness in Decompression Sickness Risk
• Hyperbarics for Diabetic Foot Injury
• Respiratory Muscle Training for Swimming, Diving, and Running
• Collapsing Astronaut Gives Healthy Reminder
  
• Altitude Sickness on Flights
• Altitude Sickness, Viagra, and Bubbles on Flights

I am a career researcher in human performance in extremes of environment. That means extremes of heat, cold, altitude, exercise, injury, submersion, crimes (forensics) breathing different gases at different pressures (hyperbarics, see above), different g-forces, sometimes all at once. Many years of my work was spent on immersion physiology. If you are interested in scuba, diving medicine, clinical hyperbarics, wound healing in a hyperbaric environment, check my books page for three books on these topics.

Labels: aerospace, altitude, education, military fitness, scuba

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Technical Difficulties

Articles intended for yesterday and today could not be posted. Blogger is having technical difficulties. No photos or graphics are uploading to Fitness Fixer. The scheduled posts that describe healthy use of kettlebell weights would not be as fun or understandable without seeing the photos. They will come, hopefully soon. Until then, try this remarkable site www.bonkersinstitute.org.

Bonkers Institute was sent to me by reader Dr. Ern Campbell, a good man, who runs the immense resource of the Scubadoc diving medicine site and forum, scuba-doc.com. I am one of the site's diving medicine advisors.

The Bonkers Institute site, on the surface, seems to be funny stories. Look closely to realize how they intelligently expose critical topics. From their "about" page, they explain that they bring to light "shameless disease mongering and unprecedented pharmaceutical profiteering."

"...Our mission is to expose fraudulent medical pseudoscience wherever it is found… We march into the field of battle armed with a powerful weapon: our sense of humor. Fighting pseudoscience with pseudoscience…"

Labels: drugs, education, mind, scuba

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Can We Teach Young Doctors to Be Healthy?

We have been traveling for the past 2 months in Asia and are on the way to the chilly Smokey Mountains of Tennessee USA to teach medical students for a week during their rotation elective in Wilderness Medicine. This is the third year I will teach there.

I will teach the entire curriculum of diving medicine and physiology, plus a workshop on why commonly prescribed stretches are not healthful, and what to do instead. Several members of the Knox County Sheriff's Office from Knoxville TN have requested to attend my lectures, and several readers made the effort to find the class information on my web site and make arrangements to travel to the camp to attend.

As a physiologist, I design the techniques that physicians use. I spent many years as a military and university researcher in environmental physiology, which is how the body functions in the heat and cold, at altitude and underwater, breathing different mixtures of gases, doing different forms and intensities of exercise. It's important to understand why things work. If you don't understand, then you can't think for yourself, and all you can do is repeat the mistakes of the generation before you, who also were just repeating what they learned in a book from teachers who just were repeating what they had heard.

This problem occurs with some of the exercises and stretches given as physical therapy. An introduction to the problem is in the post What Does Stretching Do? In the past two years teaching at the camp, we encountered young students who were not interested to change bad stretches, and made a point of showing me after my lectures that they will keep doing their rounded bent forward toe touches, since "everyone knows" that is how it is done. However, Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch.

The problem occurs with nutrition. The medical school food at the wilderness camp is not healthy, and students have defended eating candy and junk food as reasonable, even saying that what they eat is not unhealthful - What Medical Students Told Me About Nutrition and When Did Health Become Thinking Out Of The Box?

The problem can occur with medical treatments that are in the books, even though wrong. In my diving physiology lectures, I try to show that if you understand the physiology, you will know why certain treatments do not work or are not needed. Immersion in water, for example, creates many interesting effects such as distributing blood volume more out of the limbs to the body. This is similar to the effect that occurs in space, described in Collapsing Astronaut Gives Healthy Reminder. Recently, during our travels, Paul wound up in the hospital with a swollen leg. The doctor who was Chief of Medicine of the hospital, announced that the treatment was bed rest. Paul was told he must lie flat in bed for at least three to fours days with the leg elevated to drain the fluid. We understand that bed rest is often listed in books as a treatment for this, but it is wrong. I asked the doctor if going in the water could help. The doctor said that standing in the water meant the leg would be "hanging down" and the leg needed to be elevated to drain. If you understand immersion, then you know why immersion can more effectively treat limb edema and water retention than medicines and lying in bed. Extended bed rest is unhealthy, and reduces muscle and bone health so much that it is used to study the damage to the body from floating around during space travel. We escaped the medical care and went into the water. I will post more on immersion, edema, and health soon.

I will not have Internet access for the next week to read or reply to comments. Enjoy the Fitness Fixer using the links in this article. Start taking and sending in fun photos of your successes using all the fun techniques.

Labels: aerospace, altitude, children, cold, education, fix pain, green fitness, hamstring, heat, hyperbaric, injury, nutrition, practice of medicine, scuba, sitting, stretch, swimming

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