Asthma and Diving

[Dan G]

I was chatting with a friend of mine who was certified years ago but never pursued diving much because his doctor recommended he avoid SCUBA when he diagnosed him with asthma. Now that his asthma is under control, he was curious and I recommended that he talk to a doctor who knows about diving. (as opposed to a doctor who might not)

I had never heard of this before, but then again I do not have asthma. I am not asking for a diagnosis of my friend, but wondering if anyone has any insight or experience with this.

 

[hhmoore]

Uncontrolled asthma would be a safety issue for obvious reasons.
"Well controlled" means different things to different people, depending on their background and perspective...but there are two main concerns (aside from not being as controlled as one thinks). First, and probably the least likely to be an issue, is the possibility of exercise induced bronchospasm while underwater (generally, scuba diving is pretty relaxed, once in the water...the exercise isn't usually of a nature to cause that). Second is the potential impact of breathing the cool dry air. If one's asthma is truly well controlled, the duration of recreational dives shouldn't cause much issue (imo).

If exercise induced bronchospasm is a known issue, or even a concern, pretreatment with a short acting bronchodilator is the easy answer. If a person is using a rescue inhaler every week or two, I'd probably recommend the same (pretreatment) for safety sake.

Basically, it's just another part of a diver's pre dive consideration - if one is feeling "off", common sense should dictate scrapping the dive.

 

[outofofficebrb]

I have it and get it under 2 circumstances: exercise/situational with the cold or allergens. The latter doesn’t exist underwater so it’s a non-issue for me. The first is possible - on land or underwater. In fact, eating ice cream too quickly will do it for me. Or laughing too hard and too much air passing quickly over a short period of time, similar to exercise induced ones. Cold air and exercise together...another. But mine is very minor. I do have an inhaler that I carry, but I hardly ever use it. I mostly use it as a preventative measure when I am snowboarding and am at elevation, in the cold, and having to “hike out” on a flat or when there’s deep powder. I generally don’t need it for diving. However, once I have an episode, I can tell because I’ll have a non-productive cough that doesn’t go away until I take a hit. It’s more annoying and unhelpful to air consumption but after a while it eventually goes away on its own without the inhaler or it goes away immediately with a hit.

I have a pretty mild case relative to many other people where steroids are needed and it’s a life and death situation. Everyone is different and I agree that your friend should consult a doctor familiar with it’s implications during diving and to also reach out to DAN as a great resource.

 

[Duke Dive Medicine]

Hi Dan,

It depends on the severity. In general, if it's controlled by medications to the point where the individual hasn't had to use a rescue inhaler in a year or so, a diving MD in the US will clear him/her. If the individual needs an inhaler regularly then more discussion is warranted. In the UK the MDs tend to be a little more lenient. Where is your friend? I may be able to provide a referral.

Best regards,
DDM

 

[Dan G]

Hi Dan,

It depends on the severity. In general, if it's controlled by medications to the point where the individual hasn't had to use a rescue inhaler in a year or so, a diving MD in the US will clear him/her. If the individual needs an inhaler regularly then more discussion is warranted. In the UK the MDs tend to be a little more lenient. Where is your friend? I may be able to provide a referral.

Best regards,
DDM

Thank you all for the replies. My friend lives in Colorado and it would be great to provide him with your referral.

 

[Duke Dive Medicine]

You're most welcome. Where in Colorado?

Best regards,
DDM

 

[Dan G]

You're most welcome. Where in Colorado?

Best regards,
DDM

In the Boulder area. Denver is maybe 45 mins away.

 

[purbeast]

I found this thread from a search.

I am a 36 year old male who grew up with asthma. It was bad in my early years and teens. Back when I was like 24 or so I was put on Advair and it changed my life. I use it now maybe 4-5 times a week. It's recommended to use 2x a day. I really only use it before I workout which is Monday through Thursday. I've gone 3-4 days without using it before and had no problems. I haven't used my rescue inhaler in probably around 8 years.

Like 6 years ago I went to get a dive physical, and to make a long story short, after gathering all this information, the guy I went to would not sign my waiver. It was odd to me and he said it was because technically I didn't even have asthmatic symptoms anymore and to just answer NO on the form. So I did just that.

I have done 3 dives (2 in one day) so far and now want to get certified.

I went to an orientation for a local class here in the DC area. They said that regardless of answering YES to any questions on the waiver that when doing the 4 dives, they still need a medical form signed when I get certified wherever I do my certification dives.

Because of that I've been looking for places to get checked out. I went to my normal asthma doctor yesterday and she would not sign my waiver, but wanted me to do an exercise challenge and then breathing test, and she wanted to do more research. She also recommended seeing a pulmonologist.

Today I talked to them to get a referral to a pulmonologist and she said she did more research and even if I passed the exercise test she couldn't sign the waiver. She could say that my asthmatic symptoms aren't a factor but due to just not having any knowledge in this area she recommends the other doctor.

So I have an appointment next Wednesday with a pulmonologist and told them why I want to see them, so I hope they can sign the waiver. I had a class I wanted to take August 18th and 19th and do checkout dives in Grand Cayman in September, but if they don't sign it, it won't happen.

 

[Duke Dive Medicine]

@Dan G , I recommend that your friend start with the Presbyterian St. Luke's Medical Center hyperbaric unit in Denver. Their website is linked below.

Hyperbaric Medicine Center

Best regards,
DDM