Asthma and Scuba Diving....

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The following article, which also can be found by searching the board archives at http://www.scubaboard.com/search.php?s=, may prove informative. It's a piece on asthma & diving that appeared in my Dec '00 "Dive Workshop" column in "Rodale's Scuba Diving" magazine:

"Can I Dive With Asthma?

Asthma is a chronic but often largely controllable obstructive pulmonary disease that affects about eight to 10 percent of children and five to eight percent of adults in the U.S. Signs and symptoms include shortness of breath, wheezing, tightness in the chest and lasting cough. The potential adverse impact of a severe attack under water is obvious, and could be fatal. Arterial gas embolism (AGE) as a result of air trapping from the constriction and plugging characteristic of this disease has also been a frequent, but as yet inconclusive, concern.

Asthma Triggers

Asthma is a chronic irritation & hypersensitivity of the respiratory tract, and attacks can be triggered as a reaction to a variety of conditions including stress, cold or exercise, or allergens such as pollen and certain foods and medications. The asthmatic’s body reacts to these triggers, in varying order and severity, by constriction of smooth muscle in the bronchi and bronchioles, inflammation of the airway and increased mucous production. Attacks tend to be recurrent rather than continuous, and there is often much that can be done medically to reverse breathing difficulties when they do occur. In addition, since many of the precipitants of an attack are known, they can be avoided or controlled.

Diving with Asthma

Until the mid-1990s, asthma was largely considered an absolute contraindication to diving. However, thinking in the medical and professional dive community has rather radically altered since then, and those with asthma can now be certified under certain circumstances. Although they differ somewhat, the YMCA, BASC and Undersea and Hyperbaric Medicine Society each offer protocols guiding medical clearance to dive.

For example, the YMCA* criteria include a requirement that all asthmatics have normal resting and exercise pulmonary function tests with no degradation after exercise. The criteria allow those taking routine preventative medications to be evaluated while continuing their treatment. Also required is the ability to exercise and tolerate stress without becoming symptomatic while on maintenance medications, and the absence of a need for “rescue” inhalers during times of stress or exertion.

If you suffer from asthma, it’s clearly unwise to deny or minimize this condition to yourself, or hide it from your instructor or the operators with whom you dive. Scuba can involve some of the asthma triggers discussed above, such as cold and exercise, not mention hyperdry scuba cylinder gas. If you have asthma and want to dive, or are already diving without medical clearance, it is critical that you consult a physician to obtain an appropriate pulmonary workup and permission to dive."

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

Hope you found this helpful.

DocVikingo

* The YMCA protcol & some background info on diving with asthma can be found here---> http://www.ymcascuba.org/ymcascub/asthmatc.html
 
mobymark:
Welcome to the board. Best to see a Hyperbaric diving Doctor to check out the degree of your asthma and if it is safe for diving. As long as he gives you the okay, you should not have a problem doing a course.

I am not sure an implied guarantee such as "you should not have a problem" is the result of seeing a physician. Much information, deliberation and counsel may be given; this is not assurance, but prudence. On the basis of this a person/patient/adult diver then must still be responsible for his own decision to dive. I believe the doctor would call this a risk (to health) versus benefit (recreational joy) analysis. I am healthy, but I still mindfully accept the risks assoc'd with our diversion.
 
My daughter has a very mild form of asthma which is food related (she can't eat or drink yellow or orange food - including fresh orange juice etc) So she controls it by not eating these foods. (which is easy as she's into chocolate, chips, chicken, meat etc). Last year we went to the Red Sea and on two occasions we went diving. Once on a try dive day and the second time in Eilat to dive with dolphins. On both occasions we didn't mention her allergy. I felt very guilty about this and was very worried about her but due to her excellent lung capacity (she is an advanced snorkeller with a BSAC club) and her sheer delight in the marine life she took to diving like a duck to water!

We are going to the middle east again this year and want to do a PADI course. I will probably mention this to her asthma consultant at the clinic and ask their opinion but I am afraid that they will advise against it.
 
I had "asthma-like symptoms" as a little kid. When I went for my AAUS physical, my expiratory volume was unusually low and I got held up from diving for nearly SIX MONTHS. The pulmonary docs eventually ran out of tests and listed it as "childhood lung scarring". I am now "allowed" to dive again, so long as I don't have a cold. I found that a hoot as that's a temporary contraindication for ALL divers. Oh the irony...

Still, it kept me from enlisting in the Army. They're worse than AAUS.
 
Based my posting above & the information that you have provided, I agree that it would be prudent to mention this to your daughter's asthma specialist. Also based my posting above & the information that you have provided, I think that there is no reason to be unduly pessimistic at this point.

In the event that her asthma consultant is not versed in diving medicine, you might consider asking for a referral to a physician that is or that the consultant contact DAN at http://www.diversalertnetwork.org/contact/email.asp?RE=Medicine for information & guidance.

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

Hope you found this helpful.

DocVikingo
 
fins wake:
Cause of death seems to be a textbook example of lung barotrauma. It may or may not have anything to do with asthma. Personally I'd venture toward the "breath-hold scenario" in the above case. I know plenty of asthmatics who dive. Very deep. That said, a diving doctor's opinion is always highly advisable.

yes i do agree it's more of barotrauma associated (with asthma). and this is an example of what peer pressure may cause if there are other limiting factors, in this case, his active asthma that day and not wanting to be branded as kill joy for his asthma attaks. so it leads to the attitude he had for the sport considering his condition that day.

and i do deep dives with no problems with my asthma except for some excitement (causes to activate asthma in me sometimes).
 
I have asthma and although it has been acting up lately it's mainly due to winter conditions, as it does every year in the extreme cold - and the renovation dust in my home (that's enough to make anyone cough). I've been OW certified since July and advanced since September of last year. When I first started diving I was concerned about how my asthma would react to diving but I've not had any problems so far. Right now we have been diving in the local pool on a weekly basis to keep up our skills and it still hasn't bothered me at this time of year either. I have made it part of my "getting dressed" routine before diving that I take a "puff" of my inhaler before donning my equipment.
I've had asthma most of my life and dust and stress have been my main contributors to any problems I have with breathing. My doctor is aware that I dive and his only concern was "if I felt in the least that my asthma would overcome me underwater that I'd call the dive off before I attempting it." If I was planning ANY physical activity and wasn't sure I could complete it then by all means I would not go. PERIOD. If you're prone to severe migraines and felt one coming on while getting ready - would you dive? Of course not.
Use of common sense with asthma, as with any disease, must be you're number one remedy and safe guard against personal injury. With regards to peer pressure, its like anything else - people just don't understand what it's like to have asthma unless they themselves have experienced it.

Don't be embarrassed to call any dive off if your breathing just doesn't feel right to you. It's your right. Besides if they give you any flack about it just ask them this. If a diver runs out of air they can use yours, if a diver's lungs stop working-how are you going to help me then? You should know what you're capable of doing, limitations are not a bad thing - you can learn to love them.
 
paolov:
yes i do agree it's more of barotrauma associated (with asthma). and this is an example of what peer pressure may cause if there are other limiting factors, in this case, his active asthma that day and not wanting to be branded as kill joy for his asthma attaks. so it leads to the attitude he had for the sport considering his condition that day.
I don't think anyone really can state for sure that his asthma contributed to his barotrauma. This particular hypothesized threat - that gas may be 'trapped' during an attack - is not generally stressed by diving docs nowadays, rather they tend to emphasize the problems with decreased lung capacity during asthma attacks. (This is at least how several diving docs and researchers have presented it to me.)

As for Paolov's and Starfish's comments on resisting peer pressure I agree wholeheartedly! Anyone can break a dive at any time for any reason. This certainly includes before the dive, too.
 
i found a "dive doctor" by emailing DAN and asking for referrals in my area. they responded quickly and i was able to work with a good pulmonologist specializing in diving to get cleared to dive!
 
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