Asthma question

[CuriousMe]

I've recently been having problems with Asthma....well it's looking amazingly like it anyway, they've put me on Azmacort and albuterol until I can get to the Pulmonoligist on the 15th. It's only triggered by smoke.....with the reading I'm doing it's looking like (after I get checked out by a diving doc) that I'll be able to dive again (it's unlikely I'll come upon some second hand smoke at 60 feet....even so, it's been taking about 12-15 hours for symptoms to appear after being exposed).

My question is to the asthmatic divers out there....I've heard that in the Carribean many operators will deny you diving with them even if you have proof of Dr.'s auth. How do you deal with this?

Peace,
Cathie
Hoping to be breathing well and diving again soon!

 

[Freeflyer]

you could always not tell them! I know that opens up a whole can of worms, but I've done it a couple of times.

I have very, very mild asthma that seems to be allergy related (red wine, car exhaust) and get maybe one or two instances a year, only in the evenings and never during excercise (I also race triathlons). The doctor gave me a complete all clear with no reservations on diving.

However, there are a number of operators that don't ask that, they ask whether you have EVER had any respiratory problems. They don't take excuses, they don't take doctors notes. It sucks, but that's the way it is.

J.

 

[beche de mer]

they've put me on Azmacort and albuterol until I can get to the Pulmonoligist on the 15th. It's only triggered by smoke.....with the reading I'm doing it's looking like (after I get checked out by a diving doc) that I'll be able to dive again (it's unlikely I'll come upon some second hand smoke at 60 feet....even so, it's been taking about 12-15 hours for symptoms to appear after being exposed).

My question is to the asmatic divers out there....I've heard that in the Carribean many operators will deny you diving with them even if you have proof of Dr.'s auth. How do you deal with this?

Since your asthma is triggered by smoke, it's possible that there are other physical agents which could also induce it. I expect your respiratory physician will conduct a 'histamine challenge' test or similar, in which your lung function is monitored during exposure to histamine.

For divers, a more relevant test is a 'saline challenge'. Exposure to saline aerosol is extremely common during diving.

I'd suggest you try and see a respiratory physician (do they really call them pulmonologists over there?) who is experienced in assessing divers, and ask for the saline challenge if it's not offered.

As for fitness to dive - well, there is no firm consensus. Opinions vary, but not too many dive examiners take really hard line on this any more. This page is good for a discussion:

http://www.mtsinai.org/pulmonary/books/scuba/asthma.htm

But quite a few dive operators will take a hard line. They're operating a business and it's not worth their while to take any chances.

You'll have to decide whether or not to declare your asthma.

Statistically, asthma does not feature frequently as a factor in diving fatalities.

 

[Drew Sailbum]

My question is to the asmatic divers out there....I've heard that in the Carribean many operators will deny you diving with them even if you have proof of Dr.'s auth. How do you deal with this?

I work for an operator that is highly suspect of a general G.P. signing off an asthmatic to dive. With such variation in severity, asthma really should be evaluated thoroughly before thinking about diving. We prefer to see a pulmonologist do the evaluation and make the determination on suitability to dive.

We have refused to do a referral for a student who had already completed pool training despite not having any doctor's clearance for her asthma. The explanation was that it is a "mild case" since she only uses a rescue inhaler 3 or 4 times per week. Whether the instructor initiating her training accepted that reasoning or not I don't know. Perhaps she just lied before.

On the other extreme, we have happily completed training for divers who bring a short note from their pulmonologist explaining the types of tests done prior to signing them off. The issue was that it showed the diver was taking the condition quite seriously.

 

[CuriousMe]

I work for an operator that is highly suspect of a general G.P. signing off an asthmatic to dive. With such variation in severity, asthma really should be evaluated thoroughly before thinking about diving. We prefer to see a pulmonologist do the evaluation and make the determination on suitability to dive.

We have refused to do a referral for a student who had already completed pool training despite not having any doctor's clearance for her asthma. The explanation was that it is a "mild case" since she only uses a rescue inhaler 3 or 4 times per week. Whether the instructor initiating her training accepted that reasoning or not I don't know. Perhaps she just lied before.

On the other extreme, we have happily completed training for divers who bring a short note from their pulmonologist explaining the types of tests done prior to signing them off. The issue was that it showed the diver was taking the condition quite seriously.

That's good to hear Drew. I'm not even talking about certification....I'm just talking about a two tank dive. I've been certified for a couple years now...as it turns out, this Asthma hasn't been diagnosed before....mostly because it only happens when I'm in a really smoky environment (150+ dives and cold air, dry air or exercise never triggered anything). I'll see the Pulmo next Thrusday....now that I know about the Asthma, I wouldn't consider diving until I had the appropriate tests proving I won't be putting myself in a bad situation. Frankly, as much as I love diving....there's nothing down there worth dying to see.

Peace,
Cathie

 

[diverlady]

I have mild asthma that's well controlled and I don't even remember the last time I used a rescue inhaler!! I've never actually had an asthma attack. I do cardio exercise with no troubles and I actually feel better after breathing the clean, dry air from the tank.

I don't bother telling the dive operation about my asthma. I figure it's opening a can of worms that I'd rather avoid. If I feel my asthma is causing me any diving issues, I'll not dive! The way I see it, being dehydrated is a contributing factor to DCS and since the dive operator cannot tell if a diver is fit to dive due to dehydration, why should they have the deciding vote over whether I can dive when my asthma is properly controlled?

Of course, that's MY DECISION and I don't encourage or discourage anyone else from taking the same route. Ultimately, it's YOUR CALL.

Diverlady

 

[Doppler]

I am sure you have already read and are aware of DAN'S Position on this issue. Thinking has changed on this topic over the past several years.

I sort of have a strange feeling about "keeping your medical condition secret." When I give someone a medical statement to sign before training, I expect them to answer honestly. Having someone lie on this form would be a bit of a bummer for me... far worse than the issues raised by their asthma in fact... and I am not too sure how I would deal with it.

Last time it happened (someone being dishonest about medical disclosure) a trimix candidate had recently undergone chemo for cancer! Before you jump all over me on this one, bear in mind that when someone signs up for training, whether we like it or not, the law put the onus of primary responsibility for that person's safety while in my charge -- at the least -- on me. Hence I appreciate knowing all the facts before I make the decision whether or not to "chance it."

Just something to think about.

 

[CuriousMe]

I am sure you have already read and are aware of DAN'S Position on this issue. Thinking has changed on this topic over the past several years.

I sort of have a strange feeling about "keeping your medical condition secret." When I give someone a medical statement to sign before training, I expect them to answer honestly. Having someone lie on this form would be a bit of a bummer for me... far worse than the issues raised by their asthma in fact... and I am not too sure how I would deal with it.

Last time it happened (someone being dishonest about medical disclosure) a trimix candidate had recently undergone chemo for cancer! Before you jump all over me on this one, bear in mind that when someone signs up for training, whether we like it or not, the law put the onus of primary responsibility for that person's safety while in my charge -- at the least -- on me. Hence I appreciate knowing all the facts before I make the decision whether or not to "chance it."

Just something to think about.

The past two weeks, all I've been doing is reading info on the Net re: Asthma and this week I've added diving and asthma and as I said I'll see a Pulmonologist next Thursday. But from everything I've read....I don't see that I'm going to have an issue diving once this thing is controlled. And like I said, I've been diving with asthma...I just didn't know it. The only issue I've found is reports from folks that Caribbean dive ops won't let you dive even with Dr.'s auth.

I think training is a different issue all together. I'm talking about a two tank, follow-the-DM Caribbean dive.

Truthfully, I'm considering just not mentioning it (after all, my lung doc is certainly more qualified to say if Asthma will interfere with diving than the Caribbean DM)....but I've never even thought of withholding info on a med form before.

Just looking to see what other folks with this issue have experienced.

Peace,
Cathie

 

[diverlady]

For TRAINING I did fully disclose my condition and had my doctor sign off on diving. My non-disclosing occurrences are only for dive trips where, in my opinion, the dive operator should not be preventing me from diving in conditions for which I am qualified when my doctor has approved.

Hope that clarifies.

Diverlady

 

[eggman131]

If you're an asthmatic, as I am, you know (or should know) your disease well enough to know if you should be diving--or not. For me, my asthma is completely under control via medication, so I am completely comfortable diving. Like diverlady, I had my doc sign off on it for my cert, but otherwise I consider it up to the individual to decide . . .

For TRAINING I did fully disclose my condition and had my doctor sign off on diving. My non-disclosing occurrences are only for dive trips where, in my opinion, the dive operator should not be preventing me from diving in conditions for which I am qualified when my doctor has approved.

Hope that clarifies.

Diverlady