Diving with asthma.

[Mantra]

Mods, if this CF stuff is too much of a threadjack, please feel free to move it into its own thread. I note DocVikingo's intent in posting this was as a reference on asthma.

---------- Post Merged at 11:16 PM ---------- Previous Post was at 11:08 PM ----------

so is the problem decompression and the fact she may end up with an obstruction possibly leading to embolism?
what if say you had a real dive bell that can be slowly decompressed over a longer period in atmosphere with a doctor on hand
by the way this all theory at the moment i was an instructor for 7yrs and have over 2000 under my belt so i know all the risks and won't do anything stuid but i want as much info as possible

As I understand it, there are two issues. One is an increased risk of DCS because of reduced lung function, and resultingly poor gas exchange / offgassing of nitrogen via the lungs.

But the larger issue is that the more full of sticky gunk, the more scarred, and so on the lungs, the vastly higher the risk that air gets trapped there on ascent.

As to the rest, I'm out of my depth and will leave it to the experts here. It really comes across how much you care about your sister. I guess you could talk to the deco chamber people at the Wesley too.

 

[roo29]

the doc said "When you ascend, the gas in the air sacs expands, and if it can't get out, it will blow the lungs. CF patients are susceptible to this anyway" so what do they do about it when it happens at the surface

 

[TSandM]

When a CF patient has a pneumothorax on the surface, there is no pressure to drive the air into the blood vessels. The lung collapses, and we have to put in a chest tube to evacuate the air outside the lung. Depending on the underlying lung function, this may be a big deal or just a routine treatment. The problem with it happening undewater is that the air that's trapped will continue to expand until the patient reaches sea level. This expansion can cause pressure that moves the structures in the chest around, which can impede venous return to the heart, or in the alternative, the expanding gas may get into the blood vessels and cause an embolism.

Mantra is giving you very good advice -- only her doctors know what the condition of her lungs is, and they're the ones who can really advise you. I will only say that you should definitely NOT take her underwater unless her doctors concur that it can be done with manageable risk.

 

[Mantra]

Edit: I see TS&M is online and answering. She says it better.

 

[roo29]

thanx for the help

 

[Flodad]

Doc, I am sure glad i ran across this and will begin to do more research myself. I know a female that is thinking that she wants to be a divemaster and possibly an instructor who has asthma. Would any general doctor who gives her a dive physical be knowledgable enough to really determine if she should dive or not, or should i try to find s doctor who undertands the risks of diving? just asking for advise....

 

[OldNSalty]

This is why I LOVE SB.

My wife literally just called, she was coming back from the doc and he said she has "asthma induced bronchitis." She has never had an asthma attack and can exercise but in the winter she tends to get respitory illnesses that linger for months.

She asked me if I thought she could still dive, I click on 'new post' and here was this thread. I am guessing that as long as she is clear she should be fine.

 

[TSandM]

A rough description of the guidelines is that if your baseline pulmonary function is normal, and you do not require medication except in unusual circumstances, you are good to go. Anyone who is frequently (once a week or more) symptomatic, or needs maintenance medication on a daily basis, is a dubious candidate for diving. If there is any doubt, pulmonary function testing should be done and evaluated by someone knowledgeable in dive medicine. I was surprised to forward some PFTs from one of our students to Duke and have them say that his tests didn't meet their criteria (because I didn't think they were that bad), so I would definitely lean toward getting expert consultation.

 

[Duke Dive Medicine]

This is why I LOVE SB.

My wife literally just called, she was coming back from the doc and he said she has "asthma induced bronchitis." She has never had an asthma attack and can exercise but in the winter she tends to get respitory illnesses that linger for months.

She asked me if I thought she could still dive, I click on 'new post' and here was this thread. I am guessing that as long as she is clear she should be fine.

Sounds more like bronchitis-induced bronchospasm. Lynne, is "asthma-induced bronchitis" the diagnosis du jour for this year? This is not the first time I've heard this one and it doesn't make much sense in someone who's never had asthma, especially if they're older.

 

[TSandM]

Well, we tend to call it "reactive airways disease", which is used for someone who has clear evidence of bronchospasm in the setting of an active viral infection, and no history of asthma. Asthma as a diagnosis has a significant impact on insurance, both health and life; so we try to avoid the term unless it's clear that it's intrinsic asthma and present even when the patient is not otherwise ill.