Is diving practical for me?

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DrBeer

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I've got an interesting situation. First I'd like to ask a question. Would any you be familiar with where I can find a doctor, preferably a pulmonary specialist, who has experience in dive medicine and isn't an extremist either for or against diving with asthma? I'm in Sacramento, CA. and would like to consult with such a physician if necessary.

That said, here is the situation for me that I would like practical advise on.

Had extremly minor asthma as a child (no medication needed). It disappeared. Another more minor recurrence at 13 or so. Inhaler prescribed but was rarerly needed. It went away after less than a year (I can count on one hand the number of times I actually chose to use an inhaler - it was never necessary). Started playing trumpet in middle school. Stayed physically fit by working out and leading an active life. Got to college and majored in music. One or two mild instances of shortness of breath. Attempted to join United States Marine Corps. Asthma was in medical records so was an issue. Marine Corps waived asthma (two doctors said I either did not have asthma or had mild asthma and that any previous breathing issues was either related to heavy smoking by parents until I was 6 or allergens in the air) and allowed me entry (spirometry was 100% and metacholine challenge produced no effect. However, as odd as it may sound, I strongly question the competency of the administrators of the tests and am unsure of their accuracy. This is due to the sloppiness and imprecise methods the lab techs had of administering the tests - I'd personally prefer to retake these). I was discharged for medical reasons in phase 3 of basic training, but they were totally unrelated to pulmonary functions (it was mild degenerative disc disease that while not a problem currently, might become so under the stressful lifestyle of the Corps). No breathing issues during basic training. After discharge moved to CA to plan next life step. While in CA I am running and swimming. Due to the very low air quality I have had a few minor breathing issues but nothing that stopped me from any physical activity at all. Used a bronchodilator a few times. My lifestyle for the past 7 months or so has been relatively sedentary.

The advise I am looking for is whether or not diving is practical for me. if it is, then I will obviously see a physician in person and listen to his advice. What I would like to know is if it would be worth my time and expense to visit a doctor or are risks too high. I don't like the idea of suffering AEG just to see animals I currently keep in my aquarium. :)
 
I was a hyperbaric medic in the 1980's, so here is my advice.

Contact DAN and ask them for contact information of doctors skilled in diving medicine.

If a doctor clears you to dive, the final decision will really be yours based on your confidence in doing it. If you dont feel confident, then dont do it. Getting evaluated by a doctor is never a bad thing.

Never dive beyond your education, skill level and your confidence. A good diver will always make a final evaluation right before a dive to make a "go" or "no go" decision.
 
Thank you for the advice! I'll be calling DAN in the morning to get a referral to a pulmonary specialist in the area that I can consult with. I'll find out for sure what my risks are and whether the doctor feels they are acceptable or not.
 
..Sometimes if I'm very active in cold weather, I can get to wheezing. I had a couple of spells after running in summertime smog so I went to a pulmonologist. I explained that my asthma isn't real bad and that even if I have an attack, I can continue to run for about a mile more before it finally overtakes me and I have to shut it down. He did a bunch of tests and said I have good lungs with about 7 cubic litre capacity(apparently that's alot because everybody in his office commented, and the tech that does the test said if she hadn't just had the machine calibrated, she would swear the machine was broken), but when I have an attack, I lose about 20% of my lung capacity. He put me on Advair and gave me an albuterol inhaler.

I use the meds as prescribed and also sometimes(in cold weather or bad ozone days) do a shot of albuterol right before my daily run and I have never had a problem since.

I asked what he thought about diving. He said that he didn't like the idea of it because of the possibility of having an attack underwater but that seein' as how I was running 3 miles a day with no breathing problems or attacks, that if I had an attack underwater, I would probably still be able to breathe well enough to make it back to the surface. So I didn't exactly have his blessing, but he said in my case it would probably be alright.

I had been concerned about the air being pressurized and how would that affect me. He said the pressurization would not affect me any differently than it would affect any diver, and that the real concern with asmtha and diving was that if I had an attack underwater, could I make it back to the sufrace?

I stay on my Advair as prescribed and take an inhaler with me when I go diving and take a couple of puffs shortly before entering the water as a preventative measure, and I've never had any problems whatsoever.

This is my situation, and it works for me, but there is no garauntee it will work for you. I would say that you should try to get back on a regular cardiovascular excercise program. You can't know how asmtha will affect you while diving if you are living a sedantary lifestyle. Get in shape and see how bad, or even if your attacks affect you while you are active. Then you will have an idea of what an attack would be like if it happened underwater. Seeing a pulmonologist is a GREAT idea. He will be able to tell you what your lungs are capable of and what they aren't capable of. After examining you and running some tests, he will be better able to tell you whether or not diving is a good idea. Even better if you can find a pulmonologist who is a diver, or at least familiar with the physiology of diving.

Good luck.
 
I could give you a long-winded response, but others have already spelled it out:
http://www.scuba-doc.com/asthma.htm
http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=22
and many others.
I'd guess this question has been raised on this board before, but I wasn't around and haven't searched for the threads yet.

Briefly, consensus now is that well-controlled asthmatics should be OK for diving, and that exercise tolerance is the most effective way of assessing the risks. AGE would be a risk if air trapping is present, but that would indicate there isn't good control of the asthma at the time. If you're in need of inhaler to treat (rather than prevent) bronchospasm within 24 hours of a dive, you're not in good control. If you only need a puff before exercise just to prevent bronchospasm, you're probably OK, but checking PFT's immediately after vigorous exercise would be reassuring. Maintenance/preventive meds may permit exercise without problems or needing to resort to rescue albuterol doses.

Usual disclaimer: this is not meant as specific medical advice, but only as a general guideline, etc.

DrBeer, in addition to DAN, you might ask your LDS is they know of local docs with diving knowledge. I'm sure there are several in northern CA. Or get the UHMS publication (references in above sites) and show it to your pulmonologist.
 

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