Lung issues and DCI

[h20_kat]

Just a small update... I am having to wait 14 days after lung re-inflation before I can fly. 4 more days to enjoy Singapore.

 

[h20_kat]

Another update... and some questions for any dive doctors reading.

I traveled from Singapore back home to Auckland a couple weeks ago without incident. What a relief to be home! I visited my GP upon my return and had a chest x-ray which confirmed the lung is fully inflated. I asked my GP about a referral to a lung specialist who is also a hyperbaric doctor (as a friend of mine said that a diver she knows who had a SP was referred to him by Simon Mitchell) but since I don't have private insurance he said that isn't an option unless I want to pay. My GP has requested a spiral CT scan. I have no idea how long it will take for that to get approved but probably a couple months. Should I be waiting for the lung to heal after the pneumothorax before I get the CT scan done? If so, how long should I wait?

I still question whether I somehow held my breath and was unaware of it. If the CT scan doesn't show any underlying abnormality, would it be reasonable to assume that I did hold my breath? Is a pneumothorax caused by breath holding considered traumatic? Would it be a contraindication to diving if there was no lung abnormality?

As it seems pretty certain that diving is off the table for me, I am wondering about some other activities and whether there would be any concerns. As fate would have it, my taxi driver home from the airport happened to be a dive instructor and former dive shop owner. He knew a diver who had a pneumothorax from breath holding in the bath! It's apparent that it can happen in very shallow water. I am wondering whether surfing (actually the falling and holding my breath underwater) and kayaking (breath holding while rolling) would be a problem? What about free diving? I wouldn't be going down more than a few metres, but would that even be okay or would I need to surface snorkel only?

Sorry for the million questions. There is just so much knowledge here and I have so many things I am wondering about. Too much time cooped up indoors in a hospital/hotel.

 

[Duke Dive Medicine]

Kat,

In the past, we have cleared divers in your situation to dive again if the CT was clear and we were reasonably certain that the pnemothorax occurred as a result of temporary air trapping related to inadvertent breath-holding. That may not apply to you, and your best advice will come from the physicians who interprets your CT and are able to examine you in person.

Best regards,
DDM

 

[h20_kat]

Kat,

In the past, we have cleared divers in your situation to dive again if the CT was clear and we were reasonably certain that the pnemothorax occurred as a result of temporary air trapping related to inadvertent breath-holding. That may not apply to you, and your best advice will come from the physicians who interprets your CT and are able to examine you in person.

Best regards,
DDM

Thanks DDM. I will definitely seek out the best advice I can find here and follow their recommendations. Should I be waiting to have the CT scan? I read somewhere about waiting 6 months after a SP before having the scan which I assumed was to give the lungs time to heal.

 

[Duke Dive Medicine]

That would be a decision best left to your practitioner. Overt damage to the lung tissue related to barotrauma may not show up on CT. What they'll be looking for on your scan would be any areas in the lung that could lead to air trapping: bullae, blebs, cysts, neoplasm, etc which the radiologist should be able to differentiate from trauma to the lung parenchyma, but again I'd recommend letting your practitioner decide.

Best regards,
DDM

 

[h20_kat]

That would be a decision best left to your practitioner. Overt damage to the lung tissue related to barotrauma may not show up on CT. What they'll be looking for on your scan would be any areas in the lung that could lead to air trapping: bullae, blebs, cysts, neoplasm, etc which the radiologist should be able to differentiate from trauma to the lung parenchyma, but again I'd recommend letting your practitioner decide.

Best regards,
DDM

Thanks DDM. Am I right in thinking that there could be scarring from the barotrauma that could lead to areas of air trapping? That was why I was thinking that waiting for things to heal would be a good idea.

Is it normally possible to get copies of the scans that I can then take to seek another opinion? My GP is a wonderful doctor but he is not a diving doctor nor a pulmonary specialist. I may want someone else to have a look at the CT scans.

 

[Duke Dive Medicine]

Thanks DDM. Am I right in thinking that there could be scarring from the barotrauma that could lead to areas of air trapping? That was why I was thinking that waiting for things to heal would be a good idea.

That much scarring would be pretty unlikely.

Is it normally possible to get copies of the scans that I can then take to seek another opinion? My GP is a wonderful doctor but he is not a diving doctor nor a pulmonary specialist. I may want someone else to have a look at the CT scans.

You can ask them for a CD of the scan. Most places have the ability to do that.

 

[gekodivebali]

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