Scubadoc...question for you on diving with Asthma

[champ198]

Scubadoc i have been interested in diving as my brother is a certified diver and is also wanting a dive buddy an i want to try and see if i can dive or not. the biggest problem i think i might have is as a child i was diagnosed with Asthma. with that said it has been years since i have had an "attack"
the only time i really experience any type of wheezing of any kind is when i get sick. i am very active in the colder months here with hunting activities and so on and never have a problem breathing in the cold or even with strenuous activity.
i have been reading as much as i can on here about Diving with Asthma and have seen a lot say to find a pulmonary specialist in my area. i have emailed DAN to try and find one and am waiting to get an answer from them. in
the mean time i have found a pulmonary specialist in my area that i am going to call and ask some questions about diving with asthma. i was hoping to get some info from you on some questions to ask this specialist so see if they are dive savvy or not.
i have a friend of mine that is a respiratory therapist in the same hospital and she said they do pulmonary function tests for soldiers for mask clearance of some kind so i don't if it is the same or not.
was hoping to get some info from you on it.

Thanks
Luke

 

[DocVikingo]

Hi champ198,

If by "scubadoc" you mean my old friend Dr. Ernest S. Campbell, whose diving medicine forum, Scuba Clinic, I moderated for many, many years, he is now quite senior and has pretty much retired from the Q&A biz. We closed the website & he has not been active on this board in nearly 5 years.

However, there still are some quite competent diving medicine experts here who remain active and you will get some good responses to your inquiry.

In the meantime, this should get you started --> Doc Vikingo's Diving With Asthma. Although a few years old, this article remains consistent with more recent treatments of the topic, e.g. -->

"“Diving Medicine: A Review of Current Evidence
James H. Lynch, MD, MS, Alfred A. Bove, MD, PhD
J Am Board Fam Med. 2009;22(4):399-407.

Asthma

More than 22 million Americans have asthma, which is roughly 7% of the total population. [36] Several surveys have revealed the prevalence of active asthmatic disease among divers from 4% to 7%. [37-40] There is obvious theoretical concern for asthmatic divers. Pulmonary obstruction, air trapping, and hyperinflation that accompany an acute asthma attack would seemingly place the asthmatic diver at increased risk for pulmonary barotrauma. In addition, conditions such as cold and exercise serve as triggers for many asthmatics. Based on this, asthma had been traditionally considered an absolute contraindication to diving. [9]

Despite these facts and documented decrements in pulmonary function studies after diving, the evidence is equivocal for risk of pulmonary barotrauma or DCS among divers with asthma. A comprehensive review of the literature in 2003 found no epidemiologic evidence for an increased relative risk of pulmonary barotrauma, DCS, or death among divers with asthma. [41] However, this information may be biased because it accounts only for asthmatics with mild disease who have chosen to dive against medical advice. The actual risk for all asthmatics is probably higher than what is shown in published studies. [42]

With such vast differences among patients with respect to precipitating factors, pulmonary function, and degree of airway obstruction and reversibility, it is difficult to consider asthma as a single disease when assessing fitness to dive. Rather, this condition demands individualized consideration based on each specific diver's history and disease syndrome. [9] There are several published guidelines with a variety of recommendations for diving with asthma. In Australia, all divers with asthma must pass spirometry before certification, but in the United Kingdom, well-controlled asthmatics (excluding cold-, exercise-, or emotion-induced asthmatics) may dive as long as they do not require a bronchodilator within 48 hours. [43,44] Among experts and other major diving organizations, the consensus is that lung function must be normal before an asthmatic can dive. Carefully selected mild to moderate, well-controlled asthmatics with normal screening spirometry can be considered candidates for diving per recommendations by the Recreational Scuba Training Council and the UHMS. [45] Spirometry should be normal before and after exercise testing. Medication used to maintain normal spirometry is not a contraindication to diving. Inhalation challenge tests, including methacholine or hypertonic saline, are not recommended. [19]”

Regards,

DocVikingo

 

[TSandM]

I think, from the description of your level of symptomatology, you're probably good to go. But it would be best to have some baseline pulmonary function testing done to be sure.