Recent upper respiratory illness

[Lisa Met]

Hi
I had a recent upper respiratory infection in my lungs that required antibiotics and an inhaler. I am better, and I want to dive, but notice a little inspiratory crackles with a bit of productivity. I am a bit impatient to go and dive, but my instinct tells me it would not be a good idea. This may take a long time to get over. It's been 2 weeks. Comments?

 

[Neilwood]

I would comment that symptoms like that should be investigated further and confirmation sought from a doctor that is experienced in diving related medicine.

Personally I would probably hold off until I was free from any symptoms - the ocean will still be there in a few weeks.

 

[The Chairman]

but my instinct tells me it would not be a good idea.

I am not a Medical Doctor (I heal sick networks), but I find this statement compelling. Follow that instinct. I know a few people who have died "pushing" a dive after a respiratory illness. There's nothing down there worth dying for. Take it easy. Let your lungs fully recover before you splash.

 

[Kevrumbo]

Hi
I had a recent upper respiratory infection in my lungs that required antibiotics and an inhaler. I am better, and I want to dive, but notice a little inspiratory crackles with a bit of productivity. I am a bit impatient to go and dive, but my instinct tells me it would not be a good idea. This may take a long time to get over. It's been 2 weeks. Comments?

I've been diving with asthma (under control with daily meds, an albuterol inhaler as needed, and good physical exercise tolerance) for nearly twenty years now --but I always wait for an extended period of a week or more until I'm sure of complete recovery from an Upper Respiratory Infection (URI). If you still have a productive cough, you don't want to be breathing cold dry compressed air at depth through a still inflamed airway & lung tract which could potentially elicit violent coughing spasms. . . Be patient for now and just do some easy swimming and/or surface snorkeling.

 

[Pedro Burrito]

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A ScubaBoard Staff Message...

Moved from Basic to Diving Medicine

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[chillyinCanada]

The question to me is, if you've been successfully treated, why are you still crackling? (I asked as a veteran of pneumonia wars)

In any event, I'm with the others. Wait, and then wait a little longer, definitely don't be crackling.

 

[uncfnp]

Hi Lisa. I deal with a lot of upper and lower respiratory infections but I am not dive medicine. But my advice is to hold off diving if you are still systematic with a productive cough or need to use your inhaler, too great a risk for bronchospams or mucus plug.

Chilly, when most people say crackle it can mean anything from fluid in lungs (less common) to wheeze or mucus which can be either bronchitis or pneumonia (both of which is actually a LRTI). Only way to be sure is get it check, which it sounds like she has. Pneumonia usually responds very well to antibiotics. Bronchitis on the other hand is almost always viral in healthy nonsmokers and gets better in about 2 weeks no matter what you do. Unfortunately the cough will sometimes last for an additional week or two. Inhalers or steriods may help.

Getting worse instead of better would be a reason to revisit her PCP. Otherwise, its probably just a matter of time.

 

[fmerkel]

People don't like the word but you basically had asthma temporarily. Real asthma appears on a regular basis with certain stimuli. But, just about anyone can have the same set of symptoms when they get a bug (virus or bacteria) that sets it off. Often it's just a virus but physicians with poor judgement or pressure from patients prescribe antibiotics. Often people get an Albuterol inhaler, which if it is effective for you is fine and will help.

A way to visualize this 'attack' is to think of your lung being 'sprained' by the illness. You have swelling, narrowing of the airways (bronchoconstriction), and increase in mucus productions, with a thickening of the usually thin mucus. Essentially it's inflamed. The lung only has one way to tell you it's unhappy since it does not have pain receptors > cough. Sometimes that cough is pretty damn bad. Antibiotics will do nothing to deal with a virus. Albuterol will relieve the bronchoconstriction if you have it but only for ~ 4-6 hours. The most effective medication for this is an inhaled steroid to deal with the underlying swelling, the same medication that is the cornerstone of good asthma treatment. Unfortunately unless you are a 'real' asthmatic the physicians almost never prescribe this for a 'normal' person having this problem.

Just like a sprained ankle can take several weeks to get over fully, a 'sprained lung' can be the same. Depends a LOT on HOW sprained, and what treatment. Inhaled steroids can shorten this dramatically by reducing the inflammation.

If you are crackling, and coughing productively your aren't ready for the water yet. You are past the worst part of the sprain, but you aren't fully healed yet. Sounds like you'll likely actually know when you are ready, you just aren't ready to hear it.

(Note - I'm not saying antibiotics is the wrong thing to do. It is the right thing IF you have a bacterial pneumonia. VERY often people do NOT, and get the antibiotics anyway. This is just one more step that is pushing us all toward organisms that are resistant to all antibiotics. When we reach that state the entire world is going to be in serious trouble)

 

[chillyinCanada]

I've had bronchitis numerous times, too many to count. The only times I've crackled (my perception thereof) I've actually had pneumonia. There were some other accompanying symptoms that set the pneumoniae apart from the bronchitis but they don't appear to be germane to this convo.

 

[uncfnp]

I've had bronchitis numerous times, too many to count. The only times I've crackled (my perception thereof) I've actually had pneumonia. There were some other accompanying symptoms that set the pneumoniae apart from the bronchitis but they don't appear to be germane to this convo.

You are right chilly. In medical speak crackles means fluid. The old term was rales. Usually we think fluid with something like congestive heart failure but it can happen with pneumonia as well. Listening with a stethescope, it sounds a little bit like when you rub hair together.

But when someone just tells me they hear crackles, or rattles or wheeze I always try to find out exactly what they hear/feel since their use of the terms might not match mine.

Its interesting that you can actually tell you have crackles. I don't think I have ever had a patient use that exact wording when in fact they did have crackles. More often they just describe a vague heaviness, tightness or rattle.