Asthma and diving

[JCRC]

Hello all! I am currently engaged in the Open Water PADI certification. My first pool day is tomorrow evening and am quite excited about that!

However, I have asthma that is controlled with an inhaled steroid which is working quite well. I still need the dilator (Ventolin / Albuterol). My GP cleared me but did not aske many questions and did not do spirometry tests or anything like that. (To his discharge, he knows me quite well and has been my GP for at least 10 years) So I will proceed with the pool modules of the training. I still unsure whethe I will pursue the certification dives though.

The problem is that after getting the clearance by my GP, I got curious and started reading. Well, the news are not too encouraging there!!! So I decided to seek a second opinion from a dive medicine so called specialist. My appointment is Thursday, Jan. 15.

I was told that no diving doctors would give me the go ahead in this area. If this is the case, I find this a little unprofessional on the part of the doctors. Nonetheless, if he says NO, I clearly intend to make him explain why. I will not be charged for a professional opinion and get only a "cover my behind" answer. (I am a lawyer so I know a little bit about liability )

So my question to you is whether you can think of specific questions I should ask him. I would appreciate any advice you may have!!!! Thanks a lot!!!!

 

[String]

Most "normal" GPs have no knowledge whatsoever about hyperbaric medicine unfortunately which is why its always best to get a proper medical off someone that does specialise in that area.
Asthma is complicated so nobody here can say yes or no - that has to come from the specialist.

 

[DeputyDan]

My daughter has asthma and has dove for years.

Her asthma/allergy doctor is a diver.

One of her asthma keys is exercise in cold enviroments - thus we only do warm water diving

 

[don Francisco]

It's hard to say whether diving with asthma is OK or not because there is such a broad variation person to person, so it needs to be considered on a case by case basis.

There are a few factors that might make asthma a contra-indication to diving.

It's theorized that congested lungs may trap air pockets and thus lead to expansion injuries on ascent. The other consideration is the triggering mechanism. If, for example, you're sensitive to cold, dry air it could be a problem since that's what you'll be breathing for about an hour.

Asthma per se may not be a barrier to diving, but if you're cleared to dive, you'll still need to excersize a degree of honest self assessment on a daily basis.

I also have asthma, and dive. My doc - who is familiar with the literature covering diving with asthma - and I have established ground rules, that cover when I will or won't dive, and adherence to these has served me well for almost 10 years, with zero negative consequences.

 

[DiverLS]

I have asthma and it's controlled by an inhaled steroid. My triggers are Nevada, where I live, sagebrush, rabit brush, tumbleweed, grass, etc. That is NOT a problem boat diving off the Channel Islands. I have never had a problem diving, even with excessive finning against the current for about 30 minutes that I had to do in the Red Sea a few months ago.

I don't dive when I have any problems or if I wheaze when I take the inhaled steriod.

My Allergist says I'm ok to dive if I don't go when I wheaze. My GP says he doesn't know.

I just wish there was someone locally that understands hyperbaric medicine. I live in Reno, NV, fat chance.

 

[Thalassamania]

Hello all! I am currently engaged in the Open Water PADI certification. My first pool day is tomorrow evening and am quite excited about that!

However, I have asthma that is controlled with an inhaled steroid which is working quite well. I still need the dilator (Ventolin / Albuterol). My GP cleared me but did not aske many questions and did not do spirometry tests or anything like that. (To his discharge, he knows me quite well and has been my GP for at least 10 years) So I will proceed with the pool modules of the training. I still unsure whethe I will pursue the certification dives though.

The problem is that after getting the clearance by my GP, I got curious and started reading. Well, the news are not too encouraging there!!! So I decided to seek a second opinion from a dive medicine so called specialist. My appointment is Thursday, Jan. 15.

I was told that no diving doctors would give me the go ahead in this area. If this is the case, I find this a little unprofessional on the part of the doctors. Nonetheless, if he says NO, I clearly intend to make him explain why. I will not be charged for a professional opinion and get only a "cover my behind" answer. (I am a lawyer so I know a little bit about liability )

So my question to you is whether you can think of specific questions I should ask him. I would appreciate any advice you may have!!!! Thanks a lot!!!!

Things change, I don't stay on top of all the medicine. My understanding (which is a decade old) is that asthma in an absolute contraindication to diving. I'm terribly sorry to have to tell you that.

My daughter has asthma and has dove for years.

Her asthma/allergy doctor is a diver.

One of her asthma keys is exercise in cold environments - thus we only do warm water diving

I'd consider this dangerous, the adiabatic cooling and very dry nature of the air coming out of a tank can be a serious concern even if you are diving in the tropics.

I have asthma and it's controlled by an inhaled steroid. My triggers are Nevada, where I live, sagebrush, rabit brush, tumbleweed, grass, etc. That is NOT a problem boat diving off the Channel Islands. I have never had a problem diving, even with excessive finning against the current for about 30 minutes that I had to do in the Red Sea a few months ago.

I don't dive when I have any problems or if I wheze when I take the inhaled steriod.

I just wish there was someone locally that understands hyperbaric medicine. I live in Reno, NV, fat chance.

There's plenty of chaparral growing on Catalina, that's sagebrush. I'd have a talk with Dr. Tom Neuman at UCLA.

 

[tc]

DAN Divers Alert Network : Asthma & Diving

 

[String]

Asthma hasnt been a total contradiction to diving for at least 15 years. It will prevent you becoming a commercial instructor in the UK and Australia but other than that it all depends on the type, the triggers, the controls.

 

[ScubaDocER]

Hello all! I am currently engaged in the Open Water PADI certification. My first pool day is tomorrow evening and am quite excited about that!

However, I have asthma that is controlled with an inhaled steroid which is working quite well. I still need the dilator (Ventolin / Albuterol). My GP cleared me but did not aske many questions and did not do spirometry tests or anything like that. (To his discharge, he knows me quite well and has been my GP for at least 10 years) So I will proceed with the pool modules of the training. I still unsure whethe I will pursue the certification dives though.

The problem is that after getting the clearance by my GP, I got curious and started reading. Well, the news are not too encouraging there!!! So I decided to seek a second opinion from a dive medicine so called specialist. My appointment is Thursday, Jan. 15.

I was told that no diving doctors would give me the go ahead in this area. If this is the case, I find this a little unprofessional on the part of the doctors. Nonetheless, if he says NO, I clearly intend to make him explain why. I will not be charged for a professional opinion and get only a "cover my behind" answer. (I am a lawyer so I know a little bit about liability )

So my question to you is whether you can think of specific questions I should ask him. I would appreciate any advice you may have!!!! Thanks a lot!!!!

I'll separate my opinion of lawyers and try to address the question anyway

If you do a search on this site for asthma and diving you will see a recent thread regarding this and postings from several physicians, including myself.

The basic issue has to do with the fact that asthma cannot be treated underwater. Even on the surface it can be life threatening. Asthma is a reversible form of bronchoconstriction that impairs air flow. The muscles along the bronchial tree constrict and air movement is impaired. Like stepping on a garden hose and not getting water out of the other end. On descent, this means that you have no air to get into your lungs to allow for ventilation. On ascent, you have air trapping in the non ventilating alveoli and these can rupture since there is a reduced means to equalize over these air spaces. Like have the water pressure increase through the above mentioned hose with out being able to release it down stream. With medication, the spasms can be reversed and steroids are helpful for treating the inflammation that comes with an asthma attack. The attacks themselves are impossible to predict and there in lies the difficulty. Most asthmatics have certain triggers that can create the acute attack. Even with that, you cannot predict when an attack may occur. Having an asthma attack underwater can be fatal. There is to date no means of delivering the life saving medicine underwater in a timely fashion. The attack itself also increases heart rate, respiratory rate and anxiety. Again, even on the surface, asthma can be challenging to treat. The medical community has not reached a consensus as to how diving and asthma can safely coexist. Because of that, dive agencies and Instructors are restricted in their ability to certify divers who have asthma. I am not saying it cannot be done. I am saying that if a diver has an asthma attack underwater and drowns, then the family of the diver will hire a lawyer (hint) to sue the Instructor and the agency citing that there is not a justifiable reason to endanger an asthmatic by teaching them to dive. Since the agency nor the Instructor can receive support from the medical community regarding this issue, then they have elected not to accept asthma as a condition that is allowable for Instructors to teach. The fault lies not with the agencies or the Instructors, but with the lack of research that would support them in case of a fatality. In some ways it is a subjective debate. Not all divers with asthma will have an attack while diving. If they do however, then who's to blame. It ultimately comes down to liability (another lawyer reference). Until the medical community can support them better, agencies and Instructors will probably still not teach asthmatics to dive.

 

[Thalassamania]

Asthma hasnt been a total contradiction to diving for at least 15 years. It will prevent you becoming a commercial instructor in the UK and Australia but other than that it all depends on the type, the triggers, the controls.

I think that depends on the diving community also. Without a really strong statement from a hyper-doc I would not permit an asthmatic to participate in a dive under the auspices of any institution that I worked for.