Diving post Asthma?

An acquaintance asked me about diving this week, after learning of my involvement with the sport. This person asked a question I could not answer. She stated even thought interested she feels she could never do it, becasue she either has asthma or suffered from it as a child. I am not sure of the exact situation.

Having no experience how does asthma, both current and past, effect a person's ability to dive?

And understand I will tell her to talk to a medical profession, just want to see if its even a subject to pressure?

DAN created an excellent article on the topic: Asthma & Diving ? DAN | Divers Alert Network ? Medical Dive Article

obviously she should talk to her doctor as well as a dive doctor (I think it's important to talk to both then make a judgement if the two differ), but I know quite a few people who have medically treated asthma (current condition) or asthma as a child and dive regularly. It's not a blanket 'no, don't even consider it' as long as the condition is well understood and mitigations are put in place.

the most serious problem is someone who doesn't inform the dive doctor or teaching staff.

There is a big difference between active asthma and having had some bronchospasm as a child. If the person hasn't been symptomatic for years and is on no medications at all, I think they could consider themselves not asthmatic, and proceed normally. If they have symptoms on a semi-regular basis, and absolutely if they require medication for management of their symptoms, they need a rational evaluation by a physician, and may need pulmonary function studies to see if their lungs are working well enough to consider diving. The issue is one of air embolism, and since this is often fatal, it is not to be taken lightly.

Adding to this, a lot of wheezing in children is referred to as asthma, while most of it isn't. Childhood wheezing is quite often not asthmatic. So if a child stops wheezing before the age of 6, it probably was not asthmatic.

There is no cure for asthma, you don't "grow" out of it, and it is under treated in children. It's a chronic disease that scars lung tissue, blebs can form as a result. These are injured alveoli that can get gas forced into them and on ascent, if they seal shut, can rupture and cause a barotrauma. Get evaluated by a pulmonary specialist. Every acute episode in an asthma attack will damage lung tissue to a degree. The goal in asthma management is to minimize the acute flareups.

vincent54:

There is no cure for asthma, you don't "grow" out of it, and it is under treated in children. It's a chronic disease that scars lung tissue, blebs can form as a result. These are injured alveoli that can get gas forced into them and on ascent, if they seal shut, can rupture and cause a barotrauma. Get evaluated by a pulmonary specialist. Every acute episode in an asthma attack will damage lung tissue to a degree. The goal in asthma management is to minimize the acute flareups.

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A couple of things first. For DougK's question, the medical recommendations for asthma and diving is patient's with asthma have a relative contraindication for diving. The general consensus is that patients with very mild asthma, require little or no medication, and more importantly have not had any flare ups or exacerbations in months would probably be okay to dive. Patients that require maintenance medications, have attacks that are more difficult to break, and have had recent exacerbations really shouldn't dive.

For your friend, do get an opinion from both her primary care MD since that is the person who would most likely sign her medical clearance, and if she would like more information or second opinions then the DAN article and possible phone call.

As for asthma itself, it is both under diagnosed and over diagnosed in patients. While earlier disease models focused on asthma as a bronchospasm disease where the muscles in the airways simply spasmed resulting in the characteristic breathing difficulties and wheezing, we have now come to realized that the initial trigger for the bronchospasm is airway inflammation. It can be a chronic disease resulting in scarring of lung tissue but only in very severe cases with repeated attacks over many, many years. It is very unusual to see patients with significant lung restrictions due to chronic asthma. Most patients have milder forms and the condition itself covers a wide range of severity. Not every child who wheezes actually has asthma and many can be misdiagnosed as kids then unfortunately carry the label as adults.

Bottom line is she should see her doctor first.

^^^ great answer above. and thx to kelemvor for that link. i'm gonna read that one.

i have been dealing with asthma since i was a little kid. it is nowhere near as big a problem now as it was then. but i carry an inhaler wherever i go still to this day. i am lucky in that i have a mild case of activity induced asthma and it is not a problem on a day to day basis. i don't take daily meds. the Ventolin is only for emergencies. in the 20 years i have been diving it has NEVER been an issue. but you must be aware of your own limitations. for example.....if i have any chest congestion due to a cold/flu or other infection ect i just would not dive. of course even a diver without asthma should not be diving with those conditions anyway.
i also try to keep myself in decent physical condition to be able to participate in very physical activities. and believe it or not, at times, scuba diving can be very physically demanding depending on the situation.
so my humble advise would of course mimic the others as far as getting a medical clearance. preferably from a DR. who actually understands how that medical issue might relate to diving specifically. and tell your friend they should use caution and their own good judgement as only they know what their body is telling them.
another issue a certified diver can run into is that when you travel, or if you take advanced training at a different shop other than your original certifying dive shop,you will inevitably have to fill out a medical statement with that local dive operation. if you state on that form that you have asthma, i can tell you that there are many shops that will not allow you to dive even if you are fully certified. something to keep in mind.

I have been concerned of this since I started diving. Too start off all my life I had some sort of asthma but never really saw a Dr for it. There had been triggers with most of them being allergies and the biggest being Cats. When i first signed up too dive I answered NO to all the questions thinking my symptoms was non existent so why not. I then started to get serious about diving and started to get more certs. So rather than not know how my asthma was I saw a Dr in diving medicine. He told me I was fine for diving to just take a Mucinex days before diving and with a puff that morning I would be ok to dive. Since the past 2 years I have been working on my health and running 10k's every other month. It is possible to improve your asthma but it will always be in the back of my mind. As a precaution before every dive I will use a rescue inhaler and that is the only time I ever need one.

Obviously a dive savvy doctor should have the last word. Our non medical experience has been that if asthma attacks are triggered by cold or exertion diving may not be in one's future. For many, allergens are the trigger. The good news is that scuba air is exquisitely clean and a delightful respite from many topside contaminants. If you can go into the dive clear then allergies probably won't be an issue. This may include some precautionary medication just to make sure you start out clean.

Pete