Saltwater Aspiration Syndrome - Has anyone had this?

[PBGDiver]

I moved to South Florida a few months ago, in part so I can dive more frequently. Lucky me! However, soon after moving here, I began to have frequent bouts of bronchitis, sometimes with fever and malaise. My physician was puzzled about why so many lung problems - she thought I might have allergies which were aggravating my lungs. I can correlate my worst bouts of coughing to beginning a few days after doing lots of diving on the weekend. When I mentioned the possibility of a diving connection, she suggested I see a pulmonologist. I saw the pulmonology NP a few weeks ago (the actual pulmonologist had been hospitalized with pneumonia!), who diagnosed me with hypersensitivity pneumonitis. She has ordered a pulmonary function test, which I'm having next week. And an allergy test. Along with a consult with the actual pulmonologist. I can find reports of people who have become acutely ill after diving with leaky regulators. But these people seem to get sick for 24 hours at most and then get better. I can't find any reports about people who have been sick for months. I do have leaky regulators - they've leaked off and on for years now despite regular maintenance. But I just thought that was normal for these regs. (I have older Dive Rite 3000 regs). Because of this, I haven't dived since January 1st, until I could figure out whether the regs are making me sick or if it's something else, like allergies. Even without diving, I've still had a couple of bouts with bronchitis. My question is: Do any of you have knowledge of any chronic respiratory issues such as this that can be related to diving? Would it be possible to have some sort of fungal or other out-of-the-ordinary infection in my lungs from sea critters or other organisms? I've been treated with both Zithromax and Levaquin, neither of which helped. I did get better on a course of oral prednisone. I am now on my second course of pred, after my most recent bout of bronchitis. I would like to have as much background info as possible from the diving community before I see the pulmonologist, as I'm not sure he's very familiar with dive medicine. Thanks so much for your help! PS. I am sending my regs to a new service guy, who's supposed to be the best with Dive Rite. So hopefully he can fix the leaking problem.

 

[Duke Dive Medicine]

PBG,

There's a difference between salt water aspiration and an infectious process, though it's not out of the question that the two could occur together. Salt water aspirated through a leaky reg could cause acute pulmonary edema, which may or may not resolve quickly depending on how much salt water was aspirated and the overall health of the individual. If the lungs are also seeded with some sort of microorganism it could lead to pneumonia. Sputum cultures would be diagnostic so if they've done that and the cultures haven't grown anything out then infection could probably be ruled out, though usually fungal culture is a separte order and they don't normally do those unless there's a high index of suspicion.

It's possible that you set up a chronic inflammatory process by repeatedly breathing from your reg and not allowing enough recovery time, but it's also possible that this could have an environmental etiology and I think it's very reasonable to pursue that. Have you had your house tested for mold? It sounds like you're on the right track with the allergy testing and the pulm consult (poor guy!). Please keep us updated.

Best regards,
DDM

 

[PBGDiver]

Thanks guys! Y'all rock! (Though UNC has a much better basketball team than Dook! ) I've failed miserably in the sputum-producing dept. but I'm gonna keep trying. And... I've wondered about the mold thing, as this problem started when I moved into this house. I don't see any indication of mold, but I'm working on figuring out how to test for this. Apparently I can also have some sort of blood test to see if I've been exposed to molds. Will keep you posted.

 

[Duke Dive Medicine]

Thanks guys! Y'all rock! (Though UNC has a much better basketball team than Dook! ) I've failed miserably in the sputum-producing dept. but I'm gonna keep trying. And... I've wondered about the mold thing, as this problem started when I moved into this house. I don't see any indication of mold, but I'm working on figuring out how to test for this. Apparently I can also have some sort of blood test to see if I've been exposed to molds. Will keep you posted.

Ya just HAD to go there ;-)

 

[flots am]

I do have leaky regulators - they've leaked off and on for years now despite regular maintenance. But I just thought that was normal for these regs. (I have older Dive Rite 3000 regs). Because of this, I haven't dived since January 1st, until I could figure out whether the regs are making me sick or if it's something else, like allergies. Even without diving, I've still had a couple of bouts with bronchitis. My question is: Do any of you have knowledge of any chronic respiratory issues such as this

You might also want to check/have someone check the inside of your second stage(s), and take a quick look inside your tank(s) to make sure you're not growing anything nasty anywhere.

flots.

 

[PBGDiver]

Thanks flots. That's happening right now... My cylinders are fairly new, so I think they're ok. But I'm a bit suspicious of the second stage. We'll see what they find.

Happy diving!!

 

[Duke Dive Medicine]

Thanks for the update! Now about that basketball thing...