Asthmatic looking to scuba dive - had a dive physical today...

[purbeast]

So this weekend I am going down to Cancun, MX. I really really want to try scuba diving, so I looked into the dive physical that can be taken. Just to warn you, this may be a fairly long read heh.

So I went to the DAN website and found someone who is fairly local to me and contacted him. He gave me a list of the following items that I needed to get prior to seeing him, which include the following.

- 2 Blood tests (CBC and Metabolic Profile, I believe those 2)
- EKG
- Chest X-Ray
- PFT (Pulmonary Function Test)
- Methatcoline Challenge Test

So over the past few weeks visiting 4 different places, I got all of those done. They all came back with good results.

So today I went to see the person doing the dive physical, making this my 5th doctor visit for scuba heh.

Basically he talked about my general health with me before I showed him all the results. I am a 29 year old male and I work out reguarly. I lift weights 4x a week (and have for past few years), and I run 2x a week at a pretty high intensity, but for short periods of time. I do this because I play football in the spring and in the fall on a team, so this kind of cardio training gets me in shape for that.

I have not used my actual inhaler in about 2-3 years probably, and since I got put on advair probably 3 years or so ago, I've only used it twice. I don't need it when I exercise or afterwards. I mean I am tired, but not "asthma" tired after I run.

So the test results he saw, he said they were all fine, except the methacoline challenge test.

If anyone is not familiar with this test, it basically is where you get 5 doses of medicine that tries to incude asthma symptoms, each one getting stronger and stronger, and then you do a PFT. In each of the 5 PFT's, it tells you how much airflow you are pushing out from all of your lungs.

The general purpose of this test is to diagnose asthma in people. The way people are diagnosed with asthma is when the value of the air flowing out of their larger lungs goes below -20. So by that I mean -21 and lower.

At the end of the test, the lowest mine got was -9. So my larger lungs were fine, and in a way it seems like I kind of clinically don't have asthma or have kind of grown out of it.

The concern had had was that my smaller lung parts. It was at -29. He said in a person who doesn't have asthma, it would probably be around -10 or so after the last round of the test.

So what he told me was that he would not medically clear me due to this. He even got an opinion of another Pulmonary specialist in the hospital that I was doing the physical at, and the pulmonist said that if it was him he would say the test is negative (a good thing in these tests) because all that really matters is the large lungs, not the air in the low lungs.

The doctor then explained to me what the potential risk is. Basically if there was air in my small lungs that did not blow out of my lungs, and is trapped, and I rose in the water too fast, that the air could expand and could potentially become a collapsed lung. However he also said that this is extremely rare, and that this could also happen to anybody, asthma or not.

He also told me that he really thinks I will be fine and have nothing to worry about. He just did not want to 'medically clear' me because if something DID happen to me, it could lead back to him giving me the go ahead. But he did also tell me that I should be fine. He told me that on the waiver, if I really want to do it, to just say I don't have asthma.

He himself was a diver, and he explained all the risks to me, and he even wants me to call him after my trip and let him know what I decided to do. I told him that now I am kind of skeptical because he would not clear me, but he also said that he really never EVER clears asthmatics in general. He even did tell me on the phone when I first talked to him chances are he would not pass me.

I guess why I am posting this on here is because I would like to just hear opinions of people on my situation, if they have similar experiences or anything like that.

I truly think I will be okay if I scuba. He did not even do the actual physical portion of the dive because he can tell that I'm in good shape as is, so the physical aspect of it would not be much to me at all.

Well thanks for reading this and if you have any opinions/advice on my situation at hand, please post them. I plan on scuba diving a beginner dive when I'm in Cancun (possibly a day trip to Cozumel) simply because of the test results and just from the talk I had with the doctor.

Also if anyone would like me to post any of my test results for further evaluation, feel free to ask.

 

[Crush]

Follow the advice of your physician. If you feel strongly against their position, contact DAN for another referral, then another if you need.

Next, consider that there are some excellent, accomplished divers who have been diagnosed with medical problems that might preclude diving. Some of them choose to continue to dive. Some of those who continue to dive inform their dive buddies, some don't.

It is all about responsibility; both to your dive buddies, and personal. I would implore you to tell your dive buddies, both regular and insta-, of your medical condition(s) if you choose to dive. Also, if you have dependents, look into insurance and exclusionary clauses.

Safe diving if you choose to dive.

-Crush

 

[purbeast]

Follow the advice of your physician. If you feel strongly against their position, contact DAN for another referral, then another if you need.

Next, consider that there are some excellent, accomplished divers who have been diagnosed with medical problems that might preclude diving. Some of them choose to continue to dive. Some of those who continue to dive inform their dive buddies, some don't.

It is all about responsibility; both to your dive buddies, and personal. I would implore you to tell your dive buddies, both regular and insta-, of your medical condition(s) if you choose to dive. Also, if you have dependents, look into insurance and exclusionary clauses.

Safe diving if you choose to dive.

-Crush

Thanks for the comment.

The thing that is just tearing at me is that the doctor basically said I was fine to dive and there is virtually no risk (other than the normal risks of diving, nothing specific to asthmatics), yet he would not sign the waiver thing. But I do remember him stating the very first time I talked to him on the phone that chances are he would not sign the waiver regardless.

Everyone that I'm going to be diving with of my friends, we are all new to it and never done it before. But we are all very responsible adults and they all know that I have asthma.

Another thing is that my allergist/asthma doctor who has known me for 20+ years believes I will be fine and that my asthma is very well controlled. Before my prior trip to Barbados in March of 2010, he actually signed my medical waiver. However I was still hesitant because I had talked to the guy recommended by DAN and he was telling me that chances are he would not pass me.

Also the guy who did my methacoline challenge test believed I would be fine as well after he saw the results as I was taking the test.

The thing is, my allergist and the guy giving me that test, they do not have as much knowledge as the person DAN recommended to me.

So I'm just going to feel it out and do a tad more researching before I make my decision.

 

[Crush]

The thing is, my allergist and the guy giving me that test, they do not have as much knowledge as the person DAN recommended to me.

So I'm just going to feel it out and do a tad more researching before I make my decision.

I can't help you there. You can always ask DAN for another referral.

I love diving. If I were ever told my a medical professional that I should not dive, I would have to think very long and hard on this, and look into insurance options It is up to you. I really do hope, however, that you will inform your dive buddies.

 

[terrylowe]

Hi...I attended a DAN conference this past summer....I looked up my slides and plagiarized them below....

The discussion of asthma in diving is controversial. For instance it is considered an "absolute" contraindication for people with exercise-induced asthma to dive....Up to 20% of the general population have this and many people don't realize that they have it. So that means that A LOT of people are diving with an "absolute" contraindication to diving without realizing it. When it comes to "normal" asthma, the concern about air trapping and pulmonary barotrauma is theoretical. An old (1994) review of dive accidents and fatality data did not demonstrate that asthmatics are at increased risk. DAN states that there is not enough data at this time to confirm or exclude asthma as a risk factor. The problem is that pulmonary barotrauma and air-gas embolism are serious, life threatening problems and many physicians have legitimate medico-legal concerns about clearing a diver with asthma to dive.

People with asthma CAN be approved to dive, but you will probably see differing opinions from different doctors on what is acceptable. But whatever you decide to do...don't dive while the disease is active.

 

[TSandM]

purbeast, the best advice I have for you is to PM Duke Dive Medicine or Gene Hobbs, and ask them to review your test results. Asthma in diving is somewhat controversial, and I cannot, from your description, try to evaluate your tests and tell you what they do or do not say.

But I will say that a patient who exercises regularly and hasn't used a rescue inhaler OR routine meds for several years, would meet MY criteria for mild asthma, and being safe to dive. See what the experts say, though.

 

[mrjoshw]

I had a girl that had asthema in the last OW class that I helped with. She was cleared by one of our Dive Doctors here in Okinawa and dove just fine. She did, however, run out of air very quickly during the open water portion. I don't know if this was due to her condition, she was out of shape and nervous as well.

I'm not smart on this issue whatsoever, just wanted let you know that I've seen it and it was fine. But on the other hand, the doctor that evaluated her and knew her issues signed her off.

Hope you're happy with whatever your decision is.

Enjoy Mexico!

 

[BuoyantC]

YMCA scuba used to have an asthma protocol and there were some tests the actual instructor could do to verify fitness to dive. My personal feeling is if someone is WAY more physically fit and active than me, and hasn't needed an inhaler in years, then you do not have exercise induced asthma.

That said, the PADI Medical Form is specific in asking if you now or ever had.... You may interpret that how you wish. I once had a student - a physician - answer no to everything on the medical and limp in to the pool area with significant impairment from cerebral palsy. Now that's a stretch for interpretation.

 

[Kingpatzer]

Take you test results to another pulmonary specialist and ask them if they would diagnose you with asthma.

If they would not, then your previous allergist/GP diagnosis may well have been wrong and you can consider if you think you ever had those conditions or not.

Ultimately, you have to be confident and comfortable with the answers you provide on the waiver. But the waiver exists as a legal cover for the shop/instructor and really your decisions on how you answer those questions are yours to make. I would never suggest you deliberately lie. But if you do not now have the condition being asked about, did you ever?

 

[2 Big 2 Fail]

Look. You say your reason for posting is that you really think you'll be okay but want some opinions and experiences. First, experiences mean nothing at all. For that matter, most people with frank asthma won't be here reading this. But choosing the option you want to choose based on someone's reported experience is like deciding to smoke because you know of elderly smokers who feel fine. Be honest. You've already decided to go ahead, and I won't fault that much, but you just want some stories and opinions to make you feel better about it. It's your choice, and the DAN-recommended doc is probably right, that there's some risk but but much additional within the realm of all other diving hazards. (Asthma or not, there is or was some respiratory issue.) A lot of things are like that. I'm certainly at some greater risk at 61 than I would be at 25. My wife is at some greater risk on account of a disability that requires her to swim mostly using her arms. Since the docs don't recoil in horror at the mere thought of you diving, I think what matters is how you deal with it if one day you find it really is a problem and you have to decide to hang it up or push it.