Alveoli bursting

[TMHeimer]

I've recently heard that chest congestion while diving can cause aviloi to burst. Never heard of that before. I'm recovering from a cold. I have the usual "post nasal drip"--stuff drips from sinuses to throat causing coughing. I don't THINK there is anything in my lungs (if that is what she meant by chest congestion). Deep breathing is OK. Equalising to 6' in the pool here no problem. My charter will be to 80-90'. I have dived before at this point but to 30' or so with no problems. Anything to be concerned about? Is there a certain amount/level of "chest congestion" that puts one at risk for this? Am also curious as to why I've never heard about this before, and if it is a concern, why it's not to my knowledge specifically mentioned in PADI manuals, especially the Encyclo. or DM manual. The only stuff I ever hear about regards equalising. Appreciate any info.

 

[Jax]

Disclaimer NOT a medical person!

As I understand it, when you take a breath, the mucus could shift and block some of the path out. As you rise, the little avioli cannot release the air, the air expands, and the avioli can burst. I have no idea at what point that may happen.

 

[pasley]

NOT A DOCTOR OR VERY SMART PERSON, THE FOLLOWING IS FOR ENTERTAINMENT ONLY

I've recently heard that chest congestion while diving can cause aviloi to burst. Never heard of that before.

I will agree that the PADI Open Water Diver Manual copyright 1999 Version 2.1 beginning on page 23 and continued on page 24 right hand column, LUNG OVEREXPANSION INJURIES and further down on the same page last paragraph you will find REVERSE BLOCK does not do a good job of covering this topic. But it is there

I'm recovering from a cold. I have the usual "post nasal drip"--stuff drips from sinuses to throat causing coughing. I don't THINK there is anything in my lungs (if that is what she meant by chest congestion).

Sounds like you have already talked to either a doctor or dive professional who has advised you against diving.

Deep breathing is OK. Equalising to 6' in the pool here no problem.

Remember you will be going up from 4 atmospheres. I know your question is about your lungs but, the ears are a player here too. Clogged ears with air that expands 400% in volume is not a good thing.

My charter will be to 80-90'. I have dived before at this point but to 30' or so with no problems.

Yes, and you have exceeded the speed limit on the roads and not gotten a ticket. Just because you got away with it once does not mean this time will have the same result.

Anything to be concerned about?

Yes, there is. Ever hear of the Chokes? Rupture of an aviloi (assuming you don't get a large tear) would cause the Chokes. A deep breath on deck would result in coughing with or without blood. Happened to a friend of mine. Review the above referenced PADI Manual pages 22-27, or better a NAUI manual or any other dive manual. For quick reference, See Divers Alert Network links below for a start.

Is there a certain amount/level of "chest congestion" that puts one at risk for this?

NO, NONE AT ALL. We are talking about tissue paper thin lung tissue and very small "sacks" called aviloi and air that is going to increase in volume FOUR times.

Am also curious as to why I've never heard about this before, and if it is a concern, why it's not to my knowledge specifically mentioned in PADI manuals, especially the Encyclo. or DM manual. The only stuff I ever hear about regards equalizing. Appreciate any info.

See your PADI manual referenced above. Read DIVING SCIENCE by Michael Strauss and Igor V. Aksenov April 28, 2004, available at http://www.HumanKinetics.com This is a great read on what happens you your body during a dive and what can happen from a medical perspective during the decent, dive, and ascent. It will go into great detail and explain many things and IMHO should be included in any serious divers library.

Bottom line, evaluate risk against benefits. You know already what can happen to the ears with Squeezes and Reverse blocks and the ear drum is tougher than the lungs aviloi.
Benefit -
1.Going on a great dive trip to a warm water exotic location.
2. Beating the risk and getting away with it and having a great dive triip
Risk -
1. Sitting on the boat not diving because you can't clear your ears and get down.
2. Sitting on the boat with blood coming out of your ears from the ruptured eardrums the congestion caused either on the way down (squeeze) or on the way up (reverse block).
3. Your sitting on the deck and when you take a deep breath, your chest hurts and you cough. Commonly called "The Chokes" because you got luckily and only got a small tear in your lung "aviloi" and have to sit out diving for several months.
4. Rupturing your lung and suffering a potential life extinction event.
Is it really worth it? If you must go, sit on the boat and enjoy the ocean and the company of other divers and DO NOT DIVE until you are sure your cold is gone.

Trust me I feel you. I was in the same position last month. Doctor said lungs were clear, head was not. I sat out the local beach dives until my head cleared and took steps to ensure my head was truly clear (salt water spray, neti pot, herbal peppermint tea like it was going out of style, and of course my allergy meds. Head felt clear so I went diving. Some suggest Affrin 12 hour spray if you feel clear but want to make sure. I can not recommend this (ahem).).

Call DAN and discuss this with them.


Barotrauma Ear Squeeze (Ear Pain) Dealing with Middle Ear Barotrauma

Ear Squeeze (Ear Pain)Dealing with Middle Ear Barotrauma

Mechanism of Injury for Pulmonary Over-Inflation Syndrome

DAN | Medical Frequently Asked Questions

 

[tomfcrist]

Umm pasley.....I'm not sure which profile you were reading, but his clearly states he is a DM and that he has dove much deeper than 30ft.

Second, he wasn't asking about his ears, nor standard over-expansion injury, but about alveoli rupture which is an over-expansion injury on a small scale.

Third, your entire over the top rant and assumption that a fairly regular poster on this board is a troll merely makes you look like an idiot.

Fourth, if you are a working dive professional you would appreciate him asking a specific question about a bit of dive physiology that he doesn't have a great knowledge of. Additionally, the specific information he asks about is NOT published in any recreational agency's OW manual or other documentation.

Go scratch.

 

[uncfnp]

Think of the alveoli as a clusters of grapes attached to a thin tube that leads to larger tubes with connecting branches to more grapes. If there is a spasm or a mucus plug in a tube, the air gets trapped in the alveoli and can not escape as the diver rises and the air expands. The larger the tube plugged, the more alveoli affected and the greater the damage and risk of an AGE.

Hence part of the recommendation not to dive when "congested." This means upper and lower respiratory infections.

 

[pasley]

Tomfcrist,
Point taken. Edit done.

 

[tomfcrist]

Much better.

 

[TSandM]

The issue of concern is obstruction of small airways, leading to alveolar overexpansion and rupture. This will not generally occur in the fact of normal secretions, or even mildly increased ones. It CAN happen with thick, inspissated secretions, or thick secretions combined with bronchospasm. Someone who has upper airway irritation as a result of post-nasal drainage (which I often have for WEEKS after an upper respiratory infection) is at higher risk for reverse block and sinus damage than from pulmonary overexpansion injury. However, if you are coughing up copious, thick phlegm, or have wheezing in association with significant mucous, you probably ought to rethink diving. (And, of course, all the of preceding is assuming normal lungs at baseline, and not someone with underlying lung disease.)

 

[TMHeimer]

Thanks for the advices. My charter was cancelled until the 11th, so that's that. Remaining is my question of why this situation is not really mentioned in at least the PADI manuals I have. Any thoughts? What about other agencies?

 

[tomfcrist]

Thanks for the advices. My charter was cancelled until the 11th, so that's that. Remaining is my question of why this situation is not really mentioned in at least the PADI manuals I have. Any thoughts? What about other agencies?

Probably due to their rarity. Most people having bad enough breathing issues to cause such an injury probably won't be diving anyway.