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

[motorref]

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

I took up diving last year (after 30 years of putting it off) and despite having suffered a straddling thrombosis (a blood clot that completely engulfs both lungs, usually 85% fatal - cost me a week in a hospital and 3 months out of work) last year I was cleared by my usual doctor after having similar tests.
I consulted with 2 of my surgeons that were both divers, and very familiar with my medical issues, and both encouraged me to go for it.
And, while I am obviously not a doctor, from what you've posted, it sounds to me like your doctor is encouraging you to do it, but can't sign the form due to liability.
A consult with another doctor, possibly a pulmonologist, might help allay your concerns.

Good Luck!
KevinL

 

[TSandM]

Congratulations, motorref, on surviving a saddle embolus! That's a very rare thing. Savor every day you have, because they are special!

 

[ADSFire]

By now you have already been on the trip, but I wanted to post. I am not a physician (so my opinion is really just mine). I think it is fantastic you went to the extent you did to be informed of the severity (or lack therof) of your condition. The previous responses are all valid. Yes, there is not a whole lot of clinical data. Asthma is NOT an absolute contraindication for diving (see journal references below), but physician fear of a lawsuit is a contraindication for your medical clearance. Your physician's basically told you off the record that they think you will be fine. You are an adult. You sought expert opinions and are making a well informed decision.

Here are a few thoughts:

Plesmography (body box testing) anbd CT scans can show degree of air trapping. A dry, cold air exercise challenge that is negative for induced bronchospasm can add evidence for your medical clearance. if you withheld your ADVAIR for 12-24 hours prior, your methacholine challenge was absolutely negative. In the context of ADVAIR treatment, this is excellent. Assuming the FEF 25-75 is "the smaller airways" to which you refer, it is a highly variable number from test-to-test in otherwise stable values, so excluding your medical clearance based only on the -29 seems more a CYA move on his part. It seems, so far, that your asthma is extremely well controlled and would indicate you are at no more of an increased risk of barotrauma or bronchospasm underwater than the normal population... but nothing is guaranteed. Diving always carries a risk. You know them through training. Master your skills, start with shallow dives. Use conservative profiles, slow rates of ascent and enjoy your diving. Maintain regular check ups and pulmonary function testing. Any decrease in your asthma control or decline in PFT values should trigger you to reevaluate continued participation in your new found hobby.

Davies MJ, Fisher LH, Chegini S, Craig TJ. Asthma and the diver. Clin Rev Allergy Immunol. 2005 Oct;29(2):131-8.

Sade K, Wiesel O, Kivity S, Levo Y. Asthma and scuba diving: can asthmatic patients dive?.
Harefuah. 2007 Apr;146(4):286-90, 317.

Tetzlaff K, Muth CM. Demographics and respiratory illness prevalence of sport scuba divers. Int J Sports Med. 2005 Sep;26(7):607-10.

Tetzlaff K, Muth CM, Waldhauser LK. A review of asthma and scuba diving. J Asthma. 2002 Oct;39(7):557-66.

Héritier F, Leuenberger P. Asthma and scuba diving. Rev Med Suisse Romande. 2003 Feb;123(2):135-7.

 

[purbeast]

I know this post is REALLY old from me, however I wanted to update it since after I got back from my previous dive, I never got around to calling that doctor up to take the PFT and have him sign my waiver. In hindsight, I really wish I did though.

Since then, I have only done 1 more dive, which was last fall. Well it was 1 2 tank dive, so I don't now if that counts as 2 dives or not. And everything was just fine. I'd say my asthma now is even more controlled. I only use my advair pretty much 4x a week, before my workouts Monday through Thursday, and it's not really because I need it, more of a preventative measure and since you're supposed to take it daily, I decide to take it at that time. I will also go some weekends where I just don't take it because I don't need it and don't think about it.

Well I'm back trying to get my certification and went to a local orientation class, and I'm trying to get my waiver signed again. They told me that even if you say NO to all waiver questions, even when you do the checkout dives they want a medical waiver signed, so I'm back in this same boat.

I went to my current asthma/allergy doc and did the PFT and other stuff, and she wasn't really aware of this medical waiver so she would not immediately sign it. She said she could recommend me to a pulmonary specialist though and that I could also do an exercise challenge (where you do PFT before and after treadmill running) and that she would do a bit more research on the subject.

Well the next day (yesterday) she called me and said that even if I was fine on the exercise test she wouldn't clear me simply because she doesn't fully understand and know the risks involved. Rather she said she'd give a note or something saying that my asthma symptoms do not affect exercise and that I'm fit in that sense, so that if I go to a pulmonary specialist and do some tests there that it would kind of just be more evidence. She did recommend a pulmonary doctor to see though and I now have an appointment next Wednesday with them, and I explained to them that I want to get SCUBA certified and they have some tests they will run.

The class I wanted to take was August 18th and 19th which includes the classroom setting and pool work, and I was hoping to do my checkout dives in September while in Grand Cayman on vacation. I'm hoping that next Wednesday they sign off on the waiver and that there is still room in the class. I don't want to sign up for the class if I'm not medically cleared though but it would really stink to not be able to do it this time. I wouldn't be able to take the class again until October if I can't do this one, but at least it would give me more time to find a doctor if this one isn't enough.

 

[alvinsuper]

Sorry to head about this. I have to say it is a bit disconcerting how different standards are across the world. I just needed a simple certification from my family doctor stating I was fit for recreational physical activity, when I signed up for scuba classes. He just asked me about my medical history. I learned a lot from this thread and I commend you for your perseverance. I know divers who have asthma, but I urge you not to be biased too much by the successful stories of other people. One would also need to hear about the failures, which are often untold. I think you are doing the right thing going through the gauntlet of tests and medicals. Health is one's most valuable treasure. Best of luck.

 

[purbeast]

Well I went to the pulmonoligist today but unfortunately he didn't sign the waiver (yet) because he is requiring me to get 3 different PFT's at the hospital as well as chest X-rays. I did this 6 minute walking test which I easily passed but he needs more. I am pretty confident that as long as my tests come back good he will sign off, he seemed very reasonable about it all and printed this sheet out for me (which I had read before):

SCUBA Diving and Asthma: Clinical Recommendations and Safety. - PubMed - NCBI

He said that his goal is to get me a signed waiver with 2 caveats - 1, I don't SCUBA having used my inhaler less than 48 hours prior (which shouldn't be a problem since I haven't used it in 10 years) and 2, to not use a hookah less than 48 hours prior (which I do maybe once or twice a month with friends) so that shouldn't be an issue.

That said, I unfortunately will not be able to sign up to the class this weekend, which means I won't be able to do my checkout dives when in Grand Cayman next month, so it's a bit disappointing, but I'm thinking I will take the class in October and maybe go with the class on a trip to Grand Cayman in December, if my wife is okay with that lol.

 

[tursiops]

Well I went to the pulmonoligist today but unfortunately he didn't sign the waiver (yet) because he is requiring me to get 3 different PFT's at the hospital as well as chest X-rays. I did this 6 minute walking test which I easily passed but he needs more. I am pretty confident that as long as my tests come back good he will sign off, he seemed very reasonable about it all and printed this sheet out for me (which I had read before):

SCUBA Diving and Asthma: Clinical Recommendations and Safety. - PubMed - NCBI

He said that his goal is to get me a signed waiver with 2 caveats - 1, I don't SCUBA having used my inhaler less than 48 hours prior (which shouldn't be a problem since I haven't used it in 10 years) and 2, to not use a hookah less than 48 hours prior (which I do maybe once or twice a month with friends) so that shouldn't be an issue.

That said, I unfortunately will not be able to sign up to the class this weekend, which means I won't be able to do my checkout dives when in Grand Cayman next month, so it's a bit disappointing, but I'm thinking I will take the class in October and maybe go with the class on a trip to Grand Cayman in December, if my wife is okay with that lol.

See my reply in your other thread.

 

[purbeast]

I'll keep the asthma discussion to this thread instead of the other one, but he was basically just saying for me to make that promise to him. It wasn't something official. It was basically him just reiterating what they say in the last line of the link I posted above, as well as just saying "hey smoking before you dive isn't a good idea."

 

[caruso]

This thread is a great read for anyone who is considering scuba diving who has a medical condition that "might in some way have an effect on diving" and wonders if they should say anything about it.

It's your life, and it's at your own risk.

Once you put it out there you can't take it back. Every doctor you consult with, every dive instructor you speak to is going to have one thing at the top of their mind and that is to cover their own behind in the event that something happens to one of their patients or students.

 

[flyboy08]

The OP deserves an honorary C Card! Well wishes to you my friend and thanks for reviving your thread!

Best of luck!