Divers with Asthma

[Gene_Hobbs]

This has been a great thread!

UHMS has periodic programs in conjunction with NOAA that trains phsysicians on evaluating fitness to dive. There are other programs as well that will train the phsyician to evaluate divers for fitness.

This is a good program and serves as a starting point for the Duke Fellowship in hyperbaric medicine.

I am currently working on a systematic review of literature evaluating the relative risk of diving with asthma when compared to the general population. My intent is to publish the work. I will keep teh board updated as I work through the project

This is good to hear! Please let me know if you are having any problems locating a reference.

The most recent articles I liked were:

British Thoracic Society guidelines on respiratory aspects of fitness for diving.
Thorax. 2003 Jan;58(1):3-13.
PubMed ID: 12511710

and

Asthma and the diver.
Davies et. al.
Clin Rev Allergy Immunol. 2005 Oct;29(2):131-8.
PubMed ID: 16251767

Others of note are:

Elliott DH (ed). Are Asthmatics fit to Dive. Proceedings of a Symposium held 21 June 1995. UHMS Publication Number 06-21-95. Bethesda: Undersea and Hyperbaric Medical Society; 1996; 81 pages.
---This symposium has a nice forward that discusses the legal implications of clearance (held after the Americans with Disabilities Act to form a consensus statement).

Vorosmarti J, Linaweaver PG (eds). Fitness to Dive. 34th Undersea and Hyperbaric Medical Society Workshop. UHMS Publication Number 70(WS-WD)5-1-87. Bethesda: Undersea and Hyperbaric Medical Society; 1987; 116 pages. RRR ID: 4249


and one closing thought from the 34th UHMS Workshop on Fitness to Dive. "Fortunately, most of us have a basic understanding of what asthma is because the participants of the CIBA Foundation study group on the 'Identification of Asthma' concluded, 'Asthma could not be defined on the information at present available.' (1). (In that respect, asthma seems to be somewhat like pornography; we can't define it, but we all know it whne we see it.)..." --TS Neuman.

 

[movieflick]

I have asthma and have had it my whole life. The last real asthma attack I had was about 8 years ago when I was a smoker. YEA and asthmatic that smoked :no

I have always been interested in diving but always thought it was impossiable but with all the new info it would appear under the right circumstances it is possiable. I have decided to try and pass all the testing and get a doc approval. I have never had a determination if my asthma is allergy or excersize induced so I am just keeping fingers crossed that it is allergy. Sorry for all the back history just trying to fill ya in.

My concern is that I will be prevented from diving not because I am not medically fit but because my instructor or doctor is too much of a panzy and denies me due to fear of lawsuit. :mooner: COME ON you pay the premiums might as well use the insurance some time just kidding. But seriously I think it is discrimination to a certain extent. From what I can tell the "REAL" studies do not show an increased risk for asthmatics so why should there be a contradiction? It is all very confusing

 

[Chaseh]

My advice is find good Drs. Then, listen to those who are trying to help and/or protect you, and don't get involved with discussing it with those that are trying to protect themselves.

 

[mdjh51]

Thanks Gene,

I will let you know if I need any help. SO far, Medline via ovid has given me about 20 or so papers to review.

BTW, I really like the asthma to pornography analogy... very fitting...

 

[Nova SS]

I agree, only genticaly altered people with gills should dive, it just too much of a risk for any "lung laden land lover" to venture into the water. Look down for a sec.....WE GOT FEET !!! OUT OF THE POOL ALREADY WILL YA !

Plus theres all those darn sharks out there .....CHOMP CHOMP CHOMP.

I have asthma.

I bet most people who dive with asthma are more aware of their own overall physical condtion ( not just with asthma) before they get into the water then the 300 lb guy next to them.

 

[movieflick]

I am an asthmatic as I said before and I was approved to scuba and completed the pool sessions this weekend.


I am not a doctor and have no medical training BUT I would think if someone had bad enough asthma that scuba was a danger they would not be able to make it through the pool sessions. This was WAAAAAY more demanding than I thought it would be.


After all the information I have read during my pursuit of SCUBA combined with my conversation with my regular doc, testing by my asthma doc, my exam with the SCUBA doc and the experience of going through the course I will have to agree that SCUBA is NOT acceptable for all asthmatics.


I would hope that any asthmatic who wants to pursue SCUBA should go through the same process I did to make sure this is a good sport for them. I could have jumped in after my regular doc signed off but I am glad I took the time to do it the right way. With SCUBA there are a lot of things to think about while you are underwater and when something happens it is much more stressful than you might think.

I know what it feels like to have an asthma attack and if I was underwater and started to have one could I remember to let my buddy know, make note of how long I was down and how deep, ascend slowly and if necessary take the time for a safety stop? After I got to the surface could I swim to the boat if I had to and safely get out of the water and my gear off all before I could administer a treatment? I want to say yes but I could not say for sure that it is possible. The whole process may take 10 minutes or more depending on how deep I was and for how long. Keep this in mind before you SCUBA with asthma.

 

[Nova SS]

Great, it nice to see that you have an understanding what your are getting into but dont scare your self into giving up before you start. If you want to drop out fine, thats your choice, dont let anyone talk you into doing your not comforatable doing.

I rememeber my first OW dive to get certified, I almost bailed out. I was in the water on the surface and ready to go down and I got this overwelming fear of everthing that could go wrong, asthma attack included. I took a few minutes to get my mind straight and vent my BC. After that no problem

Getting certified ( the diving part) is like boot camp . It teaches what to do if anything goes wrong, and lets you parctice it. It should be the worst dive you will ever have.

I only dive to 60 ft or less. At that depth if I ever did had an attack its up I go, a nice steady slow rate. EXHALING ALL TH WAY !! My dive partner already knows this so its no big deal, I dont to have to find then to get permission.

Once on the surface inflate your BCD. If you are tired the boat will come to you or you budy can give you a little tow. JUST DONT PANIC. That is how people get hurt .

Right now my Asthma is acting up, do to pollens so I have NO desire to get in the water. It would be stupid. Diving with certain types of astham can be done but it doesnt give you free rain to dive and put yourself or partner in harms way

 

[TSandM]

Please note, you guys, that ascending while exhaling the whole way may not be safe for someone with asthma. Or at least, may not be safe enough. The reason is that, although you can vent the portions of the lung which are not being affected much by bronchospasm, you CANNOT vent the portions which are, no matter how much you exhale. Air trapping behind an area of bronchospasm is the huge risk of asthma, and the reason why it used to be considered an absolute contraindication to diving. It is still considered a contraindication if the symptoms are exercise-induced, or if they are not extremely well controlled on medication.

I absolutely love diving. But I do not want to die doing it. Asthmatics need to be realistic about the risk-benefit ratio.

BTW, I am asthmatic, so I know what I'm talking about both professionally and personally.

 

[movieflick]

Great, it nice to see that you have an understanding what your are getting into but dont scare your self into giving up before you start. If you want to drop out fine, thats your choice, dont let anyone talk you into doing your not comforatable doing......

I wasn't saying that at all. Sorry if I came acrossed that way. I am hooked and will dive for a very long time. But I want others with asthma to understand that it isn't like playing football or running track or any other sport. You can't just take a couple puffs and go on your way. There are a lot of things you have to do before you can get to your inhaler.

If you get me by a cat I start wheezing and coughing and I can get into very serious trouble with my asthma. Others might not understand this. To some a cat is not a big deal, or to someone else it makes them sneeze and theirs water but nothing serious but for me it is VERY serious. SCUBA is the same way. I can dive fine with asthma as many others but if any aspect of SCUBA is a trigger for you - cold, exercise, stress or even deep breathing than SACUBA is your cat. Just like you say not to let people talk me out of diving it is important not to talk anyone into it if it may be dangerous too them.


If you can go outside in the winter and run around or shovel snow without need an inhaler during or after (30 mins or more after) then you are probably ok and you should visit a doctor to get tested to make sure you are good to go.
I love my experience with diving so far (pool time only) it is unlike anything I have ever done and I plan to make it a lifelong hobby. And I recommend it to anyone that can do it SAFELY!