Diving with Asthma

[KOMPRESSOR]

To me diving with asthma is a big no-no. Sure, one can "have it under control", but there's no way you can have any arising situation 60ft below under control. The extremly dry air in a tank may trigger asthma itself. And if not, a stress situation under water could certainly tip it over for you. I will not say that you cannot dive. I am just not going to say you can.

 

[lionfish-eater]

I am not in the medical profession, so experts please respond to correct my post or to expand on the topic if you have something to add. Thank you.

Hi I have asthma that is triggered by allergens, cold weather exertion, smoke and fumes. Snowblowing is a real trigger due to the cold and gas fumes. I use a steroid inhaler and albuterol as necessary. Scuba diving is the very best therapy for my lungs. I use nitrox, so more oxygen is available to absorb with less effort. I would breathe it on the surface if the tanks werent so heavy. Tropical climates are much easier on me, humid and salty sea breezes are better than below zero super dry air of Minnesota. I think the main benefit however is that diving is like a mini pressure treatment. The blood is forced into the core from the extremeties due to the pressure. Also the pressure forces out the mucus from deep in my lungs and I spit out phlegm that is deep yellow/green that I never see, even if I have a bad cold. The yuckiest stuff comes out when I dive below 80-90 fsw and after the first dive of the day. I sometime cough and spit at depth right through my reg if necessary. I take a puff of albuterol before each dive, and I have sometimes taken an inhaler down with me, so if I felt like I was having a problem, I could end the dive,surface and use the inhaler without having to get back on the dive boat or to shore. I would recommend that you try an informal underwater stress test, where you swim fast as if you had to help your buddy or swim against the current as if you were trying to get back to the drifting dive boat. Use common sense and skip the dive if you have any concerns, as there will always be another day. I'm 50 plus and have a few extra pounds, but otherwise in good health. With regards to the dry mouth, I will put a piece of hard candy in my mouth to stimulate saliva. I use the individually wraped after dinner mints from the bowl at the restaurant to take down with me if I need one. You would be amazed at the looks I get when I offer another diver a mint at 70 feet. Be safe, know your limits, be prepared for the emergency situation that can occur at any time and cause you to exert yourself or make you panic. It's easy when everything is going smooth, but everything changes when the s--t hits the fan.


Eat a lionfish Save a reef
Get out of the jar.

 

[Powercath]

the major problem with asthma is not to have a attack underwater but some specificity about the sickness. In a asthmatic lung you can have some air trap when you are breathing and this air can expend in volume when you come back at sea level. It can cause air embolism. I won't suggest to any person who suffers from severe asthma to resume diving.

 

[DocVikingo]

Here's the most recent published meta-analysis of the topic (bolding mine):

"Sports Med. 2003;33(2):109-16.

Asthma and recreational SCUBA diving: a systematic review.

Koehle M, Lloyd-Smith R, McKenzie D, Taunton J.

Allan McGavin Sports Medicine Centre, Department of Family Practice and the School of Human Kinetics, University of British Columbia, Vancouver, British Columbia, Canada. mskoehle@interchange.ubc.ca

Asthma has traditionally been a contraindication to recreational self-contained underwater breathing apparatus (SCUBA) diving, although large numbers of patients with asthma partake in diving. The purpose of this paper is to review all the research relevant to the issue of the safety of asthma in divers. MEDLINE and MDConsult were searched for papers between 1980-2002. Keywords used for the search were 'asthma', 'SCUBA' and 'diving'. Additional references were reviewed from the bibliographies of received articles.A total of fifteen studies were identified as relevant to the area. These included three surveys of divers with asthma, four case series and eight mechanistic investigations of the effect of diving on pulmonary function. The survey data showed a high prevalence of asthma among recreational SCUBA divers, similar to the prevalence of asthma among the general population. There was some weak evidence for an increase in rates of decompression illness among divers with asthma. In healthy participants, wet hyperbaric chamber and open-water diving led to a decrease in forced vital capacity, forced expired volume over 1.0 second and mid-expiratory flow rates. In participants with asymptomatic respiratory atopy, diving caused a decrease in airway conductivity.There is some indication that asthmatics may be at increased risk of pulmonary barotrauma, but more research is necessary. Decisions regarding diving participation among asthmatics must be made on an individual basis involving the patient through informed, shared decision making."



And here is DAN's take --> DAN Divers Alert Network : Asthma & Diving

Regards,

DocVikingo

 

[Duke Dive Medicine]

Well said as usual, DocVikingo. You're a hard act to follow but I'll try.

More reading:

A DAN abstract from one of the UHMS annual meetings.
Rubicon Research Repository: Item 123456789/1780
It's unclear in the study whether those with asthma were previously cleared to dive or not.

An interesting study on the physiologic effects of diving on the lungs of asthmatics.
Rubicon Research Repository: Item 123456789/7649

A small cohort study of asthmatics who had been cleared to dive.
Rubicon Research Repository: Item 123456789/1524

A great hypothetical case history, written with Mike Bennett's typical tongue-in-cheek but poignant style.
http://archive.rubicon-foundation.org/dspace/bitstream/123456789/8079/1/SPUMS_V33N3_5.pdf

Thanks as always to Gene Hobbs for his tireless work at Rubicon.

The take-home message is this: Diving is all about risk mitigation. Many patients with asthma are able to control it such that their risk of diving injury appears to be level with the "normal" population of divers. If you are a diver with asthma and have never been evaluated by a diving physician, it can be difficult to discern those risks and thus you may lack the tools to make an informed decision. Some of the posts I've read here are a little scary to me. Please, if you're a diver with a history of asthma and have never been evaluated by a diving physician, do so! You may be surprised at what you find. DAN can provide names of practitioners near you, as can I via PM if anyone would like.

 

[movieflick]

I dive with asthma and had to go through testing to ensure my asthma was not a diving cntradiction. Here is a thread I was runing at the time that I specify what the tests were and the results http://www.scubaboard.com/forums/diving-medicine/187924-such-thing-safe-asthma-dives.html

 

[CanesDiver337]

I see that many of you are diving with asthma. Has anyone ever heard of diving causing asthma? I lived in Miami for most of my life and dove without a problem. I then moved to Ocala and began having numerous problems with asthma due to the pollen and ragweed. I've been told I'm allergic to cats, ragweed, and pollen. I always carry an albuterol inhaler on board in case it is needed, but haven't had any other problems since.

 

[Scubaru_Steve]

Hey OP here!

Wow, never would have thought this thread would get so much feedback and I would find I am not in fact the only asthmatic scuba diver, haha.

I have only been on a handfull of dives. In the past year I have acquired 2 20 year old tanks for free, both hydro tested and inspected. A regulator setup with a dive computer of some age but all functions work perfectly.

The way I handle this goes like this:
- I know what triggers my asthma: extreme cardio exercise, exercise when its very cold out, and allergies.

- In recent weeks I have begun to work out more in preparation for the summer. I give myself a target of 1 mile, take my heart rate before and after, and write down my time. It's amazing to see how much more controlled I can get it just in 1 month.

- I work at a convience store putting away the truck in the coolers and freezer. So all school year I have been in cold enviorments working hard to rotate and move product for 5+ hrs a night 3x a week, which I have noticed there an increase in resistance to asthma like conditions.

Pretty much when it comes time to dive I can feel if anything will act up or if I have been feeling anything for the past few days, I wont dive. On the boat I always have like 3 bottles of water to keep myself heavily hydrated to combat dry mouth or any other complications just from dehydration.

The way I see it is I found a sport that makes me happy and quite honestly unique, everyone is like "you dive? I wish I could" and it gives me a sense of "Yeah I'm that guy" lol. But although Scuba is a very active sport, its a full body exercise that I don't even realize is going on. The second my head submerges I am immersed in this world like no other that no matter how stressed I might get down there, I take a deep breath and look around and I feel fine again.

I have this mentality to me to show people what can be done. Coaches in high school and my scuba instructors knew I had asthma, so before a big swim or a run they would tell me "you can sit this one out".... I would run/fast pace swim the entire event just to prove to not only them but myself that sure I have asthma, but I can do this. It's that mentally that keeps me diving cause I am taking myself to limits everyone said I couldn't go to. I hope this summer to get out of "Open Water" into "Advanced" so I can see even more great wonders of the deep!