Primary Spontaneous Pneumothorax and shallow pool diving

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The question is not directly about scuba diving, but about diving in a shallow pool. I apologize if it’s somewhat off-topic, but this board seemed like the best place to ask.

My background is that I am a tall, lanky guy. I used to smoke for a few years (but not all my life). Approximately 4 years ago, I had primary spontaneous pneumothorax (“PSP”). There was no particular cause – I just remember waking up with a chest pain, going to work hoping it would go away, but as it didn’t I went to the A&E (British for ER) in the evening, they x-rayed my lungs and said I had PSP. They pumped the air out, told me not to smoke, and sent me home. I had a follow up a a month later and the doc told me the usual advice – if it will recur, it will most likely do so within a year; if it doesn’t, you should be fine. I do not specifically recall what the advice on sky diving and scuba diving was – I recall these were mentioned as things I should not be doing ever again or at least not until a year goes by. I did not listed as I wasn’t interested in those things. No CT was done and the cause was not investigated. Doctors just assumed it was because I was tall and smoked.

4 years went on without any incidents. I quit smoking. I had a few odd chest pains, which were concerning, but they went away each time by themselves and I have not visited any doctors about the PSP since. Now I feel fine. I do quite a lot of sport including cycling, tennis, and some moderate weights.

Now, recently I had the desire to go and learn swimming. I was never a good swimmer so I signed up for some 1-1 classes with a good coach (as odd as adult swimming lessons may sound).

My first lesson was yesterday. The coach (who did not know about my condition) asked me to dive to the bottom of the pool (about 5ft, or 1.6m deep) to get confrontable with the sense of being underwater. Generally, the lesson was fine and I really enjoyed it. I did have some difficulty of staying underwater for too long, but I figured that was mostly because I am a nervous swimmer (hence why needing lessons). That issue aside, I felt great after the lesson and was really looking forward to the next one.

The question of PSP did not even enter my mind at all until today. I thought about why I was having difficulty being underwater for too long, and it occurred to me that maybe it was because of PSP. Then I remembered the contra-indication given by the doctors about scuba diving, and now I am very concerned whether regular diving is also something I should not be doing.

I am really worried. What do you think – is it safe for me to dive to such shallow depths? I want to learn swimming as it is great for the body but I am really worried about what is said generally about PSP and scuba diving. For e.g. elsewhere on this board I read about PSP being considered an “absolute contraindication” to diving. The information elsewhere on the internet is just as concerning.

I will ask my doctor but as this is such a specialized field I fear she won’t know. I may have to be referred to a specialist which will take time.

In the meantime, any views on here would be greatly appreciated.
 
Yes, I too have searched the forum. I thought my scenario was slightly different to the ones discussed on the other threads, due to the fact that 1) the depth to which I am considering diving is very shallow 2) I would be diving with no scuba, and in fact exhaling any air I have in my lungs prior to submerging fully. I don't know what difference (if any), specifically in terms of physics surrounding pressure etc, that makes to the usual suggestion that diving is contra-indicated for people with PSP.
 
My understanding of the danger of spontaneous pneumothorax for scuba divers is that it is associated with breathing compressed gas. The gas going into a diver's lung is at ambient pressure. If a pneumothorax happens, the escaping gas will be at increased pressure in relation to the surface. When ascending, this gas will not exit through the airways and will compress the lungs and possibly other internal structures.

If you are breath holding, you will not breath compressed air, which puts you out of the same danger that affects divers. I do not believe swimming, even if it involves diving to shallow depths, puts you into any significant risk due to previous PSP.
 
A PSP is indicative of some congenital weakness in the lung tissue causing it to tear and let air out into the double walled lining of the lung. If that air is under pressure, it expands and bad things happen as Nirvana describes.
In free diving you do subject the lungs to more pressure in a 'closed' system than you do from spontaneous surface breathing. OTOH a cough or sneeze develops some significant pressures also. As long as you keep to shallow depths, don't try to pack as much air as possible into your lungs before diving, and only dive shallowly I don't think you are in any more danger than simply walking down the street. If it happens you won't like it but you should be OK to get to safety. It's not like you lose all respiratory capacity, just 50%, though it feels worse than that to start.

Happened to a friend of mine on vacation in Paris. He thought he was having a heart attack in his early 20's, sat down on a bench and expected to die. He never had another and went on to do serious bike riding including amateur racing.
 
Concur with fmerkel and Nirvana. Of course your physician would be the person from whom you should primarily seek medical advice, but swimming should not pose any additional risk for recurrence. If it does happen in the pool and you become weakened and unable to swim, you would want to be assured of a quick rescue. Scuba diving is a completely different activity, as previous posters have pointed out in detail.

Best regards,
DDM
 
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