Urticaria, Xolair and diving

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stepfen

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Location
Greece
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Hi,

3 months ago I developed chronic urticaria/hives. The exact type or cause in my case is still unknown but it is not the “cold induced” type.

My allergist prescribed me several medications: antihistamines (with good improvement but in relatively high doses), corticosteroids (with not much success) and recently Xolair. I’ve taken 5 shots of Xolair (2 shots on the first time, another 2 shots 4 weeks later and 1 shot 2 weeks after that (that was last week). Since last week the symptoms have vanished and I've stoped all other medications (I will probably have some more Xolair shots next month).

A month ago I had to renew my DAN insurance. During the renewal I mentioned to them about Xolair and the antihistamines I was taking back then. A doctor appointed by them came back to me (after a long delay) telling me that I need to consult a specialist doctor. He also told me that although I don’t see any side effects in my normal life, “depot drugs” (as he called it) such as Xolair may cause even fatal side effects during a dive. From what I’ve seen Xolair doesn’t seem to have such dramatic side effects (the most dangerous one I see is allergic reaction to it during or soon after the shot) but who am I to judge?

I did ask my allergist and he told me that he doesn’t think that Xolair or urticaria is incompatible with diving. He even signed the standard diving medical form declaring that I am fit to dive. He is not diving specialist though and DAN told me that they normally need the form to be signed by a specialist doctor.

I’ve tried to get in contact with a specialist to get another opinion so far without success. I am now away from home visiting Indonesia (Jakarta). I contacted few doctors here, even one suggested by DAN itlself, telling them I need their consulting to get a clear to dive certificate but they seem reluctant to see me.

At the end of the month I have arranged a week long dive vacation in Raja Ampat and as days pass by I don't think I will manage to see an appropriate doctor before then.

Anyone with more experience that could give any suggestions? Can indeed an IgE suppressor have such dramatic side effects?

Given my level (AOW, ~50 dives) and the location (Raja ampat) I was planning to have some relaxed, swallowish dives away from NDLs etc. Should I turn to snorkelling instead?

Thanks a lot in advance for any advice
 
Hi Stepfen,

The drug has not been tested in divers specifically (most drugs are not), so its compatibility with diving is not known. Just looking at the prescribing information and mechanism of action it seems that the risk of any untoward side effects specifically related to diving would be low, so I think it is worth seeking out a diving medical specialist in your area for a second opinion.

Best regards,
DDM
 
That's what I am thinking too but then why the doctors I've contacted (three so far including the one suggested by DAN) are reluctant to see me? Are they just too busy or maybe from their side the risk of clearing an unknown individual for diving is too high for the price they can ask for the assessment? BTW how much such examination would typically cost?
 
Hi again.
Just an update for anyone that might be interested. I did manage to talk with the doctor suggested by DAN. It was over the phone. I did describe my condition and the medication I take and his opinion was that since several days have passed since my last shot (it's already more than a week and it will be 2+ weeks when I will be diving) I can proceed with diving.
Thanks a lot anyway
 
Great to hear, I'm glad it worked out well for you.

Best regards,
DDM
 

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