10 replies to this topic

[peterbj7]

Do you have any form or degree of asthma yet dive regularly? What sort of Asthma? What frequency of attacks, and what are your diving experiences? I get very mixed messages from the medics on this, and I'd like to find what actually happens.

[ScubaDadMiami]

Let's see who 'fesses up on this one.

[Twinklez]

I'm fessin'

Before moving to Texas I had severe asthmatic "symptoms". The doctors had many different names for it, (chronic airway disease, restrictive airway syndrome, night asthma, etc.), though none were ever able to actually diagnose me with anything let alone "asthma". They provided me inhalers of every kind, steroids, and albuterol in tablet form. For three years I was chronically ill to the point that my throat was literally scarred. A year before moving here I found out that the majority of my problems were caused by allergies -dust mites, cigarette smoke and smog. I couldn't even laugh without having an "attack".

I still have allergies but they seldom bother me, and on a very very rare occasion I will have an attack (maybe once or twice a year). My attacks occur in the throat rather than in the lungs. It feels like my esophagus dries up and sticks together. I can breathe - through my nose mainly, and the best way to clear it up is to get a glass of water which seems to relax the muscles that are constricting. Swallowing is the next best way but doesn't work as well.

Since moving to Texas it has only occured on a few occasions at night while I was sleeping with the exception of once when I was at a customer's house just after moving a dusty computer from under her desk. This leads me to believe that the few issues I now experience still revolve around my main allergy (dust mites). There are dust mites present in your carpet, pillows and mattress, and a host of other places in your home (no matter how clean you are), which explains the attacks at night.

I've thought about this a lot...could I breath through my reg if I had an attack under water. Yes, I believe I could...not well, but I could. Would I panick...I've never panicked before and since I know what it is and what I need to do, it's not likely. Would I require an emergency ascent - I don't believe so...cut my dive short, maybe, but not an emergency ascent. Since the "attacks" are brought on by allergies - more specifically dust mites; the chances of this happening to me under water breathing through my reg are also not likely.

I've used an inhaler once since moving to Texas in 2000 and that was within the first year. I still keep albuterol tablets; however have not had to use them in over three years and only then when I actually catch a virus or something that causes congestion and wheezing. In fact, last year over the Christmas / New Year holiday I had pneumonia and never once required albuterol or an inhaler and never had an attack or exhibited asthmatic symptoms.

Peter, if I were having attacks regularly, or my attacks were such that I absolutely could not breath, or brought on by something other than allergies (like exertion or stress); I would not dive...not at all! In fact, if I become ill and congested...I will not dive until I know that I have absolutely no congestion and no wheezing what so ever; and the possibility of me experiencing asthmatic type symptoms has diminished. I will wait and dive another day when my risk factor is no different than anyone else.

As far as what actually happens...you have to gauge that on the individual since not all asthmatic symptoms are the same. They vary in severity, and even in form for each individual. One can only speculate what it would be like under water based on what happens up top. If you can't breath at all up top; you'll die under water. If you can only breath through your nose; you'll likely drown trying to figure out how to get air to your nose under water. If you panick when you have an attack; it'll be compounded 10x under water.

I know this...if I had been formally diagnosed as having asthma, or exhibited any symptoms my instructor would not have signed off on my card; and if I ever do start exhibiting symptoms; he'll yank my card quicker than I can blink my eyes. I appreciate him for that.

Asthma is a direct contraindiction to diving!

Edited by Twinklez, 12 January 2006 - 10:55 PM.

[peterbj7]

I have medical advice that asthma under some circumstances does not preclude diving. I won't let anyone dive if they admit to asthma, unless an appropriately informed doctor says they can. As most doctors are ultra-conservative this isn't likely to happen.

A few weeks ago we had a trainee diver who had completed a "clean" medical self-declaration. There were no tell-tale signs that she had any health issues, and she performed well in confined water. On her first open water dive, however, she became very nervous and started to have difficulty breathing. This rapidly developed and she bolted for the surface. We didn't need to tell her we couldn't continue with her training - she had learned the hard way that the questions on the medical form were there for a reason, and fortunately had survived. Sad, but diving isn't for everyone.

[Twinklez]

What are the circumstances and how do you determine that the doctor is appropriately informed?

Almost sounds like your student had an anxiety attack rather than an asthma attack. But then, one can bring on the other.

[nextariel]

This Thread may be of interest.

[maninthesea]

Its allways been my understanding that there are two basic types of asthma-Panic or Stress caused asthma and Allergy caused asthma. Panic/Stress Asthma would preclude diveing for obvious reasons. Allergy caused asthma should not since the air you breath underwater is some of the best you will ever breath. I have seen doctors clearences based on this.

Cheers Jim

[peterbj7]

Yes. The girl in this case had an anxiety attack which did indeed bring on an asthma attack, though as she'd lied to us (deliberately) we were rather taken by surprise. I think she wasn't just trying to do something we wouldn't have let her do if she'd been honest - she was in self denial. This "near death" experience brought it home to her, and I think she'll be more rational in future and recognise her physical limitations.

By a "suitably qualified" doctor I mean one with training & experience of diving medicine. In the UK such a doctor has a separate designation and I can get a list of them, but I don't know if that's the case in the USA. The same's true for "flying doctors". A doctor who's not appropriately trained will know & should tell you up front, and should transfer an emergency case to an appropriate doctor as soon as possible.

In Belize I simply go to the doctors at the local chamber. I know they're appropriately trained.

Nextariel - thanks for the reference. I'd forgotten about that thread, even tho' I contributed to it! But what I was after here was real life experiences rather than informed medical opinion. Many of us know what we should do, but many of us do things differently and get away with it. More stories like Twinklez's are what I hoped to see.

I may start another thread on diabetes, because I know that many divers "break the rules" on this without the slightest problem.

Edited by peterbj7, 14 January 2006 - 12:33 AM.

[Twinklez]

I've been told my instructor has diabetes though I've never seen him take medication, so if it's true it must be very mild. I have however dove with two different individuals both on an insulin pump. Both men feel they know their conditions well enough that they can disconnect their pump for a dive. Scary!

I, on the other hand dive with an entirely different problem that is not so serious, but could cause ver serious problems under water. I tell my dive buddies in advance so that if they see something that doesn't look right they'll know what's happening to me and be able to help.

On my checkout dives last spring, I drank so much fluid that I dislodged a kidney stone which has never passed. I've been to the ER twice with it since that day, and always in the evening after a full weekend of diving.

So what happens if it decides to move while I'm under water? For me it means pain to the point of paralysis - I just can't move from my waist down. It means I become lethargic and start vomiting. Things grow dark; though I've never passed out and I've always managed to keep my wits about me. This is my fourth stone, but the first that's not passed within the first day of movement so by far, it's the worst. For those who've never experienced a kidney stone it may not seem so serious. But for those who have, well... you know.

I do not take pain medication since it could be days, weeks or months before it hits again and I refuse to be doped up waiting for something to happen. Because of the vomiting it's pretty much useless to take anything after the pain starts. I don't know where it is because at 5K a pop, another CT scan is out of the question. I just know it's there and will remind me again one day; it's just a matter of where and when.

[peterbj7]

Your 4th stone! Maybe you should be on statins. And if a CT scan costs $5k, it'll be cheaper to fly across the pond and have one done here (in England) - the scan would be free.

Can't stones be broken up by ultrasound so the pieces can then be passed?

[Twinklez]

Ok, here's the "duh" question... what are statins?

This is what I know...I passed the first one in the ER after laying on the floor crying for over an hour. After I passed it they decided to admit me, took a look at the stone and told me they'd check to see if I had any others but if I did it wouldn't make much difference because they weren't the kind that could be broken up. I'd have to pass them, or if they didn't pass on their own; have them surgically removed. I passed a second stone (which I don't count) the very next day while at work. Ouch! I was 26 then and still living in California where I had absolutely WONDERFUL health insurance!

The other two, and my current stone showed up after moving to Texas (within the last 6 years). The next two presented within a few weeks after a major surgery (helped along by IV fluids I'm sure); and this last one of course the night of my OW checkout dives. I didn't really worry about the other two since they both passed within a day of first presenting themselves. This one is a different story all together and unfortunately comes at a time when I do not have health insurance; so I grin and bear it but monitor myself carefully for symptoms of possible complications. Only once have I been fortunate enough to be admitted to the ER in time to receive pain medication prior to the pain subsiding on it's own. The doctors in California told me I had a remarkable tolerance - if they only could have felt what I was feeling!

I have a friend who has had stones broken up by ultrasound. He said it's just as painful as passing them on their own. Each time a stone shatters it sends a handful of pieces in different directions in your kidney, and then they move until you pass them. They can be as small as a grain of sand and still hurt like the dickens. Ultrasound makes them "possible" to pass whereas they might not be otherwise.

But wow...what a great excuse to travel to England! I'm curious to know how that would work when one is only a visitor in there. I've never been out of the US. To meet a new friend, dive, solve a major problem in my life, AND visit a new place all at once would be fantastic!

Edited by Twinklez, 14 January 2006 - 11:19 PM.