Asthma & diving

[Kate]

I've just been contacted by a friend saying that her doctor wont sign her off for her medical because she has very mild asthma. He has told her that "No one with asthma can dive"

She has googled this and has found out that as long as it is mild and under control (she has not had an attack since 1992!!) then it should be ok

I was under the same impression.

She has done 4 trial dives at obviously weren't very deep and she didn't encountered any problems.

Could some light please be shed on thie fr her benefit please. She is desperae to be signed of so she can do her OW!

Thanks guys!

[tom]

Tell her to go to a diving doctor for her medical, rather then the local GP (which is what this sounds like).

Check the UKSDMC list of medical referees for one in her area.

[Sean]

Originally Posted by Kate

I've just been contacted by a friend saying that her doctor wont sign her off for her medical because she has very mild asthma. He has told her that "No one with asthma can dive"

She has googled this and has found out that as long as it is mild and under control (she has not had an attack since 1992!!) then it should be ok

I was under the same impression.

She has done 4 trial dives at obviously weren't very deep and she didn't encountered any problems.

Could some light please be shed on thie fr her benefit please. She is desperae to be signed of so she can do her OW!

Thanks guys!

Tell her to get a new doctor this one is talking rubbish. I have a very mild asthma and I know others who have I think H is one as well never had a problem

Sean

[purple vonny]

It depends..... if you have asthma due to an allergy, eg: cats, dust mites, and you won't be subject to breathing those in scuba diving, then you can dive with a Dr's OK.

If you take preventative medicine or get asthma on exertion, use inhalers or tablets regularly then, no. Wheezing could come on at any time and breathing dry air could bring on an asthma attack.

So... it depends what kind of asthma you have.

[ScubaK@]

I'm under the same impression as Vonny, Allergy triggered Asthma that's under control should be fine, but stress or exercise triggered Asthma is a big no no! E-med offers consultations with your own private online doctor by e-mail, phone or in person - online doctor, private doctor, london doctor is often a good place to start looking for advice!

[Clare Gledhill]

Her doctor - if talking from general principle rather than something specific to her case is talking nonsence - probably because he is unsure what to do.

I have a predisposition to asthma too - primarily brought on by allergens, and the doctor who carried out my HSE medical was particularly through in investigations regarding peak flow post exercise.

As I do quite aggressive decompression dives I also have an annual chest x ray to check all is well.

[dlegros]

Originally Posted by purple vonny

It depends..... if you have asthma due to an allergy, eg: cats, dust mites, and you won't be subject to breathing those in scuba diving, then you can dive with a Dr's OK.

If you take preventative medicine or get asthma on exertion, use inhalers or tablets regularly then, no. Wheezing could come on at any time and breathing dry air could bring on an asthma attack.

So... it depends what kind of asthma you have.

Your second paragraph isn't quite correct there.

Use of preventative medication (such as inhaled steroids) is not necessarily a contraindication to diving, it is still possible to have an allergen mediated asthma, but where sensitivity is high - preventative medication is needed. It is easier to avoid an attack than treat one.

[ChrisP]

Hi Kate

It has mostly been said by others but here are a few comments.

One of the major problems with asthmatics diving is the risk of air trapping in the lungs with obvious implications during ascents. The other is of developing an acute episode under water.

There used to be a blanket "no" to all asthmatics diving. This still exists in some countries (not sure which but Australia was one and may still be?).

Some years ago this was looked at in the UK and it was realised that many asthmatics were diving successfully but not declaring it on self cert forms. Therefore guidelines were developed and in the past it was advised that only a diving doctor should sign an asthmatic as fit to dive. More recently the British Thoracic Society produced very thorough guidelines on respiratory diseases and diving, incl asthma,based on expert opinion and these are what doctors generally follow these days.

Currently if your asthma is well controlled using no more than regular steroid inhalers and occasional bronchodilators (ventolin / salbutamol etc) and you do not suffer from stress or cold (as in chilly not infection) induced asthma then one could be found fit to dive.

Assessment should be in the form of proper lung function testing before and for up to 30 minutes after exercise (usually a step test) for which you can use your regular steroid inhaler but not the bronchodilator one. Your lung function should be normal (the guidelines have the figures for what is considered normal) before exercise and not drop more than 15% after vigorous exercise. Including a quick medical and the history taking this assessment can not be done in less than an hour.

Most GP's and I am afraid some respiratory consultants are not aware of these guidelines and we do see people given the wrong advice.

I would advise talking to your local doctor from the UKSDMC list.

Finally the guidelines advise not diving while using a long acting bronchdilator such as salmeterol or fometerol (the former is in Seretide which is increasingly commonly prescribed). This has recently been the subject of some discussion amongst UKSDMC members but the current guidelines have not been changed (yet?).

HTH

[Clare Gledhill]

Gene Hobbs (Rubicon Foundation and WKPP medical officer) saw this thread and emailed me with some fantastic information that your friend may be interested in Kate. I can't put up PDFs on here but if she would like more info PM me with her email address and I will pass on.

[Tonio Anastasi]

[quote=Kate]I've just been contacted by a friend saying that her doctor wont sign her off for her medical because she has very mild asthma. He has told her that "No one with asthma can dive"[/QUOTE
Suggest this link to your friend. Its from Divers Alert Network.A group dedicated to hyperbaric medicine research DAN Divers Alert Network : Asthma and Scuba Diving
Apart from that the advise that you have been given to get a second opinion from a Doctor specializing in diving medicine is your best bet.
Wirting in to medical pages, or reading up about it is not a good alternative to getting checked by a specialist in the field.
There are too many variables for generalizations.

Tonio Anastasi
BSAC AI 505
POWSI 612103