asthma and freediving?

[pbarnes]

The dive doc had some interesting things to say. I was mainly there to get my PADI form signed off (which he was quite happy do do despite my asthma) but I also had an informal chat about some of the issues that have been mentioned here. Spirometry results like the ones I posted above are apparently fine for diving. He did not seem at all concerned about the possibility of hyperbaric injury due to mucous plugs. He said he has never heard any report of it actually happening. That leaves only bronchospasm as the major risk factor for diving (of any kind).

So the take home message was this: dive sensibly. Don't dive if you need to use Ventolin regularly; take regular steroid inhalers such as Becotide instead. Don't dive if mild or moderate excercise is a trigger for your asthma. Don't dive if you have a cold or a chest infection. My personal (non professional!) conclusion about freediving is that if holding one lungful of air is OK at the surface, then it's probably going to be OK at depth too. It can't expand to a volume or pressure any greater than what it was at the surface unless of course, you surface so rapidly that you shoot out of the water and ascend to 1000 feet )

I also agree with what has been said about the usefulness of swimming and excercise in general: maintaining a good level of fitness is far and away the best way to manage asthma. Over many years I have observed that the severity of my symptoms is directly proportional to the amount of time I spend sitting on my backside!

Happy diving to all,
Pete

[Paul Kotik]

I recently took part in an interesting discussion about asthma and freediving which included an excellent freediver who had severe, asthma as a child, a champion freediver who spent his childhood in a cramped apartment with 2 chainsmoking parents, and a degreed sports physiologist.

The focus quickly turned away from the effects of freediving on asthma and to the opposite causal chain: the effects of asthma on freediving.

The physiologist noted ( and I cannot verify this ) that a recent US olympic swimming team consisted almost entirely of asthmatics. The freediver who had childhood asthma (until mid adolescence) currently does depths and times that are quite surprising in view of her training habits (none) and experience ( infrequent). The champion noted that he had grown up in a thick cloud of smoke, and has lung capacity and other parameters that are just about off the charts.

We ended with a theory that oxygen deprivation, whether caused by asthma or pollutants (in this case cigarette smoke, with the extra added bonus of CO2 and CO) may cause and adaptive response aimed at utilizing available oxygen with greater efficiency: richer capillary beds, etc.

If this is so, then a history of asthma may be associated with anatomical and physiological adaptations which would be an advantage to a freediver.

[pbarnes]

now that is interesting. I can quite agree with your theory in principle.

Another contributing factor may be the night-time apnea that many asthmatics (including me) suffer from. Basically, it involves waking up in the middle of the night with a wheezy chest, a light headache and some difficulty breathing. Presumably the headache is caused by mild hypoxia or hypercapnia, so it is not unreasonable to suggest that the body builds up some tolerance to these conditions.

[fpernett]

Hi Fellas,
I don't think so optimistic. Sleep apnea is not the same as training, because a life time of hypoxia induces pulmonary hypertension, and righ heart hypertrophia and dilation.
Night wheezing indicates only poor control of asthma.
The fact that many elite swimmers and some freedivers have suffered asthma in childhood, for me, is proof that human beings can overcome any disability and succeed.
The barotrauma during ascent is extremly rare, but it happens (Bayne CG, et al. Can pulmonary barotrauma cause cerebral air embolism in a non-diver? Chest 1982;81:648-650) they describe a case of a breath-hold in a swimming pool, that end in fatal air embolism, the guy was doing 25 yards of apnea in a 2 meters depht pool. The autopsy was conclusive of pulmonary barotrauma and brain embolism.
The theory that air shift within the lung to a compartiment that get full at depht, and get closed off before the ascent can be reviewed at
Dahlback GO, Lundgren CEG. Pulmonary air-trapping induced by water immersion. Aerospace Med 1972;434:768-764

I don't want to sound fatalistic, probably this will never happens to you, but as a physician my duty is to tell you the dangers. You decide on what to do.
Maybe will be good for you to get a peak flow meter, and do a test before dives, in that way you will be fully sure that your lungs are working at full capacity. And of course avoid immersion if you have cold or any lung or sinuses infections.
Hope I don't get bad karma, but facts are facts

[Paul Kotik]

Interesting, Frank.

Are the pathologies you mentioned endemic to populations living at high altitudes ? Seems to me your causal model would predict a higher incidence in high-altitude populations than in sea-level populations, controlling for everything else.

It is of immediate, actionable concern, because many elite athletes, including several top freedivers, are now sleeping in
hypoxic tents on a nightly basis.


Paul Kotik

[fpernett]

Hi Paul,
Those are the marvelous things about adaptation.
The high altitude natives does have pulmonary hypertension, and extreme polyglobulia (high Hb), but this doesn't correlate with pathology. Dr. Saldaña made an study in people from andin region and found hypertrophy of carotid body in a lot of woman, without any disease. But High Altitude has some problems theres is Monge's disease that is like chronic mountain sickness, the patients lost the high altitude tolerance and get extreme polyglobulia, severe hypoxemia and reduced mental and physical capacity.
The sleep apnea syndrome occurs mainly in obese, sedentary people, a physical profile quite different of an athete, also the diet is important because hypoxemia releases a lot of superoxygen and reactive oxygen species.
I do believe in hypoxic training, in fact is all I made, despite living at moderate altitude, but we need to prepare our body for the hypoxemic stress.
That is the difference between pathology and physiologic adaptation.

[MattHolt]

Ive been doing a few CO2 tables recently and am now absolutley convinced that in my case they reduce bronchial constriction. To test this I have been taking a peak flow measurement immediately before and after the table. Before the last 3 tables I have done I measured my peak flow to be 600 l/min (about normal for me), after the table this had increased to between 680 and 700 l/min (average of three measuremnts). Problem is I have not really been suffering from asthma lately so Im not sure if this data is particarly meaningful? Should I be taking any other measurments to make this more meaningful data?

I am guessing that no research has been done on the benefits of freediving breathing techniques for asthmatics? Ive been thinking about looking further into this. Can any one provide any useful links or info? What would be ideal is a large group of freediving asthmatics willing to do lots of PF measurements - any volunteers?

Also - slightly off topic but ive been reading a bit about a breathing technique known as Buteyko which is reportedly beneficial to astmatics. Does any one know anything about this and its possible applicatuion to freediving?

Sorry to ask so many questions. Any help much appreciated.

Matt

[pbarnes]

many apologies... it's taken me over a year to reply to this! I also have a strong suspicion that over the last few months, regular breath holds have improved my lung function. If you do ever hear of any trials (or even oranise some experiments yourself!) send me an email and I'd be happy to take part.

Pete

[SanSan]

hey

here's another freediver whith bronchitis and astma. Actualy I'm quite better the last years and my problems vanished about 2 years ago when I started training apnea...

My astma was qite bad in my yunger years so on doctors orders I was totali avoiding sports till my 16-17 year. I remeber once we measured our vital capacity at school (I was 13) and i got the lowest score in the whole class. Eaven the girsl beat me. I did 2,8 l...

I had a polmulary checkup at my 18y (btw. I'm 25 now) and did a bit better. I'll try to find my results because I have another checkup on 18. this month and will try to compare them. Im expecting a great improvement due to my recent physioligicaly condition and apnea results. The only thing that worryes me are my allergies that still cause my a lot of mochous and I feel my lung capacitiy getting smaller.

Well I'll keep u posted on my results.

[Florance]

Originally Posted by pbarnes

Do any of you have any experience?

With warmest regards,
Pete

hi,

Unfortunately I dont have any experience with asthma related to freediving. But I have done my degree work on how swimming can be a good effect on asthma + and there is a column where I talk about how does swimming and breath hold helps asthmatic syndromes.

if you want I can translete a few sentences from it

Aniko

[SanSan]

Originally Posted by Florance

if you want I can translete a few sentences from it

Sure.. It would be greatly appriciated.

[SanSan]

Add: sorry for the long post but I think it is interesting

Hey guys and grils of course

Well it took me quite some time but I managet it at last. I made my second spyrometric test 3 weeks ago. I also did a asma provoke test (hope this i right) and I scaned the results. I don't know much about this but i belive some of U will be able to do something with the numbers.

I also found a test I did 7 years ago but nothing before that.

Just for info, I had my last big astma atack about 10 years ago. I got my first atack when I was 9 months old and ended in the hospital for the first time. I wasn't aloved to do sports till I was 15 or 16. Then I started doing something on my own. First some kickboxing, some general fitness. I did that for 2 years 2 times a week. Than came 2 years of my lazyness again. I started with freediving about 2 years ago but I trained only 2 times a week for an hour in the pool. I had some moments when I trained more but this were exeptions. From this January I'm training really hard 5-6 times a week mostly for 2h a day.

I like it and I think I'll keep it up. Now my doctor said I have to make test every 3-4 months, so I will write in this post telling U about how much I trained and if any of the results will change. Maye I'll throw in my PB also.

Now here are the results of the test.
First the one frome 1998:


and the one form may 2005:


and the provoke test may 2005:
http://www.po-bitenc.si/forum/s2005-2.jpg

If anyone can comment this nubers please do so .

I can only tell u what my doctor said. Well i made the test to get the medical for our national championships, and the dr. pulmologyst didn't wan't to aprove it. He said that I can do what sport I want but not at a competitive level. He said that I have a "latent bronchial astma". I passed the provoke test just by a bit.
He put out the resutl from Metaholin provoke test PD 20 FEV1 = 2,75l. I don't know what it means exactly so if anybody can help with this? I belive it has something to do with my bronchies closing and my volume capacitiy diminishing.
He said aslo that it si to danegrous if I get an astma atack during the dive that there is noone who can help me... I said I can take this risk being realy small so I went to get another opinion and got the medical and did really god on our nationals.

Here is my results progress:
2 years ago after a month of trainig apnea:
STA=4min
DYN=70m
DNF= didn't do at this time

1 year ago. 1 year of training 2 times a week:
STA=4min 30sec
DYN=76m
DNF=50m

The last year I progressed only a meter o 2 untill last beginning of may. And then my performances bursted unbelivably:
Nationals on 21st of may 2005:
STA=4min58s (my pb wet is 5.06 and dry 5.47)
DYN=107m (pb)
DNF=82(pb)

Ok enough for now .

[fpernett]

Hi SanSan
The bronchoprovocation Methacoline test is a test to rule out asthma when the spirometry is normal, as is your last one. Methacoline is a bronchoconstrictor and it`s nebulized until the FEV1 reduces 20% from baseline. In your case it`s normal. I don`t know if your doctor had found wheezing on examination, but the results are normal. I don`t think of a real danger in pool freediving, but deep freediving with bronchoconstriction is not good. If there is doubt regarding the diagnosis of asthma, I reccomend you to get a peak flow meter and test on a daily basis if you are thinking in deep freediving.

[naiad]

A few weeks ago I developed asthma for the first time in my life. This happened after a very bad chest infection, but it continued after the infection had cleared up. I didn't have any asthma attacks, but every night the wheezing would get very bad. The doctor prescribed an inhaler and it made the wheezing better, but my breathing was still very 'bubbly' at night, and it was very difficult to get any training done. It was getting progressively worse despite treatment, and I was seriously worried about my health.

I decided to do some detective work about when and where it got worse. During the day there were hardly any symptoms, but within a few minutes of getting into bed, the trouble started. I always woke up at about 5 in the morning with breathing problems and had to use the inhaler to avoid serious blockages and more infections.

A few days ago I got a new anti-dust mite mattress, and replaced all my bedding with hypoallergenic ones which can be washed at high temperatures to kill dust mites.

I haven't had any asthma since. I haven't had to use my inhaler even once since I threw out the old mattress.

What a relief! Victory over asthma!

Lucia

[SanSan]

HI

good for U Lucia. Nice to hear Ur fighting ur astma well. Althought be carefull because U only eliminated the problem that causes U to develope astma (the trigger) on one place. Also I don't think its good to train while U have trouble breathing. Phisical stress is also one of the triggers for astma so it could make things worse. Be gald ur only alergic to one thing. I have a long list of those. The worse is pollen (i guess u call it so) and I live a bit out half way to the counry...

Now the advice would be avoid dusty places and have ur inhaler allways with U. U just can't know when ull need it.

@fpernett
Thanks for the advice. I thought so that my doctor is exaggerating. I'll keep up my regular exams and see if anything changes.
btw. where could I get a peak flow meter and are those things expensive?