I am composing this thread to present my own alarming case with immersion pulmonary edema/lung squeeze, in hopes of receiving some feedback about how I should handle my situation. I also think it's worthwhile to present interesting cases pertaining to this topic, to contribute to the body of knowledge that we are accumulating on this perplexing issue in this forum.
I did already read the most recent thread concerning immersion pulmonary edema ("Depth, pressure and squeeze"), which did somewhat address my issue, but I find that several of the factors involved in my case differ from those presented thus far. I have also tried to read most of the threads about lung squeeze, which seems to me to be very related to immersion pulmonary edema, and is perhaps synonymous in certain cases, but full-on lung squeeze (coughing up blood, impaired breathing for several days or weeks, etc.) sounds more severe than my cases of immersion pulmonary edema.
I actually experienced a rather bad dose of immersion pulmonary edema in my dive today. The following symptoms were present:
This is essentially what have I dealt with in about one out of every three dives, throughout almost the entire past year. I dive up to twice a week, but some times endure spells where I don't dive for a couple of weeks. It's clear that my lungs are very susceptible to fluid filling, which I am calling immersion pulmonary edema rather than lung squeeze, because my episodes don't sound quite as severe as lung squeeze:
Here are some of the peculiarities to my case:
I did already read the most recent thread concerning immersion pulmonary edema ("Depth, pressure and squeeze"), which did somewhat address my issue, but I find that several of the factors involved in my case differ from those presented thus far. I have also tried to read most of the threads about lung squeeze, which seems to me to be very related to immersion pulmonary edema, and is perhaps synonymous in certain cases, but full-on lung squeeze (coughing up blood, impaired breathing for several days or weeks, etc.) sounds more severe than my cases of immersion pulmonary edema.
I actually experienced a rather bad dose of immersion pulmonary edema in my dive today. The following symptoms were present:
- highly impaired breathing
- audible "rales" during my exhalations
- occasionally coughing up sputum, which had a light-pink tinge (does this imply that red blood cells were in it? or is plasma normally this color?)
- throughout the rest of the day my breathing has been somewhat impaired, and rales can be heard when I exhale with effort
This is essentially what have I dealt with in about one out of every three dives, throughout almost the entire past year. I dive up to twice a week, but some times endure spells where I don't dive for a couple of weeks. It's clear that my lungs are very susceptible to fluid filling, which I am calling immersion pulmonary edema rather than lung squeeze, because my episodes don't sound quite as severe as lung squeeze:
- I have had the problem occur many times in much shallower water than lung squeeze would be expected to happen, such as in as little as 25ft of water. I have heard lung squeeze defined as only occurring once you surpass residual lung volume depth, although I know that's arguable.
- Fluid remains in my lungs and my breathing is impaired throughout the rest of the day, but all symptoms usually abate by the next day, rather than sticking around for several days or even weeks as I have heard in serious cases of lung squeeze.
- I have never coughed up blood, although I finally noticed today that the sputum I can cough up during an episode has a slight pink tinge.
Here are some of the peculiarities to my case:
- As often as I dive, I would expect the problem to happen just about every time, but it has happened very unpredictably. I have had some diving days in the 60 - 100ft+ range where the problem never presented itself, or at least not noticeably so (i.e., I avoided rales). And some times these successful dives were in the same week as unsuccessful dives where I experienced the problem. In cases of lung squeeze, most individuals seem to be very susceptible to having it happen again, certainly within as short a time frame as a week...But as I mentioned, I sometimes seem to defy this.
- I have had a few dives where I got really cold (shivering), and it didn't come on.
- Many individuals have pointed out an association between the onset of lung squeeze with experiencing contractions at depth. I have never detected this myself, and I usually don't even experience any contractions in most of my deep dives since I am down for only 1:30 - 1:45.
- Fast descent rates have been implicated in lung squeeze; I am usually only descending ~1m/s, which I don't consider fast. And that is usually my peak velocity when I am freefalling past 80ft...I am not even descending that fast during the first 10m, when some have pointed out that it is important to go slow.
- As far as I know, I am usually not overhydrated before diving.
- I get over incidents of the edema relatively quickly. Usually by 24hrs I feel fine and can't detect any more breathing impairment. I am a competitive triathlete, and I have not been able to detect that my performance has suffered at all from my problem. My lungs seem to perform their duty very well during workouts once I've recovered from an episode (whereas I have been downright pathetic when I've attempted to workout on the same day as a bad dive). So at least I feel pretty sure that I'm not causing any cumulative damage to my lungs, as least not any that would impair my endurance activity performance.