Can you dive if you have asthma, heart disease, or for example diabetes? The answer used to be "no", but times have changed. Diving physician Catherine de Maeyer explains what's possible and what's not.-
17-10-2016 - by Kevin Van der Straeten
Can you dive if you have asthma, heart disease, or for example diabetes? The answer used to be "no", but times have changed. Diving physician Catherine de Maeyer explains what's possible and what's not.
Hi Catherine, welcome back to our studio.
Today we're not going to talk about diving accidents, but about... Well, can you dive with for example conditions like asthma, heart disease, or for example diabetes? Previously we always thought the answer is no, but things have changed lately.
Yes, regulations have changed a bit. For example, people who suffered from a heart attack can dive under specific conditions. There are two conditions that have to be fulfilled. First of all, the cause of the ischemia or the lack of oxygen has to be solved. If you're with a blockage in your coronary artery, it has to be solved. So if you do the bicycle test, the exercise test, then it has to be OK. You have to have a normal test. And the second condition that has to be fulfilled is that the pump- force or ejection fraction, has to be normal as well, because if you go diving, even at 10 or 20 meters, the heart is put under a lot of stress and a lot of pressure, and so it has to function in a normal way. But if you can fulfil those two conditions; a normal bicycle test and a normal pump-force or ejection fraction, then with specific restrictions, you can be cleared to dive.
And what can those restrictions be?
Well, the idea is that if you would suffer from a new problem, then you should get up, out of the water, as quickly as possible. Of course, with a normal ascent rate, but for example you can't do deco-dives. You don't want to hang at 3 meters with chest pain, of course not. And so you're not allowed to do cave-dives or ice- dives, below the frozen water surface, either.
I can imagine it's also important to tell your dive buddy that you have a condition.
That's really crucial, because if there's a problem, you should be able to depend on your dive buddy. But if he doesn't know that you have specific medical conditions, he can't take it into account. So for example it's important for people with diabetes... They always have to have a sugar gel with them, and most of the time they put it in their jacket, but your buddy has to know where it is. So if you would suffer from a low blood sugar or hypoglycaemia, your buddy can help you, if he doesn't know, he can't help.
And can everybody with diabetes dive or are there still differences?
Yeah, there are differences. It depends on the type of diabetes that you suffer from, So if you're already on medication, so oral medication, then the restrictions are less than if you would be on insulin. And until a few years ago we didn't allow people with diabetes on insulin to dive, but now we know that if the diabetes is well regulated, so if it's stable, and if you follow different rules like tracking the sugar level before you go into the water, always explaining to your buddy, avoiding really stressful dives, and checking the sugar level after the dive. Well, if you do those things, then you can be cleared to dive. But again there are also restrictions like no deco-dives, for the same reasons as for people with heart conditions.
So you can always ascend whenever you need?
Yeah, and especially with the diabetics, it's very important to check it with the dive doctor or dive physician. And with the specialists and the endocrinologists as well, because it's really a very specific condition.
What about asthma?
Well, asthma is one of the medical conditions where we are tolerate less problems, because of course the lungs and the respiratory system are very vulnerable during the dive, and they're also very important. So asthma patients, when it's a really heavy form of asthma, or if people really need their inhalation therapy every day, they can't dive. But for example, if you suffer from asthma 2 months a year, because there are a lot of flowers or a lot of trees causing your asthma problems, then you can dive during the rest of the year and not during those 2 or 3 months. But for example people who suffer from exercise asthma, so asthma that is caused by heavy exercise, they are not allowed to dive, because during your dive you should and you will do exercise, and so if that causes an asthma attack, it can be lethal. Because as you know, you have to exhale if you ascend. If you have this asthma attack and everything is blocked up here, you will die, because you will have a massive barotrauma.
The most important thing I remember is: consult a doctor every time.
Yes, if you have a specific medical condition, and we didn't take about epilepsy or other things, seizures, but you really have to talk to your doctor, and he or she should consult a specialist for a specific condition.
Catherine, thank you very much.
And you at home: thank you for watching our show. I hope to see you next time!