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Posted : October 23, 2011
Hi Dr, I had a spontanious pneumothorax (SP) 16 years ago. This was followed by a second SP on the same lung one month later. After the second I underwent a pleuredisis procedure on the affected lung.
7 years later I passed a basic drive medical (no CT scan) in Thailand and completed my PADI open water. I have dived about 30 times since completing the PADI 10 years ago and have not experienced any problems. I am also fit and participate in other sports. However, I have recently read more on diving following an SP and I'm now unsure if I am ok to continue diving.
Basically I would like to understand if I have an increased risk of barotrauma occurring whilst diving or is it that I simply have an increased risk of another SP in general I.e is it more likely to happen out of water as it is underwater given that I only dive about 2 times a year?
Thanks Ronan


Answer
Posted : November 23, 2011
Sorry for the delayed response.

You don't mention how old you are, but statistically the chance of a pneumothorax decreases with age, and according to the UK Sport Diving Medical Committee, are rare after the age of 40. The same committee advises that "in individuals with a history of spontaneous pneumothorax who have had a bilateral pleurectomy or who are unoperated upon but had no pneumothorax for five years the risk of pulmonary barotrauma is small and not significantly greater than for many in the general population e.g. smokers. Such individuals may dive provided that a CT scan of the chest and lung function tests, including flow-volume loops, show no reason to suggest that there is significant residual lung disease."

There is no definitive answer to this and you will find that doctors in different countries have wildly differing opinions - some will ban anyone with a history of pneumothorax from diving at all. In answer to your question, there are good reasons that breathing compressed air at depth could predispose you to barotrauma - as you ascend, any trapped gas will expand and potentially stretch or tear the lung tissue. So you are at increased risk of another pneumothorax if you dive. The question is, how much? That is the difficult part to answer.

My advice would therefore be to see a diving doctor to go through your story in detail, with the aim of getting some idea of your risk (and how much risk you are prepared to accept).

Regards, Dr O
Answer provided by Dr Oliver Firth
Dr Ollie Firth

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The views expressed by Dr Firth & Dr Jules are their own and the publishers accept no liability for the advice and views expressed by Dr Firth , Dr Jules, or other users, which are provided as a general service to divers. Users are warned that secondary posts are the views of other users and may not be medically correct.
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