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Lung diseases

Pleurodesis and Scuba Diving

01/01/2011

Question:

 I am a fifty year old male in modest shape for my age. When I was a teenager I suffferred from spontaneous pneumothorax problems in both lungs. Ultimately had thoracotomy with pleurodesis to correct the problems. Left lung in Dec 1979 and right lung in July 1980. No lung problems since. My 16 year old son wants to take scuba diving lessons and I would like to take them with him. (Note, I`m not looking to go on any dives deeper than 30 -40 feet down) Is it safe for me to do so? And, is my son at risk, he`s tall and thin, if he takes scuba lessons?

Answer:

Recreational diving after suffering a spontaneous pneumothorax is a common question without a clear-cut answer. The general advice in textbooks is that you should not dive after a spontaneous pneumothorax as you are at risk of a pulmonary complication such as pneumothorax or arterial gas embolism, a problem where air bubbles go into your blood and may travel to your brain. The rate of reoccurrence of pneumothorax with diving after treatment by pleurodesis does decrease, but it is still not zero.  Of course, the fact you had a pneumothorax in both lungs would double your risk for a pulmonary complication.  

So although having undergone pleurodesis decreases your risk of recurrence, you may still suffer a pulmonary complication if you decide to dive. In order to make an informed decision, you would benefit from an evaluation of your unique situation and risk.  This should be done preferably by a Dive Medicine specialist, or if there are none in your area, then a pulmonologist. 

As for your son's risk, spontaneous pneumothoraces are more prevalent in families suggesting that he may be at a higher risk for a spontaneous pneumothorax than the general population. His size and shape are also consistent with the classic description of young males who are at risk for pneumothorax. There are no recommendations for general screening of family members of people who have had a spontaneous pneumothorax.  However, given your history and his body habitus, if he does want to pursue diving he should consider an evaluation by a Dive Medicine specialist or a pulmonologist to determine if screening is indicated.  

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Response by:

Jarrod  Bruce, MD Jarrod Bruce, MD
Former Third Year Fellow
College of Medicine
The Ohio State University

John G Mastronarde, MD John G Mastronarde, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University