Diving After COVID-19

[mikiedfd]

I'm sorry if I offend anyone, but I'm only going to offer my story, to be a number for the counts of "I returned to diving after Covid, no issues." ... I had a mild case of Covid in early November. No clue where I got it - I work in a school that has been in full-time since August with a sprinkling of isolated cases with ZERO known transmission at the school. Started with "sinus infection," then went to the fever/body ache, then went to the sleeping 29 hours a day, then 6 days of high fever 101-102 . . . Never developed any chest symptoms (thankfully), but I'm also on ace inhibitors for blood pressure, doc says that may have contributed - I also pushed fluids and vitamin C throughout the illness and tried to walk as much as I could when not in fever mode . . Never had any racing pulses nor and blood pressure was only slightly elevated, but otherwise was normal... While covid felt major to me, in the grand scheme of things, it was no worse than the flu - only "worse" part of it was how long it lasted - I count my blessings. After 11 days of symptoms, doctor said you can resume your normal activities after 48 hours of fever free, as I felt ready for things, including sports and hockey. First week was just a lot of recovering from the fever - super tired, barely making it through a day of work, in bed by 4pm... Week 2 I started back at the gym, just to move around... Week 3 I finally was back to a normal wake/sleep schedule, started playing hockey again, skated twice that week, was tired, but not as tired as I would have expected (I usually skate 3-4 nights a week)... By week 4, I was pretty much 100%, just obviously beat up physically from not really working out for 4 weeks... Week 5 and 6, led a normal schedule, back to hockey 3-4 nights a week and Week 7 was vacation time! With a winter break/teacher schedule/dictated teacher vacation: I went cave diving . . . Dove with a group of friends who were all intro divers, so I didn't push anything crazy, but did the usual 2-3 hour dives on CCR, didn't feel anything different . . . Am I playing with fire - yes - but I'm sorry, I just can't wait around for the world to figure itself out - I'd rather be a specimen of science. Mentally I needed that break from reality. We're only getting older. I'll take my chance - probably have a better chance of dying driving I-75 to FL than from Covid complications... My family knows from a conversation long ago, don't sue if anything happens while diving. But is DAN or doctors going to give a blessing to go diving when you're asking them to sign off - absolutely not!

[TotDoc]

... their two principle concerns seemed to be the integrity of the lungs. Would that be associated with fibrosis? And potential pockets for trapping gas that would result in some type of barotrauma. Would that be associated with the cavitation?

A simple xray being normal may well be sufficient to detect fibrosis or air pockets in your case, for the simple reason that you never got sick enough to require hospitalization. CT scan is better, but I don't think it's realistic to expect that every person who wants to dive post covid will need one. If you were sick enough to be hospitalized, however, I think the pre test probability of underlying lung injury is higher, and that would warrant the more sensitive test

[TotDoc]

If a person has had a lung x-ray done after a covid infection, would that show any potential issues? Would a general physician notice them?
Thanks.

A chest xray, as read by a board certified radiologist, is likely a good enough screen for non hospitalized patients.
A chest xray read by a general physician, in my opinion, would not be sufficient.
Radiologists, aside from being specialists and reading films, will be looking at your films in a dark room, on a much fancier and higher resolution screen than your general doc. That makes a HUGE difference on seeing the more subtle problems.
I look at my own films all the time in the emergency room. When the radiologist sees something I don't, I try to run down to their reading room to see if I can see what they did. The difference between their screens and ours is massive.

[jxh2297]

I did a dive the day I tested positive to no deeper than 5 feet for boat hull cleaning. The water temp was in the low 40s.

It was terrible, I felt like I couldn?t get a full breath. Literally got out of the water, checked my phone and had a positive test.

Haven?t dove since, been about 2 weeks. Definitely can?t wait 6 months to get back in.

[kitsap_diver]

A chest xray, as read by a board certified radiologist, is likely a good enough screen for non hospitalized patients.
A chest xray read by a general physician, in my opinion, would not be sufficient.
Radiologists, aside from being specialists and reading films, will be looking at your films in a dark room, on a much fancier and higher resolution screen than your general doc. That makes a HUGE difference on seeing the more subtle problems.
I look at my own films all the time in the emergency room. When the radiologist sees something I don't, I try to run down to their reading room to see if I can see what they did. The difference between their screens and ours is massive.

That's interesting. I appreciate that insight. When a family physician orders a X-Ray as a test do they typically get a report from a radiologist or do they just get the xrays for interpretation? I assume the perspective you're providing is an ER setting as you've eluded to.

[bent]

Dove with a group of friends who were all intro divers, so I didn't push anything crazy, but did the usual 2-3 hour dives on CCR,

Sorry for the OT question but people do 3 h cave dives as Intro divers? Is that normal?

[TotDoc]

That's interesting. I appreciate that insight. When a family physician orders a X-Ray as a test do they typically get a report from a radiologist or do they just get the xrays for interpretation? I assume the perspective you're providing is an ER setting as you've eluded to.

Most office docs order xrays and get the report from the radiologist, not the images. Urgent care docs, however, are more likely to interpret images themselves, without the support of an immediate read by a radiologist. There can always be exceptions, though!

[mrki]

Thank you for the info.

[kitsap_diver]

Again I'm just providing updates so that others may know what to expect or see my journey through this path in the even that they have to pursue getting released medically after COVID-19. I'm certainly not trying to provide any medical guidance or recommendations.



Update: This rolls slow, but I had a doctors appointment back around 1/21. I tried to pass along the word before the doctor's appointment that the doctor would likely want to consult with DAN+, but my doctor did not. I left the doctor's appoint with the doctor saying "I will contact DAN+ and get a hold of you about any test we need order". I heard back from my doctor today who told me she is ordering a chest X-Ray PA and Lateral and will want to conduct a spirometry test. She told me (and I'm not surprised) that DAN+ was not interested in discussing the details of my case too much, but that they provided a written form of guidance for her to work to. The guidance was based of the severity of my symptoms during COVID-19. Asking questions like "how long did systems last? Did you ever need supplemental oxygen or struggle to breath? Did you ever see low SpO2 levels using a pulse oximeter"? From there she ordered the test suggested by DAN+. She mentioned that DAN+ does not require any specific cardiac release for my level of symptoms other than normal exercise tolerance.


I did happen to catch my doctor reference that DAN+ does recommend a Chest CT for COVID cases with more severe symptoms.



Obviously the guidance that she has from DAN is aligned with what we've seen TotDoc and DEbersole discuss in this thread (I'm sure that's not a coincidence). I'm making my appointment to get the chest X-ray schedule ASAP.

[kitsap_diver]

Just for sharing with the community and giving folks an insight. I got this report last Friday and got to talk to my doctor about it on Tuesday evening of this week. It took mea little bit to share it publicly, not because it's embarassing, but because I'll admit that it was emotionally a little tough to face reality. I had high hopes that the CXR would come back with normal findings and that would be the end of my return to dive evaluation. Unfortunely even though I had mild symptoms during the COVID-19 disease and a relatively sort duration of symptoms when compared to others I did have findings on my Chest X-ray that are concerning the report is as follows:



//** Report **//
Technique: PA and lateral views of the thorax were performed.

Findings:
Lungs: Mild patchy left lower lobe opacity. No pulmonary edema, pleural
effusions, or pneumothorax.

Cardiomediastinal silhouette: Normal.

Regional osseous structures: Grossly intact.

--
IMPRESSION:
Mild patchy left lower lobe opacity.
//*** End of Report **//



As a result my doctor, following the DAN+ guidelines has elected to order a Chest CT. I have that CT Scheduled now for next Friday (2/19).



Some of the things that Ive been learning about are the normal lung function and the elasticity of the lung cells. Scarring of the tissues making my diving more susceptible to a collapsed lung or barotrauma. Although I have been given hope by many that any indications could resolve in a weeks to months time frame.



The first step is to get the CT and see what the results say, if they also show indications in the lungs than I'll be tracking out some method to track recovery and pray that the indications resolve.