Dr. Amol Kumar Wasudeorao Diwan
Allergy Specialist
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
Before two weeks, I got lung barotrauma from free-diving. I dived to a depth of 253 feet. Upon surfacing, I was fine without chest congestion, pain, or urge to cough. After 12 hours, I started to have phlegm with brown blood. I thought it was old blood. After a morning, I got more phlegm with brown specks. It has been two weeks now and I am producing phlegm with brown specks. It concerns me a lot. I had some small squeezes in the past with some chest congestion and an urge to cough.
After that, I will produce some phlegm with a small amount of red blood. I consulted a doctor and the doctor told me that traces of blood can result due to barotrauma squeeze happening at various levels from the paranasal sinus to the airways. The alveoli and terminal bronchi are fairly collapsible while the trachea and large bronchi have a large cartilaginous structure and they are not susceptible to collapse. The capillary bed under the epithelial lining is very vulnerable to a dramatic drop in the level of barometric pressure during freediving. So traces of blood can result from it.
If there are traces of blood due to airway squeeze, then it likely involves capillaries of the respiratory epithelial lining. But it gets healed in a few days. Damage to cartilage rings causes some different levels of damage. I consulted another doctor and he told me that injuries to the cartilage rings are painful and injury to the alveoli can cause some symptoms. So he suspects that damage is caused due to capillaries of the epithelial lining. What is your opinion? Is this normal to have old blood streaks for two weeks from this type of damage? Please mention the severity of the injury. Will it get healed soon? What is the possible reason to have delayed blood coming out for two weeks of having dive?
Hi,
Welcome to icliniq.com.
Freediving is a technique of breath-holding diving technique and it is harmful after doing repetitive diving sessions. It causes changes in the pressure of the lungs and heart. You can have some symptoms like mild cough, dyspnea, blood-stained frothy expectoration to blackout, and lung squeeze. Lung barotrauma can occur either during descent or ascent. It involves a combination of factors. But in your case, it seems to be mild barotrauma as your symptoms are not aggressive and severe.
So it can be pulmonary edema and alveolar membrane rupture causing alveolar hemorrhage during ascending technique. It usually gets resolved within 24 hours and it takes up to seven days to get cleared. Generally, these symptoms are transient and they get cleared within a few days. There is no long-term damage. But individual variation can occur and we cannot relate it exactly. This is not something serious but if the symptoms persist for a longer period, then it is good to consult a doctor soon.
Patient's Query
Thank you doctor,
I have a lot of confusion. Does CT contrast helps me to provide a clear picture? I am going to stop doing freediving for a month as a conservative treatment. The risk of having another injury is very high.
Hi,
Welcome back to icliniq.com.
I am not familiar about the sport injuries due to freediving. Freediving causes injuries while diving. It depends upon your training and endurance to have injuries. You can have some symptoms such as mild cough, dyspnea due to pneumothorax, pneumomediastinum, barotrauma, hemoptysis to unconsciousness, and death. Individual variations occurs based on your training.
Patient's Query
Thank you doctor,
It has been 17 days now. I am still having phlegm with brown flecks. How long it lasts? Is it alarming?
Hi,
Welcome back to icliniq.com.
Even after 17 days, you still have phlegm with brownish flecks. It is not alarming but if it occurs in association with other symptoms like cough or fever, then it is good to consult a physician for clinical examination. You can have a possibility of having upper respiratory tract infection like flu or sinusitis. Bronchitis has to be ruled out. It is good to have a physical examination by your physician and do X-rays or blood tests. After that, take necessary treatment. For now, you can take OTC (over the counter) cough expectorant.
Patient's Query
Thank you doctor,
I do not have fever or cough. I am using pulse oximeter to check my readings. I feel fine but I have a mild pain in my chest below my right nipple. It is very mild. I am trying to consult a physician soon. I am going to do a CT scan soon.
Hi,
Welcome back to icliniq.com.
Many things get cleared after having a clinical examination. It is good to hear that you do not have fever or cough. HRCT (high-resolution computed tomography) chest is appropriate to diagnose the underlying pathology.
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Allergy Specialist
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