Q: I have asthma and am thinking of taking a diving course on my next holiday. Will I need to get a medical certificate before I will be able to dive? I have done a try-dive before and the doctor there said that I was OK to descend to a certain depth.
Dave Botfield
Dr Jules Eden replies: If you have asthma, you need to get passed as fit to dive by a certified diving medical referee. Your general practioner probably won't have the necessary experience to do this, but the Professional Association of Diving Instructors (0117 300 7234, Professional Association of Diving Instructors) can give you details of someone in your area or, alternatively, if you email me, I can also give you details.
Not so long ago, anyone with even a hint of asthma was told they couldn't dive, but we are wiser now. In cases where it is only mild and well controlled, your risk of problems under water is the same as a smoker, and as they are not barred from diving there may well be no problem with your condition.
The other point is that you should make sure your diagnosis is correct. I have seen many so-called asthmatics over the years who tell me they have assumed they were, even when there haven't been any symptoms for years, because their GP diagnosed it.
Since then they have run a marathon a month and swim 50 lengths a week without using an inhaler or even wheezing slightly. So it is worth discussing the complete history of your problem with the diving doc when you see them.
Q: Any tips for a diabetic going trekking in Thailand?
Rob Hartley
A: The travelling diabetic has to be aware of a few factors that could ruin their holiday. It starts with arrival at the airport in Thailand. If you are carrying syringes and needles with you, it is a good idea to have a letter explaining your problem. If the letter was written in Sinhalese, that would be even better - I believe the British Diabetic Association has a supply of these. If you are insulin dependent, then you may need to keep your insulin supply cool while in the jungle. Finally, if you get any illness that may derange your blood sugar, such as diarrhoea or other infections, then monitor your blood glucose regularly and treat the illness quickly with appropriate antibiotics, such as Ciproxin.
Q: My GP has told me that my child should not fly with his ear infection. As we are due to travel to Mexico in one week's time, should we cancel the trip now or hope that it will be fine by then?
Ros Durtnall
A: This is a hard call to make without looking into the ear. If he has an outer ear infection (of the outer ear canal), then he is okay to fly. The issue is with equalising. This involves the middle ear and the Eustachian tube. If he has a middle ear infection, then it can affect the patency of these organs, and not allow air to pass in or out of the middle ear. The poor chap will scream the whole flight as the air expands on ascent then can't get out. A treated middle ear infection could be better in five or six days. Ask your doctor to assess the ear, the day before the flight. If, when he inspects the eardrum, it moves on swallowing and blowing into a closed nose, then Eustachian function is fine and he can fly.
Ask the flying doctor If you have any questions you want to ask Dr Jules Eden, email travel.doctor@theguardian.com, or write to The Flying Doctor, The Guardian, 119 Farringdon Road, London EC1R 3ER.
· Dr Jules Eden created E-med as an online support service for anyone who finds themselves a long way from a doctor's surgery. You can get free pre-travel information on any destination in the world. Log on and click on the Travel Clinic icon.
