The Last Word: Tony Alleman, MD, MPH, Medical Director

UNDERWATER Magazine had the opportunity to speak Tony Alleman, MD, MPH, Wound Care and Hyperbaric Center Regional One Health

tony alleman

How did you become familiar with hyperbaric oxygen therapy and the commercial diving industry? What is your background?

I started out in family practice and after a handful of years, moved to occupational medicine. I attended Duke for two years and was board certified in occupational medicine and then moved to Lafayette, La., in 2003. Dr. Joseph Serio came to work with me in Lafayette, and he was managing all the dive patients. I figured I should get trained in hyperbaric medicine to be able to treat those commercial divers. So, I went to LSU and did the fellowship for hyperbaric medicine.

How have you dealt with the challenges brought on by the pandemic? How has the pandemic changed the commercial diving industry?

The challenge is making sure that people offshore are safe in the sense that we don’t want people with COVID to be spreading the disease to other people, because in the offshore situation, there’s limited medical care. If they started having severe problems due to COVID, getting back to shore is a big challenge sometimes, especially when there’s bad weather. If you have somebody that’s rapidly deteriorating, then logistics of getting them to healthcare on land can be a big challenge. Some companies are mandating COVID tests before they leave and others are not. People from multiple companies are on a ship together, so you may have one company that’s mandating it and another company where they don’t, and then everyone is exposed.

What specific precautions should divers take (in accordance with the ADCI consensus standards) to guard themselves against the virus?

Some doctors have been putting off the pulmonary function tests to reduce spread. At one time it was felt that they should not be done because you might spread the disease in your office by blowing in this machine. A lot of our concern for the health of the divers is making sure they’re actually fit to dive after they’ve had COVID as it can affect your lungs and your heart – sometimes your brain. These are the same tests we’ve had access to for years, but let’s just take, for example, a diver who had COVID and required hospitalization, including needing a ventilator. Well, we’re going to check out their heart. We may do an echocardiogram and a stress test to make sure that their heart has adequately recovered from COVID.

I think you know there’s a lot of controversy over whether you should get the vaccine, because you could still get COVID, but if you get the vaccine, though, the COVID symptoms seem to be much less severe. So it may prevent you from going to the hospital. It may prevent you from dying of COVID.

In terms of masks, it’s hot outdoors and the last thing you want to do is put on a mask.But if it keeps you safe, then it may be worth giving up that comfort to protect yourself.

How have you been involved with ADCI?

As I was reading through the consensus standards years ago, I notice several things that I thought should be changed. So I contacted the ADCI, and I think Phil Newsum had just started. I told Phil I’d like to suggest some changes and he was in favor of forming a committee and so we did. We got a bunch of doctors together. We met in Morgan City in 2005, and we worked on revisions to the consensus standards. After that, I asked Phil if they could instate a formal committee. And ADCI did – the Physicians Diving Advisory Committee.

What has been the most rewarding part of your career?)

Getting the training in both occupational medicine and hyperbaric medicine is probably the most rewarding. Also, helping divers with decompression sickness and then with a little oxygen, we take all their symptoms away. That’s very satisfying to see.

What medical issues are most prevalent in the industry now (aside from COVID)?

There are so many diseases and problems that have the potential to affect a commercial diver. Unfortunately, we see a lot of doctors across the country performing diving physicals who haven’t been trained, and they don’t realize that. Unbelievable things from other doctors saying they think a diver was fit to dive when they really shouldn’t. There are not enough doctors around the country trained for divers to get an accurate diving physical, so they are going to their family practitioners, pediatricians, etc., to have their papers filled out and approved.