Imagine sitting in the belly of an airplane, flying above the clouds at 100 miles per hour, then seeing the door of the plane slide open to reveal a blinding blue sky. If you can't imagine launching yourself out the door, you might be what Kevin Payne calls a "wuffo."

"A wuffo is what we call people who don't skydive," says Payne, 50, a research methodologist and skydiving enthusiast in Parkville, MO. "Wuffos are the ones who ask the rest of us why we want to jump out of a perfectly good airplane. It's slang for 'what for?'" Payne, who was diagnosed with relapsing-remitting multiple sclerosis (MS) in 2002, has been jumping out of perfectly good airplanes since the 1990s. "You either get it or you don't," he says. "I skydive because it's a joyful, life-affirming expression."

But for Payne, skydiving is more than just thrill-seeking. It also helps him deal with MS. "Too often, living with a chronic illness becomes a slow, sad slide of saying goodbye to things you used to enjoy and not thinking about what you can accomplish," he says.

Prospective skydivers should be in good physical condition and not be taking medication that could interfere with judgment or performance, according to the US Parachute Association (USPA). But physical impairment does not automatically disqualify someone who wants to try, says Susan Hunter-Joerns, MD, a neurologist in Juneau, AK, who skydives. "I've met many fellow skydivers with chronic conditions," she says. "One of them was blind from type 2 diabetes, another was born without legs, and a third was a paraplegic who had to roll himself out of the airplane. You'd think those conditions would disqualify them from jumping, but they did just fine."

Although the risks of the sport are real—in 2018, USPA members reported more than 2,000 unspecified skydiving injuries that required medical treatment—there are greater risks from driving a car. Last year, the USPA reported 13 fatalities out of 3.3 million jumps. By contrast, more than 37,000 Americans die in vehicular crashes each year, according to the Association for Safe International Road Travel.

"Skydiving can potentially cause a heart attack. It also can potentially cause death. But so can staying on the ground," says Dr. Hunter-Joerns, a former member of the US Parachute Team and an eight-time national champion at the USPA National Parachuting Championships. As a physician, she says her responsibility is to make sure patients aren't at excessive risk of injuring themselves during a jump, but it's ultimately their decision. "Having done it myself, I'm more inclined to tell patients to go for it," she says.

Skydiving doesn't require a lot of preparation, says Payne. A typical jump takes about 30 minutes, with 20 of those minutes in the plane. Expert skydivers can jump at an altitude of over 30,000 feet, but most jump out at 14,000 feet. In a standard jump, participants free-fall for 90 seconds before deploying their parachute at 4,000 feet. After that, it's about a five- to six-minute float until landing.

Other types of skydiving include tandem jumps (where the jumper is strapped to a licensed skydive instructor), formation jumping (where several participants dive together, creating formations with their arms and legs as they fall), and instructor-assisted deployment (where the parachute is opened immediately after the person leaves the plane).

For those with chronic conditions, instructors can make adjustments to accommodate specific physical needs. For example, as Payne's MS progressed and caused reduced sensation below his knees, he and an instructor practiced landing safely by jumping from a ladder on the ground.

When Joe Akmakjian, a 28-year-old event manager in Fort Collins, CO, who has spinal muscular atrophy (SMA) and uses a wheelchair, decided to try a tandem jump to celebrate his 24th birthday and raise awareness of SMA, he discussed the risks with his doctors. Akmakjian worried that the 8,000-foot fall, as well as the jerk of the parachute deployment, might snap his neck or cause his legs to hyperextend in midair due to his bone fragility and lack of muscle control (his cervical vertebrae are fused). But when his doctors, who he says know his body better than he does, gave him their blessings, he decided to go ahead with his plan.

First, he called local facilities and visited landing areas, known as drop zones, to see which ones he felt the most comfortable with. After speaking to three companies on the phone and visiting two areas, Akmakjian settled on a place about four hours from his house. The drop zone, he says, was owned by a group of firefighters, which put him at ease.

"[The owner] had jumped with a few people who used wheelchairs, and as a firefighter he had experience working with people who had different abilities," Akmakjian says. The two discussed the various accommodations he'd need to feel safe during the jump, such as straps around his arms and legs to keep them close to his body during the fall.

On the day of the jump, Akmakjian was accompanied by his caregiver and a dozen friends. He slipped on the harness, and the owner hoisted him from his wheelchair through the plane door. "The plane isn't set up with seats like a commercial airplane. There's a row of benches, and you straddle the bench when the plane goes up," Akmakjian says. When the door opened for the jump, "they looked at me and said, 'Are you ready to go?'" he recalls. "They strapped me to the instructor, pulled me to the door, and we jumped, even though I was saying 'No, no, no!' the whole time."

But soon after he felt the open air, his fears dissipated. "Initially I thought, 'Holy crap, what have I done?'" Akmakjian says. "But then I snapped out of it. I only had 90 seconds to experience this, so I figured I'd better enjoy it."

The jump wasn't completely painless, however: When the parachute deployed, the movement jerked Akmakjian's body and caused him to hyperextend one of his legs, despite them being strapped together. But because he had done plenty of research and knew the risks, the discomfort from the hyperextension did not detract from his experience.

"If you're not comfortable with the risk, you shouldn't jump," Akmakjian advises. "Find an instructor willing to work with you and be clear on what you need."

Although Akmakjian hasn't jumped again, Payne jumps almost every day. "I'm not a religious person, but skydiving is a spiritual experience for me," Payne says. His favorite jump is known as the "sunset load," the last run of the day when the plane flies to altitude just as the sky changes to hues of orange, pink, and purple. "As beautiful as a sunset is on the ground, it's breathtaking a few miles up," he says. Best of all, skydiving gives him a feeling often hard to experience with a chronic condition: freedom.

"I haven't had a pain-free day in about 20 years," Payne says. "Sometimes I get frustrated because of the pain, or because I'm clumsy or fall. Skydiving reminds me how wonderful and precious this life is. None of those other concerns are there. It's just me and this big, impossibly beautiful sky."

4 Steps to Skydiving

1. Talk to your doctor. Bring up the idea and discuss the risks of skydiving with your doctor, says Susan Hunter-Joerns, MD, a neurologist in Juneau, AK, and a former member of the US Parachute Team.
2. Research the operators. Arrange to meet instructors in person and ask detailed questions about what to expect, says Joe Akmakjian, who went skydiving to celebrate his 24th birthday and raise awareness of spinal muscular atrophy. "Finding the right instructor makes all the difference."
3. Ask for accommodations. Explain your condition to the instructor and discuss ways to be safe, whether that's using extra straps to support body parts or jumping tandem with a veteran instructor, says Dr. Hunter-Joerns. Akmakjian says finding a company that would accommodate his disorder was a must, for both his comfort and safety. "Every person needs to take different precautions if they're skydiving with a disability," he says.
4. Visit drop zones. Check out different drop zones or landing areas until you find the one you like best, says Akmakjian. Reputable drop zone sites are partnered with the US Parachute Association (USPA) and use USPA-rated instructors and approved skydiving equipment. Operators of drop zones should be forthcoming about their safety record and any contingency plans in case of emergency or injury.

Skydiving Companies

Start your search with one of these three companies, all of which work with jumpers of varying abilities.

Out of the Blue Skydiving 
outoftheblueskydiving.com; 719-784-1166

Skydive Grand Haven
skydivegrandhaven.com; 616-350-8020

Start Skydiving
startskydiving.com; 513-422-5867