OWD license without a doctor's certificate?

[tursiops]

Placed on ignore list

Great idea. Ditto.

 

[SapphireMind]

I definitely understand the challenges, I just want to point out that by not filling out the form "accurately", the diver is then releasing the dive shop from liability. That protects the dive shop/instructor. It all falls on the diver themselves.

I agree with you that I think there needs to be a better system, one that encourages more communication, because I definitely understand the concerns that one could go through all that, have the doctor's note, and then still be refused. People don't want to risk that. In the meanwhile, by people checking no, it does not put the dive shop/instructor at additional liability. It doesn't communicate with the staff anything that could be pertinent (and honestly, I'm thinking on land, not in the water - Maybe I was going to dive, but I got on the boat and wasn't feeling well so I called my dive and stayed on the boat and then I had an issue, or I tripped and hit my head and they are trying to communicate to emergency services about anything they should know, etc.)

Perhaps that's what I have not communicated as clearly as I should. My issues are incredibly unlikely to affect me underwater, but there's still a multitude of accidents that can happen on land and on a boat and I would hope people with me would be able to communicate for me if I was unable, which is where I see the real "danger" in ticking "no". Or if someone with a health issue gets on the boat but decides to not go in the water because their health issue is anything but perfectly controlled, then being able to communicate about why they may be ill/calling the dive might be useful/helpful. I want everyone who may be in a position to tell EMS about my medical condition to know basic important things.

I likely will get my form signed this year for the next time I need to show one, but I think I'll follow someone else's lead and just not check boxes. In my mind, you either need to know about my medical details because you actually care and want to know in an emergency, in which case open discussion should happen and a doctor's note may not be necessary, or you just care for liability reasons that someone else is assuming liability, in which case no information is needed and just the note, or the person can accept all the liability onto themselves and check "no".

People have different goals and opinions of course, but I do rather like the skydiving way of doing it.

 

[dmaziuk]

People have different goals and opinions of course, but I do rather like the skydiving way of doing it.

Vote with your wallet: don't dive with ops that ask for the checklist. Let The Almighty Market sort them out. I've filled in that form exactly once: when I got my OW cert. Every op I dived with since asked for a simple waiver.

 

[Seaweed Doc]

I likely will get my form signed this year for the next time I need to show one, but I think I'll follow someone else's lead and just not check boxes.

This seems like a legitimate course of action. "You don't need to know my details, just that I'm fit to dive" would satisfy me. If I saw such a form, I'd probably speak privately to the person to inquire if there was anything I needed to know, not for dive safety reasons (which I will presume they don't have or they wouldn't have been cleared to dive), but for classroom or general teaching purposes. Is there anything that I can do that would help them or help the class work with them? If you lie and check "no," I wouldn't ask.

I think it's worth remembering that not everybody is each of us. These aren't individualized forms and processes designed to meet our individual situations. While one person may be able to say "no" and lie and know for sure there is no risk relative to whatever condition is at issue, another person (and likely several more) will say "no" and lie just for convenience or do not have sufficient background knowledge to competently assess themselves. (Personally, I'm skeptical of self-assessment, even or perhaps especially among medical professionals.) Rules often have to be made for the lazy as opposed to principled, unfortunately.

 

[SapphireMind]

This seems like a legitimate course of action. "You don't need to know my details, just that I'm fit to dive" would satisfy me. If I saw such a form, I'd probably speak privately to the person to inquire if there was anything I needed to know, not for dive safety reasons (which I will presume they don't have or they wouldn't have been cleared to dive), but for classroom or general teaching purposes. Is there anything that I can do that would help them or help the class work with them? If you lie and check "no," I wouldn't ask.

I think it's worth remembering that not everybody is each of us. These aren't individualized forms and processes designed to meet our individual situations. While one person may be able to say "no" and lie and know for sure there is no risk relative to whatever condition is at issue, another person (and likely several more) will say "no" and lie just for convenience or do not have sufficient background knowledge to competently assess themselves. (Personally, I'm skeptical of self-assessment, even or perhaps especially among medical professionals.) Rules often have to be made for the lazy as opposed to principled, unfortunately.

I agree with the issues with self-assessment, I just resent needing a permission slip - if I say I've spoken with my care team, that should be enough and I also don't like transferring liability to them. If something goes wrong on a dive related to my medical stuff, it would be because I screwed up, not them. Like a well controlled diabetic decides that injecting extra insulin just prior to a dive would be spiffy (not that I think anyone would do that), it's not on the doc that they were dumb about that. In my situation, I know that I should never dive while I have gastroenteritis, that would make it a high risk situation for me. If I ignored that and decided to be stupid, that's on me, not my medical providers.

Again, I absolutely think people should be talking with their care team about issues and having them worked up if appropriate - but I also think requiring the doctor's signature is asinine. Or, if they want to require it, then every diver should have an annual physical requiring a doctor's note.

 

[doctormike]

I likely will get my form signed this year for the next time I need to show one, but I think I'll follow someone else's lead and just not check boxes. In my mind, you either need to know about my medical details because you actually care and want to know in an emergency, in which case open discussion should happen and a doctor's note may not be necessary, or you just care for liability reasons that someone else is assuming liability, in which case no information is needed and just the note, or the person can accept all the liability onto themselves and check "no".

This may seem patronizing or presumptuous, but hear me out. Obviously I don't know you, I haven't examined you, and what I'm saying may seem totally off base. But sometimes it's good to look at something with fresh eyes. I also don't know if your dive count is correct, or how invested you are in diving.

If you actually have syncope, I would be very concerned about training you, and about diving with you. If you aren't solo diving, your medical condition affects your buddy as well, and possibly puts them at risk in a rescue situation.

I understand that you get a prodrome before your syncope, and you feel that you will have enough time to ascend since you aren't going to be in a virtual or physical overhead environment. But I don't think that the mechanism of syncope is always that clear. The day may come when whatever is happening to restrict cerebral blood flow (or whatever the pathophysiology is), will happen more rapidly.

This is sort of like seizure disorder and driving. A seizure or syncope on their own aren't necessarily dangerous. But if they happen behind the wheel or underwater, it's clearly a different story.

Dive professionals are in no way capable or inclined to assess your fitness to dive. When you make yourself the sole judge of that, it's sort of a conflict of interest. Trust me, I'm going through exactly that right now. I'm an obsessive local diver, I dive every weekend, I'm a technical CCR diver. Diving is incredibly central to my life. And I had a medical event recently that has sidelined me. I feel terrific, and it's driving me CRAZY not to be able to dive right now. But I won't do it - even though I feel great - until someone objective with actual data has cleared me.

I have never seen a medical clearance form outside of training, but if some of you have been asked for one before diving, I'll believe you. But please everybody, take the medical form seriously. Don't do an end run when there is a significant medical condition.

 

[TMHeimer]

I definitely understand the challenges, I just want to point out that by not filling out the form "accurately", the diver is then releasing the dive shop from liability. That protects the dive shop/instructor. It all falls on the diver themselves.

I agree with you that I think there needs to be a better system, one that encourages more communication, because I definitely understand the concerns that one could go through all that, have the doctor's note, and then still be refused. People don't want to risk that. In the meanwhile, by people checking no, it does not put the dive shop/instructor at additional liability. It doesn't communicate with the staff anything that could be pertinent (and honestly, I'm thinking on land, not in the water - Maybe I was going to dive, but I got on the boat and wasn't feeling well so I called my dive and stayed on the boat and then I had an issue, or I tripped and hit my head and they are trying to communicate to emergency services about anything they should know, etc.)

Perhaps that's what I have not communicated as clearly as I should. My issues are incredibly unlikely to affect me underwater, but there's still a multitude of accidents that can happen on land and on a boat and I would hope people with me would be able to communicate for me if I was unable, which is where I see the real "danger" in ticking "no". Or if someone with a health issue gets on the boat but decides to not go in the water because their health issue is anything but perfectly controlled, then being able to communicate about why they may be ill/calling the dive might be useful/helpful. I want everyone who may be in a position to tell EMS about my medical condition to know basic important things.

I likely will get my form signed this year for the next time I need to show one, but I think I'll follow someone else's lead and just not check boxes. In my mind, you either need to know about my medical details because you actually care and want to know in an emergency, in which case open discussion should happen and a doctor's note may not be necessary, or you just care for liability reasons that someone else is assuming liability, in which case no information is needed and just the note, or the person can accept all the liability onto themselves and check "no".

People have different goals and opinions of course, but I do rather like the skydiving way of doing it.

I agree with all you say. But, there are a multitude of things that can happen to you anywhere. If I'm walking down a city street and collapse, people around may know I'm allergic to penicillin (IF I'm wearing the tag), but will have no other medical history on me.
There are risks no matter what you do. I just spent 2 weeks in the cabin in Northern Manitoba completely alone, with no internet and very spotty cell service.
One can fill out the dive form any way one wants. Personal responsibility and risk assessment. And the shop will be happy.

 

[SapphireMind]

This may seem patronizing or presumptuous, but hear me out. Obviously I don't know you, I haven't examined you, and what I'm saying may seem totally off base. But sometimes it's good to look at something with fresh eyes. I also don't know if your dive count is correct, or how invested you are in diving.

If you actually have syncope, I would be very concerned about training you, and about diving with you. If you aren't solo diving, your medical condition affects your buddy as well, and possibly puts them at risk in a rescue situation.

I understand that you get a prodrome before your syncope, and you feel that you will have enough time to ascend since you aren't going to be in a virtual or physical overhead environment. But I don't think that the mechanism of syncope is always that clear. The day may come when whatever is happening to restrict cerebral blood flow (or whatever the pathophysiology is), will happen more rapidly.

This is sort of like seizure disorder and driving. A seizure or syncope on their own aren't necessarily dangerous. But if they happen behind the wheel or underwater, it's clearly a different story.

Dive professionals are in no way capable or inclined to assess your fitness to dive. When you make yourself the sole judge of that, it's sort of a conflict of interest. Trust me, I'm going through exactly that right now. I'm an obsessive local diver, I dive every weekend, I'm a technical CCR diver. Diving is incredibly central to my life. And I had a medical event recently that has sidelined me. I feel terrific, and it's driving me CRAZY not to be able to dive right now. But I won't do it - even though I feel great - until someone objective with actual data has cleared me.

I have never seen a medical clearance form outside of training, but if some of you have been asked for one before diving, I'll believe you. But please everybody, take the medical form seriously. Don't do an end run when there is a significant medical condition.

Your attitude is exactly the problem though, and why people hide things. I have stated again and again that I have been thoroughly worked up and we know the mechanism of my syncope - I have vagus nerve irritation when I have certain GI symptoms. And even when I have GI symptoms, I've always had a prodrome for a significant period of time prior to actually getting to a point where I am starting to get hypotensive/bradycardic. I can drive safely. I can do everything safely, as long as I am aware of the cause, which I am, and vigilant about it, which I am, additionally, I take a small dose of medication that prevents those GI symptoms from occurring, just to be on the safe side, while I'm diving. I have never suggested that someone with a condition be the only person to evaluate it. I've said multiple times that I think they should be involving a medical team with it.

I simply don't like the piece of paper needing to be signed to prove it, and transferring responsibility to the physician. I don't know how many ways I can say that differently, since you seem to not be able to comprehend it.

I agree with all you say. But, there are a multitude of things that can happen to you anywhere. If I'm walking down a city street and collapse, people around may know I'm allergic to penicillin (IF I'm wearing the tag), but will have no other medical history on me.
There are risks no matter what you do. I just spent 2 weeks in the cabin in Northern Manitoba completely alone, with no internet and very spotty cell service.
One can fill out the dive form any way one wants. Personal responsibility and risk assessment. And the shop will be happy.

It can, but the people on the street, when asked by EMS will not say "I have medical information on the person", as a dive shop might.

 

[doctormike]

Your attitude is exactly the problem though, and why people hide things. I have stated again and again that I have been thoroughly worked up and we know the mechanism of my syncope - I have vagus nerve irritation when I have certain GI symptoms. And even when I have GI symptoms, I've always had a prodrome for a significant period of time prior to actually getting to a point where I am starting to get hypotensive/bradycardic. I can drive safely. I can do everything safely, as long as I am aware of the cause, which I am, and vigilant about it, which I am, additionally, I take a small dose of medication that prevents those GI symptoms from occurring, just to be on the safe side, while I'm diving. I have never suggested that someone with a condition be the only person to evaluate it. I've said multiple times that I think they should be involving a medical team with it.

Sorry if you think that I have an attitude problem here. I tried to give you some advice as a diver - it had nothing to do with the clearance form. It was advice for you as a new diver with a specific symptom constellation.

You seem to feel that you are guaranteed that your prodrome for your vasovagal episodes will always follow exactly the same temporal course as time passes and as you get older. I'm not sure what workup could give you that guarantee, but if diving is non-negotiable to you, then I hope for your sake that you are right.

Personally, I'm crushed by considering the possibility of never diving again. But I also know enough about medicine to know that there are no bright lines, there are only bell curves. And if it's not to be, then it's not to be.

 

[TMHeimer]

[QUOTE="SapphireMind,

It can, but the people on the street, when asked by EMS will not say "I have medical information on the person", as a dive shop might.[/QUOTE]

***************************************************************************

As I said, I do agree with your post, and admire that you are concerned that all aboard a boat (or dock, etc.) know of your condition ahead of time, what what to do, who to contact, etc. I was just curious what you do to be "safe" the 98% of the time you're not diving. Not that it's any of my business.