OWD license without a doctor's certificate?

[SapphireMind]

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.

Right, but apart from my prodrome, I also have to be ill. Ill with violent abdominal illness + prodome = potential (not guaranteed) that I could have syncope. This is where you seem to be deliberately obtuse, and you negate everything everyone else has said. I have had an extensive workup with multiple cardiologist visits, tilt table, orthostatic and endocrine work ups. I've also had it for going on 30 years. Those people say I'm good. But you, in your opinion, have the potential to be able to refuse me if I'm honest, despite what other experts say. That is not motivation to disclose.

There are no guarantees with medicine, but there are also not guarantees with life. This is a devil I know, and know well, as does my medical team. You haven't talked about what your issue is, and I'm sorry that it is one that might keep you from diving, but not everyone is in that situation and your "advice" to me as a new diver is not made with knowledge or really care, but trying to be dominant in this situation. I started diving with this issue - It's not like I was a diver, developed it and had a motivation to keep going. I (as I have stated ad nauseum on this thread) have had extensive workup and research prior to considering the sport. I was not sure initially when I considered diving that it would have a risk profile I'd be comfortable with. But it does, surprisingly.

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.

It's one of those things that it's not an issue in my brain because I haven't been handing out forms to strangers. If someone gets ill around strangers, it is what it is and there will not be strangers volunteering information that is potentially incorrect. They will be strangers and not know what is happening. Most people I know are aware of my major medical quirks. Just like I know where my type I friend keeps glucagon, if he were to pass out in front of me.

It's like asking "you always wear a seatbelt because it's safer, but what do you do on public buses when there is no seatbelt?" It's a different situation. I have emergency medical information available on my phone, under the ICE heading, which is helpful, though my medical quirks (except for my issue with green tea, which is not given in an emergency situation) are non-life threatening, otherwise I would wear some sort of med alert jewelry. My passing out almost never occurs out of my home, because of the combination of needing to be ill and having some lead up warning that it's that kind of illness. In thirty years I can count on one hand where I've not been home, and that was because I was far enough away from home that I decided to not drive myself because it was easier to be sick where I was, and honestly before I learned how a small dose antispasmodic can keep it from happening at all.

For me it's the fact that someone has a piece of paper that could then be passed on to someone else to be helpful or harmful. My situation wouldn't be harmed by people not knowing what meds I take, but someone else might. Keeping it hushed so no one is aware doesn't make people safer, it just makes it more difficult to talk about medical issues with diving, and people who haven't been diagnosed with something officially are more motivated to talk about things that might impact diving (might not) or that it's nice that if you have acquaintance bystanders, they can be helpful.

 

[KenGordon]

I have had an extensive workup with multiple cardiologist visits, tilt table, orthostatic and endocrine work ups. I've also had it for going on 30 years. Those people say I'm good. But you, in your opinion, have the potential to be able to refuse me if I'm honest, despite what other experts say. That is not motivation to disclose.

This point seems to support providing a form signed by a doctor, any argument with the dive centre about fitness is over.

The test is whether the doctor thinks the diver is genuinely fit enough to dive. If a properly qualified doctor says that the diver is fit then good. The difficulty only arises if they do not.

Someone has to make the decision. The dive centre is not qualified, the diver is biased, who does that leave? Although the decision to ALLOW diving falls to the doctor the decision to actually dive lies with the diver. Whether it is a good idea or not is a discussion to be had between them. It is much easier to find a doctor who knows about diving than a dive centre than knows about medicine.

 

[SapphireMind]

This point seems to support providing a form signed by a doctor, any argument with the dive centre about fitness is over.

The test is whether the doctor thinks the diver is genuinely fit enough to dive. If a properly qualified doctor says that the diver is fit then good. The difficulty only arises if they do not.

Someone has to make the decision. The dive centre is not qualified, the diver is biased, who does that leave? Although the decision to ALLOW diving falls to the doctor the decision to actually dive lies with the diver. Whether it is a good idea or not is a discussion to be had between them. It is much easier to find a doctor who knows about diving than a dive centre than knows about medicine.

It's that they have to sign. *shrug* It bothers me. I've had the same extensive workup whether my doctor signs the form or not, shifting liability to them. Again, as stated many times before: I think people should have issues worked up and speak with their physician. I just think forcing the physician signature is the problem. People who are going to be truthful will be truthful. People who will lie, will lie.

 

[KenGordon]

FFS the world does not actually revolve about liability. Sometimes people design systems to actually work. Like “are they questionable,if so get them to see a doctor, how to achieve that?, ask for a signature from the doctor”.

 

[SapphireMind]

FFS the world does not actually revolve about liability. Sometimes people design systems to actually work. Like “are they questionable,if so get them to see a doctor, how to achieve that?, ask for a signature from the doctor”.

Or tell them to see a doctor. *shrug* If you aren't going to trust them that they actually see a doctor, why do you think they'll be honest on the form?

 

[doctormike]

Right, but apart from my prodrome, I also have to be ill. Ill with violent abdominal illness + prodome = potential (not guaranteed) that I could have syncope. This is where you seem to be deliberately obtuse, and you negate everything everyone else has said. I have had an extensive workup with multiple cardiologist visits, tilt table, orthostatic and endocrine work ups. I've also had it for going on 30 years. Those people say I'm good. But you, in your opinion, have the potential to be able to refuse me if I'm honest, despite what other experts say. That is not motivation to disclose.

There are no guarantees with medicine, but there are also not guarantees with life. This is a devil I know, and know well, as does my medical team. You haven't talked about what your issue is, and I'm sorry that it is one that might keep you from diving, but not everyone is in that situation and your "advice" to me as a new diver is not made with knowledge or really care, but trying to be dominant in this situation. I started diving with this issue - It's not like I was a diver, developed it and had a motivation to keep going. I (as I have stated ad nauseum on this thread) have had extensive workup and research prior to considering the sport. I was not sure initially when I considered diving that it would have a risk profile I'd be comfortable with. But it does, surprisingly.

Wow.

I'm not being obtuse. I'm not trying to be dominant. I'm not your doctor, I'm not "refusing you", since I'm not the one who decides to clear you or not.

I'm some rando on a scuba forum who tried to bring up a possibility that you might not have considered, regarding your recent decision about your totally elective participation in a sport that could have lethal consequences. I mentioned it because other people than you read these threads, sometimes years later. I want other people with syncope to understand that the human body is not always predictable, and that no doctors note or workup can give them a guarantee of safety.

I tried to do it in a polite way. This is how I started my first post, so I'm not sure what's up with the attitude: "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."

Sorry I wasted my time. I really don't care what you do.

 

[SapphireMind]

Wow.

I'm not being obtuse. I'm not trying to be dominant. I'm not your doctor, I'm not "refusing you", since I'm not the one who decides to clear you or not.

I'm some rando on a scuba forum who tried to bring up a possibility that you might not have considered, regarding your recent decision about your totally elective participation in a sport that could have lethal consequences. I mentioned it because other people than you read these threads, sometimes years later. I want other people with syncope to understand that the human body is not always predictable, and that no doctors note or workup can give them a guarantee of safety.

I tried to do it in a polite way. This is how I started my first post, so I'm not sure what's up with the attitude: "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."

Sorry I wasted my time. I really don't care what you do.

It was because after I stated that these things had already been taken into account and worked up thoroughly, you continued, as if I had not said anything or hadn't posted extensively about the issue and workup and involvement of medical personnel who are familiar with me. And the discussion point has been that people do not want to disclose (even if they have all that work up) because there will be people who ignore that and them and still think they are not fit to dive.

 

[rsingler]

there will be people who ignore that and them and still think they are not fit to dive.

...and there will be people with medical issues who have been worked up and perhaps waived, who still think they don't need to follow the system, and expect the commercial operators who don't know them, to just take their word for it.

Those people place our self-governance at risk, because the inevitable misadventures are then followed by lawyers and bean counters who think we should have an even more highly regulated system.
@SapphireMind , as much as you feel we are not listening to you about your extensive workup and discussions with your fellow divers, you are not listening to us either. We do not want to change our somewhat balky, but workable system for you. We believe the consequences of doing so would end up being worse for the rest of us.

And that is ignoring the possibility that you have a spectrum of conditions which is NOT compatible with safe diving over the long term, and that you would not be waivered by a diving medicine specialist. In that case, your approach would be bad, not just for us, but for you too. That would make you a poster child for retaining a system in which divers need to jump through ALL the hoops, for their own safety.

 

[SapphireMind]

...and there will be people with medical issues who have been worked up and perhaps waived, who still think they don't need to follow the system, and expect the commercial operators who don't know them, to just take their word for it.

Those people place our self-governance at risk, because the inevitable misadventures are then followed by lawyers and bean counters who think we should have an even more highly regulated system.
@SapphireMind , as much as you feel we are not listening to you about your extensive workup and discussions with your fellow divers, you are not listening to us either. We do not want to change our somewhat balky, but workable system for you. We believe the consequences of doing so would end up being worse for the rest of us.

And that is ignoring the possibility that you have a spectrum of conditions which is NOT compatible with safe diving over the long term, and that you would not be waivered by a diving medicine specialist. In that case, your approach would be bad, not just for us, but for you too. That would make you a poster child for retaining a system in which divers need to jump through ALL the hoops, for their own safety.

I don't think we're saying the same things, honestly. The extensive workup is only coming into play when people are making the argument that I shouldn't be diving, form or not. Overall, I'm looking at it from the position where many people currently lie because whether they have seen a doctor or not, they are afraid of being blocked from diving, like those here who might see checked boxes and decide they don't care what doctors have said. That helps no one. My own displeasure at not being trusted that I've seen a doctor is additional. You seem to be looking at it from the ideal position, I'm looking at it from the currently done position.

And the insistence that by checking no on the boxes (because you forgot your form, or because you're afraid of being blocked from diving) somehow puts the dive shop at additional risk is factually not true. You put yourself at additional risk and if you don't get your medical conditions evaluated for safety while diving, but there is no legal liability given to the shop/instructor. You have released them from liability by checking no.

Finally, if safety were really the concern, not liability, everyone should need an annual physical and doctor's note to dive.

 

[dmaziuk]

...and there will be people with medical issues who have been worked up and perhaps waived, who still think they don't need to follow the system, and expect the commercial operators who don't know them, to just take their word for it.

You are not seriously suggesting that having checkboxes on the form changes that in any way, are you?