Disclosure of health conditions to dive ops/fitness (thread split

[Lorenzoid]

. . . If, on the other hand, the form asks to disclose any medical issues, then I find it problematic to leave that blank. Known medical issues help rescuers/first responders to do their jobs. Putting first responders at greater risk is unacceptable. . . .

Wasn't this discussed either upthread or in another recent thread about medical waiver forms? It was argued--persuasively to me at least--that first responders may not have timely access to the waiver form you gave the dive shop. There's something of a paradox here: Because it is well known to dive ops that many divers do not accurately complete those forms, a dive op's first reaction in an emergency probably isn't to dig the diver's form out and rush down to the dock with it to meet the first responders. So you go to all the trouble of listing your medical history, and nobody pays any attention to it because they don't trust it to be accurate. I think the better approach for someone who has a medical condition that genuinely might be useful for first responders to be aware of would be to wear a medical alert bracelet/tag. Your doctor can determine what information, if any, would be useful to provide to first responders in that manner.

 

[Rescue Diver68]

I am late to this discussion and I'm going to disagree with the overwhelming willingness to lie on the medical questionnaire. When you go diving and have an accident or incident there are usually others involved in the rescue and or recovery. You are not just risking your own safety, you are endangering everyone on the boat and everyone who responds to your accident or incident. You have a heart attack, at least one if not more are likely to attempt a rescue. There are lots of scenarios, fast ascents, etc. where rescuers become victims too. It is also not fair to the dive op who some how gets blamed for being unsafe even tho they are just the bus to the dive site.

 

[dmaziuk]

If diver X has a medical condition that is under control and the questionnaire asks something to the effect of, "Do you have any medical conditions that would preclude you from diving?" then I can see why diver X would respond, "No." If, on the other hand, the form asks to disclose any medical issues, then I find it problematic to leave that blank. Known medical issues help rescuers/first responders to do their jobs. Putting first responders at greater risk is unacceptable.

The way I understand it,
- In this century 90% of people over 50 (if not 40) would answer "yes" to at least one of the questions on the WRSTC form.
- Medical conditions that are likely to kill you are not specific to diving. Diving may be more likely to trigger them than, say, eating lunch, but it really is a crap shoot.
- Neither the dive op nor the first responders are going to treat you based on your answers on the WRSTC form. They're going to administer CPR, oxygen, and rush you to a hospital or pronounce you DOtS,

All of which makes the form entirely pointless for what you're talking about.

 

[Rescue Diver68]

From your perspective perhaps.

People who are told by their doctors that they shouldn't be diving, dive anyway, have a medical emergency consequently put others in danger. Be honest. If you have Yes's then have the doctors note to back it up. If you can't be released from the doctor then don't dive and risk your life and worse, the lives of others.

 

[doctormike]

I'm late to this discussion too, but I think that it's important to distinguish between conditions that increase your risk for diving and conditions that are absolute contraindications to diving. The average overweight middle aged diver who works a desk job during the week is at increased risk for diving, and for many other activities. Someone with a history of spontaneous pneumothorax or uncontrolled seizure disorder or a tracheotomy (with one exception!) should not be diving under any circumstance.

So the standard can't be that we shouldn't dive if we aren't 20-something Navy seals, because of our increased risk. It's just like clearing people for elective surgery - something that I do every week. Every decision is made balancing the risks and the benefits, and some patients are just at increased risk. If it's not something that can be optimized (like waiting for a patient to recover from a cold), we don't deny people procedures just because they aren't in perfect health.

That having been said, the operator or instructor shouldn't be put in an untenable position. The doctor's note is a way of formalizing the discussion between the diver and his or her doctor that looked at the whole picture, assessed the risks and came up with a decision about diving. When I sign a note, part of what I am providing is a transfer of liability to me - that's part of the job. So yeah, tell the truth on the form and get a note, it makes everybody happy. I don't know if an insurance company would withhold medical benefits or life insurance payouts if they found out that something was omitted on the form, but it certainly seems possible. They do what they can to protect their bottom line just like the rest of us.

 

[drrich2]

It's worthwhile to not group all 'medical conditions' together. Consider these...

1.) Diver A has asthma, pretty well controlled, but has the rare asthma attack & keeps a rescue inhaler in his dive bag. If he comes up with marked respiratory distress, knowing that inhaler's handy could make a difference. As opposed to someone maybe suspecting immersion pulmonary edema?

2.) Diver B has diabetes, pretty well controlled, but flare ups can happen. Might be more an issue of a 'comorbid' condition to be aware of if something happens. But not so clear cut.

3.) Diver C had a history of high cholesterol, not severe, maybe fasting total cholesterol readings around 220 - 250, now nicely controlled on a modest dose of a statin.

4.) Dive C has a history of mild hypertension, 145/95, controlled with a small dose of antihypertensive med. Or, maybe not on a med., and that's the pressure. No history of severe spikes,

In the event these 4 get on the dive boat, the odds of an acute medical crisis, and the utility of knowing this history to boat crew or caregivers, varies with each case.

For some people, these 'shades of grey' won't make a difference, but for some they will.

Richard.

 

[KeithG]

From your perspective perhaps.

People who are told by their doctors that they shouldn't be diving, dive anyway, have a medical emergency consequently put others in danger. Be honest. If you have Yes's then have the doctors note to back it up. If you can't be released from the doctor then don't dive and risk your life and worse, the lives of others.

Would be it fine for these people to golf? Or maybe they should take up skydiving? How about cruise ship relocation cruises?

My obtuse point is why are divers so fixated on thinking their hobby is so special compared with the rest of life?

 

[Lorenzoid]

Would be it fine for these people to golf? Or maybe they should take up skydiving? How about cruise ship relocation cruises?

My obtuse point is why are divers so fixated on thinking their hobby is so special compared with the rest of life?

Because some medical events that are more survivable on land are less survivable underwater?

 

[doctormike]

Because some medical events that are more survivable on land are less survivable underwater?

Yes, this is a key point that often gets overlooked in these discussions. As divers, we have a subconscious desire to minimize the risks of our sport. Dive professionals may even make a conscious effort to do this, to avoid bad press and lost business from people considering scuba. So it's almost with a sense of relief that we decide that a death was "medical", and the inevitable posts are made that this person could have just as easily died playing golf or mowing the lawn.

But that's not really true. Yeah, if you have a massive MI that causes you to loose a significant degree of your heart's pump function, you are going to die whether you are on the Andrea Doria or shopping at Macy's, and all the medical care in the world isn't likely to help you. But most medical events aren't so dramatic, and things that are almost always survivable on land are often deadly underwater. A brief loss of consciousness from a TIA or a seizure is rarely a significant medical problem, but at depth it's a disaster.

 

[boulderjohn]

Would be it fine for these people to golf? Or maybe they should take up skydiving? How about cruise ship relocation cruises?

My obtuse point is why are divers so fixated on thinking their hobby is so special compared with the rest of life?

Because some medical events that are more survivable on land are less survivable underwater?

Lorenzoid is right. Scuba is very different from those other hobbies. Have an asthma attack on the golf course and you can whip out your inhaler and be OK. Have a seizure on a golf course and you should be just fine after it has run its course. Both of those would likely be fatal on scuba. Be pregnant while golfing, and it is no problem. Be pregnant while diving and you could go through life dealing with a severely handicapped child (we don't know for sure on that).

Remember that in most cases, the only time you need the medical form is with instruction, and the primary reason is informed consent. For example, most pregnant women intending to get dive instruction would have no idea that the child could be at risk.