Diving and Epilepsy

[enquire]

wingflyer,

The problem with the 'don't ask don't tell' approach is that if she goes diving, having lied on the fom, and something else (unconnected) happens then her Insurance will be invalid and she, and her familly, could be ruined. She doesn't want to risk that.

Apparently she could legally dive in the UK with BSAC. Maybe I should suggest she goes there. Cold though !

enquire

 

[Northeastwrecks]

Dear Wingflyer:

I found your posts regarding the use of a FLiP (family limited partnership) and your comments that you are hiding your condition most interesting and somewhat disturbing. It suggests that you can do what you want because you believe that you have rendered yourself judgment proof and that lying is acceptable.

I will not comment upon the various ways to penetrate a FLiP or to obtain payment on a judgment against supposedly judgment proof debtors. It is sufficient to say that I have burned through asset protection devices in the past, including FLiPs. Before you go off on that, I do not chase ambulances. I specialize in complex commercial and intellectual property litigation.

However, who cares? What you are saying is that you have minimized the consequences of an accident upon you and your family.

Suppose for a moment that your buddy is in need of assistance and that you have a seizure. The few moments that it takes you to recover could literally be the difference between life and death for your buddy. He/she will be no less dead because you believe that you are judgment proof.

Your buddies have the right to know your situation and to make their own decisions about diving with you. Similarly, your instructors have a right to know that you have a condition that subjects you to increased risk. You do not have the right to risk someone else's life or professional license (PADI suspends the licenses of instructors involved in a diving accident pending an investigation) or to increase their risk level by withholding relevant information.

Your posts indicate that you have informed at least one of your buddies. Do you inform each new buddy and provide them with the opportunity to make an informed choice? If not, you should not be diving with them.

By the way, I am not singling you out for special treatment. I dive in a two buddy pair group of relatively experienced wreck divers. We know each others strengths and weaknesses have been examined by physicians for conditions that might put us at increased risk during more difficult dives. I know my dive buddy's gear as well as I know my own and am prepared to effectuate a rescue if it becomes necessary. Every member of our team is prepared to do the same because we train together and practice our skills regularly.

When we (collectively or singly) dive with a new person, we discuss our experience, equipment, expectations, procedures, buddy techniques and attitudes before we get on the boat. The point is to determine how to conduct the dive and whether it will go off at all.

I would not exclude you as a buddy based on your condition. However, I would want to know that you might have a seizure and what to do about it. Depending on the dive environment, I might change the dive plan or ask a third diver to accompany us as additional redundancy and to assist (either of us) in an emergency. This is no different than the attitude you would get if it turned out that you have some other medical condition that might have an effect upon my risk, or if you lacked decompression or penetration experience.

I might call my dive. I would not, however, stop you from diving.

 

[AllenG]

NortheastWrecks - Thanks for a well conceived, balanced, and well articulated response to the various overplayed positions that sometimes accompany discussions of diving with certain medical conditions.

(and greetings from around the corner - one of my offices is over on Deerfield Road in Windsor)

 

[Northeastwrecks]

Dear AllenG:

Thank you and hello from Griffin Road South, Bloomfield.

I'm hoping to hear from Wingflyer as I think that this is an interesting issue that deserves further exploration.

 

[padiscubapro]

Originally posted by wingflyer152
I have one question for you guys. What if somebody told you you couldn't dive? There are avenues that you people are failing to see that we epileptics have so that we can scuba dive. As a diagnosed epileptic, I was told that I would never fly my airplane or scuba dive again. However, I safely do both. I fly as a private pilot with a Certified Flight Instructor as a safety pilot in the right seat. I scuba dive with an AGA full face mask with an oral nasal cavity in case I have a seizure underwater, I will not lose the second stage and drown like you guys have said. You didnt even explore the possibility of this. You left it out alltogether. I also have underwater communications with my dive buddy, who is knowledgeable of my condition and what to do.
I am sick and tired of you losers trying to make diving sound more serious than it really is. It is not space flight, where you muset be in the best shape of anyone on earth. You people should really have much more of a sane and open mind about diving and things of this nature. Sure, there are concerns for safety, but most of the time, this can be resolved and the person still be able to scuba dive. After all, what right do you or DAN or PADI or anybody have to say that I can not scuba dive? You can say that until you are blue in the face, but until you are faced with a bad health situation that was not your fault and those in better health are denouncing you just to make themselves feel better or to make them selves sound more "elite" as divers, you will never understand our position. Also, nitrogen narcosis is a mild effect and a very mild risk when diving with a buddy in shallow water, all you must do is surface, or ascend for a time, after all people narc for fun!!! This is a prime example of you, DocVikingo trying to make the sport sound more "elite" as I stated before. Dont worry though, you are not alone, you have a lot of company in this sport. We disabled divers have a voice, and I will soon be hosting a URL to acnowledge the efforts of those who have overcome their disability, whatever it may be. Anyone who disagrees or agrees with me, feel free to email me at wingflyer152@aol.com with your concerns.

I have a few questions?? Do you only dive with a buddy or do you occasionally dive with a group..

If you are only with your buddy and no other divers around you are limiting possible interaction with others in the event of an even which would probably be a good thing.

If you are diving with a group do you let everyone know of your condition, if not you are probably endangering your self and anyone else who may try and assist not knowing your condition.

If I saw a diver seizing the first thing that would immediately come to mind is "otox" and get the diver on a lower FO2 mix (I have seen a seizure underwater fortunately the diver survived).. if you are on a full face mask you are now making me decide if pulling that mask off is a good idea or not.. I would probably decide against it and now I would have to get your ass to shallower water ASAP, if you are convulsing you now Risk an embolism. If I was aware of your situation I would probably just make sure you stay in place and have a gas supply, and try and wait it out or slowly bring you to the surface. You diving with this condition doesn't only involve you it involves everyone around you.. I agree you have the right to take the risks but you don't have the right to endanger others, they should be able to decide if they want you diving with them...
As an instructor I couldn't certify you without a medical waiver to cover my ass but if you lied to me about your condition that is unfair to me and any other students... Most if not all training agencies(and their insurance carriers) require INSTRUCTORS and Divemasters to report all accidents and assist if possible.
Think about the impression you would have if I had some students with me and we were on the same boat and My students saw you convulse.. first off I would probably have to leave my students to take care of a life threating event and second these people who are new to a sport may now be turned off for life... because of your actions.

Unless you are alone your actions and choices effect others.... There are always consequences, that many do not think about.. We don't have the right to stop you (when you are diving alone) but, you don't have the right to force your actions on others either... its a catch 22... either inform everyone in that case they may decide they don't want you around, they may accept you with open arms, but its not only your decision..

 

[Northeastwrecks]

PADIScubapro got it right. Wingflyer152 does not exist in vacuum.

There is a phrase in the common law that goes "Danger invites rescue". It stands for the proposition that, in general and to our credit, people will try to help when another person is injured. It also means that a victim may be held liable for injuries to rescuers.

I invite correction from our medical members (or from anyone else who knows the answer), but is seems to me that the symptoms described (unawareness, lack of response, blank stare) are similar to passive panic.

If I find a diver presenting these symptoms and don't know otherwise, I'll follow doctrine, control the diver, ascend and initiate first aid at the surface. This may not be the best protocol, but its better than nothing, particularly since Wingflyer152 has not responded to requests that he/she explain proper treatment for an in water seizure.

Dr. Stein asked about criminal liability for failure to disclose. Many states have statutes that make it a criminal offense to act in a manner that recklessly disregards another's safety and that causes injury. I am unaware of any cases involving criminal liability for negligent behavior involving scuba diving; however, I am aware of at least one case in which a person was held criminally liable for failing to disclose known hazards (shallow depth) while cliff diving in a quarry. In other words, criminal liability is not out of the realm of possibility.

IMHO, this diver is a ticking time bomb, not because of epilepsy, but because of his apparent disregard for the effect his actions have upon innocent third parties and his belief that he can do whatever he wants because he is judgment proof.

I once again invite Wingflyer152 to respond and comment.

I'm sorry, but I must add this. THE FOREGOING IS MY OPINION. IT IS NOT LEGAL ADVICE. YOU SHOULD CONSULT WITH AN ATTORNEY OF YOUR OWN CHOOSING.
:upset:

 

[Laurence Stein DDS]

Northeastwrecks

I'm glad to see an attorney's take on this subject. I haven't checked this thread lately...wingflyer hasn't responded much.

As much as I am sympathetic to wingflyer's wishes, I know that particiation in diving is terribly risky for the diver and any buddies--especially if they are not informed.

The response in which wingflyer proclaimed to be judgement proof also made me somewhat angry. This person is actually acting like a spoiled, selfish brat. To heck with others...I WANT TO DIVE!

The response to the synopsis of the ADA was also strange. I was accused of bias. The synopsis stands for itself...the web address was posted and could have been visited if clarification was needed.

Anyway, glad to have you on board. Stay tuned for more action.

Wait, what's that I hear...an AMBULANCE!...you gotta go!

Regards,

Larry Stein

 

[AllenG]

Laurence - Without commenting on the accuracy of respective statements by you or Wingflyer, please understand that misinterpretations of ADA, be they willful, out of ignorance, or out of misinformation from others, are more readily circulated than the actual provisions or regulations. And again without commenting on the positions offered by Wingflyer, individuals with disabilities who (1) fought hard to secure the protections of ADA and (2) have taken the time to carefully understand what the law provides and what it doesn't, are often angered by the degree to which misrepresentations are so freely offered as "absolutely clear facts."

The nuances of ADA are many-fold, from who is protected (e.g., just being "REGARDED as having an impairment . . . that substantially limits one or more major life activities" makes one eligible for ADA protections) to what entities must comply (e.g., the U.S. Senate and House of Representatives must comply; the federal executive branch is exempt).

In the hope of adding some verifiable information to our discourse, please note the ADA expressly provides that a public accommodation may exclude an individual, if that individual poses a direct threat to the health or safety of others that cannot be mitigated by appropriate modifications in the public accommodation's policies or procedures, or by the provision of auxiliary aids. A public accommodation will be permitted to establish objective safety criteria for the operation of its business; however, any safety standard must be based on objective requirements rather than stereotypes or generalizations about the ability of persons with disabilities to participate in an activity.

While the ADA does have provisions requiring auxiliary aids, it does not require the provision of any auxiliary aid that would result in an undue burden or in a fundamental alteration in the nature of the goods or services provided by a public accommodation. It should, nonetheless, be recognized that the public accommodation is not relieved from the duty to furnish an alternative auxiliary aid, if available, that would not result in a fundamental alteration or undue burden. Both of these limitations are derived from existing regulations and caselaw under section 504 of the Rehabilitation Act. Application of such limitations have been determined on a case-by-case basis.

Moving beyond ADA and Wingflyer's comments re judgment-proofing himself, which only seemed to fan the flames of hostility in others: I would suggest that the only real questions to consider (1) what are the diving-related risks associated with manifestations of petit mal (the diagnosis that Wingflyer is reporting to us); (2) what are the diving-related risks associated with the particular symptoms (including frequency and severity)Wingflyer currently presents with; and (3) what obligations does any diver and then Wingflyer in particular have relative to his buddy and to others on the dive re his condition. Please note that "petit mal" covers any awfully big diagnostic territory, is sometimes erroneously used to "soften the blow" of an epilepsy diagnosis, and is often misapplied. More info than Wingflyer opts to provide in this forum would be needed to make an informed statement.

Re a diver with epilepsy (or any other medical condition) engaging in behaviors that are risky to self and risky to others, if you overheard others on a dive boat planning a non-nitrox dive that you knew posed great risk for decompression problems, would you assert a right to stop them from diving because you may be impacted if or when said divers encounter problems? Consider the newbie attempting a particulary difficult open water dive that you sense is beyond his/her capacity (e.g., nasty currents around rocky entrance/egress point) - again, do you assume the right and responsibility to get the person bounced from the dive? If, as some assert, smokers have higher pulmonary risks during diving, compared to non-smokers, do you have the right to require the smoker to "disclose" or to get the smoker bounced?

Please don't assume my questions signify acceptance of Wingflyer's positions. I would simply ask that we consider the logic and consistency of our personal opinions.

And, in closing, a warning:

1. Unlike NortheastWrecks, I am not a lawyer, so my opinions stated above should not be construed as legal advice; and
2. I am not a physician (and don't even play one on TV), so my opinions stated above should not be construed as medical advice.

 

[Northeastwrecks]

Originally posted by AllenG

Re a diver with epilepsy (or any other medical condition) engaging in behaviors that are risky to self and risky to others, if you overheard others on a dive boat planning a non-nitrox dive that you knew posed great risk for decompression problems, would you assert a right to stop them from diving because you may be impacted if or when said divers encounter problems? Consider the newbie attempting a particulary difficult open water dive that you sense is beyond his/her capacity (e.g., nasty currents around rocky entrance/egress point) - again, do you assume the right and responsibility to get the person bounced from the dive? If, as some assert, smokers have higher pulmonary risks during diving, compared to non-smokers, do you have the right to require the smoker to "disclose" or to get the smoker bounced?

I do not claim a right to stop anyone from diving.

However, I do have a right to refrain from diving with someone who will increase my risk level beyond what I consider to be acceptable limits.

In addition, I would hate to see anyone get hurt.

Thus, in the first case, I might ask the divers how they planned to handle the deco obligation that they are going to incur if they execute their plan. If they had the situation under control, I would shut up. If they truly had no clue, I might consider mentioning this to the divemaster. However, I would not stop them.


In the second case, I would probably do what other people did for me when I was a newbie, i.e., strike up a conversation with the newbie, offer some guidance if asked and answer questions. If asked, or if it looks like the newbie is looking for an invitation, I might offer to buddy.

In the third example, it is not the smoking that is a problem. Rather, it is the symptoms that the diver presents. Thus, I would evaluate the diver the same way that I evaluate any other potential buddy.

My point about disclosure was not that we need to bring our entire medical chart and disclose personal details. In the case of Wingflyer152, however, the symptoms he might present are outside of normal dive rescue training and could, therefore, lead a rescuer to initiate an inappropriate course of action (bringing him to the surface instead of waiting for the seizure to end). Compare this to a smoker who's habit may place them at an increased risk for an event that dive rescuers are trained to handle.

 

[Laurence Stein DDS]

AllenG-

I thought you provided a very insightful response especially if you are not an attorney.

I had not considered bias regarding the ADA on the particular website I enclosed. It certainly is possible. This site had a synopsis of a long and long winded law. From my limited experience with it, the points made were accurate. That being said, interpretation of this complex law is case by case.

With regards to your statement about a diagnosis of petit mal diagnosis of Wingflyer, I don't believe that they ever gave that diagnosis. I mentioned that I had an experience with a person who suffered a petit mal seizure in dental school (nearly 30 years ago) and they had failed to note that on their medical history.

It is certainly true that petit mal is a diagnosis which helps avoid the stigma associated with epilepsy--where none should exist. Other seizure disorders may be misdiagnosed and placed into that category.

I think this next part is especially interesting in light of this thread. Last week a patient of mine was in with a problem. Her medical history INDICATED past seizures. She has been free of any problems for more than 10 years and off medications. When she came in, she mentioned her child was recuperating from a near drowning. When I asked more, she asked me if I had seen the news several weeks earlier--about a driver and their child who ended up in a lake off a local expressway. I did remember something about it. It turns out this was her and her child!

Here was a person medically cleared to drive and out of the blue, they had a seizure while driving. Two strangers stopped their cars and jumped into the water, rescuing both people. The child is still suffering from some neurologic damage. The doctors do not know if it will be permanent.

This is a true story. Makes you think about Wingflyer's condition, huh?

Regards,


Larry Stein