Diving and Epilepsy

[Lloyd]

Wingflyer,
I would like to reiterate the fact that your buddy is diving with out a buddy. You can not be relied upon to assist him in an emergency. The stress and rapid breathing in assisting a buddy in trouble could trigger an episode in you especially if you have to descend in order to retrive him. Sorry, but life is never fair.
Lloyd

 

[Laurence Stein DDS]

Dear Mr. Wingflyer,

Why not just agree to disagree. I'm sure you have read the general consensus that your medical condition poses potential problems to others you may dive with. The other general consensus is that we all empthetic to your position and condition. I would have no problem diving with you or anyone with a disablilty.

Many of us who have followed this thread expressed concern about your nonchalant attitude to this condition vis-a-vis its potential to affect others around. Of particular concern is the way you almost flaunted your "judgement proof" status. It came as a very callous remark. Most people do this to protect themselves from financial risk associated with their activities such as work or hobby--especially if there is a potential large sum of money that needs protection.

In my profession, hiding information such as yours would be unethical and I view your personal world view as suspect.

You bet I'm biased. Nobody on earth isn't.

You don't like others telling you what you can and cannot do...but that is not the way the world works. The reality is that it is the attention to such details that prevents doctors, attorneys, and even SCUBA certifying agencies from allowing you to participate in this sport. What you have to do is show those in charge that you have a foolproof way to work around your problem that doesn't put strangers at risk. Right now only your buddy knows your problem and even that person is at some risk.

Just disagreeing,

Larry Stein

 

[Northeastwrecks]

Dear Wingflyer152:

Thank you for warning us that you might be diving in our area. I'll keep a sharp watch out for divers from Tennesee with pilot's licenses, full face masks and the type of attitude that gets buddies killed. That way, I can find another boat and, preferably, another ocean.

I ran into someone like you this weekend. I am a DM candidate and tagged along during a diver's AOW class (OW had been obtained from another shop). All of the diver's paperwork appeared to be in order, with no disclosed medical conditions.

The instructor and the diver walked to the entry point. I followed behind. As the three of us prepared to swim out, the diver vomited and fell face first into about five feet of water.

My instructor and I got him to the surface and did the usual first aid/rescue stuff. At this point, we had no bloody clue what was wrong with him. All we knew was that we had a semi-conscious diver on the beach.

At this point his wife came running. She informed us that the diver was diabetic.

The short version is that this ()*#()* idiot's blood sugar was way off. I did the one-hundred yard dash to my medical kit (it was closer than the one in the shop's van) and grabbed my deco bottle (50% O2, which I had intended to use for a boat dive on Sunday). We administered glucose, which brought him around, and put him on my O2. Someone else brought the O2 kit, so we switched over.

We checked the diver's disclosure forms. There was no indication of any medical condition. The diver later admitted that he had failed to disclose his condition because he didn't think that it was relevant. Apparently, he also forged his medical certification. His comment was that his medical conditions were his business and that it was the instructor's job to teach him, not to tell him that he couldn't dive.

If this had happened at depth, we would have had a situation in which someone could have been hurt. Moreover, by failing to disclose, the diver complicated his treatment.

The mere fact that this diver is diabetic would not have stopped us from diving with him, so long as he was cleared by a doctor. Now, however, he is banned from the shop until he obtains the required medical certifications AND gives us permission to contact the examining physician for verification.

You, sir, are doing the same thing and are just as irresponsible as this person.

Why do you continue in your mistaken belief that you have the right to put others at risk without even the courtesy of a warning? Exactly who do you think you are?

Your rage at your condition is no basis for putting anyone else at risk.

I write this after having been interviewed by the police (we called EMS) and having been debriefed by several people at my shop. It was not fun to have everything I did questioned. It was even less fun to miss my Sunday dive because this )(*# moron sucked down too much of my deco bottle and I did not have time to refill it (see above for why).

Before you respond with sarcasm and pointless rhetoric, I would request that you actually answer the questions. In the meantime, have you considered SASY? It goes with your maturity level.

 

[Laurence Stein DDS]

Northeastwrecks,

Your story really was scary! What nobody knows until it happens to them is how YOU feel during and after that situation. While you know you did your best, you still wonder whether you could have done it better and you wonder what would have happened if the victim died.

You might even wake up thinking about it or think of it years from now on another dive. It can haunt you--"been there, done that".

I don't know how Wingflyer will react. Perhaps, rather than a simple, I see your point, you will get more retoric about his own right to self determination or distruction. Heck, he might even start picking on you instead of me...what a relief.

Glad you had a "good" outcome. Regards,

Larry Stein DDS

 

[Northeastwrecks]

Dear Dr. Stein:

Thanks for the note. The funny thing is that I didn't get particularly upset until after the event was over. Then I sat down and had a nice case of the shakes while waiting to be questioned. I hung out with my wife and spoke with some OW students who had observed the entire incident. They were freaked out.

Two of the students were Massachusetts State Troopers. They told me that I had "done good".

Fortunately, the diver was fine. However, he refused transport and denied that there was a problem. His wife drove him home.

I'm certain that we could have reacted differently and more efficiently. For example, I should have grabbed the O2 kit instead of a deco bottle. However, I'd already taken time to strip my rig, my car was closer and I was jogging in a dry suit in 80 deg. weather. Saving the extra steps seemed like a good idea at the time. I also could have called for help earlier. Instead, I waited about 1 minute to see if he would come around.

That said, if the diver had told us that he was diabetic, I might have stuffed a tube of that glucose stuff in my dry pocket (the same way that I stuff an EpiPen in my pocket when I hike with a friend who is allergic to bees). I would have been sensitized to the symptoms and could have started appropriate treatment sooner.

Overall, the fact that the diver is alive and kicking (and complaining) leads me to believe that, while we might not have been perfect, we were close enough. After all, this guy walked out under his own power.

My point is simple. Poo-Poo occurs. Plan for it. Don't risk others live's so that you can have fun. Don't assume that nothing bad will happen or that your actions don't effect those around you. It will, they do, and others will need to clean up your mess.

I hope that Wingflyer responds. I am truly curious to hear his reaction.

 

[AllenG]

NE Wrecks -

Since the rescued party apparently didn't see fit to recognize your efforts, let me offer a tip of the hat to you for your handling of the emergency. Per my earlier offer of greasy pizza, I just e-mailed you a phone number to reach me at work, so give me a call so I can congratulate you in person.

Unfortunate as the incident is, it makes the point all too well re diving with medical conditions. I too would be interested in hearing a reasoned response from Wingflyer (but not his usual rhetoric) re your most recent experience.

The incident does highlight one issue for me: Imagine, for the sake of discussion, that the diver had properly secured medical certification and clearance to dive. Now, take the situation away from an OW instruction setting and move it into a vacation setting where only your buddy knows you and your medical condition: Should the diver be obligated to inform all others present that "hey, I have this medical condition which ordinarily I wouldn't even disclose to some personal friends, but which I am nonetheless now telling everyone because it could impact my health and safety during the dive" or something like that? Those of us who persist in this thread would likely say "yes indeed. No harm will necessarily come of it, and perhaps some good will come of it." Sounds about right so far, no?

So now let's extrapolate: let's say this individual with diabetes was participating in some other activity, not diving, and as he prepared to begin the activity, he "vomited and fell face first" on to the floor. From the Department of Slippery Slopes, if this activity is called, say, "work," is it okay to require that the individual disclose his medical condition to everyone in the workplace ("ah, excuse me, you don't know me, but I'm Marty Munchausen, down in bookkeeping, and I just wanted to let you know that I have diabetes, so if you see me start vomiting and fall, remember that it's just that I'm too flippin irresponsible to take care of my own diabetes." "Oh, well thanks for sharing that precious insight with me. I'll be sure to carry some glucose with me . . . "). This person is with his/her co-workers much longer than the assembly of dive students and the probability of having diabetes-related complications or symptoms in the presence of co-workers is probably much greater. Should the employee be required to make this disclosure? I'm not the lawyer here, but I believe there is a law that speaks to this matter, no?

Obviously, there are different parameters and risks associated with diving compared to employment, but I believe that a skilled barrister will appreciate the potential for unlawful exclusion or restraint of trade from an activity solely on the basis of a diagnosis. Why, a number of years ago when PADI refused to certify me for instructor on the basis of a diagnosis, attorney friends (and I'm sure some wit on the board is going to say that the notion of an "attorney friend" is an oxymoron) were anxious to litigate on my behalf! So, ignoring Wingflyer's willful pursuit of irresponsibility, how do we set reasonable parameters to facilitate productive disclosure? Expect the diver to tell the DM? Well, in most group dive settings, the de facto UW role of the DM is little more than setting the direction because divers invariably demand that they are granted the flexibility to go where they want, therefore the DM doesn't actually monitor the individual divers. It is more likely that another diver (and not necesssarily even the person's buddy) will be the first to encounter the diver in peril.

And because the DM has no way of determining if the diver's medical condition is currently as good as it was when the MD gave medical clearance, his/her natural inclination is going to be "sorry, I don't have enough current, verifiable information to enable an informed decision re whether to allow you to dive and, because I do not wish to assume undue or unnecessary risk, I prefer that you not dive on my boat . . . . " Think it wouldn't happen like this? Take the incident back to employment and consider Ms. Bea Stove-Burton, who has a history of back problems which today does not impact a physical capacity-related BFOQ and who requests no accommodations to perform any essential job duty. A prospective employer turns her down because "there was a risk that she might re-injure herself." Sound like a recent ADA case? So what's best way to promote disclosure?

As always, many questions and, unless we are dealing with flagrant irresponsibility to self or others (aka, your student with diabetes, Wingflyer's don't ask/don't tell strategy), so few answers.

As always, a pleasure beating this issue to death!

 

[Laurence Stein DDS]

Northeastwrecks,

I know exactly what you mean. I've been DM certified for years. I don't wish to teach or safety dive. It was just something I wanted to do. There wasn't a Masterdiver rating then so since I didn't want to teach, DM was the highest rating for me. While I dive a lot I don't practice rescue skills but some are ingained.

My most memorable incident involved an out of air situation in 80 ft of water. The victim "appropriated" my main reg. Thank goodness I suspected it would happen. We made it up including a safety stop. The victim ended up in ICU with water in his lungs.

It was only after the dive that I got the adrenalin shakes. The more I thought about it the more I would shake. We both could have died!

Congratulations on doing the Right Thing. Wasn't it you who said:

"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.

No truer words have been spoken.

BTW would you all call me Larry. That Dr. stuff is only when I'm answering tooth questions.

Regards,

Larry Stein

 

[DarkAussie]

Hi,

I am very new to this stuff so I don't know whether this will go to the forum or not. I have been diving for 27 years (20 of them as a passionate cave diver). 6 months ago I had an episode on a significant cave dive, 400 mts from the enterance. My initial reaction at the time was O2 tox so I switched gas several times but no relief. The sensation lasted about a minute (it was the most frightening experience of my life) then reoccured 3 more times during my exit. I some how made it to the surface and chose not to dive for the rest of the weekend.

Then started the barrage of doctors (Hyperbaric, ENT, cardiologists and neurologists). Turns out I have Terminal Lobe Epilepsy (TLE), simple partial seizures - seemingly confirmed by lesions of the Hippocampus (MRI scan) and a mildly abnornal EEG. I am being treated with Tegretol and so far so good.

I was searching the Internet for some reference material as all the medical references I have are dated in the 80's and 90's and came across your forum.

Let's just say that diving (and particularly cave diving) has been my life since I was 15 years old. I am Tech instructor, senior cave diving instructor, 1000 cave dives, blah, blah blah. I also have a family and I don't believe in any form of life after death, so I don't expect to see them again after this life.

To say the news of TLE is hard to swallow is an understatement. I keep asking all the questions - why me, I don't drink or smoke and keep myself fit. Although devistating, the choice for me seems simple - hang up the fins and jump reels. I have a greater responsibility to my family and my diving buddies than my own personal gratification. There is not much you can do with the hand you are dealt - and trying to cheat (death) is not an option for me.

So to the guy who lies and goes diving with epilepsy - you are not too smart. Just because you can close your eyes and walk across a busy street doesn't make it safe. You will get hit eventually and your family WILL GET HURT.

BTW, I don't consider myself to be disabled just unlucky.

Dark Aussie

 

[Laurence Stein DDS]

Dear DarkAussie,

Sorry to hear about your experience. I've recently had one too--initially thought to be DCS type II. Now it looks like its
probably not. But for the first two months I did 4 chamber dives, been check by eye docs, nerve docs,
MRI's, blood tests--the whole nine yards.

If, in fact it were DCS II, my dive days are over. I too have a family. Unfortunately, if you read the entire thread, there was a, very opinionated diver with a huge chip on his shoulder trying to prove that a disability does not have to hold you back from any endevour you wish.

A wonderful philosophy but not realistic in the real world. Consequences get in the way. You could continue to dive but it is your family that may pay the price. I feel for you--I have been diving since 9 years old and really don't have anothe hobby I enjoy as much.

Unfortunately, you probably don't have any choice (as much as our other epileptic diver would differ). And goodness forbid if YOU DON'T DIE. You will be a burden to your family and on the health system paid for by the taxes of others.

As much as I admired his zest for life, his attitude could get me or others killed so he better dive alone or with his soon to be dead buddy.

So, you got equipment you want to sell????--That's the first thing my friends asked me.

Regards and good luck

Larry Stein

 

[AllenG]

Dr. Stein -

I was saddened to read that you are dealing with medical complications of your own. I would imagine that dealing with all the diagnostic uncertainties has been as frustrating, if not painful, as the symptoms themselves. From your humorous close ("got equipment you want to sell?"), I can hope that things are looking up for you. And having shared this thread with you, I also hope that things don't progress such that you do have to make a decision that, from an intellectual and rational perspective level is both easy and obvious, but from an emotional level is nothing short of painful.

As opportunity and your spirits may allow, let us know how you are doing.

Allen