DIVING OVER 50 YEARS OLD

[scubadada]

Yes I amended our website a couple of days ago with a 'holding policy' for now. I'm still thinking through the best way to approach this. I've exchanged a number of emails with DAN who have no specific answers. They said that in the absence of proper medical facilities or transport here that they would need to talk someone through procedures over the phone, and then maybe wait until the next day to arrange transport. That's not something that reassures me! Neither ourselves or anyone else around here has an oxygen supply that can last that long. The reality though is that is the facilities don't exist, then not even DAN can use them!

I note however with some amusement the posts to this thread who just say they wouldn't come based on me starting a discussion..... I feel something positive then has been achieved by this!!

Call DAN and ask them what the emergency evacuation protocol for Little Corn would be for an episode of DCS II or AGE. Tell them it's for the Guardian Plan, highest level, if that makes a difference. Let us know what they say. It's not that much oxygen, come on now. You would likely not have to use it. An episode of DCS, explained or unexplained, or an episode of AGE is really on the diver, not the operator. The operator takes flak based on their emergency plan, support, and execution.

 

[chillyinCanada]

. . . I note however with some amusement the posts to this thread who just say they wouldn't come based on me starting a discussion..... I feel something positive then has been achieved by this!!

You may be amused but I'm grateful and curious. First, your original question let me make some extrapolations and therefore limited time to hit all my chosen areas, now leaves Little Corn (or at least Dolphin off my list). Simple

I'm curious because I'm wondering where you're going to dive after your 50th.

 

[tarponchik]

I would be more wary of a dive operator who didn't give much thought to the issues. You seem to be weighing various options, some more palatable to us potential customers than others, but that's fine. I'm convinced safety is a top priority to you. Kudos.

I am so happy you two safety worshipers found each other. As further means to improve your safety, may I suggest you folks dive your 40 min x 40 ft dives on NITROX but set your comps to AIR?

 

[rmssetc]

I applaud the OP for wanting to make his dive op safer. I just question that this is the best way to go about it.

As you applaud the concept, do you have any helpful suggestions?

Scenario..

54 year old diver plans trip. Gets the required general physical form and heads to his PCP. Provider does a basic health exam, signs off on the form (assuming he is willing to accept the liability), hands the bill and the form to the patient.

The patient makes his planned trip, goes diving, suffers a heart attack and dies. Keep in mind too that the odds of surviving a heart attack while diving are pretty low wherever you dive. And with the older population and health risk diving, statistically I think myocardial infarction is the greatest concern.

How did the physical benefit the diver? After all, isn't that what the OP is after?

Here's another scenario, with 100% the same amount of plausibility as the one you presented:

54 year old diver plans trip. Gets the required general physical form and heads to his PCP. Provider does a basic health exam, finds a health condition either previously unknown to the diver or which has increased in severity. Diver postpones his planned trip until the health condition is resolved. Diver later makes his planned trip, goes diving, doesn't suffer a heart attack and doesn't die. Diver goes home and buys his doctor a pony as a gesture of gratitude.​

(OK, maybe the last bit isn't too plausible.)

 

[agilis]

Jesus, I have kids over 50. I can't take any of this seriously.

 

[uncfnp]

As you applaud the concept, do you have any helpful suggestions?



Here's another scenario, with 100% the same amount of plausibility as the one you presented:

54 year old diver plans trip. Gets the required general physical form and heads to his PCP. Provider does a basic health exam, finds a health condition either previously unknown to the diver or which has increased in severity. Diver postpones his planned trip until the health condition is resolved. Diver later makes his planned trip, goes diving, doesn't suffer a heart attack and doesn't die. Diver goes home and buys his doctor a pony as a gesture of gratitude.​

(OK, maybe the last bit isn't too plausible.)

Actually I have at least twice made concrete suggestions including contigency plans which looks like the op is doing, staff preparation and training, AED and other emergency/first aid supplies.

FIY I work in the medical field. I know how likely (read unlike) a nonfocused routine health physical is in detecting a life threadening medical condition. If it were that easy no one would die of unexpected causes.

And these unexpected events can happen in the young as well as the old. How often have you heard of the student athlete collaspng on the field. And remember, these athletes had a focused sports exam or they would not be playing.

I agree that travel to remote destinations with sketchy medical care has risks, to everyone. Precautions need to be taken, by all. The question is whether a dive op should arbitrarily require a medical release beyond the requirements already in place by the dive industry.

 

[mattia_v]

Experience can only help so much. Anyone can have a heart attack, and older people seem to have more heart attacks than younger people.

"To better understand the specific role of age in these deaths, we went back to the associated injury data and this time looked at the trends by dividing members into two age groups: over 50 and under 50. In this analysis, we found that older divers were three times more likely to die from asphyxia; four times more likely to die from AGE and 13 times more likely to die from cardiac events than the under-50 dive group."

Alert Diver | DAN Research Updates

Looking at the DAN mortality data linked , what strikes me most is the low incIdence of mortality - 10/100,000 ages 15-25, 30/100,000 ages 65 and up. Of course this only registers diving related deaths, not overall mortality. CDC figures for the same year are 80/100.00 vs >2000/100,000.

So your relative risk of dying appears to be better if you're older and do dive than if you're older and don't. And the absolute risk difference is pretty minimal to say the least. Factors such as population composition may skew the effect some as well. E.g younger divers may not have insurance as frequently, smaller percentage of the diving population, and lower event rates, leading to more inaccurate estimates that may skew things in their favor.

 

[redacted]

[QUOTE="uncfnp, post: 7630913, member: 13231

I agree that travel to remote destinations with sketchy medical care has risks, to everyone. Precautions need to be taken, by all. The question is whether a dive op should arbitrarily require a medical release beyond the requirements already in place by the dive industry.[/QUOTE]

I suspect the only benefactor will be the other dive shop on the island.

 

[rmssetc]

Actually I have at least twice made concrete suggestions including contigency plans which looks like the op is doing, staff preparation and training, AED and other emergency/first aid supplies.

Sorry, I clearly didn't read the thread closely enough -- I didn't mean to overlook your suggestions.

Contingency plans, staff prep, training, on-site supplies, etc. are all great ways to respond to an incident. I'm still curious about ideas to prevent divers from having incidents, rather than respond after the fact.

So far, I think the best suggestions may have been the hand-written acknowledgment of risk and the idea of having all divers--regardless of age--provide medical clearance. The first is well aligned with widely-held beliefs re. taking personal responsibility, while the second at least sidesteps the accusations of ageism.

Personally, I'm torn -- I don't think a dive op should be in the position of evaluating my medical state (ie., being given the details of a medical release, unless it contains specific restrictions such as 'should not dive below X feet') , but I have much less of an issue with an operator requiring that I have been evaluated by a 3rd party and cleared for the activity. Is the request to provide proof that a medical clearance was granted fundamentally different than providing proof that the diver has been trained and certified to dive by showing a C card? It's interesting that no one complains if a OP wants a check-out dive for someone who hasn't been in the water for 6~12 months, and there's frequently advice given here to get recertified if you haven't been diving for several years, yet there's such an objection to an OP proposing a different type of evaluation of fitness to dive.

What if the op introduced more diving-related qualifications, rather than just medical? What would the reaction be if the statement was something like "Because of the remote location, difficult access to medical care, etc., all divers must carry solo-dive certifications or dive-master or higher and show 50 or more logged dives within the last 6 months."? Sure, that would exclude a lot of customers (more than the medical requirement, I'd guess), and people here would jump all over it because those requirements are way out-of-proportion to the dive conditions...but I bet there would be a less hostile response, with none of the rhetoric about a pre-dive qualification being such an imposition on personal liberty.

FIY I work in the medical field. I know how likely (read unlike) a nonfocused routine health physical is in detecting a life threadening medical condition.

Agreed...but... plausible != likely.

Perhaps a nonfocused routine physical could be compared to, say, a $99 OW dive certification -- neither is ideal, but each has some plausible benefit over not having any pre-dive evaluation or training, and each could lead an over-confident, underprepared diver into trouble. So...do we advocate eliminating certification just because a person might get poor training?

All of this reminds me that I'm about due to schedule an annual physical. Since I'm over 50 and check some "Yes" boxes on the standard medical-release-for-diver-training form, I'll probably have my GP sign it again, so I've got it ready in case I decide to do any training...or go to Little Corn.

 

[redacted]

So far, I think the best suggestions may have been the hand-written acknowledgment of risk and the idea of having all divers--regardless of age--provide medical clearance. The first is well aligned with widely-held beliefs re. taking personal responsibility, while the second at least sidesteps the accusations of ageism.

n.

So, you really think that a diver will go through the expense of travelling to such a location only to cancel their diving and lay on the beach when they write down the risks?

A shop that goes above and beyond to create obstacles to diving will not last long.