Failed medical - should I get a second opinion?

[dolfyn]

Hi All,

I'm hoping for some advice on whether to pursue a second opinion as I didn't pass the dive medical. I'd love to get certified & have done a few discover scuba dives which were terrific & had no problems. really loved it!!!

I booked in to do a dive medical (I'm in Brisbane, Australia) at my regular GP clinic. The doctor called me to cancel my appointment as she had looked through my file and wouldn't pass me as I have had 2 instances of dizziness in the past 6 months. so disappointed

The first instance was the very first time i've had any problems with dizziness. I had a cold (usual sniffles, blowing nose, coughing) and about 1-2 weeks later, was dizzy when i woke up. The doctor said it was probably an upper respiratory infection causing my ear to have a problem causing some dizziness / vertigo. Nothing to be done, would go away on its own, got prescribed some anti-nausea medication. It wasn't too bad, I never took the medication and still went to work (on the bus) after 1 day off. Took about 2 weeks to be completely normal.

Second time was similar, went snorkelling and a discover scuba dive (yeay, was fantastic!). My ears got a little achey which happens after they get water in them sometimes. Then about 1 week/10 days later, mild dizzines. Went to the clinic & saw a different doctor who was very unhelpful. Dizziness went away after 3-4 days and I was still working during this time.

Based on these two incidents, the doctor has said I would not pass a dive medical. Is there any hope that I might get a different opinion from someone else? Or does this type of dizziness rule a person out completely?

I feel like these were specific incidents to do with various infections (respiratory, ear) and should be fine at other times.

I'm happy to go to someone else with more experience of diving or do more tests if there is a chance I could dive.

I'd love any advice!
(only just found this forum which seems really good but just thought i would say anyway - I'm not looking for dodgy workarounds. If its a legitimate medical concern, I'll stick to snorkelling.)

cheers

 

[antattack]

Most agencies do not require a dive physical until you start training to become a dive professional - at least that's the case in the USA. My experience is that Open Water training only requires that you fill out a medical questionnaire.

I applaude your thoroughness in getting a physical- take care of your health. Maybe your doctors advice will change if you stay healthy for a year?

Dive safe!

 

[TSandM]

I understand that Australia has some much more restrictive regulations on diving than the US does.

For me, the first episode would probably not concern me at all, assuming you were otherwise healthy and it resolved. The second episode is more worrisome. You do not provide information as to your age or other medical history, which would go to trying to decide whether episodes of dizziness were related to serious health problems or not. It is also very important to get a handle on precisely what "dizziness" means, because some people use the term to describe being lightheaded and feeling as though they are going to faint, and others use it to describe a spinning or rotational motion, often associated with nausea, which is more precisely termed vertigo. The two have quite different implications as to cause and prognosis.

I do think it's quite unfair of the doctor to cancel your appointment without at least seeing you and taking a good history on what these episodes comprised. I would try to find another physician who would not offer such a summary judgment.

 

[bowlofpetunias]

It is a requirement in Australia to have a dive medical before you can take an OW course. Some doctors are more inclined to say no for even slight reasons due to lack of understanding or fear of being held liable in the case of an event.

I would strongly suggest you do a little homework. Talk to a couple dive shops, check with DAN and find a Doctor who is known to be thorough but fair and reasonable regarding the physical. It is too bad Dr Simon Mitchell is no longer in your area. You do not want to be "rubber stamped" but you also don't want to be denied the chance to participate in this amazing activity without good reason either. Good luck on your quest!

I know people who have dived safely for sometime with controlled medical conditions that in the past would have been an automatic NO WAY. Some doctors who do the Dive Medicals are not really "Dive doctors" but doctors who just get the paperwork to do the medicals for diving. There is a big difference! I would try to go through a "Dive Specialist" preferable one who dives or has been a diver!

 

[gcarter]

Whether medical, legal, or life in general. a second opinion never hurts. BUT. The trick is to not get into the "venue shopping" trap where you keep going until you get the opinion you want to hear. You need to trust the professionals, but if the second opinion differs, make sure you ask that Dr why their opinion differs and factor that into your decision. Don't automatically assume the second opinion is the right one. Critically evaluate.

 

[Quero]

In Australia it's different, antattack.
For the OP, yes, go to a dive medicine specialist for your medical clearance. Phone to Divers Alert Network in Ashburton for the name of a doctor local to you: +61 -3 9886 9166.
If a dive medicine doc gives you clearance, you're golden; if not, well, don't take the risk.

 

[adamn]

Dolfyn, there is a very knowledgable doctor (cant remember his name off the top of my head sorry) that specialises in dive medicine at the Surfers Paradise Day and Night Medical Clinic. I would recommend you book in there and have a talk to him instead of your local doctors. He is pretty cheap for the certificate too, something like $66.00 from memory.

 

[TSandM]

The trick is to not get into the "venue shopping" trap where you keep going until you get the opinion you want to hear

This would be good advice, had the doctor in question even bothered to see the patient. I don't think you can accuse someone of "doctor shopping" when the first physician they try to see won't even bother to take a history and do a good physical exam, especially if the problem they are balking at is less than a clear-cut major contraindication to diving. I do not think it is unreasonable for the OP to try to find someone who will actually SEE him, and finding someone who is dive-savvy would be wise, as well.

 

[davetowz]

Most agencies do not require a dive physical until you start training to become a dive professional - at least that's the case in the USA. My experience is that Open Water training only requires that you fill out a medical questionnaire.



Dive safe!

"The purpose of this Medical Questionnaire is to find out if you should be examined
by your doctor before participating in recreational diver training. A positive
response to a question does not necessarily disqualify you from diving. A positive
response means that there is a preexisting condition that may affect your safety
while diving and you must seek the advice of your physician prior to engaging in
dive activities.
Please answer the following questions on your past or present medical history
with a YES or NO. If you are not sure, answer YES. If any of these items apply
to you, we must request that you consult with a physician prior to participating in
scuba diving. Your instructor will supply you with an RSTC Medical Statement
and Guidelines for Recreational Scuba Diver’s Physical Examination to take to
your physician."

Copied directly from the RSTC Medical statement form.

 

[Jim Lapenta]

In addition to the standard dive medical I have my own criteria that might require a medical based on new research and trends in society. I cleared this with my insurance company and they thought it was a great idea as it goes further to reduce my risk. The std medical asks about blackouts/fainting where the person was unconscious. I want to know about concussions whether or not they were out cold. There are a few other items I've added as well. If the OP came to me and told me about this I'd not only suggest, but require, they see an ENT specialist if they wanted to train with me. Not just a GP. If they chose not to they could find another instructor.