Middle-aged Diver...Stress Test? Other??

[WrmBluH2O]

I will need to select a new GP for my next physical. (My fantastic one of 13 years recently went over to concierge medicine.)

My new doctor will likely not be a diver. I will bring a copy of the RSTC guidelines with me.

From reading up on DAN’s site, SB, and elsewhere, I have been trying to figure out (as best a layperson can) what might make a good fitness to dive examination for a 49 year old recreational diver.

What tests, if any, ought I suggest he or she consider for me? Perhaps a stress test ECG?

Please assume that a basic review of systems will be done and that lifestyle questions will be asked. CBC, comprehensive metabolic panel, lipid panel, and TSH (ultrasensitive TSH) are typically done. I am 49 years old and get my eyes, ears, skin, and additional plumbing checked out regularly by an ophthalmologist, ENT (who dives, yay!), dermatologist, and urogynecologist, respectively.

I am very fortunate to have pretty good medical coverage. My doctors tend to be partnering types. So, as long as I don’t go off the rails, I imagine they will at least consider any diving-related concerns I might raise and/or test(s) I may request (as long as I’m tactful and reasonable).

Know I can’t mitigate all diving risk, and that some tests themselves have risks. And, I understand problems can be caused by false positives and false negatives.

What tests would you hope would be performed? Thanks!

P.S. If I’m overthinking this all, lemme have it!

 

[Wingy]

Lung function/Lung age, Hearing test, Cardiovascular - depending on your previous medical history - those are the main three tests when I have a dive medical

 

[Duke Dive Medicine]

WrmblueH2O,

You mentioned that you get checked regularly but didn't provide a medical history. May I ask why the TSH test? That's not typical for a standard physical or any dive physical that I know of. Beyond that, your question is difficult to answer going by the information you've provided.

Best regards,
DDM

 

[WrmBluH2O]

DDM,

Thank you very much for your reply. It would appear that the TSH has been ordered for me each of the last three years. I’m embarrassed to say I have no idea why and simply assumed it was part of the “normal” battery. Thyroid-related Jazz has never even been discussed with me.

Thanks again for having responded!

Wingy,

Thank you for your reply. I will inquire as to which lung tests, if any, may be appropriate.

WrmBluH2O

 

[Duke Dive Medicine]

WrmBlueH2O,

You're most welcome.

Again absent a medical history, I can only generalize with respect to a diving physical. When screening divers for fitness to dive, there are a couple of schools of thought. Commercial and military divers are generally screened proscriptively, that is, there is a list of "thou shalt not haves" like medical conditions that require medications to control (e.g. hypertension, diabetes). The same doesn't necessarily apply to recreational divers. Civilian diving medical practitioners will generally look at an individual diver's health and physical condition and evaluate whether those are compatible with the type of diving that the individual plans to do. Tests may be ordered if a physician has questions about a particular aspect of the diver's health. If you are otherwise healthy, in good cardiovascular condition, and the examining physician has no reason to question you cardiovascular health, a stress test is probably not necessary.

Best regards,
DDM

 

[PatW]

Thyroid issues are quite especially in middle aged ladies. It can be tricky to catch early. Just testing regularly would not seem to be imprudent. My wife had thyroid issues. Luckily her GP, having keen eyes, spotted it early, ran the test, and confirmed it. It is not hard to treat if it is not allowed to proceed unchecked.

 

[PatW]

You might want to go to the Divers Alert Website, DAN. They have a section on medical issues in diving. The risk of serious cardiovascular issues increase with aging. DAN has an extensive section on the cardiovascular system which goes into extensive detail. If you have a slow evening sometime, it is worth reading.

 

[Bert van den Berg]

My wife is 69 years old, has been diving for 5 years, and was not allowed to take the drysuit class because she answered "yes" to the PADI questionaire about prescription medicines (hypertension). She was required to present a doctors certificate saying she was qualified to dive. She took the local medical center's "Dive Physical" exam. It took about 15 minutes. Other than a whole lot of questions very similar to the PADI questionaire, the only "examinations" that took place was for blood pressure and listening to her heart. She's now $90.00 poorer but was able to take the drysuit class.

 

[WrmBluH2O]

WrmBlueH2O,

You're most welcome.

Again absent a medical history, I can only generalize with respect to a diving physical. When screening divers for fitness to dive, there are a couple of schools of thought. Commercial and military divers are generally screened proscriptively, that is, there is a list of "thou shalt not haves" like medical conditions that require medications to control (e.g. hypertension, diabetes). The same doesn't necessarily apply to recreational divers. Civilian diving medical practitioners will generally look at an individual diver's health and physical condition and evaluate whether those are compatible with the type of diving that the individual plans to do. Tests may be ordered if a physician has questions about a particular aspect of the diver's health. If you are otherwise healthy, in good cardiovascular condition, and the examining physician has no reason to question you cardiovascular health, a stress test is probably not necessary.

Best regards,
DDM

DDM,

Thank you. Your first reply was helpful, the second one even more so. I appreciate your perspective!

I am keeping in mind all that you wrote above. That said, would you feel similarly or differently about pulmonary function tests? As I had been with the stress test, I am simply trying to decide how much I should (or should not) advocate for myself with respect to any test(s). Thank you again for your help, and thanks in advance for any additional insight you may choose to provide.

WrmBluH2O

 

[WrmBluH2O]

Thyroid issues are quite especially in middle aged ladies. It can be tricky to catch early. Just testing regularly would not seem to be imprudent. My wife had thyroid issues. Luckily her GP, having keen eyes, spotted it early, ran the test, and confirmed it. It is not hard to treat if it is not allowed to proceed unchecked.

PatW,

I am glad your wife’s issue was detected early and is being managed well. Thank you for sharing.

You might want to go to the Divers Alert Website, DAN. They have a section on medical issues in diving. The risk of serious cardiovascular issues increase with aging. DAN has an extensive section on the cardiovascular system which goes into extensive detail. If you have a slow evening sometime, it is worth reading.

Will do, thanks!