PCP would not sign off.

[hambleto]

I am sorry to post this and ask. But I would like some advice from people. When filling out my PADI form I answered yes to two questions. Since I answered yes I followed the directions and went to see my Primary Care Physician. He took my BP and it was 120 over 80 and he checked my breathing. He then said that he will not approve and sign off on me to dive. He then proceeded to tell me that I will have to get down to 200 lbs, be off all of my medications, and then he will give me a stress test before he will approve me to take SCUBA courses. (I am 24 years old and currently 280 and I have lost 100 pounds since last September) I am a little upset, change that I am very upset with him right now and I do not know what I should do. I admit I am not in as good of shape as I was in high school but I am in better shape then my girlfriend (who he approved to dive today). I know there are risks I will take to dive being that I am obese; I have read the literature and warnings. I am willing to take these risks. I am not looking at going very deep. I just wish to be able to explore the reefs and the beautiful scenery I always see from the top when snorkeling. Should I contact DAN and find a doctor who specializes in dive medicine? Should I ask my doctor to reconsider? Should I find another doctor locally who will approve me? I will not lie on my form (I could just put no for everything) but I will not do that to myself or to PADI. I am listing below the medicines I am on and dosages. Just as a side note, he actually took me off one of the medications I am on today.
I thank you for taking the time to read this. Please tell me your honest and truthful opinions. Please feel free to post a reply here PM me. Thank you for your time again.
Sincerely,
Ben Hambleton

10mg Inderal twice a day
160mg Diovan once a day
40mg Nexium once a day
5mg Norvasc once a day (I was taken off of this as of today)
180mg Alegra once a day

 

[raviepoo]

120 over 80? That's not high blood pressure. I don't know anything about the meds you are on. Perhaps your doctor has a reason to object to you diving while on those meds.

I assume this is an ordinary family doctor, not an expert in dive medecine. If I were you, I would find another doctor. I'm not talking about shopping doctors until you find one lax enough to sign your hall pass. Call DAN and ask them to refer you to someone appropriate. If an expert says, "no diving" then you shouldn't dive. But if your PCP is anything like my PCP he probably doesn't have sufficient expertise to make that decision on your behalf.

Good luck.

 

[detroit diver]

Ben,

I'm a diver, not a doctor, so take this for what it's worth.

I appreciate your desire to dive, but there are obvious concerns that your doctor has with your health. This sport is not free from stress, although it's not like playing football or hockey, either.

Your comment about your girlfriend tells me that your doctor might have some inkling that your are not fit to dive at this point in time. If he's ready to allow her to dive, for whatever reason, then he must have some knowledge of the consequences of you diving. And he's the doctor that truly knows you best.

You can shop doctors and find one who will give you the okay. That's true of just about anything. But you are not doing yourself or family any favors. You'll be able to dive, but will you be able to get out safely? Remember, there are issues with some medications and the ability to properly decompress.

I really commend you for losing the amount of weight that you have so far. That is quite an impressive feat. My suggestion would be to stay on track and get to a health level that your doctor feels comfortable with. This will do a couple of things. First, you'll have an okay from someone who knows your medical history. Second, you will probably feel better when you finally get to dive.

You've done a great job so far, just don't push the envelope. It will come in time.

Jack

 

[hambleto]

Thank you for your input. I know my doctor knows me and is just concerned for me. However, the requirements that he put on me to dive (reaching 200 pounds and being off all my meds and passing a stress test) are a little extreme. After all, once I am off all of my meds, and my BP is normal, I do not need his approval to dive. Then there would be no "yes" on my paper at all. I feel that although he knows my medical history he has no idea of my cardiac state. He says that I can free dive all that I wish. I am allowed to play contact sports. But he will not allow me to dive. I guess I am also upset since I have already put out a good deal of money (buying the personal gear, books, and videos) For both my girlfriend and myself. I feel bad because my girlfriend will not take the course unless I will. So now we have all this gear that the LDS will not take back since we have used it on our discovery scuba. I do not know, I am upset and disappointed. I will probably ask my doctor to reconsider before I cancel the courses we are scheduled for and loose the deposit. I apologize for ranting and thank you for your concern and input.
Sincerely,
Ben

 

[zeN||]

120/80 is within normal limits, btw zeN

 

[hambleto]

I know 120/80 is normal. But that is being controlled by drugs as of right now. Since last september I have been taken off of one of the drugs and another has been cut in half. The only reason I had to go to the docs was because I am on the medications to control my Blood Pressure.
Thank you,
Ben

 

[Big-t-2538]

I am going to second what DD said here...

I commend you for having lost as much weight as you have, that's excellent. Diving is not necessarily stress free, your doctor obvioulsy knows that, and has some reservation about clearing you to dive because of it. If something were to happen while you dove, the consequences can be fatal, he doesn't want that, and neither do you.

I know zilch about the meds your on, but some of them might have some affect on the way your body loads and off-gasses Nitrogen, which would be a concern. Hopefully one of the medical docs on the board will read this thread, and you can get some more input.

As for the gear you purchased, I hope the LDS only sold you mask, fins, snorkels, and booties. Maybe a light weight wet-suit, I would consider much more irresponsible on the LDS's end. Concerning your deposit, if the shot doesn't honor your deposit for a future class (say one when you're cleared to dive) than I'd be pretty pissed. Did they tell you up-front before you gave them any $$$ that you had to be medically cleared to dive? If not, there's no (good or logical) reason you shouldn't be able to get your $$$ back.

 

[DocVikingo]

I'm sure that this is most frustrating & disappointing to you, and understandably so.

I concur with the others that your 100 lb weight loss is quite commendable. However, just knowing that you are now 280 is of little value in the absence of knowing your height, build & level of physical conditioning.

Also, as I indicated in several replies to your earlier post, you have a somewhat complicated medical history. There are not only the weight & BP issues, but also orthopedic, respiratory & gastrointestinal ones. These may have played a role in your doctor's decision.

The fact that your BP is 120/80 is good news, but as you have admitted this is only with medication. And, these medications have implications for safe scuba. For example:

*Diovan's diuretic action can result in fluid & electrolyte imbalances. While this may not be a problem topside, scuba exposes the diver to multiple sources of dehydration, thereby making fluid & electrolyte imbalance a possibility worth pondering. Additionally, it can cause headache & dizziness that could be dangerous underwater & be confused with DCS.

*Inderal is beta blockading drug and can limit the heart's capacity to respond to exertion. While normal, tropical, recreational diving typically doesn't make great requirements on the heart, it can. Fighting a wicked downcurrent or performing a buddy rescue can demand very substantial cardiac output, and could result in fainting. And, the medication can cause dizziness or lightheadedness even the absence of strenuous exertion.

As you see, the matter is not all that simple.

You are of course free to pursue the matter, but I wouldn’t just doctor shop until you obtain the answer you desire. In an earlier response to you, I indicated that you or you physician may submit questions to DAN http://www.diversalertnetwork.org/medical/. This remains a possibility. Also, DAN may be able to make a referral to a diving medicine doctor in your area.

Alternatively, your physician may be aware of an appropriate referral.

Best regards.

DocVikingo

 

[hambleto]

Thank you for getting back to me. I know that my doctor is looking out for my best interest. I also know that I know have one more reason to work even harder at loosing weight. I will not shop around and find a doctor that will approve me to dive. However, I contacted DAN to see if there are any diving medicine doctors in the Philadelphia Pa region.
I also have proposed to my doctor to allow me to take the class and the confined water portion of my PADI course. That way I will not loose the money I have paid already and at the same time I will not be going into deep water on compressed air. (Which is one of my doctors concerns) I hope that he will be willing to allow me to do this portion. Once I have completed the classroom/confined water portion I will have a year to complete my open watercourse. I have several trips planned for the spring and two of the locations I am going will have PADI open watercourses available. I am confident I will be able to get to the point I can take the open water portion with my Doctors consent. In your opinions do you think taking the confined water portion of the class would be a serious risk to me? I thank you for your time and the information
Thank you,
Ben Hambleton

 

[DocVikingo]

My pleasure. I can apppreciate your anxiety & concern over the situation.

Given the limitations inherent in responding to direct fitness to dive questions on a message board, I think the best plan of action is to ask your physician to assess the risks to you of taking only the confined water portion of the class.

Best of luck & please do let us know the outcome of your next appointment.

Best regards.

DocVikingo