physician clearance

[TSandM]

It is interesting to read the positions on anticoagulation. I'm not sure I'd be as conservative as my colleagues. Anyone on anticoagulation is at increased risk for bleeding with any trauma, and that includes accidents from running, bicycling, or riding horses. I think patients need to be coached on what the risks ARE (and people who are poorly controlled may need to scale back further than those whose doses are stable). But I'd have a hard time telling all my anticoagulated patients that they had to turn into couch potatoes because they might hit their heads doing something . . .

 

[Carl_F]

As someone who's been on warfarin for six years now, I don't feel that I'm at any different incrementally increased risk from diving than I am with any other activity such as running, hiking, yard work, etc. I keep my INR fairly well controlled (found some anti-biotic meds that don't interact well.) I feel my decreased risk of adverse blood clots after flying due to taking warfarin offsets any increased risk of being on warfarin while diving. Inherently, I don't see any increase in risk in the diving activity while on blood thinners. It does increase risk of adverse consequences from adverse dive events. So I need to be extra mindful and careful to avoid the adverse dive events ... this mitigates the increased risk. (I'm not in the same situation as OP, though, since I don't have any cardiac condition.)

 

[hobie16]

Thank you all, great feedback. to answer some of your comments:
No I did not hold back any information, the instructor is a friend who knows me for 15 years. I wasn't going to do my open water untill I had clearence.
As for comparing diving to snorkelinmg of sailing, you are off a bit. It is far more strenusous to snorkel on the surface and free diving to a 10 foot deep reef than to gradually decend to the reef and breathe. As for the sailing, if you have ever flipped a hobie 16 in 3-5 foot surf and had to right the boat you would know that it far more strenuous than diving or swimming. I have been a very strong swimmer my whole life.
The other item to clear up is the arrythmia I suffer from is atrial flutter. I have had an oblation to correct this issue about a month ago so I am probably not going to even attempt to proceed until next spring or summer because I would robably wait a couple of months to be sure the oblation took. The meds I take is Tykosin. I will be seeing Dr. Darryl Miller of Cleveland Clinic next Thursday to be thoroughly examined and have him review my records.
My goal is not to progress to a tech diver or even venture past 50 feet. I live in the greatest place on earth for water sports and that is ft. lauderdale. Ther are hundreds of places to dive that don't require more than a 30 foot dive. That is all I want.

---------- Post Merged at 06:56 PM ---------- Previous Post was at 06:54 PM ----------

I agree there, I keep my INR checked regularly and it stays around 2.5 to 2.8. It just requires that we are more aware of our surroundings and activities, Therefore making us far more careful in what we do.

---------- Post Merged at 07:01 PM ---------- Previous Post was at 06:54 PM ----------

This is probably an odd comparison but, they are saying that it is dangerous for me to dive because all these things MIGHT happen to me, as TSansM said, They can happen anywhere. I am being advised that diving is dangerous, what about me driving a 2000lb piece of steel through the streets and have an episode, now how many peopole are at risk?
And by the way, in 19n years with the valve I have only had the A-flutter occur three times and it is just uncomfortable. I have never been in a situation where it has been a problem.

 

[flots am]

My goal is not to progress to a tech diver or even venture past 50 feet. I live in the greatest place on earth for water sports and that is ft. lauderdale. Ther are hundreds of places to dive that don't require more than a 30 foot dive. That is all I want.

People can recommend that you not dive, but nobody can actually stop you.

At the end of the day, it's your call as to whether or not you accept the risks involved with SCUBA.

flots.

 

[TSandM]

Well, it does effectively stop someone from getting officially certified, if a doctor won't clear them. I think everybody wants a medical clearance to get into a course.

OP, if your ablation is effective, they may take you off the arrhythmia meds altogether, which would remove some of the concern. I think you would want a good period of being in sinus rhythm before you would be cleared, but if you have only had 3 episodes of AFlutter in your life, it may be very hard to figure out if the ablation has been effective for quite some time!

 

[Hawkwood]

Thank you all, great feedback. to answer some of your comments:
No I did not hold back any information, the instructor is a friend who knows me for 15 years. I wasn't going to do my open water untill I had clearence. ....

Maybe this is what confused us:

I am having trouble with my doctor giving me clearence to complete my certif. I have completed my 30 ft. dive and all my pool skills with flying colors.

 

[boulderjohn]

Here is the DAN page on cardiac conditions and diving:Scuba Dive Medical Articles

Here is one part of it:

An individual with any cardiac dysrhythmia needs a complete medical evaluation by a cardiologist prior to engaging in scuba diving. In some cases, thorough conduction (electrophysiologic) studies can identify an abnormal conduction pathway and the problem can be corrected. Recently, doctors and researchers have determined that people with some dysrhythmias (e.g., certain types of Wolff-Parkinson-White Syndrome) may safely participate in diving after a thorough evaluation by a cardiologist. Also, in select cases, some people with stable atrial dysrhythmias (e.g., uncomplicated atrial fibrillation) may dive safely if a cardiologist determines that there are no other significant health problems.​

Here is a link to the DAN position on blood thinners: Scuba Diving Medical FAQ Articles

Here is what it says:

A diver who has been prescribed an anticoagulant, e.g., Coumadin® or Warfarin®, should be warned of the potential for bleeding: excessive bleeding can occur from even a seemingly benign ear or sinus barotrauma. There is a potential risk that, if decompression illness occurs, it may then cause significant bleeding in the brain or spinal cord. The diver must be able to equalize without difficulty. Also dive physicians would recommend conservative dive profiles to help further reduce the risk of DCI.​

 

[flots am]

Well, it does effectively stop someone from getting officially certified, if a doctor won't clear them. I think everybody wants a medical clearance to get into a course.

As far as I know, all agencies want a medical form, however if the OP really wants to dive and can't get a card, and is willing to accept the risks, it's certainly possible to do so without being certified.

flots.

 

[hobie16]

Thanks for all the great feedback and thanksto 00Wabbitt for the referal to DAN. It helped a lot and will help me with my meeting with the cardiologist that is a scuba diver himself. Over the years I have become very educated on my condition and believe I kknow what my limits are.