Question Prior Injuries and Diving (Wounds, Stroke, DCS)

[Trace Malinowski]

Why is it that you can be cleared to dive if you have received permanent injuries to the neurological system such as to the brain, brainstem or cranial nerves from explosions, concussions, foreign bodies (i.e., shrapnel), and strokes, but a person is medically disqualified from diving if the damage resulted from decompression sickness? Wouldn't any damage, scarring, etc., be similar regardless of cause and cause a reduction of off-gassing efficiency in affected tissues in a similar fashion?

We have "wounded warriors" and stroke survivors learning to dive or returning to diving, but why isn't someone with permanent injuries from DCS allowed to dive as long as they can physically meet the demands of the sport? For example, if you have lost the use of an eye, lost hearing in one ear, or you are left with a slight limp, but can pass a rigorous fitness test such as being able to compete as a professional triathlete or be a professional ocean lifeguard, then why can't you return to diving?

 

[happy-diver]

The reason is that those pretending to act in your best interests are really only
acting in theirs and from that comes irrationality with them appearing unstable

Great to hear your voice Trace

 

[Subcooled]

why can't you return to diving?

why can't you be a return customer?

1. Decompression illness could recur. Perhaps you are more susceptible to it from the beginning or perhaps there is residual damage that increases the risk of recurring DCI. One example case: Recurrent DCS
2. I have understood that there is a serious risk of your next DCI being worse than the previous one. I tried to find publications on this, but a quick search returned no hits.
3. Insurance companies might not want to cover the cost of your next treatment which would probably be more complicated and more expensive.
4. An instructor who has duty of care and/or lives in a litigative society does not want to take you diving. If something would happen, the istructor would be in trouble. Same applies to doctors, of course.

Disclaimer: I am not a medical professional of any kind. Hence, my comments may not be completely accurate. This is a best effort only, and by a layman.

 

[rhwestfall]

Trace!

 

[Marie13]

Trace - good to see you!

 

[rjack321]

Welcome back Trace!

I have prior injuries (spinal surgery x3), DCS x a couple, and 10+ years ago I would have been told "no diving" per the standard brainless PADI forms at the time. I never asked. I've done 600+ uneventful dives since then and medical clearance is no big deal. Times change, if you want a physician to assume the burden of liability and responsibility for you *now* then you're going to have a tough row. If you want to swim around conservatively in shallow water on EANx and well within NDLs, then return in a year to your PCP, you are more likely to have a persuasive argument that you are fit to dive.

 

[Trace Malinowski]

Welcome back Trace!

I have prior injuries (spinal surgery x3), DCS x a couple, and 10+ years ago I would have been told "no diving" per the standard brainless PADI forms at the time. I never asked. I've done 600+ uneventful dives since then and medical clearance is no big deal. Times change, if you want a physician to assume the burden of liability and responsibility for you *now* then you're going to have a tough row. If you want to swim around conservatively in shallow water on EANx and well within NDLs, then return in a year to your PCP, you are more likely to have a persuasive argument that you are fit to dive.

Thanks! That is really good advice. {{{{BIG HUG}}}}

I know a famous diver returned to diving after losing half his hearing ability in an ear from DCS.

 

[Trace Malinowski]

The reason is that those pretending to act in your best interests are really only
acting in theirs and from that comes irrationality with them appearing unstable

Great to hear your voice Trace

Thanks! See. Answers like that are encouraging. I remember Jim Bowden the deep cave world-record diver saying, "Never say 'No' to yourself because there will always be many others willing to say 'No' for you."

 

[rhwestfall]

Interesting question. My tech instructor was bent on the Doria, and that was long before I took my instruction from him...

 

[boulderjohn]

Who is ruling out the diving, Trace?

The standard medical forms apply mostly (with exceptions) to students, not regular everyday divers. What is stopping someone from going to a dive boat post DCS, showing a certification card, and going diving? I am about to go on an extended dive trip, and there is no way the dive operators would know I had DCS two years ago.

If a standard medical form is required for some reason, that form lists POSSIBLE reasons why you might not be able to dive, but it is ultimately the decision of a doctor. If you write YES on any of the POSSIBLE contradictions on the form, you can have a doctor signing off that you are fit to dive anyway.

If it is an insurance company that won't insure the diver under those circumstances, I assume there are other insurance companies.

If it is the diver's personal physician saying no, then I would ask that physician for the reasons. They might well be good ones.