Thank God we insist on a medical

Prior to BSAC ditching dive medicals in fovour of self assessment our branch experienced new members who had medical problems picked up on dive medicals which meant they couldn't dive. As a consequence when BSAC went over to self assessment our branch voted to keep the medical for new divers. Thank god we did because we have had 2 people fail the medical since, both for high blood pressure. The second one, last week, was so bad his doctor sent him straight to hospital. He was told if this hadn't been picked up he would have been dead within 5 years, (probably on one of our dives!) He is only in his mid 30's.
Not only am I thankful for those 2 people who will now live longer as a consequence but also for all my members who will not have the probability of dealing with a life threatening incident whilst diving.
Food for thought for all those branches that don't insist on a medical and for BSAC to have a re-think

Derek Perry
D.O. Kensington Cosmos S.A.C.

Prior to BSAC ditching dive medicals in fovour of self assessment our branch experienced new members who had medical problems picked up on dive medicals which meant they couldn't dive. As a consequence when BSAC went over to self assessment our branch voted to keep the medical for new divers. Thank god we did because we have had 2 people fail the medical since, both for high blood pressure. The second one, last week, was so bad his doctor sent him straight to hospital. He was told if this hadn't been picked up he would have been dead within 5 years, (probably on one of our dives!) He is only in his mid 30's.
Not only am I thankful for those 2 people who will now live longer as a consequence but also for all my members who will not have the probability of dealing with a life threatening incident whilst diving.
Food for thought for all those branches that don't insist on a medical and for BSAC to have a re-think

Derek Perry
D.O. Kensington Cosmos S.A.C.

Question 1:

Have you suffered at any time from diseases of the heart and
circulation including high blood pressure, angina, chest pains and palpitations?

Now if their blood pressure was so bad they needed to be sent straight to hospital, can they honestly put their hand on their heart and say they have had no warning symptoms?

:=Prior to BSAC ditching dive medicals in fovour of self assessment our branch experienced new members who had medical problems picked up on dive medicals which meant they couldn't dive. As a consequence when BSAC went over to self assessment our branch voted to keep the medical for new divers. Thank god we did because we have had 2 people fail the medical since, both for high blood pressure. The second one, last week, was so bad his doctor sent him straight to hospital. He was told if this hadn't been picked up he would have been dead within 5 years, (probably on one of our dives!) He is only in his mid 30's.
:=Not only am I thankful for those 2 people who will now live longer as a consequence but also for all my members who will not have the probability of dealing with a life threatening incident whilst diving.
:=Food for thought for all those branches that don't insist on a medical and for BSAC to have a re-think
:=
:=Derek Perry
:=D.O. Kensington Cosmos S.A.C.

Question 1:

Have you suffered at any time from diseases of the heart and
circulation including high blood pressure, angina, chest pains and palpitations?

Now if their blood pressure was so bad they needed to be sent straight to hospital, can they honestly put their hand on their heart and say they have had no warning symptoms?

I know someone who had a heart attack, and was told after an ECG at the hospital that it was probably his third attack.
He had never noticed any symptoms of the first two attacks.

I've also had high blood pressure but I had no inkling of it until a recent medical exam.




.

:=Food for thought for all those branches that don't insist on a medical and for BSAC to have a re-think

No. I don't think so. these two may well have made fantastic divers. They may have enjoyed it, and may have been assets to your branch. Granted, they have high blood pressure, but then a very, very large portion of the population do.

The big problem with the medical system is that it does not have a box which says "THe doctors says I would be at HIGHER RISK of an adverse incident whilst diving, but I wish to ignore that advice and dive anyway."

In my opinion, it is not for a parenteral medical system to decide who may and who may not dive. It is for the system to advise them such that they may make a decision. It would then for the insurance companies to risk assess them, and if they were 'un-insurable' then it is up to the individual whether they wish to take on the personal liability.

I would rather that, than have people telling porkies on their forms, and there are a large number of folk out there who are telling porkies on their forms, I am certain!

IMO, your branch is wrong to 'insist' on a full medical. however, they would be well within reason to 'recommend' it.

Get a grip. Yes, they 'might' have dropped down dead on a dive trip. someone did on a trip I was running last year. he could, however, have died doing something he really enjoyed, after a fab dive, or he could die walking down the high street, or in the car on the way to work.......... The Procurator Fiscal's enquiry is a lot of stress, though.

Derek,
There are many ways at looking at the situation, in my opinion the fact that your club picked up 2 persons with medical problems is a very strong argument for the full dive medicals. I am for example am not medical trained to a level which would allow me to judge any of the questions answer with any real certainty.
I have had to assist on live threatening resuces and again agree with you that doing any and everything to NOT expose club members to such an event, especially if one is unsucessful, is the way to go.

On the other hand it may be an idea to conduct realistic risk assessments and come up with specific dive restrictions for the different medical conditions.

If we go back about 10 years we will remember that many more medical conditions resulted in a outright disqualification.

Medical sience has progressed since then and we know today that it is acceptable to dive dispite certain medical conditions as long as we follow the special guidelines developed for such cases.

Having made now an agrument for both sides I think that a yearly medical is a good thing for anyone, even non divers. My brothers Lukemia was pick up during such a yearly medical.

Like always prevention is better than finding a solution but do we need to be so rigid when looking to prevent any and everything?

Well that are just me thoughts.

Khaled

He queried with the doctor that he didn't feel unwell, or have any symptoms. The doctor has told him that he wouldn't have any particular symptoms and that he may not have had any at all until the day he dropped dead.
Secondly
Another reason we kept medicals was for exactly what you are suggesting. That someone lies on the form. A very good reason for keeping the medical!!!!!!!!!!
It might cover you legally but you might still be put in the situation of rescuing that person at a later date.


Derek

:=Prior to BSAC ditching dive medicals in fovour of self assessment our branch experienced new members who had medical problems picked up on dive medicals which meant they couldn't dive. As a consequence when BSAC went over to self assessment our branch voted to keep the medical for new divers. Thank god we did because we have had 2 people fail the medical since, both for high blood pressure. The second one, last week, was so bad his doctor sent him straight to hospital. He was told if this hadn't been picked up he would have been dead within 5 years, (probably on one of our dives!) He is only in his mid 30's.
:=Not only am I thankful for those 2 people who will now live longer as a consequence but also for all my members who will not have the probability of dealing with a life threatening incident whilst diving.
:=Food for thought for all those branches that don't insist on a medical and for BSAC to have a re-think
:=
:=Derek Perry
:=D.O. Kensington Cosmos S.A.C.

Question 1:

Have you suffered at any time from diseases of the heart and
circulation including high blood pressure, angina, chest pains and palpitations?

Now if their blood pressure was so bad they needed to be sent straight to hospital, can they honestly put their hand on their heart and say they have had no warning symptoms?

It seems to me that your argument is based on the fact the 2 people are no longer diving and that we have lost assets to the club, rather than probably saved their lives.
My argument is that
1/ we have 2 very grateful people (Their words) that due to our policy will live longer and happier lives, all be it maybe without diving. As for being assets to the club, what does that matter when you are talking about someone?s life?

2/ my members have not been put in the possible position of having to rescue these people.

3/ you seem to under the impression that we won't now let them dive. Not true.
We do not ban these people from diving. It is their choice. The first chose not to continue diving and the second is hoping to return to diving once his condition is under control and diving referee permits.

I feel it is you that needs to 'Get a grip' as you seem more concerned with peoples enjoyment and the fact we have stopped them enjoying diving than actually taking a realistic look at life and it's risks. Life is actually more important than diving (though my wife would argue I don't really think that way)

2 very grateful people is all the argument I need to convince us we are right.


Derek

:=:=Food for thought for all those branches that don't insist on a medical and for BSAC to have a re-think

No. I don't think so. these two may well have made fantastic divers. They may have enjoyed it, and may have been assets to your branch. Granted, they have high blood pressure, but then a very, very large portion of the population do.

The big problem with the medical system is that it does not have a box which says "THe doctors says I would be at HIGHER RISK of an adverse incident whilst diving, but I wish to ignore that advice and dive anyway."

In my opinion, it is not for a parenteral medical system to decide who may and who may not dive. It is for the system to advise them such that they may make a decision. It would then for the insurance companies to risk assess them, and if they were 'un-insurable' then it is up to the individual whether they wish to take on the personal liability.

I would rather that, than have people telling porkies on their forms, and there are a large number of folk out there who are telling porkies on their forms, I am certain!

IMO, your branch is wrong to 'insist' on a full medical. however, they would be well within reason to 'recommend' it.

Get a grip. Yes, they 'might' have dropped down dead on a dive trip. someone did on a trip I was running last year. he could, however, have died doing something he really enjoyed, after a fab dive, or he could die walking down the high street, or in the car on the way to work.......... The Procurator Fiscal's enquiry is a lot of stress, though.

He queried with the doctor that he didn't feel unwell, or have any symptoms. The doctor has told him that he wouldn't have any particular symptoms and that he may not have had any at all until the day he dropped dead.

I trust that the GP has now been changed!

If you go to a Doctor complaining of "unwell" then the *Standard* tests should have been carried out ...including a Blood Pressure Test.

There is no way that this symptom can be misinterpreted. You either have high blood pressure or you dont. The fault here probably lies with not doing the test in the first place!
(and if it does not then I apologise to the GP - but point out that if there was no problem during routine health checks there was no reason to expect it to be picked up in a Sports Medical either - the fact that it was is merely coincidence).

Things like High Blood Pressure should be screened for during "Well Person Clinics" which every UK citizen is invited to attend periodically (more often if at risk for any reason).

With the current emphasis on the way that Heart Desease is crippling the nation things like BP are high on the list of things GPs are being asked to check. They do not even need to do it themselves...they have competent practice nurses to do it for them!

The move to self-cert assumed that:

1) Competent GPs would pick the things being asked about on the form

2) Sensible people attend GP clinics for an "annual service" when invited to do so (rather than simply waiting for something to go wrong - as a diver who presumably gets your DV services regularly I KNOW that you understand that being alive to go diving is just as important as having kit that works!)

Perhaps there should be a box on the form that says "Have you had all regular health checks that your GP has requested in the last 5 years?"

With a requirement to go get up-to-date before the self-cert can be signed.

About the lying...that is a training/education issue for you and your branch to tackle (not a responsibility that you should dodge)

What was PROVED before we moved to self-cert was that GPs with little or no knowledge and training in Diving Medicine used to get medicals wrong. The self cert system allows them to revert to their areas of expertise by screening for the simple things that show warnings. And then they refer to a specialist - just as they would refer to a diabetes/heart/kidney/orthopaedic/etc specialist if they found something that told them to do that.

By "insisting" on a full medical - you are forcing people proved to be ignorant of the specialist issues to make a judgement in an area they are not usually qualified or competent to do so in (and this is not fair on the GP - or the patient). You would not expect your GP to manage renal failure for you would you? There are far more people out there who have been referred to the care of Renal specialists than there are, or ever will be, divers (healthy or not). Why expect your GP to have expertise in an area of medicine that he has less experience of than others he refers?

I trust that you are medically qualified enough to gainsay the entire UK Sports Diving Medical Committee before making such proclamations within your branch?

John

He was told if this hadn't been picked up he would have been dead within 5 years, (probably on one of our dives!) He is only in his mid 30's.

You're kidding yourself trying to justify a position that is wrong by appealing to non-evidence. You are using emotive words and going against the medical advice. This is politician speak. From the title onwards you are using verbal tricks.

Why should he die on your dive? High blood pressure doesn't kill people suddenly blocked cardiac arteries do. When did you last have an angiogram? I went diving the weekend before my heart attack and it was a good dive. Even climbing the ladder with 40Kilos of twinset.

Now I have medicals every year, there are lots of boxes on the form I can't tick now. You're the kind of person that would say "Heart attack? It's obvious you can't dive." Well surprise: It isn't.

nigelH

I think it would be somewhat interesting to get a survey done of all the branches to find out what policies they are implementing. Frankly, some of them seem to be laws unto themselves. At the very least, it become obvious that branches need better education about the new medical system, it's validity and use.

:=He was told if this hadn't been picked up he would have been dead within 5 years, (probably on one of our dives!) He is only in his mid 30's.

You're kidding yourself trying to justify a position that is wrong by appealing to non-evidence. You are using emotive words and going against the medical advice. This is politician speak. From the title onwards you are using verbal tricks.

Why should he die on your dive? High blood pressure doesn't kill people suddenly blocked cardiac arteries do. When did you last have an angiogram? I went diving the weekend before my heart attack and it was a good dive. Even climbing the ladder with 40Kilos of twinset.

Now I have medicals every year, there are lots of boxes on the form I can't tick now. You're the kind of person that would say "Heart attack? It's obvious you can't dive." Well surprise: It isn't.

nigelH