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This month I’ll think a bit about the general philosophy of diving fitness. Many of us started diving as teenagers or in our early twenties when fitness was a matter of whether you were carrying a sports injury and might not be available for Saturday’s game! Not whether you got breathless on one flight of stairs, were trying to give up the smokes and were 20 kilos overweight! Passing a medical was a formality when young, but in your 40’s and beyond that is not often the case. As we get older it is an obvious fact of life that chronic illness and general lack of fitness occur despite our best efforts. This usually creeps up on us unless a sudden illness occurs, and if we are regular divers we may not notice this insidious deterioration as we usually dive within our personal limits.
Problems arise however when we misjudge a situation and a bit of extra exertion is required (the classic example of having to swim up-current back to the boat). That’s when the breathlessness, the obesity, the underlying heart disease and all those other nasties come into play to turn an unpleasant situation into a disaster. Not to mention the predisposition some of these health issues give us to other diving health problems like decompression illness.
So what is the answer? Stay fit and dive within your limits is the obvious solution but human nature being what it is this simply doesn’t happen for most. A reasonable idea however is to consider a further dive medical or even regular dive medicals as we pass a certain age (?40), or any time we have a significant change in our health status. It is important to know that since most of you had your initial medical there has been a drastic change in the philosophy of dealing with recreational divers regarding their health. The South Pacific Underwater Medical Society (SPUMS) along with Australian Standards now determine the format of diving medicals (AS4005.1 Recreational, AS2299.1 Occupational). The new approach emphasises an open discussion and weighing of risks between the physician and the diver, in other words working out how to minimise a diver’s risks given his/her known medical problems. This is different to the old stance of blanket refusal to pass as fit anyone who suffers any one of a host of conditions. All this encouraged was a group of divers who lied about their disorders and continued to dive, but without the knowledge of how to dive safely with their condition!
This new approach will not give willy-nilly approval for everyone to dive, but by taking the time to explain to divers why their medical condition constitutes a risk, many people will make their own decision to call it a day and hang up their fins. For those who insist on continuing with diving, they will be armed with the knowledge of how to minimise their risks. Naturally some divers or potential divers will still be counselled in the strongest terms not to proceed eg the active epileptic. At the end of the day a doctor doesn’t make the final decision, it is up to the individual. Of course a doctor can refuse to supply the certificate that an employer or dive shop might request!
A list of doctors (who at a minimum must do a 2 week course in diving medicine) qualified to perform dive medicals is available on the SPUMS website (www.spums.org.au). Unfortunately dive medicals are not refundable under Medicare, so you might expect to pay between $70.00-150.00 for your consultation depending on the complexity of the problems the doctor encounters. Allow up to an hour for a thorough history, examination and some basic tests.
So, next time you reach the top of the stairs and you’re puffing and panting, wondering where your next breath will come from, think about how you will manage towing your buddy back to the boat against that 2 knot current sweeping past the Hobart when you’ve drifted away from the mooring line. Maybe two dive medicals in 40 years is not a bad idea!! |
