High blood pressure meds

[mmerriman]

unfortunately that's not the question - the question is "are you presently taking prescription medications" Its not a gray area questions. Additionally it asks Have you ever had, or do you currently have... High blood pressure or take medicine to control blood pressure?

again - no gray area.

---------- Post added February 19th, 2015 at 02:54 PM ----------

I've dove with Prodive and they don't ask for medicals to dive that I recall - yes for classes

 

[redacted]

I've dove with Prodive and they don't ask for medicals to dive that I recall - yes for classes

I dove with Pro Dive last summer at the Occidental Grand and they required a medical form for diving, no classes involved. I remember clearly because they were out of the English version so I had to fill out a Spanish version of the questionaire.

 

[freewillie]

Can anyone speak to the complications or considerations that being on medication can have with dive ops, insurance, waivers, etc. My doc has now put me on blood pressure meds. He says it won't impact my diving...at least physically. When signing the dive shop waivers I've never had to check the yes box before. Is the dive op going to want something in writing? What else should I consider?

If you are asking about complications and considerations for diving with hypertension medications in a general public forum soliciting advice from non medical personal I assume you want advice about whether or not a diver has had a problem with a dive boat by checking yes or no and the consequences thereafter.

If you are asking about how diving medicines impact your diving then this is not really the forum to be posting. But, since I am a board certified internist and an actual MD I will try and educate.

For starters the medical advice is to be truthful on the medical form. I understand why a diver may not want to disclose any health information. I understand that health privacy is between the patient and the doctor. But, when a sport like diving has physical limitations and there are real medical implications for not disclosing appropriate medical information then I recommend that you be truthful on the form. When you are travelling I would also recommend getting a doctor's letter of clearance to take with you just in case you need it when filling out the forms.

I have nothing against pharmacists. I am actually married to one! But pharmacists have a certain knowledge about drugs but have very little practical experience on when to use them and what type of side effects you expect from a medication. They are more likely to know about a side effect based on the published information but not practical experience as to what the patient complains of and if it is actually related to the medicine.

As for diving and hypertension medications it will depend on the class of medications and how well the blood pressure control has been. General rule of thumb is that if the blood pressure has been well controlled and there have been no recent changes to your medicines you should be able to dive without any restrictions. The only caveat is if the medication itself has any side effects or if they will affect your mental status in any way. Fortunately almost all hypertension medications have little if any affect on mentation. I would not expect any real side effects causing lethargy and sedation. However, beta blockers will slow your heart rate down and may have an effect under water by not allowing your heart to speed up under physical activity and a diver may then feel tired and sluggish. That would affect your diving. Also, just about every hypertensive medication has feeling light headed and dizzy as a possible side effect. So if you have that as a side effect it would be like experiencing motion sickness/sea sickness while diving. If very mild to not noticeable then you should be okay. If severe then it will impact your diving.

If there are questions regarding the safety of the medicine and side effects then consult your personal physician or call DAN.

 

[tursiops]

I understand why a diver may not want to disclose any health information. I understand that health privacy is between the patient and the doctor. But, when a sport like diving has physical limitations and there are real medical implications for not disclosing appropriate medical information then I recommend that you be truthful on the form. When you are travelling I would also recommend getting a doctor's letter of clearance to take with you just in case you need it when filling out the forms.

PADI says the purpose of the medical questionaire is so the person receiving it knows whether or not to ask you for a doctor's signature on page 2. So if you want privacy about your medical conditions, just get the doctor's signature and don't fill out the medical form; all the Yes's and No's are not then needed. Just be sure it is all dated.....12 months is the oldest the signature can be, but more recent is even better.

 

[Lorenzoid]

Lying on a medical form is not a "personal" choice. It's a choice in which you have involved your buddy, your instructor, your DM, the boat crew, other divers, the shop owner, the boat/resort owner, etc. All without their knowledge or permission. At the risk of being melodramatic, I've even seen such "personal" choices end up involving Coast Guard boats, helicopters, hospitals, coroners, grieving spouses, and fatherless children.

That's a great point, Ray--that a diver's decision not to disclose something could impact not only the diver but other, uh, stakeholders. But to play Devil's Advocate, why do we want to chastise the diver for a decision not to disclose medical information more than we would chastise him for deciding not to disclose other information that could similarly impact other stakeholders? Shouldn't the diver disclose the fact that he's a lousy diver, lousy buddy, hates authority figures, thinks he'll freak if he sees a shark, just doesn't feel comfortable today, or whatever? Where are THOSE questions on the form? If I recall (and I may be mistaken here), I don't even think most release forms ask if the diver has consumed alcohol or smoked marijuana in the past X hours. So, are we giving more weight to a decision not to disclose common and well-controlled medical conditions than decisions not disclose other information that could potentially impact one's buddy, DM, other divers, loved ones, etc.? There's plenty more that could impact safety more than the fact the diver takes common blood pressure medication that keeps the diver's BP well controlled. So why answer "Yes" to that one but not disclose other things? Just because the dive op's form didn't ask about those other things? The dive op's form only asks what is standard to ask, because their insurance company wants them to ask those things. Medical questions are asked because maybe that seems obvious to an insurance company. But we as divers know there are a host of other risk factors. I guess in an ideal world, divers would weigh all these things in their minds and disclose all of their potential risk factors or vulnerabilities, regardless of whether medical or other.

 

[RJP]

Nobody is more interested in me surviving a dive, than me.

You better hope you not only survive any accident, but also remain conscious and coherent.

Ever put an unconscious diver into an ambulance? When the EMT's ask "any allergies or medications" the only information I can provide is what the diver has put on their medical form. If it's erroneous... so will be the hospital's information about you. Any HCP will tell you they'd rather have no information than WRONG information.

---------- Post added February 19th, 2015 at 07:45 PM ----------

That's a great point, Ray--that a diver's decision not to disclose something could impact not only the diver but other, uh, stakeholders. But to play Devil's Advocate, why do we want to chastise the diver for a decision not to disclose medical information more than we would chastise him for deciding not to disclose other information that could similarly impact other stakeholders? Shouldn't the diver disclose the fact that he's a lousy diver, lousy buddy, hates authority figures, thinks he'll freak if he sees a shark, just doesn't feel comfortable today, or whatever? Where are THOSE questions on the form? If I recall (and I may be mistaken here), I don't even think most release forms ask if the diver has consumed alcohol or smoked marijuana in the past X hours. So, are we giving more weight to a decision not to disclose common and well-controlled medical conditions than decisions not disclose other information that could potentially impact one's buddy, DM, other divers, loved ones, etc.? There's plenty more that could impact safety more than the fact the diver takes common blood pressure medication that keeps the diver's BP well controlled. So why answer "Yes" to that one but not disclose other things? Just because the dive op's form didn't ask about those other things? The dive op's form only asks what is standard to ask, because their insurance company wants them to ask those things. Medical questions are asked because maybe that seems obvious to an insurance company. But we as divers know there are a host of other risk factors. I guess in an ideal world, divers would weigh all these things in their minds and disclose all of their potential risk factors or vulnerabilities, regardless of whether medical or other.

All of those other things are fair game for discussion/questioning by buddies, instructors, dive ops, etc... but since they are not medical, they don't really belong on the medical form.

BTW - I really wish people would stop saying things like "the diver's decision to not disclose medical information" or similar. If people want to do that... at least own it for what it is "A diver's decision to lie on the medical form."

If someone decides that they want to "not disclose" any information they should d say "I decline to answer." Saying "NO" when the answer is "YES" is not a decision to not disclose. It's a decision to provide false information with the deliberate intent to deceive. (Which happens to be the dictionary definition of "lie")

 

[flots am]

You better hope you not only survive any accident, but also remain conscious and coherent.

Ever put an unconscious diver into an ambulance? When the EMT's ask "any allergies or medications" the only information I can provide is what the diver has put on their medical form. If it's erroneous... so will be the hospital's information about you. Any HCP will tell you they'd rather have no information than WRONG information.

If I check the "yes" box, nobody will have to put anybody in an ambulance because I wouldn't be diving. I've stood right there while dive ops told divers that "checking yes" means they don't dive.

If they want the information to give to medical personnel in case I have a problem, they can look in my BC pocket.

---------- Post added February 19th, 2015 at 08:14 PM ----------

BTW - I really wish people would stop saying things like "the diver's decision to not disclose medical information" or similar. If people want to do that... at least own it for what it is "A diver's decision to lie on the medical form."

I'll own that.

I see no reason to be truthful with someone who wants personal information they're not entitled to.

Know who else doesn't know I take BP meds? My employer, the guy who cleans my chimney, the restaurant I have lunch at frequently, the gym I use or the mountaineering club I belong to. None of them have asked or care. Nobody cares except dive operators.

I see no more of a problem lying to a dive op than I do lying to a panhandler who wants to know if I "have any spare change".

In fact, I see nothing but a huge HIPAA liability in even possessing completed copies of those forms and would not want to be the dive op if someone disclosed on the form that they have space-herpes or whatever, and it became public.

flots.

 

[freewillie]

If I check the "yes" box, nobody will have to put anybody in an ambulance because I wouldn't be diving. I've stood right there while dive ops told divers that "checking yes" means they don't dive.

If they want the information to give to medical personnel in case I have a problem, they can look in my BC pocket.

---------- Post added February 19th, 2015 at 08:14 PM ----------



I'll own that.

I see no reason to be truthful with someone who wants personal information they're not entitled to.

I see no more of a problem lying to a dive op than I do lying to a panhandler who wants to know if I "have any spare change".

In fact, I see nothing but a huge HIPAA liability in even possessing completed copies of those forms and would not want to be the dive op if someone disclosed on the form that they have space-herpes or whatever, and it became public.

flots.

Normally I would try and stay out of one of these discussions. It's a little like liberal v. conservative and buddy v. solo. There are strong opinions on both sides and neither is entirely right but neither is entirely wrong.

But we've recently seen an outbreak of measles in large part because a certain small segment of the population has taken the stance that despite medical evidence that vaccines are generally safe and effective that the parents won't vaccinate the kids for whatever personal reason they have. While I agree that each parent should be given the right to make their own decisions for their child I also hold the position that you also shouldn't be allowed to put an entire population at risk. You can't yell "fire" in a movie theater and then claim free speech when somebody gets hurt in the panic.

The bottom line is that there are medical risks for diving and a diver must meet medical standards to be allowed to dive. There are certain medical conditions that will put not only the diver at risk but everyone else in the group at risk. And that diver will inconvenience every on the dive boat when the emergency signal comes and all divers must get back on board so the boat can take the stricken diver to get medical attention. So a dive operator that wants to know that divers are medically fit to dive certainly has an obligation to ask. Now, what they do with that is a different matter. The dive operator should not be able decline a fit diver with hypertension that is medically managed and well controlled. From a medical perspective they are fit to dive.

I am also having a difficult time wrapping my head around the notion that having high blood pressure, having had a heart attack in the past, thyroid problems, etc. are such socially unacceptable conditions that you couldn't tell someone that you have high blood pressure and you are well controlled on medication. I just don't see the concern. It's not like you are disclosing that you have some mental illness where privacy issues would be valid.

 

[tursiops]

I am also having a difficult time wrapping my head around the notion that having high blood pressure, having had a heart attack in the past, thyroid problems, etc. are such socially unacceptable conditions that you couldn't tell someone that you have high blood pressure and you are well controlled on medication. I just don't see the concern. It's not like you are disclosing that you have some mental illness where privacy issues would be valid.

Wow, you really are missing the point. The point is not whether my condition X is socially acceptable or not, the point is that the DM on the diveboat (or wherever) does not need to know I have condition X, he only needs to know whether I am cleared to dive. So I can answer NO to all the questions, or I can give him a doctor's signature; my privacy trumps his curiosity...because he has what he needs, the doctor's signature. I can't believe you are a physician and aren't aware of medical privacy laws; that's scary. When the pharmacy calls my house to tell my wife her prescription is ready, they won't even tell me which prescription it is......and you want me blabbing to some boat guy I don't even know?

 

[RJP]

In fact, I see nothing but a huge HIPAA liability in even possessing completed copies of those forms and would not want to be the dive op if someone disclosed on the form that they have space-herpes or whatever, and it became public.

flots.

Then you need to get a better understanding of HIPAA, because it only applies to three specific covered entities:
- Health care providers
- Health plans
- Healthcare data clearing houses

HIPAA does not apply to information you disclose, and it certainly doesn't cover dive boats, dive shops, etc.

---------- Post added February 19th, 2015 at 10:53 PM ----------

If I check the "yes" box, nobody will have to put anybody in an ambulance because I wouldn't be diving. I've stood right there while dive ops told divers that "checking yes" means they don't dive.

Checking the "yes" box doesn't mean you can't dive. It simply means you need medical clearance to dive.

---------- Post added February 19th, 2015 at 11:02 PM ----------

I am also having a difficult time wrapping my head around the notion that having high blood pressure, having had a heart attack in the past, thyroid problems, etc. are such socially unacceptable conditions that you couldn't tell someone that you have high blood pressure and you are well controlled on medication. I just don't see the concern. It's not like you are disclosing that you have some mental illness where privacy issues would be valid.

Had a student a few years ago who had all "NO"s checked off on his form. When he was suiting up for OW dive one it became very apparent that he lied on at least two of the questions...

When I asked him about it he told me his medical history was none of my business. I agreed, but assured him that his lying on the medical form WAS.