Getting certified with a pacemaker

[gasdiver]

My 13 yr old daughter has a pacemaker. Her cardiologist has cleared her to dive up to the manufacturer's recommended limit of 50'. Our local dive shop had no problem with the class after getting the cardiologist's letter.

Now I'm in Bonaire with a referral letter and the hotel dive shop will not complete the check out dives. They insist that the cardiologist's letter is not good enough and that we need a letter from a hyperbaric physician. We are going to try and get an appointment with one of the local hyperbaric physicians, but I anticipate him saying that the cardiologist is more qualified to make this call.

Has anyone else run into this issue and if so, how did you resolve it?

 

[Cave Diver]

Have you tried contacting DAN about this? The contact information for them is at the top, right above your post. They might be able to offer some advice, as well as a good contact person there.

 

[wedivebc]

I don't know about your situation but I know a guy who is a very active diver and his pacemaker is rated to 100ft.
I wish you best with your daughter. I think it is wonderful that she is diving.

 

[Bubbletrubble]

If you're a DAN member, perhaps you could get a DAN representative to intercede.

There are several other dive shops that do scuba instruction on Bonaire. I'd call the other places until I find one that will agree to do your daughter's check-out dives.

In the future, with less common medical situations such as your daughter's, I'd recommend calling the scuba shop ahead of time to find out what kind of "clearance" they require. It's their prerogative to refuse to provide service/training to a customer if they think that it might place the customer or a dive shop employee (instructor) in a dangerous situation. That being said, it's unfortunate that they didn't find the cardiologist's letter acceptable.

 

[tc]

Part of the issue may be that a normal hyperbaric treatment for DCS goes to 60 ft. in the chamber and normal treatment for AGE is to 165 ft. If she were ever taken to a chamber unconscious and the chamber folks didn't find out about the pacemaker prior to the treatment the results could be fatal.

Always make sure there is someone with her that knows the depth rating of the pacemaker and make sure they have a copy of the documentation for it readily available in case she ever needs a treatment. Treatment could be delayed if the folks running the chamber can't verify the depth rating of the equipment.

 

[Kilili]

Hotel dive shop must not be very experienced. Lots of divers running around with pacemakers. Cardiologist is really final word along with mfg specs, and you have that. Perhaps tell them you will leave hotel, and go somewhere else, where your business is appreciated. If not a DAN member, she should really be one. Of course, Dan, along with most any doctor, will defer to your cardiologist on the subject.

I've been diving about 10 years with a pacemaker, about 1,000 dives, and don't even bother carrying the letter anymore. Never encountered a problem.

Manufacturer depth ratings for pacemakers vary quite a bit and some are quite conservative, like your daughter's. If she keeps diving try to get something more robust next time.

 

[oly5050user]

My 13 yr old daughter has a pacemaker. Her cardiologist has cleared her to dive up to the manufacturer's recommended limit of 50'. Our local dive shop had no problem with the class after getting the cardiologist's letter.

Now I'm in Bonaire with a referral letter and the hotel dive shop will not complete the check out dives. They insist that the cardiologist's letter is not good enough and that we need a letter from a hyperbaric physician. We are going to try and get an appointment with one of the local hyperbaric physicians, but I anticipate him saying that the cardiologist is more qualified to make this call.

Has anyone else run into this issue and if so, how did you resolve it?

I know that you do not want to hear this,but, from a liability and moral standpoint your LDS should never have started to teach her to dive if the cardiologist placed a limitation on her being fit to dive.Sounds like they took an easy opportunity to make some $ bat your expense.
Does not matter if pacemaker is rated to 500' if the Dr placed any statement on the medical form other than "I find this individual fit to dive" then we would have turned her down..Sorry..

 

[DocVikingo]

My 13 yr old daughter has a pacemaker. Her cardiologist has cleared her to dive up to the manufacturer's recommended limit of 50'. Our local dive shop had no problem with the class after getting the cardiologist's letter.

Now I'm in Bonaire with a referral letter and the hotel dive shop will not complete the check out dives. They insist that the cardiologist's letter is not good enough and that we need a letter from a hyperbaric physician.

Hi gasdiver,

Here's what DAN has to say about diving with pacemakers:

Pacemakers and Diving
DAN Divers Alert Network

As you can see, there are some discepancies between the depth limit recommendations specified by DAN and the manufacturer of the device at issue.

This nothwithstanding, the letter from the cardiologist appears to meet the recommendations of the World Recreational Scuba Training Council (WRSTC) (WRSTC :: World Recreational Scuba Training Council) regarding diving with medical conditions. Also, that letter should go a long way in absolving a dive op of real or imagined liability.

As Bubbletrubble has indicated, there are lots of good ops on Bonaire and it wouldn't be inappropriate to seek a "second opinion."

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.

 

[gasdiver]

Update: Yesterday (Monday) was a holiday on the island and everything was closed. I called DAN and the medic (not MD) I spoke to agreed with me that the hyperbaric physician would say that the cardiologist is the person to make the call. Of course the cardiologist has signed the letter saying "I find no medical condition that I consider incompatible with diving." The cardiologist did put a note referencing the pacemaker manufacturer's (Medtronic) letter saying the device should operate normally up to 49.5 fsw.

The dive operations manager here still refuses to complete her checkout dives until the hyperbaric physician on the island reviews her case. We have an appointment with him at 4:00 pm this afternoon. Hopefully, he will agree with DAN and my daughter will be able to complete her training dives tomorrow.

 

[DocVikingo]

Hi Gasdiver,

Thanks for the update.

Best of luck.

Regards,

DocVikingo