Middle-aged Diver...Stress Test? Other??

[WrmBluH2O]

My wife is 69 years old, has been diving for 5 years, and was not allowed to take the drysuit class because she answered "yes" to the PADI questionaire about prescription medicines (hypertension). She was required to present a doctors certificate saying she was qualified to dive. She took the local medical center's "Dive Physical" exam. It took about 15 minutes. Other than a whole lot of questions very similar to the PADI questionaire, the only "examinations" that took place was for blood pressure and listening to her heart. She's now $90.00 poorer but was able to take the drysuit class.

Bert,

Although it was frustrating, I am glad your wife got to take the drysuit class.

I hope that my new doctor chooses to do a bit more than ask questions, listen to my heart, and check my blood pressure. That said, I am trying to determine what it generally makes sense to ask for (or not).

 

[uncfnp]

Bert,

Although it was frustrating, I am glad your wife got to take the drysuit class.

I hope that my new doctor chooses to do a bit more than ask questions, listen to my heart, and check my blood pressure. That said, I am trying to determine what it generally makes sense to ask for (or not).

My take as a medical provider is that if you have to research what you need done for a comprehensive health assessment you have the wrong provider. All you should need to do is discuss your health, risk factors and concerns. The provider will then taylor your exam to include routine age related tests and tests/procedures indicated by your unique needs. As an, I assume, healthy 49 yo (female?) minimal additional tests beyond the routine are likely necessary.

And don’t discount conversation as a large part of your visit. Especially on your initial exam. A good PCP can get a lot of needed info just from talking to you. In fact, I would say this is the most critical part of the exam and too often time constraints limit this portion and the provider may substitute it for tests that really may not be needed and can indeed lead to futher unnecessay visits, tests, costs, and anxiety. I’m not saying that It isn’t a team effort and having your questions and concerns ready is a very important part of the conversation.

Take the ETT or stress test you mentioned. It has very limited value to anyone without risk factors. And for females, it can be an especially unhelpful test.

The Pulmonary Function Test? Unless you have symptoms or risks I would not order one.

Again, I am not a dive medicine provider so take this for what its worth.

 

[WrmBluH2O]

Hi uncfnp,

Thank you for your perspective, particularly as a medical provider. I agree with everything you write.

In terms of trying to find a good GP (who is taking new patients), I will ask for recs and do the best “due diligence” I can. My prior doctor’s nurse practitioner was wonderful; I will miss her too.

Please know I didn’t mean to diminish (at all) the importance of the conversation piece. There was no way you could know from what I had written, but I totally get that! I understand how much medical providers glean from that portion of the exam.

Yes, I need to let the doctor do the doctoring.

Thanks again!

WrmBluH2O

edited to write “nurse practitioner”

 

[uncfnp]

I sincerely hope I didn’t come across to strong. The best relationship is a partnership. You haven’t said but if you do have some health concerns that impact your safety diving then it is important for you to do your due diligence and have the info ready for your GP, especially one that does not dive.

And good luck with your search.

 

[WrmBluH2O]

I sincerely hope I didn’t come across to strong. The best relationship is a partnership. You haven’t said but if you do have some health concerns that impact your safety diving then it is important for you to do your due diligence and have the info ready for your GP, especially one that does not dive.

And good luck with your search.

uncfnp,

Not too strong at all!Thank you very much both for your help and for the well wishes.

WrmBluH2O

 

[Duke Dive Medicine]

DDM,

Thank you. Your first reply was helpful, the second one even more so. I appreciate your perspective!

I am keeping in mind all that you wrote above. That said, would you feel similarly or differently about pulmonary function tests? As I had been with the stress test, I am simply trying to decide how much I should (or should not) advocate for myself with respect to any test(s). Thank you again for your help, and thanks in advance for any additional insight you may choose to provide.

WrmBluH2O

You're most welcome. Re the PFT, I'd agree with my Carolina Blue colleague across town... we probably wouldn't order it unless there was some question about your lung function. That's not a hard-and-fast rule though, and if you want one it would probably be easier to convince your GP to order that than a stress test.

Best regards,
DDM

 

[WrmBluH2O]

You're most welcome. Re the PFT, I'd agree with my Carolina Blue colleague across town... we probably wouldn't order it unless there was some question about your lung function. That's not a hard-and-fast rule though, and if you want one it would probably be easier to convince your GP to order that than a stress test.

Best regards,
DDM

DDM,

Thank you very much for your perspective regarding the PFT and help overall. I am very grateful for your contributions here and in many other threads.

Thanks again to the North Carolina contingent and everyone else who was kind enough to share their thoughts!

WrmBluH2O