PADI Medical Release, what makes for deferral?

[wolfgangmob]

I'm going to be going for PADI OW in the next month but one of my concerns is the medical release form. I know it is pretty standard for a physical form but this has an emphasis on diving so my concerns jump to the fact that I have roughly 1&1/4 lungs after I had 3/4 of my right lung removed after it had a rapidly spreading infection but that was 15 years ago and I have no shortness of breath, no doctor ordered physical limitations, no low O2 levels. Other than that also overweight but no issues with the rest of the form.

 

[hroark2112]

Your instructor may request a doctors release. It's a good idea to check with him to make sure it's all good and to see if there are any dive specific limitations.

 

[torrin]

You just need your doctor to sign it, that releases PADI from liability. With my age and family history, mine looked like a completed bingo sheet, my doctor signed off on it and I am now OW certified.

 

[underH2Oman]

The purpose of the medical is to confirm any condition that may make diving more hazardous to your health. When it comes to any medical contraindication, agencies require a doctor acknowledges that it will be safe for you to dive. After all we due not want to put someone at risk of injury if a condition is known.
I know of a person that dives and only has one lung. He is active in the sport without incident.
I am sure your doctor will not have concerns if there is no risk to you while diving.

 

[Scott]

I'm sure you'll receive a number of responses to your post from some very knowledgeable doctors here on the board, all will advice you to consult with a physician.
I would contact Divers Alert Network and ask for the number of a doctor in your area that understands diving and seek a consultation with them. While your doctor may have placed no physical limitations, they may not have thought about diving.

 

[Skittl1321]

Just so you know- keep a copy of the doctor's signed sheet. I had a boat trip where I had to provide it (after I was certified) because they made us fill out the PADI health waiver, and I had to check a few conditions on it.

 

[Colliam7]

I'm going to be going for PADI OW in the next month but one of my concerns is the medical release form. . . . I have roughly 1&1/4 lungs after I had 3/4 of my right lung removed after it had a rapidly spreading infection but that was 15 years ago and I have no shortness of breath, no doctor ordered physical limitations, no low O2 levels.

OK, you will HAVE to answer YES to one of two questions on the Medical Statement:

Have you ever had or do you currently have…

_____ Any form of lung disease?

_____ Other chest disease or chest surgery?


Doing so (answering 'YES' to any question) requires that a physician then sign off on your Medical Statement, indicating, under 'Physician’s Impression', either:

I find no medical conditions that I consider incompatible with diving.

OR

I am unable to recommend this individual for diving.

I agree with the recommendation to contact DAN for the name of a local physician with dive medicine qualifications. The chances are you will be able to get a medical approval without difficulty. But, that will be required when you answer 'YES' to one or more questions on the form..

 

[freewillie]

First I'm going to ask a generic question. What is your concern regarding the risk of diving and what your previous past medical history including lung surgery will affect or impact your ability to dive? More on a personal curiosity, what kind of advice are you looking for when posting medical questions to mostly lay people with no medical training?

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Just as a disclaimer I actually am a board certified physician in primary care. Not to directly answer your specific question but more for educational and informative purposes I will review the medical recommendations for divers with lung surgery.

When a patient has lung surgery and the lung tissue itself and what is called the pleural space (basically the inside of the chest wall, the lung itself, and the adjacent linings on the chest wall and lung) is operated on then scar tissue forms as the incisions heal. The concern is that the scar tissue may create a fixed point referred to as an adhesion. Also, the scar tissue is more stiff than regular lung tissue and will not expand like normal lung. Both of these conditions may create a potential closed space at depth, then as the diver ascends and the gas expands it has nowhere to go and can create an overexpansion lung injury.

You will at minimum need to have formal lung function test measuring total lung capacity and volume. Depending on your age and risk factors it would not be unreasonable to have a cardiac stress test not for your heart but to document there are no physical restrictions for stamina and exertion after having a portion of your lung removed. And a high resolution CAT scan of the chest with specific thin cuts for the lung looking for scar tissue and potential problems.

Most diver candidates with prior history of lung surgery would be strongly discouraged against diving due to the potential risk. Although not absolute it is highly recommended that the person not dive.

For highly motivated diver candidates then they need full medical clearance from their doctor, hopefully one familiar with dive physiology and diving requirements. DAN can provide someone near your area. At very minimum you need to have very slow ascent rates and plan your dive accordingly.

 

[wolfgangmob]

My main hope was people in similar situations or people knowing people in similar situations who were cleared for diving. My concerns are more will it keep me from diving as I have no real issues unless doing intense activity like lifting large loads like steel bar gate portions weighing 50 pounds or more each for farm work and even then I can keep a decent pace for extended periods at a time and I have no plans of doing much work diving outside of the weight of my equipment. As far as the closed space I did find that in some of my research on the topic and that is a concern for me but I also never had my lung checked for regrowth since it was a possibility given my age at the time being borderline for regrowth. The doctor who I was under the care of at the time, who was the head of rare and infectious disease, did say it was fortunate it happened as a kid since it meant I would more easily adapt to the reduced lung capacity and it would just become my body's normal lung capacity for life. As far as diving restrictions I expect them and will be cautious, I know I will never be particularly capable of anything extreme and plan on just sticking primarily to OW restrictions and only doing "quick" ascents for emergencies only, no real plans of making this more than a hobby as I have other interests in life that are above ground.

 

[raftingtigger]

2 big questions arise with your history. The biggest: is there any greater chance of air trapping and or overexpansion injury. The second: do you have the respiratory capacity to dive safely (which sounds like you do).

As someone who performs these physicals I would need a clearance from a pulmonologist before giving clearance. You need to talk to DAN and probably have a physical from a specialist in dive medicine. Your case is one that generalist like me should NOT give clearance - at least the first time.