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Fitness and Diving - Age

Dr Jules Eden, dive medicine specialist and founder of e-med, answers divers' questions - as published in Sport Diver magazine:
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Q - I've just reached my 70th birthday and my wife's promised me a diving holiday in the Maldives to celebrate. I used to be a runner and quite fit up to my retirement, but since then too much fine food and wine has made its way to my waistline. I know I need to lose some weight to dive safely, but how fit should I be? Is there any guidance you can give me?

A - Physical fitness depends on three main variables: the heart, the lungs and muscle strength. All three decline gradually with age. Increasing blood vessel stiffness causes a gradual increase in blood pressure and a thickening of the heart muscle, the lungs become less elastic and shrink in size, and muscle power lessens by 10-15% per decade. Great. But with regular exercise the rate of decline can thankfully be halved. What this means is that someone who’s exercised throughout their life can often be fitter than a sofa-bound slug 20 years their junior. So age alone is not an issue. Rather than sadistic step-test torture, one kinder and oft-used way to assess fitness in the older diver is the timed swim: a 200m swim in less than five minutes, or 1km in less than 30 minutes, is acceptable proof of adequate fitness. So take that as your initial target, as it will also strengthen your swimming and general aquatic skills.

Q - My daughter is a good swimmer and really wants to try SCUBA diving, but I've heard there are potential risks to growing children from diving - something about bubbles in the joints? I don't know much about it and she's only 14 - old enough to try it but I'm worried about her doing damage to herself. Am I being an over-protective mum?

A - If you’re referring to bone growth then you’ve touched on a question of some importance. The way we “grow” in childhood is by the ends of our long bones, called the “epiphyseal growth plates”, gradually elongating. This continues until about the age of 18. These plates are mostly cartilage and they don’t have much blood supply, relying on diffusion from nearby areas for their nutrients. So if they are damaged, stunting of growth and shortened arms or legs may result. Again, there’s no experimental or clinical data on whether diving causes damage to these areas, but looking at saturation divers there is a risk of bone thinning after many years. However, considering the depths and times that children are restricted to, the risk of this occurring is minimal.

Q - Why is it that children can't dive below the age of 8? I suppose there has to be a cut-off at some point, but is there a good medical reason why a 7 year-old can't dive? I'm asking because my 7 year-old son has got very jealous of his 9 year-old sister doing her Bubblemaker and I'd love to put him out of his misery but the rules say no.

A - They do say no, for good reason. As you mention, to some extent there has to be a cut-off point somewhere, and there will always be exceptions to any rule, but there is a physical reason diving below the age of 8 is not advised. Up to about this age, the areas of the lung where gas exchange takes place (the alveoli) are multiplying, and the elasticity of the lung tissue is reduced. Theoretically this puts children at higher risk of barotrauma, particularly when you take into account their emotional immaturity and consequent increased chance of panicking and ascending rapidly. The rate at which children develop varies enormously, and for this reason there are some who would not allow children to dive until twice this age. So perhaps try to distract your 7 year-old with some other activities for now – didgeridoo lessons perhaps, or bee keeping?

Q - Both our children have decided they want to learn to dive. (Lord knows why, having watched their mum and dad unattractively flopping about in Wraysbury.) Anyway, one is 8 and the other is 10, and we've been trying to find out whether they're more likely to get decompression illness or other problems whilst diving. Can you advise?

A - I think if any diving doctor decided to dunk kids underwater in the name of research, they’d be struck off quicker than a soggy match trying to light a stove on a weekend’s camping holiday in Wales. There’s no evidence I’m aware of that suggests children are more susceptible to DCI. That’s not to say they aren’t, just that it’s unethical to do the studies you’d need to find out. Most of the knowledgeable authorities agree that depths and times should be restricted to minimise the risk of bubble formation for this reason though. There’s also a question about whether children are more sensitive to oxygen toxicity, but if we take the 1.4 bar maximum that applies to adults, and remember that children can’t dive on Nitrox, then they would have to dive to 60 m plus to be at risk. So we can pretty much discount this too.

Q - Whilst holidaying with my daughter and grandchildren in the Maldives I was given the opportunity to dive. I had only ever snorkelled previously and scuba diving was a revelation. But at the ripe old age of 63 how many years of this wonderful sport do I have left?

A - Potentially plenty. Browsing through a news website recently, I came across an article about 72 year old Donald Sutherland, the bearded Canadian thespian whose latest flick involved his learning to scuba dive. Apparently he was taken ill with chest pains during a break, and began coughing up blood. After much diagnostic confusion (including being mistakenly labelled with lung cancer) a clued-up physician finally twigged that the blood was due to a fragile lung vessel which had leaked during a dive.

The point of this arduous preamble is that he was then told by the specialist that he shouldn't have been diving past the age of 50. Now in these days of political correctness and disability discrimination the onus is on us docs to justify why someone shouldn't dive. Admittedly anno domini wreaks its mischief on us all in terms of declining strength and agility, but to designate an age past which diving is unsafe is ludicrous. There are some considerations – older divers are more prone to hypothermia as they generally have less fat tissue and a slower metabolism. Also, a higher proportion will have chronic problems, such as lung or heart disease, which need to be managed appropriately, and with medications that are sanctioned safe for diving. But we all age in time to our individual genetic clocks, and I know several divers in their 60's and 70's who are far fitter than numerous younger lardballs. Their wealth of life experience makes them far safer than your average anxious 18 year old novice. So it's two fingers up at Father Time, all you over 50s divers (including you, Donald) – get some new fins and jump in.

Q - I am 70YRS old, is it wise of me to carry on diving?

A - It depends very much on your physiological age.

Are you a Des O’Connor or a Harold Steptoe?

The former and I assume you are fit and virile, don’t look your age and up to the strains and pressures of diving. The latter and you would be a wheezy old git, smelling of greyhounds and pigeons, and a risk to your buddy. It is possible to convert to the former by moderate exercise, a good diet and a sun bed.

So as you have to tick the over 45 box on the PADI form, I suggest a diver medical to assess your fitness, and let the doc decide.

Q - I am holidaying in Australia soon and am going out to the Great Barrier Reef. I want to do a helmet dive. That's walking on the bottom, 5 meters down with just a helmet on.

I am 60 years old reasonably fit, had a by pass operation 6 years ago so far no complications but I take blood pressure tablets for a mild blood pressure condition. I know I can't dive with a tank but will this type of diving be okay for me?

A - Before you get a helmet on and go onto the bottom, you might find you are OK for a quick tank.

The rules are that fit post-bypass, well controlled mild hypertensives can dive. So see a dive doc and you could find that you may well pass as fit, even for Australia. If you can't be arsed and want to walk the bottom then I bet you will be alright but call the operator first to make sure of their local rules.

Q - I am 58 yrs old and, following a try dive whilst on holiday, have got the Scuba bug. I have just completed my PADI open water qualification and am looking forwards to developing my expertise.

My question is, how long can I expect to be able to continue Scuba diving? Is there a sensible age at which to retire gracefully without compromising myself or my Buddy?

A - I can hear a lot of people reading this thinking " I know old Roger, should've retired years ago, he's a liability!"

But the reality is that age is really no bar to diving. Of course we all may have seen a 70 year old bouncing off the coral but, hey, 20 year old beginners do it too so let's get the blame in order.

I suppose the real issues are that with advancing age some of the faculties can go. Eyesight, the ability for the heart to respond to exertion, even the state of the blood vessels and lungs to clear nitrogen.

However this is a gradual process and there are no rules.

My advice is to look at yourself and fitness. You must already have a good degree to be passed in the first place. It a question of keeping it like that.

Stay fit, and if you get any problems like shortness of breath, chest pains or even fuzzy sight then get them assessed by a diving doc before you dive again.

My record is 82 for a female diver I saw in Dominica, and if there's anyone older out there then let me know so we can write in to Mr McWhirter.

Q - My partner and I are going to book a trip in May to El Quesir. We are both PADI Open Water and last had a dive medical in 1999. We thought that since we are both 50 plus we needed a medical every 2 years.

We were told by the doctor's surgery that the process is now self certifying. However, we have since heard that self certification is not always accepted. The dive centre in El Quesir is CMAS affiliated.

Please can you clarify?

A - Errr... no. I think the deal with any of these resorts is to make sure you know before you go.

E-mail them and ask whether a self cert will do as the last thing you want is to be running around an Egyptian town on arrival looking for a doctor to get a cert. It may be cheaper there but the hassle isn't worth it in my book. So sorry but I don't know what the El Quesir rules are, but from my experience Egypt isn't a problem area. Malta, Gozo and some of the Maldive Islands are well known for needing a doctors note. Just check first.

(other dive medical questions)


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