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Which Dive Medical? - HSE

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 have just made an appointment for a medical on Monday 17th December. Basically i am a qualified Divemaster, going on to do the IDC in Egypt at the end of this month, and wanted to confirm which medical was the most appropriate - Divemaster or HSE preliminary? Look forwards to your response.

A - Here's the rub. If you are going to only DM or Instruct in Egypt then you can get away with the very basic Fit to Dive medical that you find in your DM or IDC pack. But if you are going to help out, back in the UK, then you will need to get the full on HSE medical.
There is a cost differential. The basic is about 40 and the big one 120, so the best thing is to look at what you want to do with your diving and I or any other dive doc will do what's best for you.

Q - I am due for my HSE medical as I am going to become a PADI Instructor. But the little problem is that I recently ruptured some knee ligaments and I hear there is a very demanding exercise test to do which I think I might fail.

Should I do it now or postpone the medical until I feel I should pass.

A - The point of the exercise test in your HSE medical is two fold. Firstly to make sure that you have a basic level of fitness that you would need as a Dive Instructor, and secondly to see if you have any cardiac problems that would seem OK at rest but then only become apparent when your heart is beating far more rapidly.

The main ways of testing fitness in these medicals is to either get you on an exercise bicycle or on an 18 inch high box for some step ups.

If you think that the box may aggravate your knee problem then see if you can do the bicycle ergometer instead as you wont be bearing any direct weight through the knee itself. If you have a good level of fitness I'm sure you will be passed as fit, however if your knee does limit you in any hard activity then you should wait until you are able to fin properly and even complete a long surface tow if needed as you can never tell what you may have to do for a student in the future.

Q - Hello, I just have a question on diving medicals.

I am currently a PADI scuba diving instructor and will be in need of my first HSE medical, having never had one before. There was just one thing that concerned me before making an appointment with you.

I have a slight curve of the spine- a scoliosis I am told. I have been diving for many years and am fit and healthy. It has never interfered with any part of my life, and only recently I found out about it. Does this play a part in the medical? Thanks for your time.

A - A scoliosis is a curvature of the spine in a lateral direction. So if a doctor looks at your spinal vertebrae they will see it bend either to the left or right from the normal direction. You say that it doesn't affect anything you do in day to day life, but when we do an HSE Medical on you we will check for a couple of things. Firstly does it affect your ability to bend over and lift. As an Instructor you may have to deal with an emergency and have to lift someone out of the water. If the scoliosis still means you have full power that will be OK. Secondly, are there any neurological signs as a consequence of malpositioned vertebrae. We will make sure they are noted at this stage, so that if you ever have a suspected bend, then any loss of sensation or power would be known in advance and not mistaken for DCS.

I have never known a mild scoliotic patient fail an HSE for that reason alone, so I think you should be fine.

(other dive medical questions)


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