You bring up a very important issue for recreational scuba divers. Since annual physical exams are not required in the United States, what is the role of fitness in scuba diving? Let's start with the basics.
Fitness is not only a product of a healthy lifestyle, such as limiting fats and carbohydrates in our daily diets, but also a function of how we address health issues. Lack of fitness poses two risks in scuba diving: the first risk is what we assume ourselves; the second involves the degree of risk to our buddies and potential rescuers.
Scuba diving requires a level of fitness that allows us to respond to the sudden need for a cardiovascular or respiratory exertion. Because we are in a seemingly weightless environment (with proper buoyancy control), and often pushed along by a current, we can easily underestimate the level of physical fitness required to perform safely in the water during an emergency situation.
But even a relaxed dive can produce sufficient cardiovascular and blood flow changes to stress a heart that already has some baseline cardiovascular disease (CVD). An emergency situation may require even more physical exertion. Several apparently healthy divers die each year from sudden cardiac death during a dive. Of those, some appear relatively healthy.
A good way to monitor your health is to have a regular check-up with your primary physician. This provides information that can help you avoid illness and disease and maintain a lifestyle that promotes good health.
Why get periodic physical examinations? As we get older, our chances of acquiring diseases such as diabetes, cancer and heart disease are significantly higher. Most significant is the increased risk of heart disease.
Risk factors for CVD include a diet high in cholesterol and saturated fat, smoking, lack of exercise, diabetes and high blood pressure. A certain amount of risk is also passed along in genes. Unfortunately, we may never realize we have a problem until we have the first symptoms, such as chest and arm pain, shortness of breath and a sudden loss of consciousness. Although normally associated with exertion and exercise, symptoms can occur during periods of emotional stress.
The centerpiece of a dive physical for divers 45 years or older is a cardiac stress test. Determining how well your heart can perform during this diagnostic test is helpful in determining heart health. Health problems such as irregular heart rhythms or blood pressure problems may show up during your evaluation. This can help to detect some future problems. Don't downplay your symptoms just to be a good patient; talk to your doctor about your health concerns. Why? Cardiovascular disease is the number-one killer in persons over 45 years of age.
Tell your doctor what aches and pains you may have had since you last check-up. Have you had episodes of lightheadedness, ear ringing, bowel or bladder problems?
To get a healthy stamp of approval from your doctor, you will undergo other procedures in addition to a stress test. While many aren't necessary for you to continue diving, such procedures are part of a thorough physical examination.
Take healthy eating advice to heart, and use an exercise program to build endurance and cardiovascular fitness. Determine if a combination of diet and exercise will work to lower cholesterol or if drug therapy may be required. Follow your physician's advice, and if he or she has dive-related questions, have your doctor call DAN. Take the time to take care of yourself, and scuba diving will be in your future.
- With reports by Dr. James Caruso
By Joel Dovenbarger, Vice President, Medical Services. Dovenbarger has been with DAN since 1985. A medical professional for 25 years, Dovenbarger started work as a registered nurse in 1976 and began in hyperbaric and diving medicine at the F.G. Hall Lab at Duke Medical Center in 1982.
(c) DAN -- Alert Diver March 2002