Diving after heart surgery

[Scuba]

I wasn’t sure whether to post this in the travel or health forum, but DH had a quadruple bypass in 2022. He recovered well and his cardiologist said he was fine to resume diving. Wondering if anyone on this forum who still SCUBA dives also had heart surgery?

When we booked a trip on a Great Barrier Reef liveaboard in 2023, they required that he be evaluated by a DAN-certified doctor. It was a PITA because he had to drive about 5 hours round trip twice for two separate appointments as they were no DAN-certified doctors near us. However, given that his surgery happened in April and we booked the trip 7 months later, we thought it could be a good idea for our own peace of mind even if not required. Basically they just put him through a typical cardiac stress test. He passed and all went well on the trip.

Fast forward to 2024. We booked a much easier dive trip this year - Cayman Brac and Little Cayman. Initially they told us he could just bring his medical letter from 2022 with him. They contacted me today and said he needs to be re-checked since his letter is over a year old, even though he just had a cardiac check-up in September 2023.

His cardiologist told us that DH’s heart did not have significant damage; the surgery was just to clear out his “plumbing” and he will likely eventually die of some other non-cardiac related cause. I am wondering if anyone else who’s had cardiac surgery and still SCUBA dives has to be medically evaluated by a DAN doctor every year. The good news is they’re easier to find in FL. Just wondering if we should expect to have to do this annually now? This is on top of his regular cardiology check-ups and honestly seems unnecessary to us from a health evaluation standpoint. I think it’s a CYA for the dive operators.

 

[Sunset]

I get the first time you might want to get this checked.

But after that, why tell them ? It's just going to cause a hassle at best, and at worst, they feel it's not safe and he can't dive.
Then the next trip somewhere else they feel it's ok and he dives..

I suppose if he has a big scar up the chest it might be hard to hide.

 

[Out-to-Lunch]

I suppose if he has a big scar up the chest it might be hard to hide.

"It was from a knife fight" which is sorta true...

 

[Scuba]

I get the first time you might want to get this checked.

But after that, why tell them ? It's just going to cause a hassle at best, and at worst, they feel it's not safe and he can't dive.
Then the next trip somewhere else they feel it's ok and he dives..

I suppose if he has a big scar up the chest it might be hard to hide.

Exactly. The scar is a dead giveaway.

 

[SecondAttempt]

This is on top of his regular cardiology check-ups and honestly seems unnecessary to us from a health evaluation standpoint. I think it’s a CYA for the dive operators.

I get the first time you might want to get this checked.

But after that, why tell them ? It's just going to cause a hassle at best, and at worst, they feel it's not safe and he can't dive.
Then the next trip somewhere else they feel it's ok and he dives..

I want to chime in here for a couple of reasons. I worked for a while mostly volunteering as a dive master/assistant instructor. Most operators will have you fill out a short medical questionnaire that covers stuff like this. It IS partly CYA but most operators genuinely want to take you diving but they are trying to be professional and safe. Diving stresses your body in numerous ways that many physicians might not be aware of. That's why they want an evaluation by someone DAN-certified. As an example, there is a congenital condition that can be fatal when diving. I can't recall the name now but it has to do with a little flap in our heart that is closed by the reversal of blood flow after birth and normally heals closed. If it remains open the pressure differences at depth can open it and be fatal. A friend of mine had an infant son with this defect. The doctors told them that he should either have open heart surgery as an infant or never dive in his life. The defect usually has no impact except when diving. (My friend decided his kid would never dive rather than risk open heart surgery for a recreational pursuit.)

Of course you can always lie on the form. I'm sure many people do. But that means the operator likely would not be held liable so they have CYA-ed anyway.

It sounds like your husband is fine but I think if I had had quadruple bypass surgery, I would want the DAN-certified physician visit. But I have a couple of suggestions on this front.

First, maybe get the DAN-doctor visit at your dive destination. Sure, you'd give up part of a vacation day but if you are retired is that a huge issue? Worst case is you find out he is not fit for diving but, really, wouldn't you want to know that?

Second, maybe contact DAN and see if they can have your regular cardiologist do the actual tests then send the results to a Dan-certified physician for a telemedicine consult.

Finally, the specific issue you had was in Australia. I know from experience both diving there and talking with instructors from there that they are extremely safety conscious because of what happened that was portrayed in the movie "Open Water." It's a true story that led to some very strict regulations with draconian penalties. I don't think you will experience as much CYA in other places.

 

[SecondAttempt]

Exactly. The scar is a dead giveaway.

When I was learning to work the boat there was an emphasis on watching people to observe things that might be signs of potential distress. This included things like rubbing joints (possible sign of decompression sickness), usual behavior that could suggest anxiety or fear about getting in the water. Popping pills, usually sudafed that could indicate potential equalization issues, etc. We would not generally look for scars unless they appeared to be very recent.

If your husband wants to hide his scar he could always just get a thin rashguard and never take it off.

 

[Sunset]

Having dived a long time ago, I agree getting checked out after heart surgery.

I would find it an unnecessary expense and trouble to be checked out, every year by a DAN-certified physician when they are regularly seeing their doc and nothing changes.
If that was the rules, I'd probably want to do it before going on a trip, and bring my papers with me.
Or wear a T-shirt.

What about the guy who hasn't see a doctor in 8 years ? Maybe he is a bigger risk. Seems a bit odd everyone isn't required to bring doctor papers, stating they are healthy enough to dive.

 

[SecondAttempt]

What about the guy who hasn't see a doctor in 8 years ? Maybe he is a bigger risk. Seems a bit odd everyone isn't required to bring doctor papers, stating they are healthy enough to dive.

Yes, the no doctor guy is likely a risk and frankly, I fall in that category. But I'm not going diving until I get back in shape.

The PADI form (which I have not seen in over 10 years) asked some very general questions and if you checked a yes box they would probably ask you to get a physician clearance. Generally the concern was with breathing issues. I think high blood pressure and related issues might have been included as well.

 

[fosterscik]

Yes, the no doctor guy is likely a risk and frankly, I fall in that category. But I'm not going diving until I get back in shape.

The PADI form (which I have not seen in over 10 years) asked some very general questions and if you checked a yes box they would probably ask you to get a physician clearance. Generally the concern was with breathing issues. I think high blood pressure and related issues might have been included as well.

You only complete the PADI form when you are taking diving courses through PADI (I'm sure the same applies to other agencies). We're over 65 and don't supply any medical forms when we book trips on liveaboards or resorts.

 

[WhenIsItTime]

OP: From username, clearly scuba is important in your life or at least top of mind.

If you are asking the dive operator, you are not giving them much choice but to direct you to a DAN avenue.

I had open heart surgery for a mitral valve repair via sternotomy. I made sure I was OK to dive from my cardiologist. While somewhat unrelated, I also made sure I was confident in my own physical fitness. Then, went diving. Dive operator's didn't ask about any prior surgeries and I didn't volunteer. The operator's we used are reputable and didn't ask for any forms.

 

[SecondAttempt]

I get the first time you might want to get this checked.

But after that, why tell them ? It's just going to cause a hassle at best, and at worst, they feel it's not safe and he can't dive.
Then the next trip somewhere else they feel it's ok and he dives..

Once again, I'm going to chime in here based on some experience. I am not a physician much less a cardiologist so I won't comment on the risks of scuba diving after heart surgery.

I'm just going to say a couple of things. First, dive operators WANT to take you diving. They are not looking for an excuse to leave you behind. But having a diver die on you can be a major issue. Sure, they have insurance but a death can easily shut down an operator and end the "career" of a divemaster or instructor. I put career in quotes because it is usually a moonlighting gig but there are some people at resorts or tourist towns that do it full time and it can be a great "job" even if it does not pay that well. You get to dive everyday. Do what you love and you'll never work a day in your life, right?

Secondly, I've been on a few dives where things went wrong and I've participated in a few rescues or witnessed events up close. I saw a guy pop up from 70+ feet in Honolulu. The dive was recalled and he was on oxygen on the deck of the boat and met at the harbor by an ambulance. Another time I had to help a divemaster get a family back on the boat after the mom who was getting on first slipped and hurt herself on the ladder and was screaming in pain. She was not seriously injured, just some seriously scraped skin on her shins, but her screaming terrified the rest of the family and they were swimming away from the boat into the dark. The surface was rough. I was nearly out of air and I am usually really good on air so I knew they were all nearly out. Perfect conditions for drowning when they spit out their regulator. Fortunately we got everyone home safe even if we had to be a little rough with them.

Thirdly, I live in Kona Hawaii. It is far too common to read police texts about responses to tourists becoming unresponsive while snorkeling or diving. It seems to happen at least once a month and there have been at least 3 deaths in the last few weeks, all men in their 60s-80s.

I love diving and believe it can be done safely. But the ocean can be a very dangerous place and I have a great deal of respect for the snorkel guides/divemasters/operators who are trying to show people a good time while keeping them safe.

None of this is a direct comment on the OP who, by the behavior described, did the responsible thing and got checked out. But dive accidents are far too common and stressful for the staff involved even when the eventual outcome is good. We all know that liability waiver forms are of little actual value in terms of being a defense to a lawsuit. So I hope you all give a little respect to your divemaster or operator and be honest with them if you are at risk.

 

[Scuba]

Thank you all for commenting. Since DH’s cardiologist just saw him in September 2023, just before our move to FL, he agreed to fill out a DAN medical clearance form provided by the dive operator. The operator indicated they would accept the form from his cardiologist, so it looks like all is well for this trip.

I’ll talk it over with DH with respect to future trips and disclosures. We normally purchase DAN insurance before dive trips. We have never been asked about any health conditions when buying DAN insurance, which is mainly for the unlikely event of decompression sickness.

I’m a very forthright and honest person, but sometimes it doesn’t serve us well. This may be one of those cases. I posted another thread that we informed our umbrella carrier about our new golf cart with rear facing rear seats, thinking it would be a no brainer to just add it to our umbrella coverage. Not only did the carrier refuse to do that, but they are also canceling our umbrella policy even if we don’t require the umbrella coverage to extend to the golf cart. What a mess!