Health and the aging cave diver

I recall a presentation from Jeff Bozanic that had an analysis of all the accidents that have occurred. Since we have readily available training and good gear,accidents typically fall into two categories-exceeding limits and health related issues. Since a poll on CDF shows that the median age of cave divers to be somewhere between 45 to 55,that would infer that health issues may continue to be an issue. Cave diving is a strenuous sport,if not carrying heavy gear to the water,then the act of diving. What do you do to screen for health related issues,and what measures do you take in your personal life?

Kelly, not that I am getting in the water near as much the last few years but a recent development supports some of your questions. I am 53 and I recently had to go to the ER and found out that I have atrial fibrillation (AFIB) My heart rate at rest was 160. This was on New Years day and the previous few days only a shortness of breath while bending over or squatting down was the indicator. A word of caution to all is that the whole time I was checking my blood pressure which was OK and the heart rate indicator does not accurately show your real heart rate when in AFIB. Prior to this, the only time I noticed a shortness of breath was while cave diving in a strenuous environment at say Ginnie or Little River. At the time, I chalked it up to my drysuit being to tight around my middle torso. I've been told that many go through life with some AFIB and never notice it and the real danger is the possibility of sending a blood clot to the brain (stroke) or pulmonary edema. Others like me, get carted off one day and find out about all kinds of lifestyle changes that need to be made. Little things like a low/no sodium diet, losing weight, cutting back on alcohol (the hard part!!), and exercise are on my agenda for the new year. Several years ago, I cut out the longer deeper dives like Eagles Nest and Diepolder as I am reluctant to see the inside of chamber yet again and I have spent enough time at both to last a lifetime. I may or may not cut back on cave diving, depending on the reliability of my daily prescriptions and my efforts to live healthier.

The American Academy of Underwater Scientists (AAUS) has a physical exam specific for diving and a scheduled interval for exams that increases in duration with age. The intent of this screening is to identify contraindications for diving, particularly as scientists age. I don't think it physicals should be a requirement for continued certification, but for those that want to protect themselves, the AAUS model is a good place to start. You can find more information on their web page at www.aaus.org.

My work in general keeps me pretty active (as well as my diving and family activities) but I also get a physical every year from my general practitioner doctor.
Also, a couple of years ago, my son and I had the complete, full physical done (which might be the one listed above) that was a requirement for scientific diving for the underwater archaeological program at LAMP in St. Augustine.
Cutting out the alcohol was not a problem for me 20 years ago but, being a Southerner and eating (and drinking southern-style foods), well ... that's a bit harder.
I also almost always limit my dives to one a day and I do not do a lot of deeper trimix dives.

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Originally Posted by jason

The American Academy of Underwater Scientists (AAUS) has a physical exam specific for diving and a scheduled interval for exams that increases in duration with age.

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I think you mean an interval that decreases with age....not increases.
It is a 5-year interval up to age 40, then 3 years until 60, then 2 years.

I get an annual physical.

Jason, thanks for the link - getting ready to open it.

Thanks for the post.

I am turning 52 this march and need to get in for my physical. Last one was 5 yrs ago, so I guess I am due. I am reluctant to go simply because I HATE needles.

Because of my age and weight, my doctor makes me do stress ECG every couple years. Not fun, but great to know that my heart is still in good working order. AND have a chance to experience "maximum" cardiac loading.

I an 65 in may, and my buddy is less than two years younger. We get to Florida twice a year to cave dive. We are both pretty active. I take three meds to keep my blood pressure under control and a statin to keep my cholesterol down. But the fear of dying in a cave will not keep me out of the water. My fear is dying in a nursing home. I ride horses so cave diving is not the most dangerous thing i do. The horses have more potential to put me in a nursing home. One has already got me an operation. Also I am a born again believer which takes a lot of the terror out of death. I ride a bicycle for exercise when it is warm enough. But if you ever read about me dying in a cave don't cry for me. just say lucky Rod got his wish it was not in a nursing home. and tear me up on accident analysis if I did somthing stupid, so others can learn. And if you know Jesus we will talk and laugh about it when you catch up with me.:)

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Originally Posted by bullfrog

I an 65 in may, and my buddy is less than two years younger. We get to Florida twice a year to cave dive. We are both pretty active. I take three meds to keep my blood pressure under control and a statin to keep my cholesterol down. But the fear of dying in a cave will not keep me out of the water. My fear is dying in a nursing home. I ride horses so cave diving is not the most dangerous thing i do. The horses have more potential to put me in a nursing home. One has already got me an operation. Also I am a born again believer which takes a lot of the terror out of death. I ride a bicycle for exercise when it is warm enough. But if you ever read about me dying in a cave don't cry for me. just say lucky Rod got his wish it was not in a nursing home. and tear me up on accident analysis if I did somthing stupid, so others can learn. And if you know Jesus we will talk and laugh about it when you catch up with me.:)

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I would agree with most of this, except I don't want to die in a cave and add the the statistics and bad press of cave diving.

I just turned 50, I treat my body like I treat my regulators. If it ain't broke, don't fix it, and don't open it up for fun. If I feel like I need to see a doctor, I go. My blood work and other stuff has given no indication of something lurking beneath the surfac beyond the fact that I'm considered gravitationally challenged due to my keenly developed ability to store food as energy. I've had two immediat family members die of cancer in the last 12 years, I'm not stopping till I'm done.

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Originally Posted by mfascuba

I just turned 50, I treat my body like I treat my regulators. If it ain't broke, don't fix it, and don't open it up for fun. If I feel like I need to see a doctor, I go. My blood work and other stuff has given no indication of something lurking beneath the surfac beyond the fact that I'm considered gravitationally challenged due to my keenly developed ability to store food as energy. I've had two immediat family members die of cancer in the last 12 years, I'm not stopping till I'm done.

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at least check your blood pressure.that's Why they call high
pressure the silent killer. and it's time for your first colonoscopy

It's good to get regular physicals, once one reaches a certain age (I'd arbitrarily set that at 50, for people who otherwise believe themselves to be healthy). Things like diabetes and high blood pressure can sneak up on you without many symptoms, and definitely have implications for long-term health.

However, the average routine physical consists of vital sign measurement (can be done at Rite Aid), a quick listen to your heart and lungs, a cursory review of systems, and some blood work. Such an exam will not detect silent coronary artery disease, and without concerning symptoms (and sometimes even WITH them) insurance companies aren't going to pay for even noninvasive stress testing. Still probably the best you can do is stay active -- engage in some kind of activity that raises your heart rate to the recommended level (I've seen it set at 200 - your age) several times a week. Even that will neither completely protect you nor give you adequate warning. One of the most sobering stories I know was a 38 year old physician with a HORRIBLE family history for heart disease. He was not diabetic or hypertensive, and didn't have one of the familial hypercholesterolemia syndromes. He just had a lot of relatives who died at early ages of coronary artery disease. He lived on a Pritikin diet and ran 7 to 10 miles a day, and he didn't have an ounce of body fat. He dropped dead on a run at 38.

There is no perfect protection. Activity is probably the most important; medical checkups can be useful to detect silent problems, but do not think that just because you get a physical every couple of years, there is nothing lurking inside you that could cause problems. We're not that good.

If it feels good do it.

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Originally Posted by LCF

(I've seen it set at 200 - your age) several times a week.

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Good advice.

220 - age is max heart rate. % of that number based on moderate or vigorous exercise

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Originally Posted by LCF

I've seen it set at 200 - your age

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Originally Posted by Kelly Jessop

220 - age is max heart rate.

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Yeah, Kelly's number is more realistic. Lynne's puts me at 144bpm. I do that just looking at my wife in a bikini.

Actually max rate has to be adjusted as you get older. Approaching 60 it is more like 208 minus 70% of your age. It gives a slightly higher rate. Then use 50%-85% of that figure for your target depending on fitness and intensity of exercise.

I am at 51 and very active. I workout almost every day, I do my regular MD checkups, and stay on my high blood pressure meds. My buddies know that I have high blood pressure issues and my wife knows what I enjoy doing.

For us health care providers: please put on the back of you wrist slate or wet notes your name, NOK, birth date, blood type, code status and any meds that you are on.

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Originally Posted by Jay

If it feels good do it.

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Live like it's your last day and plan on seeing the sunrise again. No one gets out of this game alive.

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Originally Posted by Kelly Jessop

Good advice.

220 - age is max heart rate. % of that number based on moderate or vigorous exercise

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OK -- first disclaimer -- before embarking on any physical fitness regimen, see your physician to make sure your able to handle the stress of that physical activity.

That rule doesn't hold true for all people. Some estimates claim that rule only holds true for about 20-25% of the population. I know from personal experience, my max HR is well over 200bpm -- I have several capture logs from bike races where I averaged ~190bpm for 45-60 minutes, with peaks above 200, and I was around 40 at the time. And last summer, at the tender age of 45, I hit 206 during a workout.

The Karvonian formula for calculating HR zones gets you closer into the ball park. http://www.sport-fitness-advisor.com...e-reserve.html

However, the best way to really find out your HR zones is by having a blood lactate test done at a sports performance clinic. If you're in Gainesville, I highly recommend the people at the UF Sports Performance Center. The test runs $150, takes about two hours, and you'll know your real physiological zones. Full warning, getting this test done is one of the most painful experiences I have ever endured. http://www.ufsportsperformance.com/e...itness-testing

Best of luck to you guys.

I'm pushing 60 and didn't take up diving until mid-50s. I snow ski, bike, paddle, hike, and like to do active stuff. Not much on the gym and haven't been able to get motivated enough for consistent running. Have a family history of coronary artery disease and would be surprised if something else killed me. I take the statins, but I'm not going to sit at home waiting for the heart attack to strike. If I die in a cave it wouldn't bum me out for myself but would bum me out for ruining it for my buddy. Same concern if I died during vigorous sex.

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Originally Posted by PsychDiver

I'm pushing 60 and didn't take up diving until mid-50s. I snow ski, bike, paddle, hike, and like to do active stuff. Not much on the gym and haven't been able to get motivated enough for consistent running. Have a family history of coronary artery disease and would be surprised if something else killed me. I take the statins, but I'm not going to sit at home waiting for the heart attack to strike. If I die in a cave it wouldn't bum me out for myself but would bum me out for ruining it for my buddy. Same concern if I died during vigorous sex.

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LoL! That all depends on your partner. Could be quite a good ego boost to say that your skills in the bedroom were literally killer! :-)

Tracy, funny you have mentioned this. For those who know me I am a 68 year old male in excellent physical condition. I exercise on a daily basis, kayak fish in the ocean, and am an avid diver. Last September I did 25 dives in 5 days and felt great. I have an annual physical and have always been passed with flying colors. Mt cholesterol, blood pressure, and EKG have always been perfect.
This last December, one week after my weekly cave dive, I had a heart attack. No normal signs that I was having problems. Was at home on Saturday watching Alabama play Auburn and all of a sudden I was out cold. Found out that my main artery was 100% blocked. I was admitted to the hospital and received 2 stents.
You may look healthy, feel healthy, and eat right, but if your family history shows heart problems you best take notice. I did not but I was fortunate enough to have this heart attack on the surface.
I am having a stress test next week to evaluate the damage and to determine when I can enter the water again.
The age poll was done by me but not for the medical interest. Seems I need to go back and revaluate the results.
Listen to your body and take notice. This post is a very serious discussion; it my save your life.

After reading John's story (OFG-1) sometime last year(?) I saw my GP and arranged for a Heart stress test. I didn't want to become another statistic or to have my family called from North Florida to report I didn't survive my last dive. Thanks for sharing your story John, I really don't know what possessed me to continue diving in caves at my age, without this information.

I'm 51, keep pretty busy, but not that physically active anymore, and wasn't really certain of the condition of my heart and circulatory system. I also worked on my dive buddy (same age) until he caved and had his own test completed. We both were fortunate to have passed with flying colours.

I know there are many things we could experience while cave diving that could have fatal results but I also know that by having successfully completed the Heart stress test, my buddy and I have greatly reduced the risk of becoming another statistic.

Don't we owe this to all of our loved ones?

At 75 I have outlived my brother (64), my father (64), my paternal grandmother (72), her father (44), and his father (64). I think my strenuous lifestyle has something to do with this. I don't think I could keep up my 45 minute workouts 6 days a week if I didn't tell myself that I do them so that I can continue cave diving. Thus, my cave diving has kept me alive a lot longer that family history would lead one to expect.

Yes. The frequency of exams increases with age. I made an error when typing quickly.

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Originally Posted by allen

At 75 I have outlived my brother (64), my father (64), my paternal grandmother (72), her father (44), and his father (64). I think my strenuous lifestyle has something to do with this. I don't think I could keep up my 45 minute workouts 6 days a week if I didn't tell myself that I do them so that I can continue cave diving. Thus, my cave diving has kept me alive a lot longer that family history would lead one to expect.

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Sounds awfully familiar :-)

Well, at 62, I have found that it is more difficult to keep any workout going, particularly with 2 bad knees. If you can think of any aerobic exercise that does not involve your knees, (and even sex requires some use of them) let me know. The knees are so bad at this point,I cant do a good looking frog kick, I cant keep the knees bent up for a long time. So I shuffle around, probably trailing silt like Pigpen in the Peanuts cartoon. So I am going to stay in bigger cave.

I do ride my bike almost every day. I have learned several things. You cannot measure your fitness and health at 62 the same as you did at 52, or 42, or 32. It is just different. I have lost range of motion over the years that as much as I stretch, It just does not want to come back.

The obvious thing is not to try the same dive profiles at 62 as you did at 52. There are a lot of wet rocks to see at 120 feet deep, and they look about the same as the ones at 270. With a few exceptions, caves look about the same at 3000 feet penetration as at 6000. I do know a couple that really do not get interesting until you hit the first big rooms at 5000 or so, but they are the exception. I am not draggin a set of 120's and 4 stages down into a sinkhole anymore, so I will be happy with what is comfortable.

After the heart attack, several things changed. First, my sac rate went up. A lot. I don't know if it is heart damage from the attack, medications, or both. Second, my cold tolerance, which has never been great, is worse. I suspect the aspirin. Because of the cold, I am just not going to do any more 3-4 hour dives. The last 16 months, I have limited myself to 100 minutes or so.

Finally, the tinnitus in my ears is a lot worse than it was a few years back. Now I do not know if it is related, but my sense of fine trim adjustments has changed. It now takes a several seconds for me to "feel" slight changes in trim, where for years, it was almost instant. I am sure its related, but as a pilot, basic aerobatics such as aileron rolls, snap rolls, and Chandelles don't feel the same either, the visual adjustment to the attitude does not happen as quickly as 20 or so years ago. Anyhow, I spend more time and effort dicking with trim than I used to.

Now, I don't know what happened to Jack, but I have learned that there are vastly different warning signs and symptoms of heart disease. Some people have no symptoms, but in retrospect, I had things going on that should have raised warning flags. I was getting out of breath sooner, which I attributed to age. I had reflux and bloating, almost with anything I ate. Severe heartburn (I thought) with pain in the center of the chest which I was sure was bloat. My heart attack was asymptomatic enough for me to drive myself to work, go into my office for a few hours, and finally, the reflux was accompanied by pain down my left arm. I did not believe it, I drove myself to the hospital, which caused the admitting nurse great consternation, and I was severely scolded. Could I have got out of a cave? I would like to think I could. 3 days before the attack, I did 100 minutes in Emerald.

You guys going for stress tests, you should know that treadmill tests are only about 60% effective. They miss 40% of the problems, and give false positive and negative results. If you get a less than favorable result, and you did not fall out on the treadmill, try it again in a few weeks. At least that is what Martha Stewart, my cardiologist (no relation) told me.

On the positive side, I've always felt that (solo) cavediving (in the early days, without cave training) increases my life expectancy. The reason was first stated (I think) by Gordon Henderson:

"When making risk assessments, people tend to err in favour of the spectacular, and neglect the merely probable".

I get bored if an exercise regime isn't interesting. And I tend to stop doing it. Cavediving gives me a reason to keep fit that's interesting, a hobby that doesn't boring after a few dives. I do a few other things to keep fit, partly so that I can (say) wade thru 200 yards of swamp with my 2x steel 80 tanks and do a fun dive at Little Gator Hole when in Florida. I'm not sure there is any cavediver who is more likely to die in a cave than of something boringly cardiovascular. By cavediving, I have a risk of cave accident (thus lowering life expectancy) but by being fitter, reduce my risk of something cardiovascular (thus increasing life expectancy).

Overall, I strongly suspect that I'm a winner. (But as someone else mentioned, that's really because Jesus rescued me from the futility of this world, long before I got interested in caves).

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Originally Posted by OFG-1

Second, my cold tolerance, which has never been great, is worse. I suspect the aspirin. Because of the cold, I am just not going to do any more 3-4 hour dives. The last 16 months, I have limited myself to 100 minutes or so.

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Interesting. I've been on a blood thinner (plavix) since having a PFO closed in September and have found something similar. I've never been a fan of cold water, but I'm getting chilled on dives now that I didn't before. I'm only required to be on it for 2 more months, so maybe that will be better.

On the other hand, I've done close to 60 deco dives since being cleared to resume diving, including a couple of 250'+ dives, and had nary a niggle...

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Originally Posted by mfascuba

I just turned 50, I treat my body like I treat my regulators. If it ain't broke, don't fix it, and don't open it up for fun. If I feel like I need to see a doctor, I go. My blood work and other stuff has given no indication of something lurking beneath the surfac beyond the fact that I'm considered gravitationally challenged due to my keenly developed ability to store food as energy. I've had two immediat family members die of cancer in the last 12 years, I'm not stopping till I'm done.

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Originally Posted by LCF

It's good to get regular physicals, once one reaches a certain age (I'd arbitrarily set that at 50, for people who otherwise believe themselves to be healthy). Things like diabetes and high blood pressure can sneak up on you without many symptoms, and definitely have implications for long-term health.

However, the average routine physical consists of vital sign measurement (can be done at Rite Aid), a quick listen to your heart and lungs, a cursory review of systems, and some blood work. Such an exam will not detect silent coronary artery disease, and without concerning symptoms (and sometimes even WITH them) insurance companies aren't going to pay for even noninvasive stress testing. Still probably the best you can do is stay active -- engage in some kind of activity that raises your heart rate to the recommended level (I've seen it set at 200 - your age) several times a week. Even that will neither completely protect you nor give you adequate warning. One of the most sobering stories I know was a 38 year old physician with a HORRIBLE family history for heart disease. He was not diabetic or hypertensive, and didn't have one of the familial hypercholesterolemia syndromes. He just had a lot of relatives who died at early ages of coronary artery disease. He lived on a Pritikin diet and ran 7 to 10 miles a day, and he didn't have an ounce of body fat. He dropped dead on a run at 38.

There is no perfect protection. Activity is probably the most important; medical checkups can be useful to detect silent problems, but do not think that just because you get a physical every couple of years, there is nothing lurking inside you that could cause problems. We're not that good.

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The "head in the sand" attitude is what will get you in trouble.

I've always gotten yearly physicals, with no issue except familial cholesterol. However, after a dear friend (not overweight) suffered a heart attack, I talked to my Primary Care Manager about getting a stress test (age 50) so I could go back to hard aerobic exercise. While my heart was "fine" (some funky valve stuff I was told not to worry about), they also found I had some beginning small airway obstruction. I quit smoking when I was 24.

Furthermore, an MRI of my lower spine also showed some plaque in my femoral (I think that is what it was) artery - again, I had quit smoking 25 years prior.


The sins of your past WILL catch up with you. Better the devil you know than the devil you don't.

All this prompted me to order a blood pressure monitor...

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Originally Posted by FW

All this prompted me to order a blood pressure monitor...

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Forrest I was told to check the pressure in both arms, if there is a large difference in BP then see the Dr. Now I always see my Dr. at the beginning of each year for a physical. This January while being poked and probed he found nothing wrong. Next day the blood work came in and he called and said my glucose (sugar level) was at 130. He mention that I could loss a little weight even thou I'm not overweight for my height. I decided maybe it's not a good idea to have a physical right after the Holliday's so I scheduled my next one close to my birthday in October. I'll be 70 then.


Sent from my iPad using Tapatalk

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Originally Posted by FW

All this prompted me to order a blood pressure monitor...

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What's her name?

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Originally Posted by kwinter

What's her name?

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Now that's funny! All kidding aside, Forreset, you don't need a blood pressure monitor, or any other pressure monitor for that matter. You don't need a woman either, FWIW.

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Originally Posted by FW

All this prompted me to order a blood pressure monitor...

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Originally Posted by kwinter

What's her name?

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I said "monitor" not "escalator" :roll:

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Originally Posted by OFG-1

Well, at 62, I have found that it is more difficult to keep any workout going, particularly with 2 bad knees. If you can think of any aerobic exercise that does not involve your knees, (and even sex requires some use of them) let me know. The knees are so bad at this point,I cant do a good looking frog kick, I cant keep the knees bent up for a long time. So I shuffle around, probably trailing silt like Pigpen in the Peanuts cartoon. So I am going to stay in bigger cave.

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First to respond directly to this: get knee replacements! I had a very bad knee because of repeated injuries. I couldn't run a step, and walking was painful. I had that knee replaced 7 years ago, and today I don't give it a thought unless reminded of it in situations like this. Getting that knee replaced was one of the best decisions I have ever made. It changed my life.

Next, I think heart rates are extremely individual. I normally ride either an exercise bike or an outdoor bike at least 4 times a week, and I try to push it as much as I can. I can't get my heart rate up to the supposed exercise target range without getting close to agony in the exercise rate. My typical exercising heart rate is in the low 80s.

My body in general is paying for the abuse it suffered in its active youth. I got the knee fixed, but I am careful with the other damage points. I don't do anything abusive in my exerize, like running, treadmill, etc. I treat my Morton's neuroma, the result of years of volleyball play, with great care, which you would see in the way I boot up that foot with my dry suit. I am doing more sidemount diving so I don't have to wander around shore with my steel 108s strapped to my back. I have recently started to let other people haul tanks as much as possible to help relieve my carpal tunnel issues.

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Originally Posted by FW

I said "monitor" not "escalator" :roll:

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Very witty guys.:-D

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Originally Posted by FW

I would agree with most of this, except I don't want to die in a cave and add the the statistics and bad press of cave diving.

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Only Forrest would be more concerned about the bad publicity for cave diving than his own death.

skip

while i am not in the "aging" timescale (just turned 30). I try to do bootcamp (cross-fit like training) for a few months of the year when diving is slow (nov-april). Especially before coming to Florida so I am in shape to do the bigger dives (in comparison to the great lakes)

A year ago, i was at 200lbs and through bootcamp, i dropped down to 180 and I try to stick around that range now. Drysuit feels nicer and more mobility.

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Originally Posted by FW

All this prompted me to order a blood pressure monitor...

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It arrived yesterday, and I am below the "worry" level. I will still keep records to show my doctor at my next physical.

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Originally Posted by FW

. I will still keep records to show my doctor at my next physical.

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33 1/3, 45 or pray not 78s??? LOL

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Originally Posted by Kelly Jessop

33 1/3, 45 or pray not 78s??? LOL

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I am still using wax cylinders...

:rollguy

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Originally Posted by FW

I am still using wax cylinders...

:rollguy

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Hmmm...you and Edison good buddys?

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Originally Posted by Kelly Jessop

Hmmm...you and Edison good buddys?

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Of course :roll:

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Originally Posted by FW

I am still using wax cylinders...

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I always had you pegged as a wet-clay-tablet and pointed stick type of guy.

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Originally Posted by gschaut

I always had you pegged as a wet-clay-tablet and pointed stick type of guy.

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Hey, I am also high tech, I just love things like wax cylinders, quill pens, etc. :-)