Failing Sharpened Romberg test
Hi,
This question is aimed at the MD's on the forum, I would really appreciate any thoughts or feedback.
I have long wanted to learn to scuba dive, and actually tried to do so about 8 years ago but the examining MD (in Australia) did not grant me clearance.
Clinical info: I have a bilateral sensorineural hearing loss in both ears as a result of meningitis incurred at age 4. Otherwise perfectly healthy, weight, lung function, BP, etc all well in the accepted range for a 40 year old male. I have been a competitive swimmer and paddler for many years, have been snorkelling many times and am extremely comfortable in and on the water.
When I went to the MD for a pre-dive medical and mentioned that I was deaf he seemed to be concerned from the start. When we got to the Sharpened Romberg test, I could not hold the pose for the requisite 30 seconds. The MD subsequently refused to give me clearance. He said that my inability to hold the pose in the Romberg test was indicative of a neurological problems and that it meant, for example, if I were to lose visibility while scuba diving, I would not be able to determine where my body was oriented relative to the surface and this would potentially pose a problem.
Over the years I have spoken to many people about this, including a professional dive instructor and a scuba-diving neurologist who expressed surprise at what happened, and all have said that in situations where they've lost visibility they don't necessarily know which way is up either, and use other methods to determine that. I also was able to get medical clearance from a MD in the USA when I lived there (just signed off on a form without any comprehensive tests) but unfortunately was unable to follow through and get PADI certification before moving back to Australia.
So...was the examining MD over the top when he refused to grant clearance or were his concerns valid? Should I try to seek a second opinion? I am seriously thinking of trying to see if I can try scuba diving again but don't want to waste my (or the MD's) time and money if I'm going to be refused clearance no matter what. I would rather do this properly and safely. I am extremely risk-adverse and would not even think of trying to dive when it wasn't safe to do so.
Thanks in advance.
I agree with Glen - it seems a little conservative to take the line that a short sharpened Romberg's time means unfit for diving automatically. I suggest seeking a second opinion form another qualified dive doctor or asking for referral to a specialist in this area.
Mike Bennett
Hello there.
Deafness per se is not a failing for a dive medical as in fact deaf people can communicate better underwater than normally hearing people in my experience (just getting that issue out of the way).
Falled SRT. While the concerns that the doctor bring up are a possibility, I would not fail someone for their dive medical personally for that reason. The bigger issue is the difficulty of determining whether a person has a diving related injury vs their normal situation.
My feeling (and this is personal not a doctrine) is that I assess diving injuries with a number of criteria so therefore a single fail in something like the SRT is not a deal breaker and I would probably pass someone with the information given.
I would get a second opinion of a diving specialist doctor and then they can assess the risk profile that you personally have.
Regards Glen
Thanks, Glen.
That is really useful information. I understand that what you've said applies to you personally but hopefully the specialist MD I do see will take everything into consideration before making a decision.
I'll give it a go!