DAN emergency noticeboard at Long Beach

Diving medical insurance

A large part of diving training involves making sure that you are a safe, competent underwater adventurer. You learn the consequences of various actions on the air spaces in your body, and the physiology related to breathing compressed air at depth, including how long it’s safe to stay down, how fast to ascend, and all about safety stops. The training you will do teaches you to manage your buoyancy so as not to make uncontrolled ascents or descents. All this minimises the chance that you will need emergency medical care after a dive.

Diving accidents are uncommon, but when they do happen, the cost of treatment is likely to be high. In the event that you’re bent – or possibly bent – you’ll have to go to a hyperbaric chamber for recompression treatment. For some perspective on what this involves, and what this feels like, I spoke to Alistair Downing of Underwater Explorers, technical diver extraordinaire. He’s been bent twice – here’s how he describes the first time (in 2003), after a deep dive on trimix out of Hout Bay, involving numerous long decompression stops:

The dive and deco went great. No problems at all.

On my final ascent from 6 metres (doing 1 metre/minute ascent rate), I felt a slight twinge in my thigh muscle, but put it down to being really cold and immobile for such a long dive – roughly two hours!

Finally surfaced and felt a little dizzy, but assumed with the rolling seas, it was a little seasickness (not that it is usually a problem…).

By the time the boat picked me up, I was exhausted. I couldn’t unkit and needed the safety diver to get my gear off me.

I just made it into the boat and needed to lie down. Just felt really, really tired. Again put it down to exhaustion, having just done a massive dive.

About two minutes later I called for the O2 – thought it can’t hurt.

A few minutes onto the O2 the pins and needles all over my body started – time to go!

We were all DAN members and as per DAN’s protocol, we contacted DAN first. They then contacted Kingsbury Chamber and we were advised to proceed there. At this stage, I was aware of my surroundings and besides the pins and needles, was doing OK. We were 16 kilometres out to sea from Hout Bay and en route my condition deteriorated. Some of these I can recall, but others were relayed to me after the fact. By the time we got to Hout Bay harbour I was paralysed from my waist down, had lost sight in both eyes, apparently had stopped breathing on several occasions and was basically out of it!

They had initially arranged for an ambulance to collect me at Hout Bay, but there was a delay so my crew decided to transport me in the back of a bakkie – I have only one fleeting memory of the trip from Hout Bay to Claremont.

DAN had put Kingsbury on full alert and soon after I arrived, Dr Rosenthal arrived. I basically went straight into the chamber and was there for about 8 hours. I forget the exact details of the treatment, but Rosenthal has all these details. What I can recall is that it was not a pleasant experience. Lots of pain, confusion, too hot, too cold, thirst, nausea, and feeling very uncomfortable. That evening I was admitted to High Care and spent the night there on oxygen. At this stage I was generally pain free, except for one mother of a headache… and a general ‘pap’ feeling.

Over the next several days I went for about five follow up treatments of about two hours each. I was also on massive doses of medication, specifically to reduce the swelling of my brain. I was not allowed to dive for a year, which in itself almost killed me! It also took about 6 months before my headache went away…

I was diagnosed with neurological bend, most likely caused by a helium bubble. After the year, I passed my medical and it was all systems go again.

Alistair dived with the same buddy both times he got bent, and his buddy experienced no problems either time. Alistair was later diagnosed with a PFO (patent foramen ovale, or hole in the heart that did not close completely at birth – about one third of people have them) which may have  predisposed him to getting bent despite meticulously following safe decompression schedules and experiencing nothing untoward on either dive. He had this surgically repaired and since 2009 has been back in the water with no problems!

DAN emergency noticeboard at Long Beach
DAN emergency noticeboard at Long Beach

DAN stands for Divers’ Alert Network. They’re an international organisation that provides top-up medical aid cover for divers, as well as diving medical information and research, evacuation services, and training in diving safety.

Alistair’s treatment for the bends he’s experienced cost between R30,000 and R40,000 each time – and if a helicopter evacuation had been required, that cost would have increased sharply. Here’s what he said about the extent of the cover by DAN:

DAN covered me in full for both bends – picked up all the bills, including medicine. I basically did not pay a cent and as a DAN Business member, was really happy about this. They however did not cover anything linked to the PFO operation, as it is post injury elective surgery, not bends incident related.  All in all, a good showing by DAN and reason enough to get cover from them.

While we trust medical aids to provide the peace of mind that your costs will be covered when you require hospitalisation or emergency treatment, the truth is that in many cases they will do everything they can to avoid paying out your claims. You should be certain that the medical aid cover you have will pick up the tab if you incur an injury while diving – many medical aids classify scuba diving (even recreational scuba on air to less than 40 metres’ depth) as an extreme sport, and treat associated claims accordingly – in other words, with great reluctance.

(As an aside, if you have life cover, you should make sure that the life insurance company is also aware of your diving activities for their records.)

Learn to Dive Today is a DAN Business Member, which means that we are able to supply you with application forms and membership information, and have access to DAN training on emergency procedures and management. It also means that we are kept up to date with developments in diving medicine, and have access to the extremely efficient DAN team in South Africa for any assistance we require.

If you dive frequently, if you like to dive in remote places, if you have a penchant – or desire – to push the limits of recreational scuba, and especially if you fit into one of the risk categories for diving (old age, overweight, heart problems), you should have this kind of insurance. If you want more information or to discuss the various options DAN offers, email Tony or contact the DAN Southern Africa office. They’re very friendly and super efficient!

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Lapsed mathematician, creator of order, formulator of hypotheses. Lover of the ocean, being outdoors, the bush, reading, photography, travelling (especially in Africa) and road trips.

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