Newtown Specialist Staffing New Dive Medicine Practice

By John Voket

RIDGEFIELD — Newtown resident David Charash, DO, medical director of wound care and hyperbaric medicine at Danbury Hospital, recently began seeing patients at Connecticut’s only diving medicine practices.

Dr Charash told The Newtown Bee during a recent visit to the office that services will focus on the comprehensive care of recreational, technical, scientific, public safety, and commercial divers, and include: recreational diving clearance, medical examination of divers, medical consultations, evaluation of the injured diver, and return to diving after diving injury or medical/surgical illness.

A recreational diver himself, Dr Charash is board certified in emergency medicine, and undersea and hyperbaric medicine. He is a certified medical fitness diving examiner, a National Oceanic and Atmospheric Agency (NOAA) diving medicine physician, and both an instructor and referral physician for Divers Alert Network.

Over the past two years, Dr Charash has developed a renowned Diving Medicine Conference at Danbury Hospital that has attracted more than 380 health care providers and community divers to improve awareness of the medical and safety requirements necessary for successful diving.

Since opening the practice, which he intended to staff one day per month, Dr Charash said the demand for appointments has surged to the point where he has already staffed two days in October.

“I’m hoping that this practice not only serves more Connecticut and western New York divers, but engenders a regional and national interest in diving medicine,” he said. “I know a lot of other physicians who are divers, and who take care of divers, but a lot of these divers go to see their own family physician or a cardiologist who may not be equipped to ask the tough questions.”

Dr Charash does not want to see colleagues less experienced in diving medicine telling patients they can dive when they shouldn’t, or being telling patients not to dive if certain diving scenarios are still acceptable and safe.

“The majority of divers go out once or twice a year,” Dr Charash explained. “While hard-core enthusiasts or commercial divers may go out hundreds of times a year all over the world.”

One factor that could bode well for the local dive medicine practice is the average age of divers today, which is 45.

“In 1970, the average age of a diver was 26. So at 45, a lot of lifestyle factors begin to play a role in increasing a diver’s risk factors and affecting their safety underwater,” Dr Charash said. “Those with diagnosed medical issues should be asking themselves, ‘Should I be diving?’ And we are here to help them get to the right answer.”

Dr Charash said the legal restrictions and mandates for medical monitoring of recreational divers in the United States has a long way to come before it is on par with requirements for divers in Europe and the UK, where an individual cannot be legally certified to dive for any reason without being cleared by a specialist with the experience and credentials of Dr Charash.

“Once you’re certified in the United States, you never have to get certified again,” he said. “So all these healthy 26-year-old who were certified in the 1970s don’t have to see a physician to keep their certification.”

This means a lot of divers are “skating on thin ice, or swimming under it,” Dr Charash said.

“Even something temporary like an upper respiratory condition can cause a critical incident if a diver makes a bad decision,” he said. By the same token, Dr Charash recently treated a diver who sustained a head injury, and who was told by his neurologist he would never dive again.

“But he came to me and we figured out a way to put his diving activities on hold until we could clear the imminent injury. He, in fact, may not be able to dive again, but at least we have a clear plan to getting to the point where we can make a true evaluation,” Dr Charash said.

In other cases where an individual may have stopped diving because of a cardiac condition, Dr Charash said there could still be hope — even if it means the individual has to dive in only warm, shallow waters for the foreseeable future.

Professional public safety, scientific, and commercial divers have even more of a critical need to have the necessary evaluations to ensure they are not a risk to themselves and their colleagues when diving.

“Only commercial divers are required by OSHA to have an annual exam, but with thousands of them across the country, I know many are getting their annual clearances from family doctors or those who may have some training, who are handling a very comprehensive evaluation.”

He said commercial divers are obviously at the greatest risk because they work very deep, and with heavy equipment. Public safety divers like individuals on Newtown’s Underwater Search And Rescue team (NUSAR) and the State Police Dive Team are among the hundreds in Connecticut and thousands across the nation who are not under any mandate to have regular recertification exams.

“These divers often work under poor conditions, in very stressful situations, and they need to be in the best shape possible, and understand the risks,” Dr Charash said.

For any diver, Dr Charash said the most common injury is to the inner ear — typically caused by fluctuations in underwater pressure that are not manually equalized. As a result, every exam he does includes an exercise that proves the patient knows how to equalize his or her inner ear pressure.

To ease the teaching process, Dr Charash uses a computerized scope with a tiny camera and a laptop computer to show the diver that he/she is performing the manual procedure correctly.

“Without being able to do that, it can lead to severe injury or in some cases even death,” Dr Charash warned.

This unique practice opened on September 19 at the Ridgefield location of Western Connecticut Medical Group, 21 South Street. To schedule an appointment, call 203-438-6541.