Medical Certificates Dilemma

Medical Certificates Dilemma
Medical Certificates Dilemma

Something has gotten up my nose!!

I have not blogged recently because, apart from just keeping my training going and entering a friendly Gala last week between the two Gyms that I am part of. It was fun, after MANY MANY years, to be back in a  gala situation and I put in a good show taking Gold in the 200m and 400m freestyle posting PBs for both of them. Sadly our teams showing was not very impressive but we still managed a pretty sizeable medal haul

gala

Up until this Gala, I felt I did not really have a lot to blog about ——-Until now.

Last week, I managed to see a post from an old Friend who, after 8 years is taking another crack at the English Channel. I wish them the best of Luck and I am pretty sure he will be successful. Anyway, he posted about the difficulty in getting his GP to sign his medical form.

Now, I currently have my new GP who has been waiting for my medical records from the last practice so that I can get a medical certificate for my swim in Italy later this year. After a few comments on My firends Facebook about his experiences, I then was approache by my doctors surgery to say they had my medical records and could I come in and have a chat – at a cost to be determined – with my GP. Remembering the issues my firend had had, I asked the Nurse to show the doctor the Form and ask if they were happy to sign it. Apparently, a fairly long discussion ensued between the doctors at the Surgery and they WERE not willing to sign it. Glad i asked them to review it before forking out £50 – £200 for nothing. They are prepared to write me a letter but refuse to sign the document that I need. I am now talking to race organisers to see if that will suffice.

LET ME JUST SAY. i WRITE THIS ARTICLE WITH NO AFFILIATION TO ANY GOVERNING BODY. I AM NOT A MEDICAL PROFESSIONAL AND NOTHING I HAVE TO SAY IS BASED ON ANY SCIENTIFIC STUDIES OR FINDINGS. I AM HOWEVER A RELATIVELY ACTIVE OPEN WATER SWIMMER WHO HAS BEEN AT THIS GAME FOR ABOUT 8 YEARS NOW AND HAVE WITNESSED THSE CHANGES

So what is happening?

Having been in this Game for a while now, One thing that really gets up my nose is the lack of Clarity with regards to this. This is what I have found so far

1 – More and more swims are asking for them, even minor swims of 6km

2- The costs vary hugely. For my EC, it cost me £50 which involved a 10 minute consult. that was 8 years ago. Last year, It cost me nothing and I was not even called into see the doctor. All they had to go on was my medical records which are slim to say the least, and a Swim resume from me. This year, they quoted me anything from £50 to £200 depending on the consultation period

3 – There is no conformity for global swims. With my Longest and most intense swim  – in America – not even wanting a certificate (as far as I can recall – I may be wrong) Whilst Europe seems to be requiring them for most swims nowadays. In the UK, The BLDSA is a lot less worried about them.

4 – Standard GPS are less and less likely to put their name on the forms

5 — The wording seems to be the biggest stumbling block. For instance, this is the wording that my My current one has on it.

I, the Undersigned, Dr…………. (Doctor of medicine.) Certify that Mr/Ms…….. born on……….. –

is in good health and physically and mentally able to participate in the……….., A long distance Open Water Swimming Race with a High Cardio-Vascular effort

Now here is where my GPs have an issue with it. They want me to go to a proper cardiologist as the form states HIGH CARDIO-VASCULAR EFFORT

The one I got signed last year, Had virtually the same wording MINUS the “High Cardio-Vascular effort”

This could be due to the fact that it was only an 11km as opposed to a 27km swim.

There is currently a discussion on the Did you Swim Today Facebook page with some very interesting points on it.

Why is this happening?

Recently,  there have been fatalities in this amazing sport. However, they are by no means limited to what I consider “Ultra” Swims. Anything over and above 25km. Since 1926, I can find 8 Fatalities in The English Channel. 2 in the last 4 years. Now The midmar mile – yes, 1 mile – 1600m has had the same amount of fatalities in the last 4 years. Most of those Fatalities occuring to extremely competent and “fit” athletes. So the affliction is by no means limited to LONG swims.

The discussion on Facebook currently is asking if ECGs should be mandatory for those on Long swims? The above goes against the fact that long swims are at fault here. especially when you look at most the fatalities in the English Channel occuring within a mile or two of the French coast so Distance has nothing to do with it.

I also think (only MY thoughts) that ECGs are not going to pick up anything UNLESS the Doctors/ Cardiologists are specifically looking for something. A perfectly fit, healthy, active person could very easily show some VERY minor issue that, in normal circumstances, would be overlooked but, take gala sprints or 15 hours of swimming, that minor issue can now become critical. For them to issue a medical certificate based on that, I can understand why they are apprehensive

I will now give you MY TOTALLY UNSCIENTIFIC FINDINGS ON THIS.

There is a mention of all marathon swimmers going for ECGs and the likes. I doubt if that will help matters much. In my experience, the closest I ever came to having problems was when I did the English Channel. I started with a stroke rate of about 72 stokes per minute. I then settled down, after about an hour, to about 65. At about 1 am in the morning, I could not see the coast and was now totally reliant on my pilot. At about 11 hours they stopped me for a feed,  they said, Right

“if you push really hard, you will make land in the next hour. But you have to push to get through this changing tide”

So I upped my stroke rate from 65 to 80 Strokes per minute – bearing in mind I could not see a thing. After about 30 minutes of this I  was going to stop the boat because I was really stuggling and there was no way I could keep that effort up for much longer. it was then that they turned the spotlights on and I could see the land – well rocks. I finished with only minor cuts and bruise after clambering over the rocks

Why do I mention this? I think, physiologically, My body was VERY comfortable at 65 strokes and had been like that for 10 hours.Then to up the effort to 80 for about 30 minutes, is going to play havoc on anybodies system, heart, Lungs, and many other areas. I think this is the same for many long swims, When you can see the end in site, you up your tempo. In some cases (Zurich marathon Swim) when you see the finish line it is still 5km away. for most swimmers, that is 1.5 hours of swimming.

I also say this as I struggle a heck of a lot more doing 100m – 400m Sprints, sending my heart rate through the ceiling, than I do swimming 25km. The difference being, once I am in a comfortable zone, I can go and go and go – at that speed for Ages – never really tested how long but Up to 12 hours. I would say My heart rate is increased a hell of a lot more and I take a lot longer to recover doing a 100m flat out sprint than it is when I swim 25km.

So Is there an Answer and where do we go?

In a society that is becoming more and more litigious, Doctors (GPs) are going to become less and less inclined to sign these forms, Especially with some of the wording. You might also start to see specialists less inclined to sign them. Some time this year, I will most likely go and see a specialist cardiologist as to be Frank, I have no clue about my heart rate, resting or otherwise, I have no idea what blood type I am, I have no clue what my Blood pressure should be. I have never been for an ECG, Cat Scan, Dog Scan, whatever other Scan. I have probably only seen the doctor about 4  or 5 times in 20 years  with most of those being for skin complaints of medical certificates. In Other Words, I am extremely fortunate to be blessed with the constitution I have. it drives the slimhippo (my support crew) mad!

Be prepared that it is by no means a cut and shut case that you will get these certificates signed by General Practitioners and Will most likely have to go the private route and as mentioned, Budget £200 for something like this as it is becoming harder and harder to get them signed off. If ECGs ever become mandatory, up that cost by a fair bit.

Some people have had success with Same Day or Walk in Clinics but I have not, so before you start anything, add the following to the list,

Download the forms from the swims organiser, and show it to your doctors to find out if they are happy to sign it.

If they are not, I can only hazard at a guess at the waiting list on the NHS to see a Cardiologist for someone like me who has absolutely nothing wrong with them. I might get to see them next summer sometime. Okay, maybe a MRI would be a better investment as, if there is anything wrong with me it is more likely to be my head. So watch this space and I will update you as to what the outcome of this adventure is.

The discussion on facebook is ongoing and there is some interseting stuff on it the latest being what I have been leading towards

I was speaking to a forensic pathologist last week, he says no to routine screening as most of the anomalies which cause death in endurance athletes would not be picked up”

So there you have it. Just another thing to add to the list of things to do.

I am looking forward to more qualified professionals to chime in. We have asked Dr Otto Thaning has to say. he is more than qualified to wade in being A heart Surgeon and 2 time English Channel swimmer and also the oldest man to swim it at the age of 73 and some.

Happy swimming and I look forward with interest to see what comes out of this

About the author

Ameteur Endurance athlete and marathon swimmer Having taken up marathon swimmng in 2008 with the challenge of the English Channel, I then continued on to Cycle up Britain, Kayak across Scotland and run a few marathons. None of those held the draw that marathon swimming held so in 2014 I was back in the water to Swim the longest swim in Switzerland and then, in 2015 I opted to take on my biggest swim to date. SCAR challenge.- 4 lakes in 4 days with distances Ranging from 6 miles to 18 miles.

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