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ENG1 and type 1 diabetes...
DocDOTcom
Posted: Monday, December 1, 2008 3:43 PM
Joined: 01/12/2008
Posts: 1


Dr Ken, I'm a keen sailor looking at the prospect of a career in the industry. The problem is that I am type 1 diabetic and so the best medical classification I can hope for is a restricted ENG1 for non-watch keeping coastal duties. Before I embark on expensive training and general life upheaval, what are my chances of getting a deckhand job with this caveat? Cheers.
Anonymous
Posted: Tuesday, December 2, 2008 8:08 PM

This is a very important question to ask at your stage and you have already provided much of the answer. Diabetes which has to be controlled by insulin has very far reaching implications for seafarers and it is only a few years since it was deemed incompatible with life at sea. More recently the restrictions/opportunities which you quote have been made available to MCA approved doctors but I think you will agree that it still places pretty tight boundaries.

I had a similar query recently and decided to discuss the issue at the MCA Annual Conference in London last week for the benefit ot the previous person. The medical guidelines are under general review right now and the revised guidelines are to be introduced for January 2010. It is likely that there will be slightly less restriction for very well controlled insulin-dependent diabetics who have supporting documentation but the opportunity to go much beyond coastal waters will also depend on other factors such as the presence of a doctor on board, as in a cruise liner. This is probably not as promising for someone looking at the yachting industry who may be faced with much the same situation as at present and I think it would be over-optimistic of me to imply otherwise.

Please write back if there are gaps in this - I realise that a lot hangs on the info - perhaps you should present yourself to an approved doctor with as much documentation as you can muster and see how you get on before you spend on training courses and relocation but, at present, the restrictions which you quote are the best you could expect.

All the best.

Dr Ken

 

 


Anonymous
Posted: Tuesday, December 2, 2008 9:05 PM
Thank you for getting back so quickly Dr Ken. I've asked this question of many people in many places and this is the first response I have had beyond "I don't know" or "It will be fine" (aka "I don't know and I'm making it up"). I'm glad the guidelines are being looked at as although I am aware of the risks of hypoglycemia in even a minor role at sea, like most "medically disadvantaged" groups, diabetics are judged on the worst of us rather than what the reality is for each individual in question. I myself am acutely hypo-aware and can feel my blood sugar dropping long before it affects my performance, even when in an emergency or rough water. However, proving this to someone you have never met is impossible, and I could well understand a Skipper's or even a Doctor's skepticism over my suitablilty for a role when they have the option of employing someone with a fully functioning pancreas instead. This, ultimately, is the crux of the issue, and something not anyone can give me a straight answer on because they fear that by telling the truth they may be opening themselves up to claims of discrimination, or they just don't want to speak for the whole industry when they are just one person/organisation. You have probably given me the straightest answer yet. I think that for now I will have to abandon my career plans in the industry, but who knows what the future holds for diabetes (to be honest, just paying less than £50 for a week's holiday insurance would be a start). Thank you once again for your time Dr Ken. Kind regards. Doc
Anonymous
Posted: Tuesday, December 2, 2008 9:06 PM
ps sorry that's all a big lump, the text formatting appears to have gone slightly awry.
Anonymous
Posted: Tuesday, December 2, 2008 10:28 PM

Thanks also for your quick reply - maybe you could contact one of the patient self-help groups eg www.diabetic.org.uk to press your point and make sure no stones are unturned. The question of discrimination turns on whether reasonable adjustments are made for the individual who is affected and you and/or your representatives such as Diabetes UK quoted above would have to make a case to support more unrestricted circumstances at sea.

It is not easy - I had a teenager turn up earlier this year with such well controlled Type I diabetes that he mentioned it almost as an after-thought but it was clearly not compatible with an imminent Atlantic crossing.

Keep in touch if and when.

Dr Ken

 


JCL
Posted: Monday, June 11, 2012 7:22 PM
Joined: 11/06/2012
Posts: 3


Dear Dr Ken, Has there been any change in the MCA attitude towards type 1 diabetese and ENG1 medical? I am currently in the Carib having been offered work as a training skipper on a yacht. I am a type 1 diabetic, and it seems that i may not be able to get a medical. (i used to be an HSEpt1 diver but did not reapply for my medical in 1994 having become diabetic. at that stage it was just a failure.) Do you thinnk i could get a medical so that i could operate as a yachtmaster with commercial endorsement? I have good insulin control.
Dr Ken
Posted: Monday, June 11, 2012 11:04 PM
Joined: 08/07/2008
Posts: 22


Hi there! It is much the same as my post 2 Dec 2008 and this does not offer a lot of scope for you. I think It is a frustration when control is good but the guidelines are designed to cope with some worst case scenarios like stormy weather, no time to eat, vomiting with whole body movement, increased exercise upsetting daily insulin/food balance - all contributing to a challenge when the boat needs fit crew ready for action. Sorry if this seems very negative but insulin-dependency at sea can produce occasional nightmares in otherwise well controlled individuals. Let me know if you have further queries. Dr Ken
JCL
Posted: Wednesday, June 13, 2012 3:40 AM
Joined: 11/06/2012
Posts: 3


Thanks so much for your reply Dr Ken. it seems ist just another case of people who are not involved with the every day detail making rules for the masses. Its discrimatory and there's no denying it. Since i lost my medical as an HSE PT1 diver i have sailed some 40,000 miles single handed. a single handed transatlantic, and many single handed cross chanell passages. i bought a boat in 2008 in the states, and have since sailed 3 transatlantics with my family (i statred with the boys at 1.5 years and 3.5 years) since then we have sailed west 45000 miles. i sailed 3500 miles single handed from maldves to egypt in feb 2011 and now we are in the caribbean. to say that diabetes is a ristriction on sailing is ridicolous. The medical profesion and the establishment is in denial about the abilities of the individual. with good controll you can do anythig. I think its discrimatory to suggest that a diabetic cant have a medical to sail. Its blatent disregard, for the abilities of the individual to be overruled by the establishment. Like all things, if you want to do it your just have to do it. To say that society cant give you a liscence to achieve your ambitions is discrimatory and should not be allowed. I feel verry strongly that the rules should be massarged so that it takes into account personal attributes and those with the will and detirmination should be allowed to be excellent in their feild. so i catagorically say to you and those that suport the views of the MCA....Buck up, there are many of us who wish to be part of the heritage of the seafareing history of the UK and who are disallowed because of some stupid spotty adolecent who deems that we cant, because of the risk to his assesment and thersfore his j9ob......what a sham....life is good and there are many able bodied people who wish to add to the full spirit of the UK but are being denied this RIGHT. Let us be a part of the UNITED KINGDOM and add to our country. There has to be a change and there are many people who want to serve the crown and counrty who are being discriminated against by the bullishit ...one tie fits all ..mentality of the HSE that is disregarding our heritage in terms of seafareing heritage. Capt jason Lawrence, diabetic, at lesat 90000 miles since diagnosed, some 50 000 singlehanded...... year, cant trust a diabetic unless there is a doctor about who know less than you EH.....
JCL
Posted: Wednesday, June 13, 2012 4:11 AM
Joined: 11/06/2012
Posts: 3


Sorry Dr Ken, im nt looking to hit you on this but is just no fair. The circumstances of massive failure at sea are minimal. OK if your inverted and EPIRB on its pretty dire. so its a 1 in 100 chance of that anyway. say your a diabetic, your no insulin time scale is prehaps 12 hours without issue. say no drugs and physical exertion its about 18 hours....then you start to get low sugars, so you have somethng like eyeryone else, ...err you can control your high sugars buy action , so that if you get low you can gem up on high sugar bars....... as a diabetic you probably have a better understanding of emotional behaviour under restriscted sugar intake than anyone else in your party.. look, its just bull that the HSE restricts able bodied men and woemen from serving their country when its apparent that they know more than the authoritires about their condition thea anyone else. i hope that you can put forward my views in the spirit of meanig and get some reality into this void of misunderstanding, which seems to be a trail of Career enhancement Best Jason
 
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