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tfd86
09-25-2009, 07:10
Anybody here dive with a know PFO? If so any troubles, should I changes my computer (suunto vyper) to dive a kinder/gentler profile?

comet24
09-25-2009, 08:01
I would find a doc. with experience in this and diving. Call DAN.

I have read a few articles on this and just understand the basics. I think part of it depends on the diving your doing and the risks. If your doing non-deco shallow diving your exposure it much less then someone doing deeper deco dives. There was a discussion about this awhile back on thedecostop.

navyhmc
09-25-2009, 08:07
I take it you're referring to Patent or Persistant Foramen Ovale? DAN has an article on it:
DAN Divers Alert Network : Patent Foramen Ovale - Is It Important to Divers? (http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=70)

From what DAN posted, yes, a kinder, gentler profile would be indicated along with maybe higher percentage Nitrox as a preferred gas. While it night limit your max depth, diving 36%-40% and using air tables would be a good starting point.

And as always, remeber that advice from an anonymous internet poster should be confirmed or refuted by a live professional expert. IOW: I'm only a simply, silly paramedic...not a doctor. or "Dammit Jim, I'm a diver, not a doctor!!!"

Grin
09-25-2009, 08:10
I would contact DAN with your plans of how deep and other specs of your dive plans. I think what your going to have to do is come up with your own dive profile that is much more conservative than any computer or published dive profile. I don't have a PFO, but was afraid I might at one point years ago. I read up on it, so I half way know what your talking about.
My guess is you will need to cut your bottom time, and accend at double slow speed, like 10 fpm instead of 30 to be safe. If DAN even thinks you should even try it at all. It aso depends on if your thinking about 100 ft dives or just 30 ft dives, etc....
Figure out what your plans are, and call DAN, and see what they say.

Lulubelle
09-25-2009, 08:21
I'm guessing that your PFO is relatively small? Any plans to close it? Or is it not clinically indicated for you? I used to work CCU at Boston Children's and they could fix just about anything. I agree with Navy's comments and sound advice but would insist that you must (as supposed to it being a good idea) see a DAN physician for specific guidelines. That's what they are there for. I plan to see one myself for some questions about another issue. Heck, I can drive over there and knock on their door for you if you like :smiley20:

tfd86
09-25-2009, 08:36
I take it you're referring to Patent or Persistant Foramen Ovale? DAN has an article on it:
DAN Divers Alert Network : Patent Foramen Ovale - Is It Important to Divers? (http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=70)

From what DAN posted, yes, a kinder, gentler profile would be indicated along with maybe higher percentage Nitrox as a preferred gas. While it night limit your max depth, diving 36%-40% and using air tables would be a good starting point.

And as always, remeber that advice from an anonymous internet poster should be confirmed or refuted by a live professional expert. IOW: I'm only a simply, silly paramedic...not a doctor. or "Dammit Jim, I'm a diver, not a doctor!!!"


MD's around here for the most part clueless on dive medicine. I would rather trust diving paramedic that can read. Two years ago wife got hit with fire coral PMD dx scabies , expensive rx 1 call to DAN = no TX went away. Already read the DAN article as well as others as in most medcine arguments differ without evidential backup.

TJDiver
09-25-2009, 09:30
This must have been what happened to a diver on a liveaboard trip I took many years ago. I booked independent, and ended up on a trip where a group had booked together from a dive shop. The owner of the shop leading the trip surfaced after one of our dives, and went limp in the water...and, the dive was a shallow profile...not something we would have even come close to NDL's on a single tank. He was unconscious by the time they got him on board. He eventually regained consciousness, but the only movement he had was facial...otherwise, totally paralyzed. They immediately administered onsite firstaid, notified authorities, and headed to the nearest pickup spot, where a CG chopper from Miami whisked him and his wife away. He did get a little movement back before the chopper arrived, but not much...mostly just wiggling his fingers and toes a tiny bit. Later, the captain informed us he was going to be ok, but didn't share any other details. I had dove with the DM on a previous trip, and he eventually shared with me that the guy had been previously diagnosed with some condition that his doc felt should prohibit him from diving (didn't share what that condition was tho). Needless to say, the DM was one pissed off you know what to learn the guy pulled that kind of stunt on his boat.

Lulubelle
09-25-2009, 09:46
MD's around here for the most part clueless on dive medicine. I would rather trust diving paramedic that can read. Two years ago wife got hit with fire coral PMD dx scabies , expensive rx 1 call to DAN = no TX went away. Already read the DAN article as well as others as in most medcine arguments differ without evidential backup.

I am sure they are. But DAN can refer you to a cardiologist who understands both PFO AND diving who can give you real, solid, advice as to what your parameters should be. Any plans to close it? I used to work at Boston Children's CCU and we did a lot of PFO closures on kids and big kids. This may be trivial to you on land, but don't play with it in the water without the right advice.

To the previous poster, there are about 8 trillion reasons why that fellow on the liveaboard may have gone out. Most of them are far more likely than a PFO. But the message is still a good one, no one should dive without clearance on their cardiovascular and respiratory health!

TJDiver
09-25-2009, 10:13
MD's around here for the most part clueless on dive medicine. I would rather trust diving paramedic that can read. Two years ago wife got hit with fire coral PMD dx scabies , expensive rx 1 call to DAN = no TX went away. Already read the DAN article as well as others as in most medcine arguments differ without evidential backup.

I am sure they are. But DAN can refer you to a cardiologist who understands both PFO AND diving who can give you real, solid, advice as to what your parameters should be. Any plans to close it? I used to work at Boston Children's CCU and we did a lot of PFO closures on kids and big kids. This may be trivial to you on land, but don't play with it in the water without the right advice.

To the previous poster, there are about 8 trillion reasons why that fellow on the liveaboard may have gone out. Most of them are far more likely than a PFO. But the message is still a good one, no one should dive without clearance on their cardiovascular and respiratory health!

Well, I doubt they number in the trillions...but yes, there are many possible causes for his event. However, this guy had one pre-diagnosed reason that made him highly susceptible to embolisms...hence, the reason for the DM's anger over the situation. Maybe I could have used a better word than "must", but from what I read in that DAN article, it fits.

Lulubelle
09-25-2009, 11:47
MD's around here for the most part clueless on dive medicine. I would rather trust diving paramedic that can read. Two years ago wife got hit with fire coral PMD dx scabies , expensive rx 1 call to DAN = no TX went away. Already read the DAN article as well as others as in most medcine arguments differ without evidential backup.

I am sure they are. But DAN can refer you to a cardiologist who understands both PFO AND diving who can give you real, solid, advice as to what your parameters should be. Any plans to close it? I used to work at Boston Children's CCU and we did a lot of PFO closures on kids and big kids. This may be trivial to you on land, but don't play with it in the water without the right advice.

To the previous poster, there are about 8 trillion reasons why that fellow on the liveaboard may have gone out. Most of them are far more likely than a PFO. But the message is still a good one, no one should dive without clearance on their cardiovascular and respiratory health!

Well, I doubt they number in the trillions...but yes, there are many possible causes for his event. However, this guy had one pre-diagnosed reason that made him highly susceptible to embolisms...hence, the reason for the DM's anger over the situation. Maybe I could have used a better word than "must", but from what I read in that DAN article, it fits.

OK, OK, maybe not trillions...especially since you have added the fact that the issue was one to cause risk of embolism.

Sure it could fit, but there are dozens and dozens of other conditions which could lead to embolism. I did CCU for a long time, so hearts are my thing, at least little hearts with defects. I'm all FOR people getting past their health barriers to enjoy scuba. But I agree wholeheartedly that people MUST be responsible for their own health issues and appropriate diving parameters otherwise they put not only themselves but others at inappropriate risk which is not OK.

I have had a number of friends who have consulted DAN docs and come out with really good and practical information on what limits and strategies can allow them to dive safely and to be a reliable buddy as well. I plan to consult one myself over some recent issues. Safety first.

Desert_Diver
09-25-2009, 11:48
Doug Debersole is a cardiologist and diver. He posts on Scubaboard. He is going to tell you to get advice from your own doctor but he will probably answer more general questions.

Art

Lulubelle
09-25-2009, 12:22
Doug Debersole is a cardiologist and diver. He posts on Scubaboard. He is going to tell you to get advice from your own doctor but he will probably answer more general questions.

Art

Sounds like a valuable resource, but PFOs can vary widely and the OP needs someone who can actually examine him. I know I'm beating this to death. I'm sorry. I just care for people to have their dreams but to do so safely.

tfd86
09-25-2009, 13:16
Ya would love to have it closed but from what I have been reading tia or cva are prerequisite

Lulubelle
09-25-2009, 13:24
Ya would love to have it closed but from what I have been reading tia or cva are prerequisite

My background is pediatrics, where they are closed, so I do not know what is standard in adults. It may be that the surgery is too risky in an adult body to do without a cause. But it might be an interesting question to ask that DAN doc since diving is a passion for you?

tfd86
09-25-2009, 16:20
The DAN website has two articles on PFO and diving neither suggest contraindication of diving only less BT & higher o2 mix, so looks like i'm still good to go.

navyhmc
09-25-2009, 19:16
Do you have nitrox cert tfd?

tfd86
09-27-2009, 14:24
Not yet But I have $$$$ time and a whole lot of cold/snowy weather coming up.

Lulubelle
09-27-2009, 14:29
Not yet But I have $$$$ time and a whole lot of cold/snowy weather coming up.

Yah, you need to do that nitrox cert before diving again. I talked an instructor into doing it for free when I did my AOW, just paid for the book. Don't do any of those online courses, my understanding is that they are not recognized at most dive ops.

Then you will be prepared to dive a safer mix for your situation. You might want to get some DAN advice on what that mix should look like for different depths.

I'm taking some advance gas courses next summer. Not because I want to go tech, I don't, I just want more flexibility within the rec limits I am diving here in NC. Knowledge is power.

jugglematt
12-13-2009, 03:53
kinda related to this post

can anyone comment on the risk of repairing a PFO , i understand as with any surgical procedure there is some risk

any divers out there who have had a PFO repaired to allow a return to diving ? what was your recovery time ??

the reason i ask i recently got a "undeserved " bend/ hit and the doctor who treated me at the chamber suggested i may have a PFO . im booked in for a TOE to asses if i have a PFO on the 23rd
this is my 2nd bend and i have a strong history of migraines .

so depending on what the outcome of the test is i may have good or bad news as a Christmas present .

Matty

ReefHound
12-13-2009, 08:29
Being diagnosed with PFO would certainly give me pause but on the other hand PFO occurs in about 25% of the population meaning there are millions of divers - and many of you reading this post - that are diving regularly with undiagnosed PFO. Ignorance is bliss?

Quero
12-13-2009, 10:23
As I understand it, the risk associated with diving with a PFO depends on the ease with which the flap opens, not with just how much nitrogen you load. Part of the TEE examination and bubble test involves coughing to put strain on the suspected PFO. If it opens easily, then something as simple as climbing a boat ladder while wearing gear might trigger a bend. I had a similar worry (and I also suffer from migraines), and so had it checked out.

In my case I was having skin issues after diving that looked and felt like skin bends. The local hyperbaric doc I consulted by telephone (one of the docs associated with DAN SEAP) guessed it was probably a developing allergy to sunshine, but as I had no history of sun allergies, as a precaution he sent me for PFO screening, particularly since I am a diving professional and risk frequent exposure. He told me that until I had a definitive answer from the tests, I should avoid any post-diving strain--I had to climb the boat ladder without gear and to avoid lifting heavy things like tanks. (Happily I was cleared of a PFO defect, and as the diving doc guessed, I soon developed a severe allergic reaction to sunshine that put me in bed for two days after a very, very mild post-dive sunburn.)

I agree with the majority advice: phone DAN and ask. For anybody who is going to be in Thailand and would like to get a TEE and bubble test, it is very, very affordable here, and the cardiologists are world-class.

Tassie Diver
12-16-2009, 03:51
... But I agree wholeheartedly...
:smilie39::smilie39::smilie39: :smiley9:

jugglematt
12-23-2009, 11:49
Hi Folks
well i recently got a bend and a couple of sessions in the decompression chamber.

the treating doctor thought i may have a PFO as this is my 2nd bend and i have a history of migraines .

well yesterday i went to sydney to have a TOE (ultrasound bubble test ) to look for a PFO , this involves inserting a ultrasound down your throat , and getting it close to the heart to get a really good look at it .

the procedure is fairly simple , firstly a ultrasound on my chest ( no PFO seen ) then the TOE , spray my throat , to numb it , drug me to calm me down . lay on side . ultrasound goes down throat , swallow , . seems like it was over with in no time . i was a bit out of it but it all went well and easy .

no PFO detected , actually went for a walk to the hypobaroic centre in the same hospital , had a chat to the doctor ,

im ok to go back to diving YAY ,
take it easy . dive NITROX on air tables , Hydrate , ect ect ect .

a Good Outcome
Matty

jugglematt
12-23-2009, 11:53
also
In Australia ALL my treatment was coverd by our National healthcare system (medicare)

which included

local hospital visit
flight in helicopter to hypobaric chamber in sydney
2 sessions in chamber

TOE and chest ultrasound & all drugs

all i had to pay for was a motel room to stay in after my first recompression .
and
a train from the hospital back home

Matty