Continue or stop diving with a PFO?

[scubaozy]

When I did my PFO test a few weeks ago the Doctor asked me if I was doing it because I had migraines. I explained wanted it checked for deep deco dives. He's like yeah good idea at my age.

What would you have done if he found a shunt? Stop diving? Operation? In my view it makes more sense to have it checked after having an unexpected dcs.

 

[Blackcrusader]

What would you have done if he found a shunt? Stop diving? Operation? In my view it makes more sense to check after having an unexpected dcs.

Surgery for this in Taiwan is common and cheap. I only paid less than US$12 to get the PFO test done. I also wanted the medical certificate for my DAN insurance as well. I've never had a DCS hit so was not really too concerned.

 

[Johnoly]

I only paid less than US$12 to get the PFO test done.

$12 ?? What is it??

 

[ginti]

In my view it makes more sense to have it checked after having an unexpected dcs.

I actually think the opposite, because I believe preventing is better than healing. Out of curiosity, what is your reasoning behind this sentence?

 

[scubaozy]

I actually think the opposite, because I believe preventing is better than healing. Out of curiosity, what is your reasoning behind this sentence?

Without established correlation between a shunt and manifestation of dcs are you willing to get an operation done? My reasoning is DAN recommendations Guidelines for Patent Foramen Ovale and Diving - Divers Alert Network

 

[ginti]

Without established correlation between a shunt and manifestation of dcs are you willing to get an operation done? My reasoning is DAN recommendations Guidelines for Patent Foramen Ovale and Diving - Divers Alert Network

Sorry, I actually didn't read well your post. Anyway, I partially agree with you. Usually, a cardiologist who is also a specialists in diving medicine could say whether an operation is absolutely useless, necessary, or in the grey area.

I will read the guidelines, thanks.

 

[scubaozy]

Sorry, I actually didn't read well your post. Anyway, I partially agree with you. Usually, a cardiologist who is also a specialists in diving medicine could say whether an operation is absolutely useless, necessary, or in the grey area.

I will read the guidelines, thanks.

I don't think a dive doc will advise you any other than DAN guidelines. If I went to a dive doc and told him that I would like to have "preventive" pfo test, I expect to hear; "I do not recommend it. It can be done if you insist but result may provoke even more ambiguity."
I am not sure what to think of a dive doc recommending a pfo closure without presence of dcs.

 

[ginti]

I don't think a dive doc will advise you any other than DAN guidelines.

Me neither. I am almost sure they will follow the guidelines.

If I went to a dive doc and told him that I would like to have "preventive" pfo test, I expect to hear; "I do not recommend it. It can be done if you insist but result may provoke even more ambiguity."
I am not sure what to think of a dive doc recommending a pfo closure without presence of dcs.

I did a preventive PFO test with a DAN accredited cardiologist. I discovered I have a PFO, but it is so tiny that I don't need to close it. If it was more prominent, the cardiologist might ask me not to do deep mandatory deco diving or to close it (if it is huge) BEFORE a potential accident.

As a matter of fact, many people (with big PFO) experience tiredness before closing the PFO. However, being tired doesn't count as an incident, so they wouldn't close it without a preventive test. And if they don't close it, at the first serious mandatory deco dive, they might experience severe problems.

Prevention is good

 

[scubaozy]

Me neither. I am almost sure they will follow the guidelines.


I did a preventive PFO test with a DAN accredited cardiologist. I discovered I have a PFO, but it is so tiny that I don't need to close it. If it was more prominent, the cardiologist might ask me not to do deep mandatory deco diving or to close it (if it is huge) BEFORE a potential accident.

As a matter of fact, many people (with big PFO) experience tiredness before closing the PFO. However, being tired doesn't count as an incident, so they wouldn't close it without a preventive test. And if they don't close it, at the first serious mandatory deco dive, they might experience severe problems.

Prevention is good

Not sure what exactly did you prevent. Outcome of the test was exactly expected, only 6 percent of the people have larger size PFO and 27 percent has a PFO. I will copy paste from the article: Detection of a PFO after an episode of DCS does not guarantee that the PFO contributed to causation.
Risk is DCS is already so low that increasing it by 3-4 factor with PFO will not increase your probability that much. People writing the guidelines look at the data and provide most rational algorithm. Not easy to outsmart or outprevent.
BTW, DCS treatment has very high success rate, and I am sure this is also considered in the guidelines. Now are you willing to go through a closure op in your heart that maybe will decrease your chances of getting bends or get a several hour chamber ride with 10000:20 probability. Tricky.

 

[ginti]

Not sure what exactly did you prevent. Outcome of the test was exactly expected, only 6 percent of the people have larger size PFO and 27 percent has a PFO. I will copy paste from the article: Detection of a PFO after an episode of DCS does not guarantee that the PFO contributed to causation.
Risk is DCS is already so low that increasing it by 3-4 factor with PFO will not increase your probability that much. People writing the guidelines look at the data and provide most rational algorithm. Not easy to outsmart or outprevent.
BTW, DCS treatment has very high success rate, and I am sure this is also considered in the guidelines. Now are you willing to go through a closure op in your heart that maybe will decrease your chances of getting bends or get a several hour chamber ride with 10000:20 probability. Tricky.

I don't try to prevent anything. The doctor does if he thinks there is a need.

The benefits of prevention are significant only in the case of mandatory accelerated deco diving. The DAN guidelines are for rec divers (they cite studies about recreational diving).

@Duke Dive Medicine, @Dr. Doug Ebersole what do you think about preventive PFO screening?