Bride-to-be dies in Micronesia diving trip

[Gregordo]

I am very sorry for the family and friends. I hope that they can get some solace from knowing she was doing what she loved. I just lost my Grandmother after two horrible years of Alzheimer's and I'm sure she would rather have gone this way.

 

[Noboundaries]

Mmmm, correct me if I am wrong but this article is based on free divers holding their breath. Our bodies are made up of mostly water, and water for all intensive purpose, does not compress. I don't think that report is going to apply to scuba, especially rec diving.

Bruce

True, but there are still common effects to both breath holders and scuba divers.

Here's a thread on ScubaBoard.

http://www.scubaboard.com/forums/diving-medicine/22371-bradycardia-dive-response.html

Our bodies are approximately 45 to 75% water, depending upon hydration and tissue. True, water doesn't compress (well it does, but the volume differences are miniscule for normal diving temps), but body tissues and the physiological components that make us functioning humans are affected by pressure.

My point had to do with pressure forces on the human body and how it increases dramatically the deeper we go, even for Rec divers. Just because one feels normal doesn't mean changes aren't happening in your body or to your life pump, your heart. We're all aware of pressure's effects on gases in our bodies at depth, but that's just the tip of the changes. One crazy example is that should you be able to descend to the bottom of the Marianas Trench at 37,000 feet to experience 8,000 PSI, your bones would dissolve because calcium can't exist in a solid state at the pressure regardless of how well hydrated you are.

This poor woman apparently did everything right and still died, most likely a result of DCS. My wife and I are extra cautious, diving WELL within our dive tables, but we know she can't dive four days in a row without getting skin bends. PFO? Very possibly. She is going to have it checked, even if we have to pay for it.

I have an analytical nature. I created a spreadsheet of the reports of diving deaths I've seen mentioned here on ScubaBoard. I haven't captured them all, but there are enough that a trend has developed. Out of the 38 deaths I've recorded off ScubaBoard, 18 or 47.4% were heart failure related. The ages ranged from 38 to 77. OOA was the next closest result with 4, 10.5%.

DAN has much better statistics on the reported deaths, but heart related problems still top the list. Given that the heart problems happened either on the dive or shortly after, it is easy to conclude diving contributed to the death. Over exertion? Always a possiblity, but we're trained to conserve energy and not over-exert. Pre-existing conditions? Once again, always a possibility. But if both those do not exist, we're left with pressure forces and the effect on the heart.

That's what I've learned as a result of this thread and the point I was making. Sorry if I took the long way to get there.

 

[mrlipis]

DAN has much better statistics on the reported deaths, but heart related problems still top the list. Given that the heart problems happened either on the dive or shortly after, it is easy to conclude diving contributed to the death. Over exertion? Always a possiblity, but we're trained to conserve energy and not over-exert. Pre-existing conditions? Once again, always a possibility. But if both those do not exist, we're left with pressure forces and the effect on the heart.

With all do respect, are you suggesting that diving is hard on the heart? Neither of the links you have posted, even suggest such a thing. While you are suspicious of over exertion as the cause of a heart attack, regardless of training, it is very easy to over exert one self. While you are collecting the data on these heart attack victims it would be helpful to see how many of them are inexperienced divers. I have never seen or read anything that would support a theory that diving is hard on the heart. If I do find it to be factual, I will give up diving.

As far as your wife is concerned, I would definitely get an answer to that problem. My first thought is poor circulation. I would contact DAN asap and wouldn't dive again until that physiology problem is understood especially if this has happened more than once. BTW, what is PFO? I hope she is able to find a cause and remedy.

We need TSM to voice in here.

Bruce

 

[mrlipis]

BTW, I apologize if this side bar overshadowed the loss of a loved one. My prayers and condolences go out to the family. While not being insensitive, learning from accidents is imperative.

Bruce

 

[Noboundaries]

I'm sure TSandM will contribute. She always provides such detailed medical insight.

Here's one study that shows diving does cause changes in the heart. I tried to post the direct link to the article but it wouldn't take for some reason. The study can be found at Medscape: Free CME, Medical News, Full-text Journal Articles & More and is entitled "Important Bubble Grade Seen in Actual Scuba Diving Conditions."

The article states "Previous studies have suggested possible cardiac changes associated with scuba diving." The article details the changes in the hearts of ten healthy scuba divers diving to 104-122 feet for 22-29 minutes. Changes do occur.

Man in general has evolved a physical system that functions well under one atmosphere of pressure in a gaseous environment that consists of 78% nitrogen, 21% oxygen, .93% argon, .03% carbon dioxide, and .04% other stuff measured in parts per million. Our bodies have a normal operating temperature of 98.6 degrees plus or minus a few tenths. Whenever you change the body parameters of pressure, gas, and/or temperature, the body is going to respond. Diving involves all three and the result isn't always benign. Fitness makes a big difference, but it doesn't guarantee freedom from possible consequences.

Mountain climbers have their issues with pressure, gas, and temp. Astronauts have theirs too, plus the physiological effects of microgravity. As a new diver I've become aware of how few divers give much thought to the the changes their body undergoes while diving other than "staying warm, not getting bent, or avoiding narcosis or gas toxicity."

Since our electrically impulsed beating heart is the pump that delivers the essentials the rest of our organs need to function, when you change the ambient conditions (pressure, gas, temp) under which it has evolved, it is going to adapt. Don't assume that adaptation is universal, limitless, permanent, or perfect. It isn't. If additional knowledge opens one's eyes to a previously unknown potential problem, chances are good that awareness will cause a change in behavior.

I'm more aware now that I need to get my fat ass in shape. Over 70% of the dive fatalities DAN details involved overweight, obese, or morbidly obese individuals. My family has no history of heart problems, nor do I, but now I'm diving and it appears that diving, an environment that involves changes in pressure, gas, and temperature, does effect the heart. Becoming a DAN statistic is something none of us want or would wish on anyone and I'm just seeking knowledge to avoid that possibility.

 

[alibi 2]

Tragic..

 

[bbul]

My wife and I are extra cautious, diving WELL within our dive tables, but we know she can't dive four days in a row without getting skin bends. PFO? Very possibly. She is going to have it checked, even if we have to pay for it.

I recently wend ton a live-aboard (2 to 3 dives a day) On day 5, after my first dive, I showed signs of skin bends. Nobody new what it was at the time and this was the scariest part. I just had bruises appearing randomly (mostly on my thighs and torso) and then disappearing as quickly as they appeared. The areas were very painful.
When we got back to land we went to the chamber. They initially wanted me to have a couple of sessions, but did a full neurological battery on me, and decided I'd be ok - no drinking/smoking for a while, no flying, and no diving for at least 2 weeks.
I haven't been back in the water yet, and wonder what will happen.
ALL the dives I had done had safe profiles - no problems.
How do you get tested for PFO?

 

[*Floater*]

How do you get tested for PFO?

You just ask your doctor for it. There are two tests for it as far as I know; an expensive one, and an even more expensive one. I think one of them involves injecting/generating some bubbles in your lungs while the doctors watch with special equipment (x-ray maybe) to see if any of the bubbles slip past the heart. The other may have been that they open you up and take a close look to see if there's a hole in your heart, but I'm not sure - maybe it was something more benign, maybe they can get a closer look these days without cutting you open...

The problem is that most insurance companies won't cover the test since it's not considered necessary. I mean it's not dangerous for non-divers, and even for divers it's still theory as far as I know (though pushed by DIR-types for good (empirical) reasons from what I know).

I have some basic insurance through my university, so I asked about the test and they said no unless I would pay at least a part of it myself, around $500 or $1000 iirc, but I didn't... Maybe one day when I have more money (or better insurance)... Right now, even if I tested positive, I couldn't afford the surgery to close it.

 

[John_ZAR]

A patent foramen ovale (PFO) is a relatively common heart defect that is present at birth (congenital). During fetal development, the heart’s two upper chambers (atria) are connected by a hole through the wall of muscle that separates them (septum). This hole, along with a blood vessel connecting the pulmonary artery (artery going to the lungs) and the aorta (the main artery going to the body), must be present in the fetus in order to detour blood away from the lungs. Without these two connections the fetus would not survive and a miscarriage often occurs. This hole is called the foramen ovale, and it normally closes shortly after birth. When it remains open after birth, it is said to be “patent,” which is another away of saying “open.”

In about 15-20 percent of the general population, however, the foramen ovale remains open (patent), allowing blood to potentially or actually mix between the two atria.

So what does this mean in diving terms, bubbles carried in the veins can be transferred into the left chamber in the heart and be carried into the rest of the body by the arteries, this could lead to a stroke or another life threatening event.

I have been tested for a PFO and it is a painless yet uncomfortable experience. An ultrasound device was inserted into my esophagus and it took all of five minutes. I might add that my throat was sedated by a stale beer tasting spray. I would advise anyone who is diving and may suspect to have a PFO to please have it investigated.