Incident on the Spiegel

[elmer fudd]

I would get tested for a PFO. 25 % of the population has a PFO..... Does not sound like you should have been bent ( but of course, people with PFO's should not dive--and then would not get bent) ... and the seizure afterward could still be neurologic repurcussiopns from PFO induced dcs...

However, this is 'WILD" speculation, since the dive profile you relate, and your symptoms, don't sound like the typical DCS incident.

A big +1. The dive you describe should not have resulted in any kind of decompression sickness. That it did means you should try to find out why so that it doesn't happen again.

I know you mentioned that you shouldn't have dove nitrox, but that along with your safety stop likely prevented you from taking a much harder hit. If you'd been on air you would have had that much more nitrogen in your blood.

 

[Doubler]

If you get tested for a PFO, and the test is positive, it can be repaired and you should be able to dive again. With a PFO the same thing could happen at any depth. Get tested. Glad you kept your wits about you and you pulled through. Good on you.

 

[AfterDark]

Ditto on the PFO test. Sounds like a logical step and it may get you some piece of mind. Glad you're ok and hope you can dive again someday soon. Good luck

 

[Centrals]

I know two rebreathers who had the operation and were back into their favourite sport ie deco dive.

 

[DandyDon]

Wow Tommy, rough dive & close call. :shocked2: Just amazing. I am so glad you came out of it ok and thank you for coming here to tell us your story. I did not see any mention of DAN DAN Divers Alert Network but even if you have not talked with them, I am sure they would like to work with you, learn about your accident as well as offer medical advice from some of the top dive doctors in the world. They take emergency calls collect 24/7 for anything, even my grandson's ear drum injury free diving, but non-emergency conversations are best during business hours.

Otherwise, do any of you members giving medical advise here happen to be licensed to practice medicine? Jeeze! DAN Alert Diver magazine had an excellent article on PFOs, with comments from actual dive physicians. See Alert Diver | PFO and Decompression Illness in Recreational Divers but some of the comments may surprise you. A few of interest...

Dr. Richard Moon: It is important to keep in mind several issues. First, the relationship between PFO and DCS is an association. While there is a plausible explanation for the apparent connection (i.e., DCS triggered by arterial bubbles), this is not yet proven. Indeed, PFO has not been linked to the most common symptoms such as pain-only bends, numbness, tingling or fatigue.

Dr. Bove: I would not recommend PFO closure in any sport diver, whether or not the diver had a DCS incident.​

But there is a lot more there to learn from.

...but of course, people with PFO's should not dive--and then would not get bent...

So what do you base that claim on? It certainly contradicts the expert panel referenced.

 

[AfterDark]

Wow Tommy, rough dive & close call. :shocked2: Just amazing. I am so glad you came out of it ok and thank you for coming here to tell us your story. I did not see any mention of DAN DAN Divers Alert Network but even if you have not talked with them, I am sure they would like to work with you, learn about your accident as well as offer medical advice from some of the top dive doctors in the world. They take emergency calls collect 24/7 for anything, even my grandson's ear drum injury free diving, but non-emergency conversations are best during business hours.

Otherwise, do any of you members giving medical advise here happen to be licensed to practice medicine? Jeeze! DAN Alert Diver magazine had an excellent article on PFOs, with comments from actual dive physicians. See Alert Diver | PFO and Decompression Illness in Recreational Divers but some of the comments may surprise you. A few of interest...

Dr. Richard Moon: It is important to keep in mind several issues. First, the relationship between PFO and DCS is an association. While there is a plausible explanation for the apparent connection (i.e., DCS triggered by arterial bubbles), this is not yet proven. Indeed, PFO has not been linked to the most common symptoms such as pain-only bends, numbness, tingling or fatigue.

Dr. Bove: I would not recommend PFO closure in any sport diver, whether or not the diver had a DCS incident.​

But there is a lot more there to learn from.


So what do you base that claim on? It certainly contradicts the expert panel referenced.

Gezz light up with med practice suff, it's only a test, not medicine and he needs to ask his doctor, if the doctor doesn't think it's required it wouldn't happen anyway. It's not like he can do the test himself and nobody offered to do it in their cellar. Otherwise good post DAN advice spot on they are currrently doing reserch on PFO if memory serves me correctly. I'm sure they'd like to hear his account.

 

[DandyDon]

Gezz light up with med practice suff, it's only a test, not medicine and he needs to ask his doctor, if the doctor doesn't think it's required it wouldn't happen anyway. It's not like he can do the test himself and nobody offered to do it in their cellar. Otherwise good post DAN advice spot on they are currrently doing reserch on PFO if memory serves me correctly. I'm sure they'd like to hear his account.

DAN doctors and/or his home doctors might recommend the PFO test, and his insurance might pay for it. It just seems a bit much to be slinging medical advice around before suggesting he obtain counsel from DAN, much less stories of having a PFO repaired. Yes, DAN is researching but more importantly they can help Tommy.

Have you read the article...?

Dr Moon: Finally, most cases of DCS occur in divers without a PFO. It is difficult or impossible in an individual diver to ascribe a particular DCS occurrence to a PFO, as PFO will exist in nearly one-third of cases even if there is no causal relationship. Therefore, testing for a PFO is useful only in instances where there have been several DCS incidents of a type known to be PFO-associated, and the person cannot modify depth-time exposures or breathing gas.​

There is also a chance that no problem is found? I knew a lady who took a much worse hit from 3 shallow dives, in ICU for weeks, and they never did figure out why.

 

[AfterDark]

DAN doctors and/or his home doctors might recommend the PFO test, and his insurance might pay for it. It just seems a bit much to be slinging medical advice around before suggesting he obtain counsel from DAN, much less stories of having a PFO repaired. Yes, DAN is researching but more importantly they can help Tommy.

Have you read the article...?

Dr Moon: Finally, most cases of DCS occur in divers without a PFO. It is difficult or impossible in an individual diver to ascribe a particular DCS occurrence to a PFO, as PFO will exist in nearly one-third of cases even if there is no causal relationship. Therefore, testing for a PFO is useful only in instances where there have been several DCS incidents of a type known to be PFO-associated, and the person cannot modify depth-time exposures or breathing gas.​

There is also a chance that no problem is found? I knew a lady who took a much worse hit from 3 shallow dives, in ICU for weeks, and they never did figure out why.

I agree there may or may not be cause and effect with DCS / PFO but suggesting someone ask their doctor if they should take test X is hardly med advice. The doctors answer would be med advise. Personally I wouldn't have this test done but I'm not a new diver with issues after my 1st deep NDL dive, and I have done dozens of deco dives and almost 2000 total lifetime dives. My chances of having PFO are slim, his???

If someone is having chest pains do you give med advise by telling them to go the the emergency room? I don't see the difference.

 

[danvolker]

Wow Tommy, rough dive & close call. :shocked2: Just amazing. I am so glad you came out of it ok and thank you for coming here to tell us your story. I did not see any mention of DAN DAN Divers Alert Network but even if you have not talked with them, I am sure they would like to work with you, learn about your accident as well as offer medical advice from some of the top dive doctors in the world. They take emergency calls collect 24/7 for anything, even my grandson's ear drum injury free diving, but non-emergency conversations are best during business hours.

Otherwise, do any of you members giving medical advise here happen to be licensed to practice medicine? Jeeze! DAN Alert Diver magazine had an excellent article on PFOs, with comments from actual dive physicians. See Alert Diver | PFO and Decompression Illness in Recreational Divers but some of the comments may surprise you. A few of interest...

Dr. Richard Moon: It is important to keep in mind several issues. First, the relationship between PFO and DCS is an association. While there is a plausible explanation for the apparent connection (i.e., DCS triggered by arterial bubbles), this is not yet proven. Indeed, PFO has not been linked to the most common symptoms such as pain-only bends, numbness, tingling or fatigue.

Dr. Bove: I would not recommend PFO closure in any sport diver, whether or not the diver had a DCS incident.​

But there is a lot more there to learn from.


So what do you base that claim on? It certainly contradicts the expert panel referenced.

Don, I would base this on the fact that a PFO is a serious threat to a diver , and I would not consider it prudent to wait for absolute scientific proof on this, when that proof would mean the dive Industry would lose MORE than 25 % of it's revenue....this kind of thing tends to make the research less likely to be effective.

I would also suggest that it is well known in scientific circles, that there are massive differences between indovidual divers, and their offgassing abilities. Some divers that DO NOT have PFO's and that do have efficient cardiovascular systems, could do a 160 foot dive for 20 minutes, come up just like this guy did ( but not pulling on a rope, that is a stupid practice which begs for contraction induced blood restriction problems) and have been just fine.

I am not saying the "pull your self up the rope nonsense" is what actually caused this, I expect there will be a medical issue/cardiovascular issue/or epileptic issue which comes out...but whatever fitness level you have for diving, the pulling your self up the rope after a deep dive is a NEGLIGENT PRACTICE where current exists and where the diver will be struggling on the rope....the constriction in the contracted muscles will impede bloodflow, and the diver experiencing this, will have more bubbling in the heavily contracted muscles by far, than would their "evil twin" that did a slow free ascent( same ascent speed) without holding on to a rope.

Also, the notion that DCS can hit any of us, at any time, with no ryme or reason, is nonsense. This is junk science. It is going to hit people who probably should not have been diving, and the testing proceedures that could have discovered contraindications for diving, DO NOT EXIST in any useful way for the masses, today.

For any of you guys to be telling this injured diver that he should be looking forward to diving again soon, I think you should hold off on this..... He should not have had this incident, and given that he has a family that needs him, the BETTER advice would be to have a much more complete set of tests done, before ever diving again. who does the testing is huge, as all doctors, and all facilities, are NOT equal. There are some sharp minds in medicine, that could probably get right to the issue, and others that may just ride the insurance testing train for as long as they can...and may never determine the real cause. You could hope someone like TS&M (Lynne) takes and interest, as she could be a huge resource for picking the right tests, and deciding if you are getting the right medical "strategies".


P.s.

RELATED CONCEPTS OF SCIENTIFIC PROOF:

• According to the softdrink industry, their is no scientific proof that Aspartame is dangerous to you. It is dangerous, if you ask me, and I have zero doubts about this. I also have no doubt it would cost the softdrink industry a fortune if a definitive study came out directly linking aspartame consumption with cancer, liver damage, insulin sensitivity, and inflamation related illnesses.
• Put a raw egg between two cell phones connected ( call each other) for 5 minutes, and I believe you will have a "cooked egg"...However, as with the tobacco industry 40 years ago, profits mean a lot more than safety, so there continues to be studies showing no link to neural damage or incidence of brain tumors.
• Do you need "Scientific Proof" to realize that a drink like normal Gatorade, with over 35 grams of sugar in a serving, will CAUSE insulin insensitivity and adult onset diabetes in many people that consume it regularly--believing it to be Healthy--you know they have "science" that shows it is hi tech nutrition/hydration
• Science can be a wonderful tool, or , the worst form of prostitution. Each of us needs to apply common sense for "who has paid for the scientific studies", and who will "lose out" if a concern is ever "proven". Science in the 50's and 60's may have been mostly moral..Mostly.....Science today is more typically "bought and paid for", and any thought about morality, or rightness, or validity, will need to be investigated by each of us, not just assumed as in the old days. Thankfully we do have many great scientists today, but they are hidden by all the corporate lapdogs paid to prove whatever is asked of them.

 

[Rescue Diver68]

I would get tested for a PFO. 25 % of the population has a PFO..... Does not sound like you should have been bent ( but of course, people with PFO's should not dive--and then would not get bent) ... and the seizure afterward could still be neurologic repurcussiopns from PFO induced dcs...

However, this is 'WILD" speculation, since the dive profile you relate, and your symptoms, don't sound like the typical DCS incident.

Agreed!