Newbie to website with a PFO

[Misti]

I have been certified for three years with 100+ dives and last summer got bent while diving in Cozumel. I did not get chamber treatment but did receive oxygen in the ER. I then took the DAN recommended month off of diving. When I resumed diving, most of it was lake diving so all of my profiles were <40 ft.

A few months later I was talking to a tech diver in the scuba shop that I work part time in and after hearing of my experience and symptoms, he suggested that I see a cardiologist and get tested for a PFO. So for the past few weeks I have undergone testing - EKG, carotid artery ultrasound, calcium scan, blood work, traditional echo, and lastly, a transesophageal echo with a bubble study. In the TEE, they found the PFO. I have a 30 year history of migraines and a little over 2-1/2 years ago experienced a TIA.

After much discussion with my husband, we have decided that I will be having the PFO repaired. However, to make things even more challenging, I am highly reactive to nickel and the available PFO closure devices on the market all contain nickel. Therefore, I will have to have the PFO surgically repaired. I have discussed this with a second cardiologist (original one referred me to another) and since I want to have the repair done robotically as opposed to the traditional route, he recommends that I go to someone out of state, as he doesn't believe that anyone in Oklahoma is really qualified to repair it with the Da Vinci surgery.

My question is this - if you were in this situation, would you go to any cardiologist or would you prefer to see one that is not only experienced with PFOs, but diving as well?

My insurance will cover whatever I choose so that is not an issue. My husband spoke with a former client of his (a retired cardio thoracic surgeon) and he suggested an in-state doctor that he trained. I don't know how I feel about that. My gut tells me to go with an out-of-state doctor with experience in PFOs and diving, but I am curious as to what others would do.

Thanks in advance for your opinions. I greatly appreciate having outside input.

 

[tbone1004]

call DAN, talk to them, they'll know the best guys to fix you up. You may quite well end up at Duke for it

 

[Misti]

call DAN, talk to them, they'll know the best guys to fix you up. You may quite well end up at Duke for it

I have spoken with DAN a couple of times and they gave me the name of a cardiologist in Florida that is currently doing a study with them on PFOs. I have checked and he is in network on my insurance. However, it is a 19 hour drive from Oklahoma and there are places closer, like Houston or Dallas. Currently I'm in a holding pattern until we decide where to go. Just looking for opinions! Thanks!

 

[iamrushman]

i remember reading other threads on this subject..use the search option to further your study...good luck and best wishes...

 

[Scott]

I have spoken with DAN a couple of times and they gave me the name of a cardiologist in Florida that is currently doing a study with them on PFOs. I have checked and he is in network on my insurance. However, it is a 19 hour drive from Oklahoma and there are places closer, like Houston or Dallas. Currently I'm in a holding pattern until we decide where to go. Just looking for opinions! Thanks!

If the Cardiologist they recommended in Florida is Dr. Doug Ebersole , make the 19 hour drive!

 

[Misti]

If the Cardiologist they recommended in Florida is Dr. Doug Ebersole , make the 19 hour drive!

See - THAT'S the kind of thing that I want to hear! And, yes, that is who they recommended. My gut says he's who I want to see, but I'm still in the research phase. When I talked to DAN initially, they couldn't find any cardiologists in bordering states of me that were on their radar with PFO experience. So, basically, I'm left with choosing a doctor that either does or does not have diving experience/knowledge. Thanks for the input!

 

[fmerkel]

I think your basic position is: 1. Do the procedure. 2. Don't do the procedure or evaluate options more.
If 1 > then I think you want one of the best technicians you can get. I don't think diving experience is even a remote issue.
If 2 > then I think a diving physician with experience in this area is critical.

The procedure is not without risk, and a long recovery. You already know that people dive with PFO's and don't even know it. There's a guy in the club with one. He got migraines from dives and got it diagnosed after talking to me. He did not have it fixed, dives Nitrox all the time, limits his depth profiles, and does long safety stops. You 'got away with it' for 100+ dives so it does not seem outside consideration for symptomatic treatment vs surgery.

I am no expert on the problem or the procedure. I just know enough to meddle.

 

[uncfnp]

I too dive with a PFO, have a forty year history of migraines with aura and get skin bends very easily since my first episode at about dive 150. After multiple tests and discussions, and at my age, I have elected to hold off on the surgery for three reasons, 1) difficulty with insurance coverage 2) risk and uncertain benefit from the procedure, 3) learning to dive within my known limits.

Given the complications involved with the surgery you need, you have got to really want it. And if insurance and circumstances allow, and you do elect surgical closure, I would a least consult with Dr Ebersole and have him do my surgery if he agrees. If it were me.

BTW. Your TIA might worry me more then the bends, especially if the episode did not require a chamber treatment.

 

[NYCNaiad]

Welcome to Scubaboard! I have a long history of migraines & was diagnosed with a small PFO. I went to the best cardiologist because the likelihood of finding a cardiologist who also dives is low...& finding the best cardiologist who also dives is even lower even here in Manhattan with its plethora of top docs.

I wanted the best doctor period.

I also got a recommendation from DAN of a cardiologist familiar with dive medicine & had my cardiologist consult with the dive medicine cardiologist. So it was the best of both worlds & what I highly recommend for you.

My background: I had over a hundred dives under my belt before the PFO was discovered. I now have many more dives & have never been bent. Based upon the small size of my PFO, my dive history, PFO closure results, & discussions with the dive med cardiologist as well as my cardiologist, I elected not to get the procedure done. What I have done is become a much more conservative diver to further reduce the already low risk in my particular case. All of this was the right call for me, but obviously not for everyone.

I hope you fly through the surgery. Sending you my best wishes for a speedy recovery.