PFO and the risk of DCS

[boulderjohn]

An atrial septal aneurysm was defined as the protrusion of the dilated segment of the septum at least 15 mm beyond the surface level of the atrial septum, and hypermobility was defined as phasic septal excursion 10 mm or greater into either atrium.

I'm sure that clears things up for most readers.

 

[scubadada]

I'm sure that clears things up for most readers.

The study criteria for high-risk PFO were given in post #7. The high-risk PFO group had 10 DCS episodes in 37 divers. The low risk PFO group had 2 DCS episodes in 31 divers. The non-PFO group had had no episodes of DCS in 32 divers. The rates and summary statistics are given in the abstract. High-risk PFO is independently associated with an increased risk of DCS. It is what it is, no way to make this simpler to understand.

 

[boulderjohn]

The study criteria for high-risk PFO were given in post #7. The high-risk PFO group had 10 DCS episodes in 37 divers. The low risk PFO group had 2 DCS episodes in 31 divers. The non-PFO group had had no episodes of DCS in 32 divers. The rates and summary statistics are given in the abstract. High-risk PFO is independently associated with an increased risk of DCS. It is what it is, no way to make this simpler to understand.

I was just joking about the fact that the average person would have had no idea what that meant. All we divers need to know is that there does seem to be a correlation between PFO and DCS, something that many people would be surprised to learn has been doubted.

I myself am not a doubter. Nothing in this study surprises me.

 

[ScubaSamScubaStevesFather]

heres a question: any advice on getting doctors to do a test for PFO and not pay out of pocket? (US)

 

[scubadada]

heres a question: any advice on getting doctors to do a test for PFO and not pay out of pocket? (US)

Have a valid reason for testing, like a previous episode of DCS which was unexpected.

 

[J-Vo]

Milage may vary, but my insurance didn't balk at paying for the ECO and TEE tests, but at the actual closure. This even though the results of the test would put me in the "high risk" category as defined above.

 

[Lorenzoid]

Milage may vary, but my insurance didn't balk at paying for the ECO and TEE tests, but at the actual closure. This even though the results of the test would put me in the "high risk" category as defined above.

My wife is in the same boat. She had the two tests done, and they scheduled her for a closure procedure. All the while my wife kept calling to confirm the insurance would cover the procedure, and they would not give her a definitive answer. Three days before the scheduled procedure they confirmed they would not cover it, and so she canceled. She's going to try again. She suffers from migraines, which has been associated with PFO, but perhaps that was not emphasized properly.

 

[rddvet]

My wife is in the same boat. She had the two tests done, and they scheduled her for a closure procedure. All the while my wife kept calling to confirm the insurance would cover the procedure, and they would not give her a definitive answer. Three days before the scheduled procedure they confirmed they would not cover it, and so she canceled. She's going to try again. She suffers from migraines, which has been associated with PFO, but perhaps that was not emphasized properly.

Sadly the hospital staff in charge of getting insurance approvals is as important as the doctor. With the wrong staff, they'll get a lot of denies. Offices with staff (such as Dr Ebersole's) who've been doing it for years and years have better luck. It's kind of sad, but our insurance system is broken.
I think you may have seen in another thread that Dr Ebersole wasn't in network for my insurance at the time. I went to a Dr. in Gainesville who's office said we were good to go and just had to pay my copay. The afternoon before the TEE the hospital called and said I would have to prepay my part which I believe was either $2500 or $3000. I immediately canceled since if it was going to be that much for the TEE, I wasn't going to hope and pray I didn't owe $10k for the PFO closure. I ended up speaking to my insurance who said the hospital was 100% incorrect. Either way it soiled the experience and I ended waiting for my wife's new insurance which covered Dr. Ebersole.
Very sad the games we have to play for insurance coverage in the US.

 

[J-Vo]

My wife is in the same boat. She had the two tests done, and they scheduled her for a closure procedure. All the while my wife kept calling to confirm the insurance would cover the procedure, and they would not give her a definitive answer. Three days before the scheduled procedure they confirmed they would not cover it, and so she canceled. She's going to try again. She suffers from migraines, which has been associated with PFO, but perhaps that was not emphasized properly.

Don't give up,

I finally got my done 4 weeks ago. I think 5 cases of DCS (with photos of skin bends) and reporting possible visual disturbances finally got it approved. I also think the first submission being during coved didn't help my case.

 

[Lorenzoid]

Don't give up,

I finally got my done 4 weeks ago. I think 5 cases of DCS (with photos of skin bends) and reporting possible visual disturbances finally got it approved. I also think the first submission being during coved didn't help my case.

From the additional research we have been doing since the insurance denial, we get the impression that emphasizing the visual disturbance or "aura" with migraine might be helpful.