PFO Diagnosis

[nereas]

I don't believe that one or two headaches a month would make a neurologist recommend PFO screening or closure. Despite nereas's glowing description of modern surgery, no invasive procedure is 100% successful or without complications, so one needs to be quite sure that the problem being solved is worse than the possible problems being caused.

Remember that, given the frequency of PFO in the population, there are probably a LOT of people out there diving with them and not getting bent. On the other hand, I don't know if anybody has looked at whether people with PFOs with migraines with aura have a higher frequency of Type II hits. Given the rarity of both situations, the intersection of the two groups is likely very small.

I must say that I am indeed very impressed with the skill of modern surgeons, particularly since my recent throat surgery, which went very well. I do know that no surgery is 100% successful for all patients, and therefore I updated my will before the operation, went to confession, and offered up my prayers.

If I had a PFO, and I were a diver, I would definitely get the closure done.

The entire mechanism of off-gassing depends on a closed venous blood supply being filtered by the lungs, without leakage across the heart chambres to the arterial blood supply coming back from the lungs and going out to the body organs.

If you have a PFO, you probably should not be diving. And if you did dive with one, then no NDL schedule nor deco procedure would apply to you, due to the unique problem of the leakage of N2 saturated blood reaching the arterial blood supply and ultimately the brain and spinal cord.

If on the other hand if I were not a diver, then I would not worry about a PFO.

We are very lucky in the 21st Century to have scuba available to us to enjoy, and also to have expert surgeons to fix our bodies whenever they are flawed, diseased, or injured.

 

[nereas]

Heh -- it's great always being the different kid on the block!! I belonged to all of those groups! Or should it be
??

And I agree testing every diver is a bit extreme -- but if you are going to be doing say more than 50 -100 dives a year or you are having other symptoms that don't seem right then absolutely get tested.

Just my opinion.

I agree regarding symptoms.

If there are any symptoms at all, get tested, and then go ahead with any applicable surgery.

A truly "undeserved hit" for a conservative dive would be a valid symptom.

However many divers "push the limits of NDL" and then when they take a hit, they think it was "undeserved." Not likely!

 

[scubamickey]

Personally, I dive very conservatively. If I should ever get an undeserved hit and by some chance find that I have a PFO, I would stop diving before I had invasive heart surgery.

I wonder what the profile of those people with a PFO and DCS looked like? Did they do deep stops, or the usual "bend and mend" that is so common with the recreational crowd? What was there overall physical health? What role did genetics play?

I think that the experts may be on to something when they suspect that there is another factor at play that has yet to be discovered.

 

[D_B]

I know that one profile was pretty perfect and it did not change the outcome

TSandM & TekDiveGirl can give particulars on that operation, but it's not quite as invasive as heart surgery goes, it is done through the groin and Kimber was home the next day afterwards

If I had several, maybe even one, symptom that was unusual, and I was a diver, I would get tested .. if I dived a 100, maybe more times a year, I might get tested, and
If I had a PFO, I would get it fixed so I could continue to dive, the surgery to do so is not that scary to me now

 

[scubamickey]

I know that one profile was pretty perfect and it did not change the outcome

TSandM & TekDiveGirl can give particulars on that operation, but it's not quite as invasive as heart surgery goes, it is done through the groin and Kimber was home the next day afterwards

If I had several, maybe even one, symptom that was unusual, and I was a diver, I would get tested .. if I dived a 100, maybe more times a year, I might get tested, and
If I had a PFO, I would get it fixed so I could continue to dive, the surgery to do so is not that scary to me now

So then my next question would be: What is the overall long term prognosis for a diver who has had a PFO closed? Any other post-op risks that can be encountered as a result of diving afterwards? Or are you good as new so to speak?

I don't know--the words groin and surgery in the same sentence makes me yelp:11doh:

 

[DandyDon]

Personally, I dive very conservatively. If I should ever get an undeserved hit and by some chance find that I have a PFO, I would stop diving before I had invasive heart surgery.

I wonder what the profile of those people with a PFO and DCS looked like? Did they do deep stops, or the usual "bend and mend" that is so common with the recreational crowd? What was there overall physical health? What role did genetics play?

I think that the experts may be on to something when they suspect that there is another factor at play that has yet to be discovered.

Getting bent in scuba is very rare; you just see more about it here.

So then my next question would be: What is the overall long term prognosis for a diver who has had a PFO closed? Any other post-op risks that can be encountered as a result of diving afterwards? Or are you good as new so to speak?

I don't know--the words groin and surgery in the same sentence makes me yelp:11doh:

Do you often worry about things without a need?

 

[scubamickey]

Getting bent in scuba is very rare; you just see more about it here.

Do you often worry about things without a need?

Oh no, I'm not worried. I don't have a PFO. I'm asking out of curiosity. The morbid kind

 

[JTemple]

So then my next question would be: What is the overall long term prognosis for a diver who has had a PFO closed? Any other post-op risks that can be encountered as a result of diving afterwards? Or are you good as new so to speak?

I don't know--the words groin and surgery in the same sentence makes me yelp:11doh:

Old thread, but the question raised here is a very good one, and one I am trying to find an answer to - as my cardiologist and I are trying to determine if I should have the procedure or not.

debersole: any real life experiences here with some of your diver patients? This is such a new procedure, I realize there isn't any "very long-term" data, but how are things looking so far? TIA

 

[Lopaka]

Well, I am scheduled for this procedure with bubbles tomorrow (oh joy) as part of the follow up to an cranial MRI that showed a small "inclusion". I gather this is a small stroke or blockage. Neurologist can't say if it is from a PFO or what caused it, so the test tomorrow and a MRA Monday.

Curious to see if there is any way to "time stamp" when a blockage occurred, to help ID what was happening at that time, like my vertigo and sudden hearing loss..............