PFO - Diving with more conservatism, specifically CCR

[Scuba-Lad]

I've spoken to the odd member (and experts) about this already via PM, but wanted to ask a wider audience about their experiences as I couldn't see this specific question being asked. After visiting the chamber multiple times with DCS issues, I finally carried out a bubble study the other day where a PFO was discovered with R/L shunt. I'm aware of the fact that it's not guaranteed to be causing issues with my diving - however the PFO is not the subject of the question I would like to ask. I'm already diving conservatively in line with DANs recommendations, EN32 is the highest nitrox we have available here. Again, this isn't the subject of discussion however.

I'm looking to hear from members who have been diagnosed with a PFO (after having had DCS issues), and decided not to opt for surgery, but instead switched to CCR in order to run a high setpoint (say 1.3) and hence reduce Nitrogen saturation / improve tissue off gassing gradients, in the hope of preventing bubble formation. For now I'm talking within recreational limits, but mixed gas stories would be interesting.

In particular, I'm interested in:
The size of your PFO
The symptoms you were experiencing before switching to CCR
How switching to CCR (hopefully) reduced future instances of DCS
Your end Surface GF from CCR dives
Symptom-free average dive times (CCR)
What setpoint you run for the majority of the dives
Your ascent rate for the last 6m (20ft)

Please remember that I don't want this topic to turn into a discussion about PFOs. I'd simply like to hear from people who have taken the CCR route due to previous issues with PFO on open circuit and had success with symptom free diving. I'm also not looking for medical advice, nor will I base any decisions on information we talk about here.

Scuba Lad

 

[Whitrzac]

Issue #1: Having the PFO closed is cheaper than a CCR. Even with the USA's backwards healthcare system.

 

[grantctobin]

Issue #1: Having the PFO closed is cheaper than a CCR. Even with the USA's backwards healthcare system.

OP is in Indonesia.

That said, @PfcAJ @kensuf and @rddvet are probably the SB hive mind on this one in terms of recent experience and I’d guess all will suggest either quit technical diving or get it closed.

 

[PfcAJ]

OP is in Indonesia.

That said, @PfcAJ @kensuf and @rddvet are probably the SB hive mind on this one in terms of recent experience and I’d guess all will suggest either quit technical diving or get it closed.

I do not have experience relevant to OPs question.

My hunch based on the post is that the PFO is significant and the minor reduction in gas loading from diving a constant set point would still result in relatively high DCS risk.

 

[rsingler]

I am concerned about a right to left shunt, depending upon how frequent it is.
It often arises during effort, if it is not constant for other reasons.
One bubble could be a stroke.
We ALL bubble.

 

[davehicks]

This just seems like a bad idea. It reminds me of a friend who bought a 10k hot tub because he hoped it would help his back rather than because he enjoyed hot tubs. Well, it didn't fix his back and he didn't use it much and it got gross and unsafe. He got rid of it within a couple of years.

A CCR is not inherently safer than OC just because some of the time the nitrogen partial pressure is lower. Sometimes it is not. Ascent rates, water temperatures, workload, GF setting, and other factors all play a big role in bubble formation and your bodies ability to clear it.

Take care!

 

[uncfnp]

Not exactly your question but after several skin hits (no chamber rides) I had a study done that showed a PFO. Could not find a cardiac surgeon that wanted to do my surgery. This was about 10 years ago (by the way-I also have migraines with aura).

So I considered CCR but instead went with Advanced Nitox and starting diving on highly conservative algorithms using 100% at my safety stops on my more aggressive dives in Florida. I had been interested in tech diving and was currently pursuing cave. But still having problems so a few years after finding the PFO I tried the surgical repair route again. After making my case the surgeon agreed but of course he wanted his own study. This one did not show the opening (it was a TEE and I was sedated). So once again surgery was not an option for me. Thus ending cave and tech.

 

[PfcAJ]

Not exactly your question but after several skin hits (no chamber rides) I had a study done that showed a PFO. Could not find a cardiac surgeon that wanted to do my surgery. This was about 10 years ago (by the way-I also have migraines with aura).

So I considered CCR but instead went with Advanced Nitox and starting diving on highly conservative algorithms using 100% at my safety stops on my more aggressive dives in Florida. I had been interested in tech diving and was currently pursuing cave. But still having problems so a few years after finding the PFO I tried the surgical repair route again. After making my case the surgeon agreed but of course he wanted his own study. This one did not show the opening (it was a TEE and I was sedated). So once again surgery was not an option for me. Thus ending cave and tech.

Go see Dr Ebersole.

My PFO repair changed my life.

 

[The Chairman]

Calling @Dr. Doug Ebersole! PFO alert!

My current doctor heard what she thinks is a slight heart murmur, and considering I get auras too, she's having me checked out for a PFO. I have never had DCS, but then I'm a very, very conservative diver. I'm not sure where Dr. Doug's practice is, but it would be worth a drive for me to see him. He is the Schizznet in my opinion!

 

[uncfnp]

Thanks guys. I don’t want to hijack his thread but I will say that there is a lot I regret in my life. Little of it is for things I have done but a lot for things I didn’t do. Not pursuing this even more aggressively when I was younger is one.