Question about DCS

[mmadiver]

Thank you all for your feedback.My buddy is symptom free now.I don't know that if he had a PFO, he would get it fixed. Either way he is more likely to get DCS then he was before, so my guess is I lost a dive buddy.:depressed: Does anyone know someone who has had a PFO "fixed".

Yes, as I previously mentioned I had two friends go down with Type II from PFOs. Both received treatment to close the PFO with a rivet like device, sealing it shut. These were military divers, I'm not sure if this procedure is practiced in the civilian world.

 

[TSandM]

I was lucky enough to hear Dr. Doug Ebersole (debersole here on SB) speak at DEMA this year about the study he has been doing with PFO closures in divers.

His bottom line (and I hope he reads this to correct it if I am wrong) is that, assuming someone who has been bent and been shown to have a PFO wants to continue to dive, most should just make their diving more conservative and try to avoid bubbling. After all, it is thought to be the bubbles, not the PFO, that causes the problem. If the diver is unwilling to limit himself to shallows dives and Nitrox mixes, then PFO closure can be considered.

 

[Duke Dive Medicine]

Yes, as I previously mentioned I had two friends go down with Type II from PFOs. Both received treatment to close the PFO with a rivet like device, sealing it shut. These were military divers, I'm not sure if this procedure is practiced in the civilian world.

Yes, this definitely exists in the civilian world. You'd be surprised what civilians can do ;-)

In all seriousness though, these were Navy divers who got bent, had a bubble contrast echo that showed a PFO, underwent closure and went back to diving with the Navy?

Best,
DDM

 

[mmadiver]

Yes, this definitely exists in the civilian world. You'd be surprised what civilians can do ;-)

In all seriousness though, these were Navy divers who got bent, had a bubble contrast echo that showed a PFO, underwent closure and went back to diving with the Navy?

Best,
DDM

Yes, both were EOD divers who got bent on the MK-16 conducting routine no-d dives. They underwent the operation to close their PFOs and after aprox. six months of limdu they were cleared for diving. They had to go in for regular checkups and from what I can remember the Docs wanted to see their natural tissue grow over the "rivet" before clearing them.

If you'd like more info I can put you in touch with one of the divers and the DMO who oversaw his treatment - just shoot me a PM.

Also, thanks for the comprehensive writeup and addressing my questions, greatly appreciated.

 

[tracydr]

I know a tech diver who had PFO repaired.

 

[Duke Dive Medicine]

Yes, both were EOD divers who got bent on the MK-16 conducting routine no-d dives. They underwent the operation to close their PFOs and after aprox. six months of limdu they were cleared for diving. They had to go in for regular checkups and from what I can remember the Docs wanted to see their natural tissue grow over the "rivet" before clearing them.

If you'd like more info I can put you in touch with one of the divers and the DMO who oversaw his treatment - just shoot me a PM.

Also, thanks for the comprehensive writeup and addressing my questions, greatly appreciated.

Thanks, that's interesting. It sounds like there's been a policy change - last I heard, discovery of a PFO after a bends incident was a deal-breaker for a Navy diver. And you're welcome, hopefully you found some helpful information there.

Best regards,
DDM

 

[Nubiesan]

I have had two separate instances of bends, both in Roatan, and I have a PFO which was discovered after the second trip to the chamber. Dr. Bove at Temple University ran the transesophageal echocardiogram which revealed the problem. His advice was to dive conservatively -- above 60 feet. limit number of dives, rather than repair the PFO since the surgery carries greater risk than the possibility of DCS again if I stayed within my limits. That was about 7 years ago, and no problems since. While we occasionally will do a deeper dive to around 75 feet, we find far more interesting critters in shallower water.

 

[Ricky B]

Whoever treated him screwed up. He should of been pressed immediately. Doctors always want to do their MRIs and tests, waste of time.

There was an incident mentioned in another thread here on SB to the following effect. The diver surfaces from a dive and collapses on the boat within minutes of surfacing. Classic sign of AGE. His buddies rush him to the hospital, and the ER doctor insists on doing a workup. His buddies explain to the doc that he's wasting valuable time, their friend has AGE, and the sooner he gets recompressed, the better. Finally they get DAN on the phone, who speaks to the doc, and DAN tells them to let the doc finish his workup, which IIRC, included some kind of scan. It turns out that the diver had a condition that needed immediate surgery (a brain hemorrhage, IIRC), the delay of which would have been life-threatening. The diver's life was saved by the surgery.

 

[doctormike]

There was an incident mentioned in another thread here on SB to the following effect. The diver surfaces from a dive and collapses on the boat within minutes of surfacing. Classic sign of AGE. His buddies rush him to the hospital, and the ER doctor insists on doing a workup. His buddies explain to the doc that he's wasting valuable time, their friend has AGE, and the sooner he gets recompressed, the better. Finally they get DAN on the phone, who speaks to the doc, and DAN tells them to let the doc finish his workup, which IIRC, included some kind of scan. It turns out that the diver had a condition that needed immediate surgery (a brain hemorrhage, IIRC), the delay of which would have been life-threatening. The diver's life was saved by the surgery.

Yup, I went to NYC's only (AFIK) emergency recompression facility for my chamber ride, so they know something about hyperbaric medicine. Admittedly, I wasn't that sick, but they still got a head CT before starting recompression. Sometimes, divers have tunnel vision if all we know about medicine is what relates to diving.

 

[TSandM]

I have heard a number of stories, though, where ERs have refused to put divers on oxygen. There is no excuse for not doing that, while you are eliminating other causes of the symptoms.