Finally, a picture of me taking a picture! I might make this an avatar. I have an Olympus C5050 in an Ikelite housing with a SB 125 Ikelite strobe.
Tuesday, April 10, 2007
On March 17, 2007 myself, ..., ..., ... and ... went off to ... to divethe wreck of ... which sunk in 185ft. of water. The dive, although deepand very technical (breathing trimix 18/25), was just wonderful.Everything went according to plan and there were no incidents. Later Iwould remember that during the surface interval I had been scratching myskin due to what I thought was a mild itch. This was a sign of DCS,which I didn*t comprehend at the time. Four hours later, with spiritsstill soaring, we went for a second dive in a different location called... in 124ft. of water for about 20min. bottom time followed by about25min. of decompression. Again, the dive went without a hitch andaccording to plan. However, at the last decompression stop (10ft.) Istarted to feel some aching in my left shoulder and at first I ignoredit as that shoulder had been injured in the past and it does hurt everynow and then. As I finished my stop and made my way to the surface theaching became more pronounced so as I broke the surface I told the guyson the boat I'm going back down for more decompression. After 7 moreminutes at 10ft and breathing 80% oxygen I boarded the boat, removed mygear and resumed breathing oxygen. In hindsight, I should have gonedown to 30ft. and use up all my remaining gas decompressing. After
involves climbing from 1000ft altitude to almost 6500ft within a few\u003cbr /\>hours. I kept breathing my 80% oxygen with air breaks throughout the\u003cbr /\>trip and later even took a couple of Advil pills, which helped with the\u003cbr /\>pain. By this time the aching in my shoulder had become pain and I had\u003cbr /\>a skin rash all over my shoulder and stomach (same spots that were itchy\u003cbr /\>earlier that day). We finally got home at about 2am and I went to\u003cbr /\>sleep.\u003cbr /\>\u003cbr /\>Next day, the pain receded to just an ache again until later that night\u003cbr /\>when it came back so I decided it*s time to call Diver*s Alert\u003cbr /\>Network (DAN) and they recommended Dr. ... , a local hyperbaric medical\u003cbr /\>doctor at ... hospital. I called him and he told me to get my butt over\u003cbr /\>there really fast so he can treat me. I did as he said and although I\u003cbr /\>passed all of his neurological tests (for a potential type II DSC) he\u003cbr /\>shoved me in a recompression chamber for a Navy Table#6 which entails\u003cbr /\>breathing 100% oxygen at 3ATA (66feet) for 2 hours followed by 2.5 hours\u003cbr /\>at 2ATA (33feet) for a total of almost 5 hours). As I was inside that\u003cbr /\>tube my shoulder pain slowly disappeared. The skin was still tender\u003cbr /\>even though the rash was gone too. I couldn*t finish all 5 hours of\u003cbr /\>the treatment because I could not use that damn pee cup they gave me as\u003cbr /\>I was laying down being constrained by the single person, Plexiglas tube\u003cbr /\>chamber. Note to self: try to use a multi-person chamber next time.\u003cbr /\>The next day I had to go back in for another 2 hours in the chamber in\u003cbr /\>order to minimize a relapse. After that, no more pain!\u003cbr /\>\u003cbr /\>While I was getting treated for DCS, Dr. ... asked me if I want to get\u003cbr /\>checked for a PFO (Patent Foramen Ovale) and I agreed so he sent me down\u003cbr /\>one floor to cardiology to have an echocardiogram test. Needless to say\u003cbr /\>the test was positive.\u003cbr /\>",1]
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this, we all made the bad decision to drive back home as this driveinvolves climbing from 1000ft altitude to almost 6500ft within a fewhours. I kept breathing my 80% oxygen with air breaks throughout thetrip and later even took a couple of Advil pills, which helped with thepain. By this time the aching in my shoulder had become pain and I hada skin rash all over my shoulder and stomach (same spots that were itchyearlier that day). We finally got home at about 2am and I went tosleep.Next day, the pain receded to just an ache again until later that nightwhen it came back so I decided it*s time to call Diver*s AlertNetwork (DAN) and they recommended Dr. ... , a local hyperbaric medicaldoctor at ... hospital. I called him and he told me to get my butt overthere really fast so he can treat me. I did as he said and although Ipassed all of his neurological tests (for a potential type II DSC) heshoved me in a recompression chamber for a Navy Table#6 which entailsbreathing 100% oxygen at 3ATA (66feet) for 2 hours followed by 2.5 hoursat 2ATA (33feet) for a total of almost 5 hours). As I was inside thattube my shoulder pain slowly disappeared. The skin was still tendereven though the rash was gone too. I couldn*t finish all 5 hours ofthe treatment because I could not use that damn pee cup they gave me asI was laying down being constrained by the single person, Plexiglas tubechamber. Note to self: try to use a multi-person chamber next time.The next day I had to go back in for another 2 hours in the chamber inorder to minimize a relapse. After that, no more pain!While I was getting treated for DCS, Dr. ... asked me if I want to getchecked for a PFO (Patent Foramen Ovale) and I agreed so he sent me downone floor to cardiology to have an echocardiogram test. Needless to saythe test was positive.
A PFO is a bypass in the wall (septum) between the right atrium and the\u003cbr /\>left atrium in one*s heart. This bypass is needed while inside the\u003cbr /\>mother*s womb but it is supposed to close at birth and weld shut by\u003cbr /\>the time the child is two years old. It appears that in some 25% of the\u003cbr /\>population (due to genetic a anomaly) this PFO does not close and\u003cbr /\>depending on the size of the hole it can either be ignored (small hole)\u003cbr /\>or it can cause major problems (large). This hole allows blood flow\u003cbr /\>from right (used blood) to left (oxygenated, clean blood from lungs)\u003cbr /\>inside the heart thus bypassing the filtering action of the lungs. This\u003cbr /\>can allow blood clots (and nitrogen bubbles in a diver*s case) to flow\u003cbr /\>directly into the arteries and possibly lodge into a brain blood vessel\u003cbr /\>causing a stroke. In my case, the PFO allowed micro bubbles in my\u003cbr /\>arterial blood instead of sending them to the lungs so my decompression\u003cbr /\>was very inefficient but luckily it did not cause any major problems.\u003cbr /\>This luck is probably due to good planning and proper execution of our\u003cbr /\>decompression schedule, which proved itself in three other divers with\u003cbr /\>the same dive profile as mine and absolutely no symptoms pf DCS.\u003cbr /\>\u003cbr /\>About this time I was stressing out a lot having potential heart\u003cbr /\>defects looming over my head so when Dr. ... called me at work to tell\u003cbr /\>me I don*t just have a PFO but it could be an Atrial Septal Defect (a\u003cbr /\>hole that*s always open as opposed to the partially open PFO) I almost\u003cbr /\>freaked out. Later that day (about 3pm) I would encounter what the ER\u003cbr /\>doctor called a *vasovagal response*. That means I stressed out\u003cbr /\>over this whole thing so much that I pretty much fainted. I gotta*\u003cbr /\>tell you though, that was some violent *fainting*. It all went dark\u003cbr /\>for a moment and it seemed like my whole body was flushed with rushing\u003cbr /\>blood starting with my left arm while all my extremities went almost\u003cbr /\>",1]
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A PFO is a bypass in the wall (septum) between the right atrium and theleft atrium in one*s heart. This bypass is needed while inside themother*s womb but it is supposed to close at birth and weld shut bythe time the child is two years old. It appears that in some 25% of thepopulation (due to genetic a anomaly) this PFO does not close anddepending on the size of the hole it can either be ignored (small hole)or it can cause major problems (large). This hole allows blood flowfrom right (used blood) to left (oxygenated, clean blood from lungs)inside the heart thus bypassing the filtering action of the lungs. Thiscan allow blood clots (and nitrogen bubbles in a diver*s case) to flowdirectly into the arteries and possibly lodge into a brain blood vesselcausing a stroke. In my case, the PFO allowed micro bubbles in myarterial blood instead of sending them to the lungs so my decompressionwas very inefficient but luckily it did not cause any major problems.This luck is probably due to good planning and proper execution of ourdecompression schedule, which proved itself in three other divers withthe same dive profile as mine and absolutely no symptoms pf DCS.About this time I was stressing out a lot having potential heartdefects looming over my head so when Dr. ... called me at work to tellme I don*t just have a PFO but it could be an Atrial Septal Defect (ahole that*s always open as opposed to the partially open PFO) I almostfreaked out. Later that day (about 3pm) I would encounter what the ERdoctor called a *vasovagal response*. That means I stressed outover this whole thing so much that I pretty much fainted. I gotta*tell you though, that was some violent *fainting*. It all went darkfor a moment and it seemed like my whole body was flushed with rushingblood starting with my left arm while all my extremities went almost
or I was having a stroke (due to my newly discovered PFO, or so I\u003cbr /\>thought). Since I*ve never experienced either one I didn*t know\u003cbr /\>better. In an hour I was in the hospital*s ER under close monitoring.\u003cbr /\> The ER doctor told me he had a long talk with Dr. ... and they both\u003cbr /\>concluded that this incident had nothing to do with my getting bent or\u003cbr /\>my PFO and that I was simply freaking out. Dr. ... dismissed me an\u003cbr /\>hour later and told me to go home, relax and have a beer. I didn*t\u003cbr /\>believe him but I did go home while my brain was still playing tricks on\u003cbr /\>me. I felt very sick and weak and no advice to the contrary would make\u003cbr /\>me feel better.\u003cbr /\>\u003cbr /\>Once diagnosed with a PFO, Dr. ... referred me to Dr. ..., a\u003cbr /\>cardiologist with a private practice specializing in PFO closures. Four\u003cbr /\>days later I saw Dr. ... and had a TCD test (Trans Cranial Doppler),\u003cbr /\>which has the advantage over an echocardiogram of actually quantifying\u003cbr /\>the volume of blood (saline bubbles for contrast) that is shunted\u003cbr /\>through the PFO. The result was grim. I had a 20% shunt at rest and a\u003cbr /\>whopping 100% shunt when bearing down (such as a Valsava maneuver).\u003cbr /\>These meant that every time I coughed, sneezed, cleared my ears or blow\u003cbr /\>my nose; I was reusing 100% of my *dirty* blood for the duration of\u003cbr /\>the strain potentially having a stroke if large enough blood clots or\u003cbr /\>nitrogen bubbles would be present. This prompted Dr. ... to tell me I\u003cbr /\>have to get this hole plugged up.\u003cbr /\>\u003cbr /\>The way they plug up a PFO nowadays is very clever. The procedure\u003cbr /\>takes less than one hour and it is done on an outpatient basis. A\u003cbr /\>catheter is inserted through a groin vein (vena cava) and pushed through\u003cbr /\>the right atrium to the hole*s location. There, a device that had\u003cbr /\>been collapsed inside the catheter is deployed first on the left side of\u003cbr /\>",1]
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numb. In my mind, I was having either a heart attack (no pain though)or I was having a stroke (due to my newly discovered PFO, or so Ithought). Since I*ve never experienced either one I didn*t knowbetter. In an hour I was in the hospital*s ER under close monitoring. The ER doctor told me he had a long talk with Dr. ... and they bothconcluded that this incident had nothing to do with my getting bent ormy PFO and that I was simply freaking out. Dr. ... dismissed me anhour later and told me to go home, relax and have a beer. I didn*tbelieve him but I did go home while my brain was still playing tricks onme. I felt very sick and weak and no advice to the contrary would makeme feel better.Once diagnosed with a PFO, Dr. ... referred me to Dr. ..., acardiologist with a private practice specializing in PFO closures. Fourdays later I saw Dr. ... and had a TCD test (Trans Cranial Doppler),which has the advantage over an echocardiogram of actually quantifyingthe volume of blood (saline bubbles for contrast) that is shuntedthrough the PFO. The result was grim. I had a 20% shunt at rest and awhopping 100% shunt when bearing down (such as a Valsava maneuver).These meant that every time I coughed, sneezed, cleared my ears or blowmy nose; I was reusing 100% of my *dirty* blood for the duration ofthe strain potentially having a stroke if large enough blood clots ornitrogen bubbles would be present. This prompted Dr. ... to tell me Ihave to get this hole plugged up.The way they plug up a PFO nowadays is very clever. The proceduretakes less than one hour and it is done on an outpatient basis. Acatheter is inserted through a groin vein (vena cava) and pushed throughthe right atrium to the hole*s location. There, a device that hadbeen collapsed inside the catheter is deployed first on the left side of
catheter is unscrewed and voila, the hole is plugged. Ten years ago\u003cbr /\>this used to be done as an open-heart surgery and they would actually\u003cbr /\>stitch the PFO closed. Isn*t technology amazing?\u003cbr /\>\u003cbr /\>So, on Thursday, March 29, 2007 I had my PFO closed. According to Dr.\u003cbr /\>... , the procedure went very well although he had to use a slightly\u003cbr /\>different device than he planned due to the hole*s architecture. This\u003cbr /\>device looks pretty much like a two wire-mesh umbrella on the same pole\u003cbr /\>and it is 18mm in diameter. Since the device is made of wire mesh (some\u003cbr /\>titanium alloy) it is not designed to seal the hole by itself but rather\u003cbr /\>provide a substrate for heart tissue to form and seal the PFO shut.\u003cbr /\>This healing will take between 3 to 6 months. As I type this, three\u003cbr /\>days after my procedure, I feel great and optimistic. I am also looking\u003cbr /\>forward to put this behind me so I can dive again.\u003cbr /\>\u003cbr /\>Lessons learned:\u003cbr /\>1. Do not ignore mild DCS symptoms such as a minor skin itch or ache.\u003cbr /\>I could have avoided the bends if I would have paid attention to this\u003cbr /\>after the first dive.\u003cbr /\>2. Call DAN and ask for at least medical opinion before you disregard\u003cbr /\>any DCS suspicion.\u003cbr /\>3. Do not drive to higher altitudes the same day after major dives\u003cbr /\>with or without suspicion of DCS. That was a dumb move.\u003cbr /\>4. On major dives (involving serious decompression) allow enough time\u003cbr /\>for yourself to rest before and after the dive.\u003cbr /\>5. If you suspect DCS and decide to decompress more in the water first\u003cbr /\>ask someone to go with you and go as deep as the deco gas allows you to\u003cbr /\>go. In my case my MOD for Nx80 was 30ft. Do not do this if you are in\u003cbr /\>any serious pain!\u003cbr /\>6. I am glad I found out about my PFO, even the way I did, and I would\u003cbr /\>encourage every technical diver to get tested for it. It is a painless\u003cbr /\>",1]
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the hole and as the catheter retracts, to the right side. Then thecatheter is unscrewed and voila, the hole is plugged. Ten years agothis used to be done as an open-heart surgery and they would actuallystitch the PFO closed. Isn*t technology amazing?So, on Thursday, March 29, 2007 I had my PFO closed. According to Dr.... , the procedure went very well although he had to use a slightlydifferent device than he planned due to the hole*s architecture. Thisdevice looks pretty much like a two wire-mesh umbrella on the same poleand it is 18mm in diameter. Since the device is made of wire mesh (sometitanium alloy) it is not designed to seal the hole by itself but ratherprovide a substrate for heart tissue to form and seal the PFO shut.This healing will take between 3 to 6 months. As I type this, threedays after my procedure, I feel great and optimistic. I am also lookingforward to put this behind me so I can dive again.Lessons learned:1. Do not ignore mild DCS symptoms such as a minor skin itch or ache.I could have avoided the bends if I would have paid attention to thisafter the first dive.2. Call DAN and ask for at least medical opinion before you disregardany DCS suspicion.3. Do not drive to higher altitudes the same day after major diveswith or without suspicion of DCS. That was a dumb move.4. On major dives (involving serious decompression) allow enough timefor yourself to rest before and after the dive.5. If you suspect DCS and decide to decompress more in the water firstask someone to go with you and go as deep as the deco gas allows you togo. In my case my MOD for Nx80 was 30ft. Do not do this if you are inany serious pain!6. I am glad I found out about my PFO, even the way I did, and I wouldencourage every technical diver to get tested for it. It is a painless
called an echocardiogram and uses Doppler technology to render images of\u003cbr /\>the heart and whether the saline micro-bubbles introduced in your blood\u003cbr /\>(harmless) are able to pass from one atrium to another. I keep asking\u003cbr /\>myself, what if I was diving the Andrea Doria and had to miss some of\u003cbr /\>the decompression for any reason? I probably would have died of a\u003cbr /\>stroke before I could have been treated for DCS.\u003cbr /\>\u003cbr /\>Dive profiles:\u003cbr /\>\u003cbr /\>Dive # 1\u003cbr /\>Depth: 185ft\u003cbr /\>Bottom time: 17min.\u003cbr /\>Total dive time: 54min\u003cbr /\>Bottom gas: Tx 18/25\u003cbr /\>Travel gas: Nx 50\u003cbr /\>Deco gas: Nx 80\u003cbr /\>Deep stops @ 120ft for 2min and 78ft for 2min.\u003cbr /\>Used VR3 (+10 conservatism) computer for deco and backup tables from\u003cbr /\>V-Planner software.\u003cbr /\>\u003cbr /\>Dive # 2\u003cbr /\>Depth: 124ft\u003cbr /\>Bottom time: 20min.\u003cbr /\>Total dive time: 45min (+7min extra deco @ 10ft in my case)\u003cbr /\>Bottom gas: Tx 18/25\u003cbr /\>Travel gas: Nx 50\u003cbr /\>Deco gas: Nx 80\u003cbr /\>Deep stop @ ~70ft for 2min\u003cbr /\>Used VR3 (+10 conservatism) computer for deco and backup tables from\u003cbr /\>V-Planner software.\u003cbr /\>\u003cbr /\>\u003cbr /\>\u003cbr /\>Messages contain accident notification and discussion around the accident.\u003cbr /\>\u003cbr /\>To receive accident notification only, set your email option on this group to "Special Notices Only."\u003cbr /\>\u003cbr /\>For personal or anonymous accident related postings, send messages directly to the sysops.\u003cbr /\>\u003cbr /\>Consider copying and discussing messages herein on other diving boards.\u003cbr /\>\u003cbr /\>Moderator may delete messages or files on this board as necessary given space limitations.\u003cbr /\>Yahoo! Groups Links\u003cbr /\>\u003cbr /\><*> To visit your group on the web, go to:\u003cbr /\> \u003ca onclick\u003d\"return top.js.OpenExtLink(window,event,this)\" href\u003d\"http://groups.yahoo.com/group/divingaccidents/\" target\u003d_blank\>http://groups.yahoo.com/group\u003cwbr /\>/divingaccidents/\u003c/a\>\u003cbr /\>",1]
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test that takes 20 minutes and an IV saline solution. The test iscalled an echocardiogram and uses Doppler technology to render images ofthe heart and whether the saline micro-bubbles introduced in your blood(harmless) are able to pass from one atrium to another. I keep askingmyself, what if I was diving the Andrea Doria and had to miss some ofthe decompression for any reason? I probably would have died of astroke before I could have been treated for DCS.Dive profiles:Dive # 1Depth: 185ftBottom time: 17min.Total dive time: 54minBottom gas: Tx 18/25Travel gas: Nx 50Deco gas: Nx 80Deep stops @ 120ft for 2min and 78ft for 2min.Used VR3 (+10 conservatism) computer for deco and backup tables fromV-Planner software.Dive # 2Depth: 124ftBottom time: 20min.Total dive time: 45min (+7min extra deco @ 10ft in my case)Bottom gas: Tx 18/25Travel gas: Nx 50Deco gas: Nx 80Deep stop @ ~70ft for 2minUsed VR3 (+10 conservatism) computer for deco and backup tables fromV-Planner software.
involves climbing from 1000ft altitude to almost 6500ft within a few\u003cbr /\>hours. I kept breathing my 80% oxygen with air breaks throughout the\u003cbr /\>trip and later even took a couple of Advil pills, which helped with the\u003cbr /\>pain. By this time the aching in my shoulder had become pain and I had\u003cbr /\>a skin rash all over my shoulder and stomach (same spots that were itchy\u003cbr /\>earlier that day). We finally got home at about 2am and I went to\u003cbr /\>sleep.\u003cbr /\>\u003cbr /\>Next day, the pain receded to just an ache again until later that night\u003cbr /\>when it came back so I decided it*s time to call Diver*s Alert\u003cbr /\>Network (DAN) and they recommended Dr. ... , a local hyperbaric medical\u003cbr /\>doctor at ... hospital. I called him and he told me to get my butt over\u003cbr /\>there really fast so he can treat me. I did as he said and although I\u003cbr /\>passed all of his neurological tests (for a potential type II DSC) he\u003cbr /\>shoved me in a recompression chamber for a Navy Table#6 which entails\u003cbr /\>breathing 100% oxygen at 3ATA (66feet) for 2 hours followed by 2.5 hours\u003cbr /\>at 2ATA (33feet) for a total of almost 5 hours). As I was inside that\u003cbr /\>tube my shoulder pain slowly disappeared. The skin was still tender\u003cbr /\>even though the rash was gone too. I couldn*t finish all 5 hours of\u003cbr /\>the treatment because I could not use that damn pee cup they gave me as\u003cbr /\>I was laying down being constrained by the single person, Plexiglas tube\u003cbr /\>chamber. Note to self: try to use a multi-person chamber next time.\u003cbr /\>The next day I had to go back in for another 2 hours in the chamber in\u003cbr /\>order to minimize a relapse. After that, no more pain!\u003cbr /\>\u003cbr /\>While I was getting treated for DCS, Dr. ... asked me if I want to get\u003cbr /\>checked for a PFO (Patent Foramen Ovale) and I agreed so he sent me down\u003cbr /\>one floor to cardiology to have an echocardiogram test. Needless to say\u003cbr /\>the test was positive.\u003cbr /\>",1]
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this, we all made the bad decision to drive back home as this driveinvolves climbing from 1000ft altitude to almost 6500ft within a fewhours. I kept breathing my 80% oxygen with air breaks throughout thetrip and later even took a couple of Advil pills, which helped with thepain. By this time the aching in my shoulder had become pain and I hada skin rash all over my shoulder and stomach (same spots that were itchyearlier that day). We finally got home at about 2am and I went tosleep.Next day, the pain receded to just an ache again until later that nightwhen it came back so I decided it*s time to call Diver*s AlertNetwork (DAN) and they recommended Dr. ... , a local hyperbaric medicaldoctor at ... hospital. I called him and he told me to get my butt overthere really fast so he can treat me. I did as he said and although Ipassed all of his neurological tests (for a potential type II DSC) heshoved me in a recompression chamber for a Navy Table#6 which entailsbreathing 100% oxygen at 3ATA (66feet) for 2 hours followed by 2.5 hoursat 2ATA (33feet) for a total of almost 5 hours). As I was inside thattube my shoulder pain slowly disappeared. The skin was still tendereven though the rash was gone too. I couldn*t finish all 5 hours ofthe treatment because I could not use that damn pee cup they gave me asI was laying down being constrained by the single person, Plexiglas tubechamber. Note to self: try to use a multi-person chamber next time.The next day I had to go back in for another 2 hours in the chamber inorder to minimize a relapse. After that, no more pain!While I was getting treated for DCS, Dr. ... asked me if I want to getchecked for a PFO (Patent Foramen Ovale) and I agreed so he sent me downone floor to cardiology to have an echocardiogram test. Needless to saythe test was positive.
A PFO is a bypass in the wall (septum) between the right atrium and the\u003cbr /\>left atrium in one*s heart. This bypass is needed while inside the\u003cbr /\>mother*s womb but it is supposed to close at birth and weld shut by\u003cbr /\>the time the child is two years old. It appears that in some 25% of the\u003cbr /\>population (due to genetic a anomaly) this PFO does not close and\u003cbr /\>depending on the size of the hole it can either be ignored (small hole)\u003cbr /\>or it can cause major problems (large). This hole allows blood flow\u003cbr /\>from right (used blood) to left (oxygenated, clean blood from lungs)\u003cbr /\>inside the heart thus bypassing the filtering action of the lungs. This\u003cbr /\>can allow blood clots (and nitrogen bubbles in a diver*s case) to flow\u003cbr /\>directly into the arteries and possibly lodge into a brain blood vessel\u003cbr /\>causing a stroke. In my case, the PFO allowed micro bubbles in my\u003cbr /\>arterial blood instead of sending them to the lungs so my decompression\u003cbr /\>was very inefficient but luckily it did not cause any major problems.\u003cbr /\>This luck is probably due to good planning and proper execution of our\u003cbr /\>decompression schedule, which proved itself in three other divers with\u003cbr /\>the same dive profile as mine and absolutely no symptoms pf DCS.\u003cbr /\>\u003cbr /\>About this time I was stressing out a lot having potential heart\u003cbr /\>defects looming over my head so when Dr. ... called me at work to tell\u003cbr /\>me I don*t just have a PFO but it could be an Atrial Septal Defect (a\u003cbr /\>hole that*s always open as opposed to the partially open PFO) I almost\u003cbr /\>freaked out. Later that day (about 3pm) I would encounter what the ER\u003cbr /\>doctor called a *vasovagal response*. That means I stressed out\u003cbr /\>over this whole thing so much that I pretty much fainted. I gotta*\u003cbr /\>tell you though, that was some violent *fainting*. It all went dark\u003cbr /\>for a moment and it seemed like my whole body was flushed with rushing\u003cbr /\>blood starting with my left arm while all my extremities went almost\u003cbr /\>",1]
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A PFO is a bypass in the wall (septum) between the right atrium and theleft atrium in one*s heart. This bypass is needed while inside themother*s womb but it is supposed to close at birth and weld shut bythe time the child is two years old. It appears that in some 25% of thepopulation (due to genetic a anomaly) this PFO does not close anddepending on the size of the hole it can either be ignored (small hole)or it can cause major problems (large). This hole allows blood flowfrom right (used blood) to left (oxygenated, clean blood from lungs)inside the heart thus bypassing the filtering action of the lungs. Thiscan allow blood clots (and nitrogen bubbles in a diver*s case) to flowdirectly into the arteries and possibly lodge into a brain blood vesselcausing a stroke. In my case, the PFO allowed micro bubbles in myarterial blood instead of sending them to the lungs so my decompressionwas very inefficient but luckily it did not cause any major problems.This luck is probably due to good planning and proper execution of ourdecompression schedule, which proved itself in three other divers withthe same dive profile as mine and absolutely no symptoms pf DCS.About this time I was stressing out a lot having potential heartdefects looming over my head so when Dr. ... called me at work to tellme I don*t just have a PFO but it could be an Atrial Septal Defect (ahole that*s always open as opposed to the partially open PFO) I almostfreaked out. Later that day (about 3pm) I would encounter what the ERdoctor called a *vasovagal response*. That means I stressed outover this whole thing so much that I pretty much fainted. I gotta*tell you though, that was some violent *fainting*. It all went darkfor a moment and it seemed like my whole body was flushed with rushingblood starting with my left arm while all my extremities went almost
or I was having a stroke (due to my newly discovered PFO, or so I\u003cbr /\>thought). Since I*ve never experienced either one I didn*t know\u003cbr /\>better. In an hour I was in the hospital*s ER under close monitoring.\u003cbr /\> The ER doctor told me he had a long talk with Dr. ... and they both\u003cbr /\>concluded that this incident had nothing to do with my getting bent or\u003cbr /\>my PFO and that I was simply freaking out. Dr. ... dismissed me an\u003cbr /\>hour later and told me to go home, relax and have a beer. I didn*t\u003cbr /\>believe him but I did go home while my brain was still playing tricks on\u003cbr /\>me. I felt very sick and weak and no advice to the contrary would make\u003cbr /\>me feel better.\u003cbr /\>\u003cbr /\>Once diagnosed with a PFO, Dr. ... referred me to Dr. ..., a\u003cbr /\>cardiologist with a private practice specializing in PFO closures. Four\u003cbr /\>days later I saw Dr. ... and had a TCD test (Trans Cranial Doppler),\u003cbr /\>which has the advantage over an echocardiogram of actually quantifying\u003cbr /\>the volume of blood (saline bubbles for contrast) that is shunted\u003cbr /\>through the PFO. The result was grim. I had a 20% shunt at rest and a\u003cbr /\>whopping 100% shunt when bearing down (such as a Valsava maneuver).\u003cbr /\>These meant that every time I coughed, sneezed, cleared my ears or blow\u003cbr /\>my nose; I was reusing 100% of my *dirty* blood for the duration of\u003cbr /\>the strain potentially having a stroke if large enough blood clots or\u003cbr /\>nitrogen bubbles would be present. This prompted Dr. ... to tell me I\u003cbr /\>have to get this hole plugged up.\u003cbr /\>\u003cbr /\>The way they plug up a PFO nowadays is very clever. The procedure\u003cbr /\>takes less than one hour and it is done on an outpatient basis. A\u003cbr /\>catheter is inserted through a groin vein (vena cava) and pushed through\u003cbr /\>the right atrium to the hole*s location. There, a device that had\u003cbr /\>been collapsed inside the catheter is deployed first on the left side of\u003cbr /\>",1]
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numb. In my mind, I was having either a heart attack (no pain though)or I was having a stroke (due to my newly discovered PFO, or so Ithought). Since I*ve never experienced either one I didn*t knowbetter. In an hour I was in the hospital*s ER under close monitoring. The ER doctor told me he had a long talk with Dr. ... and they bothconcluded that this incident had nothing to do with my getting bent ormy PFO and that I was simply freaking out. Dr. ... dismissed me anhour later and told me to go home, relax and have a beer. I didn*tbelieve him but I did go home while my brain was still playing tricks onme. I felt very sick and weak and no advice to the contrary would makeme feel better.Once diagnosed with a PFO, Dr. ... referred me to Dr. ..., acardiologist with a private practice specializing in PFO closures. Fourdays later I saw Dr. ... and had a TCD test (Trans Cranial Doppler),which has the advantage over an echocardiogram of actually quantifyingthe volume of blood (saline bubbles for contrast) that is shuntedthrough the PFO. The result was grim. I had a 20% shunt at rest and awhopping 100% shunt when bearing down (such as a Valsava maneuver).These meant that every time I coughed, sneezed, cleared my ears or blowmy nose; I was reusing 100% of my *dirty* blood for the duration ofthe strain potentially having a stroke if large enough blood clots ornitrogen bubbles would be present. This prompted Dr. ... to tell me Ihave to get this hole plugged up.The way they plug up a PFO nowadays is very clever. The proceduretakes less than one hour and it is done on an outpatient basis. Acatheter is inserted through a groin vein (vena cava) and pushed throughthe right atrium to the hole*s location. There, a device that hadbeen collapsed inside the catheter is deployed first on the left side of
catheter is unscrewed and voila, the hole is plugged. Ten years ago\u003cbr /\>this used to be done as an open-heart surgery and they would actually\u003cbr /\>stitch the PFO closed. Isn*t technology amazing?\u003cbr /\>\u003cbr /\>So, on Thursday, March 29, 2007 I had my PFO closed. According to Dr.\u003cbr /\>... , the procedure went very well although he had to use a slightly\u003cbr /\>different device than he planned due to the hole*s architecture. This\u003cbr /\>device looks pretty much like a two wire-mesh umbrella on the same pole\u003cbr /\>and it is 18mm in diameter. Since the device is made of wire mesh (some\u003cbr /\>titanium alloy) it is not designed to seal the hole by itself but rather\u003cbr /\>provide a substrate for heart tissue to form and seal the PFO shut.\u003cbr /\>This healing will take between 3 to 6 months. As I type this, three\u003cbr /\>days after my procedure, I feel great and optimistic. I am also looking\u003cbr /\>forward to put this behind me so I can dive again.\u003cbr /\>\u003cbr /\>Lessons learned:\u003cbr /\>1. Do not ignore mild DCS symptoms such as a minor skin itch or ache.\u003cbr /\>I could have avoided the bends if I would have paid attention to this\u003cbr /\>after the first dive.\u003cbr /\>2. Call DAN and ask for at least medical opinion before you disregard\u003cbr /\>any DCS suspicion.\u003cbr /\>3. Do not drive to higher altitudes the same day after major dives\u003cbr /\>with or without suspicion of DCS. That was a dumb move.\u003cbr /\>4. On major dives (involving serious decompression) allow enough time\u003cbr /\>for yourself to rest before and after the dive.\u003cbr /\>5. If you suspect DCS and decide to decompress more in the water first\u003cbr /\>ask someone to go with you and go as deep as the deco gas allows you to\u003cbr /\>go. In my case my MOD for Nx80 was 30ft. Do not do this if you are in\u003cbr /\>any serious pain!\u003cbr /\>6. I am glad I found out about my PFO, even the way I did, and I would\u003cbr /\>encourage every technical diver to get tested for it. It is a painless\u003cbr /\>",1]
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the hole and as the catheter retracts, to the right side. Then thecatheter is unscrewed and voila, the hole is plugged. Ten years agothis used to be done as an open-heart surgery and they would actuallystitch the PFO closed. Isn*t technology amazing?So, on Thursday, March 29, 2007 I had my PFO closed. According to Dr.... , the procedure went very well although he had to use a slightlydifferent device than he planned due to the hole*s architecture. Thisdevice looks pretty much like a two wire-mesh umbrella on the same poleand it is 18mm in diameter. Since the device is made of wire mesh (sometitanium alloy) it is not designed to seal the hole by itself but ratherprovide a substrate for heart tissue to form and seal the PFO shut.This healing will take between 3 to 6 months. As I type this, threedays after my procedure, I feel great and optimistic. I am also lookingforward to put this behind me so I can dive again.Lessons learned:1. Do not ignore mild DCS symptoms such as a minor skin itch or ache.I could have avoided the bends if I would have paid attention to thisafter the first dive.2. Call DAN and ask for at least medical opinion before you disregardany DCS suspicion.3. Do not drive to higher altitudes the same day after major diveswith or without suspicion of DCS. That was a dumb move.4. On major dives (involving serious decompression) allow enough timefor yourself to rest before and after the dive.5. If you suspect DCS and decide to decompress more in the water firstask someone to go with you and go as deep as the deco gas allows you togo. In my case my MOD for Nx80 was 30ft. Do not do this if you are inany serious pain!6. I am glad I found out about my PFO, even the way I did, and I wouldencourage every technical diver to get tested for it. It is a painless
called an echocardiogram and uses Doppler technology to render images of\u003cbr /\>the heart and whether the saline micro-bubbles introduced in your blood\u003cbr /\>(harmless) are able to pass from one atrium to another. I keep asking\u003cbr /\>myself, what if I was diving the Andrea Doria and had to miss some of\u003cbr /\>the decompression for any reason? I probably would have died of a\u003cbr /\>stroke before I could have been treated for DCS.\u003cbr /\>\u003cbr /\>Dive profiles:\u003cbr /\>\u003cbr /\>Dive # 1\u003cbr /\>Depth: 185ft\u003cbr /\>Bottom time: 17min.\u003cbr /\>Total dive time: 54min\u003cbr /\>Bottom gas: Tx 18/25\u003cbr /\>Travel gas: Nx 50\u003cbr /\>Deco gas: Nx 80\u003cbr /\>Deep stops @ 120ft for 2min and 78ft for 2min.\u003cbr /\>Used VR3 (+10 conservatism) computer for deco and backup tables from\u003cbr /\>V-Planner software.\u003cbr /\>\u003cbr /\>Dive # 2\u003cbr /\>Depth: 124ft\u003cbr /\>Bottom time: 20min.\u003cbr /\>Total dive time: 45min (+7min extra deco @ 10ft in my case)\u003cbr /\>Bottom gas: Tx 18/25\u003cbr /\>Travel gas: Nx 50\u003cbr /\>Deco gas: Nx 80\u003cbr /\>Deep stop @ ~70ft for 2min\u003cbr /\>Used VR3 (+10 conservatism) computer for deco and backup tables from\u003cbr /\>V-Planner software.\u003cbr /\>\u003cbr /\>\u003cbr /\>\u003cbr /\>Messages contain accident notification and discussion around the accident.\u003cbr /\>\u003cbr /\>To receive accident notification only, set your email option on this group to "Special Notices Only."\u003cbr /\>\u003cbr /\>For personal or anonymous accident related postings, send messages directly to the sysops.\u003cbr /\>\u003cbr /\>Consider copying and discussing messages herein on other diving boards.\u003cbr /\>\u003cbr /\>Moderator may delete messages or files on this board as necessary given space limitations.\u003cbr /\>Yahoo! Groups Links\u003cbr /\>\u003cbr /\><*> To visit your group on the web, go to:\u003cbr /\> \u003ca onclick\u003d\"return top.js.OpenExtLink(window,event,this)\" href\u003d\"http://groups.yahoo.com/group/divingaccidents/\" target\u003d_blank\>http://groups.yahoo.com/group\u003cwbr /\>/divingaccidents/\u003c/a\>\u003cbr /\>",1]
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test that takes 20 minutes and an IV saline solution. The test iscalled an echocardiogram and uses Doppler technology to render images ofthe heart and whether the saline micro-bubbles introduced in your blood(harmless) are able to pass from one atrium to another. I keep askingmyself, what if I was diving the Andrea Doria and had to miss some ofthe decompression for any reason? I probably would have died of astroke before I could have been treated for DCS.Dive profiles:Dive # 1Depth: 185ftBottom time: 17min.Total dive time: 54minBottom gas: Tx 18/25Travel gas: Nx 50Deco gas: Nx 80Deep stops @ 120ft for 2min and 78ft for 2min.Used VR3 (+10 conservatism) computer for deco and backup tables fromV-Planner software.Dive # 2Depth: 124ftBottom time: 20min.Total dive time: 45min (+7min extra deco @ 10ft in my case)Bottom gas: Tx 18/25Travel gas: Nx 50Deco gas: Nx 80Deep stop @ ~70ft for 2minUsed VR3 (+10 conservatism) computer for deco and backup tables fromV-Planner software.
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