One Dive Too Many on The Zenobia

[openmindOW]

Thank you, AmRus, for your post. Your post may help to keep other divers safe; you have made a real contribution to ScubaBoard. Thank you.

As suggested by some of the others, I am surprised that your profile, coupled wiht an apprently slow ascent rate, produced DCS. It certainly gives me pause. I have a couple of deep wreck dives scheduled for this weekend. I will be thinking about your experience.

I guess all of us older divers need to be extra careful.

[Rhone Man]

Thanks for posting. Sobering warning for everyone.

[vladimir]

The PFO (Patent Foramen Ovale or "hole in the heart") is actually rather common but is worth getting checked - although that could be said for all divers - it occurs in 1 in 3 people if memory serves.

About 1 in 4. The tests for PFO are not without risk (and expense) and are only indicated if certain risk factors present themselves--like "undeserved" DCI hits. I did a quick search for Patent Foramen Ovale among the posts of debersole, a cardiologist and frequent contributor, and got a short course on the subject:

ScubaBoard - Search Results

[DandyDon]

Yes, PFO is estimated to a functional defect in 25%, but we don't see 25% of divers getting bent - and just because one took a hit doesn't mean one exists. Each case has to be evaluated on its own. I'm sure DAN has extensive research and expert opinions available.

[jkaterenchuk]

As I said earlier and a review of your dive profile confirms. Your dive was well within recreational limits which are well padded to protect against DCS.

Unless you can look down the list of predisposition factor which put you at greater risk for DCS and say that you were grossly negligent in one of more of those factors then you should be very concerned about this incident and more so the possibility of a future incident that might not end so well. It would be prudent to consult with a doctor that is knowledgeable in this area. Doug Ebesole is highly recommended since he is a technical diver, technical instructor and also a cardiac specialist. However, your geography might prevent using him for an assessment.

Poor or impaired circulation
Excessive Carbon Dioxide buildup
Physical Labour
Consumption of Alcohol 12 hr pre or post dive
Dehydration

The testing for a PFO is not necessarily invasive depending upon which test the doctor decides is best....accuracy varies from test to test. TTE, TEE and TCD are the three with TTE and TCD being low on the invasive scale but TTE being more invasive (probe inserted down your throat) but is high on the accuracy scale. The cost of a the test can be much lower in a foreign country other than the USA.

John

[toefa]

Hi AmRus,

I thought of this thread and your story just the other night when i went to an educational night at our local chamber.

During the lecture at the beginning of the night, the Doctor was speaking on the symptoms and the causes of DCI and what other problems can present as DCI. He mentioned one thing that immediately made me think of your story - Salt Water Aspiration Syndrome. Have you heard of this or considered it as a possibility? The low blood pressure and symptoms after the chamber could very well have surfaced because of the chamber, however if you look at the initial symptoms present, all fit within this Salt Water Aspiration Syndrome..

You seemed to dive well within the rec limits and if PFO is not the cause (which still could be a factor given the bruising) this seems like the only other reasonable explanation.

Thanks for sharing your story AmRus, it has definitely made me more aware and that can only be a good thing.

[toefa]

Here as a very vague article on it. I will see if i can dig anything else up in the meantime:

Saltwater Aspiration Syndrome

[AmRus]

Hi toefa,

Thank you for your comments and for your link, which I read with great interest (of course!). In response to my coughing fits, the DM's asked me if I had swallowed any water (not breathed it in) to which I was able to answer no. I even swam on regulator (Mares Proton Metal less than 20 dives/1 year old) back to the boat. I assume that if I had aspirated any salt water, I would have noticed it - and my coughs were non-productive. However, I was extremely fatigued, to the point that I hardly able to remove, much less store my equipment.

I will share your thoughts and link with Clive Martin (mentioned in my OP) and I'm sure I will learn more from that discussion.

After submitting this post, I have learned a lot from following the thread and really appreciate everyone's comments, suggestions and links. A great interactive forum: I hope I am a better diver for it!

[toefa]

Hi AmRus,

No problem at all.

The thing with salt water aspiration is the salt water is atomised, so you would never really notice it. We were told that if the question is posed almost immediately after diving, the victim can usually agree on the air being 'moist' to breathe.

I don't know if you are familiar with Nebulisers, but that is much of the same thing. You can breathe in medicated vapours or steam and apart from the temperature, you don't really notice being inhaled.

The atomisation can occur through regs themselves or through the tanks, so it still could be a possibilty.

Would really like to see you get to the bottom off what occurred. Would have been bloody scary anyway!

Cheers,
Toefa

[paul madox]

What about the ascent rate after the safty stop could this bring on dcs if to quick ???