2 DCS hits and a PFO closure

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Pullnglide

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I've posted a lot on CDF about my bouts with DCS and having a PFO (parent Foramen Ovale) which greatly increases risk of DCS by not being able to decompress efficiently. I am posting here to give those that are not CDF members some insight about a PFO. A PFO is something everyone is born with and closes by itself in 75% of the population. It more often than not goes undetected but can cause some medical problems and greatly increases a divers DCS risk due to the bubble load. I've had 2 "undeserved" hits in the last year and a half and it turned out to be highly influenced by a PFO. It was closed via a heart cath this past Tuesday and so far everything is going well as far as recovery goes. It's an outpatient procedure. I was in and out of the hospital in 10 hours. After my procedure I had another TTE (Transthoracic Echo (sp?)) performed to check the device and flow. While I was there a young lady was in the room next to me undergoing a TEE (Transesophageal Echo) She has 20 dives under her belt since ow certification and has been bent twice with depths of 50'-60'. Seems like that would be an ASD instead of PFO with her being bent that easily but I'm certainly no Dr.! If you've had a DCS hit especially more than once and you believe it to be "undeserved" (yes I know some people do not believe in "undeserved" so take it with a grain of salt) please see a Cardiologist and rule out a PFO. As far as the second bout with DCS it was "undeserved" as far as my dive plan but was deserved for me doing 100'+ 30-60 min deco dives 3 days in a row knowing I had a PFO, not very smart and I paid the price, well BCBS and DAN did to the tune of roughly $100k. I hear a lot of people say (When a technical diver gets bent they always blame a PFO), we'll please take into consideration that it's a viable possibility. Eric (bamafan) was with me on the first hit and brought up the PFO, I had never heard of that and did not think it caused my problems but I'm grateful he mentioned it. Closing it obviously does not eliminate DCS risk but greatly reduces it by about 5 times. Some hear that it's a heart procedure and may be weary of having it done but when you choose a great Dr. And that person has a great team surrounding them it makes it a bit easier! Attached is an actual image of the device placed in my heart to close the PFO.
 

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Good to see the PFO closure procedure done with no complication! What's the prognosis and timeframe for resuming Scuba activities again?

Also were your previous DCS hits type I or II?
 
They were both DCS II. Obviously there is no guarantee it will not happen again but my risk is greatly reduced. No diving for 3 months after the procedure; however I have Dr's orders for no diving for 6 months after the recompression therapy due to my 2nd hit which was November 13, 2016. The weekend of May 19th will be my first weekend back in the water and I can't wait!!
 
i am glad all is going well for you post surgery.....you sharing your story is quite admirable so others may learn and be aware of this problem...thanks for sharing your story and may you be back in the water ASAP.
 
I am glad things are going well. One of my students got DCS (not while diving with me) and had a very large PFO closed. that was a couple years ago. She is diving with no trouble now.

BTW, as a CDF member, I knew about this already, and I don't think the OP will mind if I mentioned that his cardiologist was Douglas Ebersole, one of the ScubaBoard medical moderators.
 
I certainly don't mind! He is a great man!! I know he's a Doctor and doing his job but he by far went above and beyond the call of duty with his bedside manner/communication and made the whole process as comfortable for me as it could have possibly been. I could have had it done an hour north of me but I drove 7 hours each way in order to have him perform the PFO closure and it was well worth it!!
 
Derek I am glad you are doing well. For those that don't know I was on the dive with Derek when he got bent the first time. I don't remember the exact bottom time but we were in Bozel which has depths of about 120' and we probably did something close to 2 hours. I run VPM+2 and generally pad my deco by about 10%. I think I had about 15 minutes of deco and Derek was running a way more conservative setting and probably did at least 20 more minutes of deco than I did. This is a cave dive so there were no run away ascents or anything abnormal with the dive at all. The only thing that I can think might be different was I always drink a lot of water but I doubt that had anything to do with the incident. He started having issues about an hour later and I really got worried when after helping him lay down I handed him an O2 reg and he couldn't put it in his mouth. I had been around the minor stuff such as skin bends and minor pain but this was definitely serious. I had never met or talked to his wife so the first time I did was to tell her he was being taken to the hospital. She actually took it very well.

For anyone that gets bent especially for a dive where you didn't screw up I recommend getting checked for a PFO.

Glad you are doing well Derek
 
Thanks for all of the kind words. I'm just happy to be able to help. Sorry about the quality of the photo of your device. I took it off the monitor with my cell phone! :)

And to everyone out there, Dr. Denoble and I are still recruiting for our DAN sponsored PFO study. If you or any of your dive buddies would be interested in participating, the link to information on the study is www.dan.org/pfostudy.

Doug
 
I have filled out the paperwork for your DAN study and will send it out Monday afternoon.
 
I think it's a vital issue to be aware of for all divers, and especially for those going into tech diving should consider mandatory PFO diagnostic screening:
. . .PFO is a cardiac lesion that causes inter-atrial right-to-left blood shunting during the periods of the cardiac cycle and right atrial pressure to exceed left atrial pressure. It can be implicated in the pathogenesis of several serious clinical syndromes, including paradoxical systemic embolism, such as ischemic stroke (3), myocardium infarction (4), neurological decompression illness in divers (5) and complications of pulmonary embolism. . .

How to use contrast enhanced transcranial doppler toward detection and follow-up
 
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