DCS in Cozumel

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He doesn't have a heart condition (see the bullet points you circled on the PADI medical form)....he has a PFO. I'll dive with him any day.

Never mind what was circled, I see the form also lists "any dive accidents or decompression sickness." So presumably if someone checks that box, then the dive op generally asks for a doctor's letter of no contraindications to diving.

Interestingly, the form doesn't ask about PFO, which is the first thing people here tend to ask about. If I had to guess, I would guess it doesn't ask about PFO because almost all divers who are aware they have a PFO became aware of it after a DCS incident.
 
interesting discussion....

I guess I will weigh in here...as a person who has had some unexpected surgeries, including heart valve repair. I had mine fixed and I am diving with no issues. My doctor said just not to do anything too deep from now on, or to limit to 2-3 dives per day, not that he can control that, just a recommendation to always pay attention to my body. Having my heart fixed (never had DCS, found the leaky valve at a doc appt), I am SOOO glad I did it. My life improved 100%. Surgery nowadays is so much better than even 10 years ago. I was diving again 4 months after my surgery which was 4 years ago.

NOW I am also scaling back on my diving intensity. I do 2 dives a day, shallow, 60' or less. Just my way of being extra safe. I am not solo diving any more either. I don't want to put anyone at risk who is diving with me, or searching for me if for some reason something happens. Just MY changes to diving.

So...to the OP.... sorry for your DCS hits. But you have had 2 hits. You need to evaluate risks and let those diving with you know what is going on.
We had a lady on a liveaboard with us several years ago who had 2 hits previously. She let the DMs know, and they put an extra DM in the water every dive she was on just in case, as an extra buddy for her. She limited herself to 2 dives a day. Just sayin'.

Just my 2 cents.
robin
 
NOW I am also scaling back on my diving intensity. I do 2 dives a day, shallow, 60' or less. Just my way of being extra safe. I am not solo diving any more either. I don't want to put anyone at risk who is diving with me, or searching for me if for some reason something happens. Just MY changes to diving.

You are exactly the type of responsible diver I'd want on my boat - kudos to you Robin. :thumb:
 
Yes, I have been dove Cozumel 14+ times since 1990. I know the reefs and dive protocol there pretty well. I understand that DCS is NOT a pre-existing condition, but HAVING ANOTHER CONDITION (PFO) that makes you more susceptible IS, which was my point that he is putting others and himself at further risk without taking action. That is why I suggested he either address the issue, or hire his own boat/DM or quit altogether.

A quick visit to the PADI medical waiver form should clearly demonstrate that no professional organization should be taking this man diving. The fact that apparently you would take him says ALOT about your dive operation and one that I would 100% avoid.


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WOW - just WOW! You certainly make some big jumps in conclusions and judgments with very limited information.

A. I don't know for a fact that he has a PFO - there is a very specific test that is run to test for it, and there is only one Dr. on the island who performs it - Dr. Moguel, the Cardiologist at CMC - this is why I asked him this question.

B. He IS addressing the issue - he is gathering information so that he can take the next step and make an educated and informed decision. I'm sure ScubaBoard is NOT his only resource, but one of many.

C. I am not a Dr. and I can't say if I would take him diving or not. There is not enough information here to make that jump! FYI, the medical clearance is actually not even required for certified divers - it is only required for STUDENT divers. Furthermore, it is not there for the dive operator to approve or deny someone from diving - it is there so that we can determine if they should be evaluated by a diving physician. Just because something is listed on the medical form and a "yes" answer is given, that is not an automatic "no" to diving either. Again, I am not a medical Dr. nor are most dive shop owners or DM's.

D. There is a Diving Doctor participating in this thread who disagrees with you, so I'm going with his opinion! There are people on a regular basis who have been cleared for diving after a case of DCS with no further incidence.

E. I can guarantee you that there are divers out there every single day who should not be diving. They are either diving with undiagnosed issues or they have lied on their paperwork - it happens everyday!

Here's a story about a diver who ruined MANY people's day last year. I had a group of very experienced divers, 5 of them, so fortunately, they had their own boat. Of these 5 divers, TWO were actually PADI Professionals (DM & Instructor) including the diver who organized the trip. They all filled out their paperwork, they ALL answered NO to all medical issues, and in two places signed a statement that "I have no known medical issues which would preclude me from diving." I also have a series of medical questions on the diver application. There is a specific question about having any lung issues, including COPD. COPD happens to be a condition that is an absolute, unequivocal NO to diving by the way. ALl divers answered NO and signed off on their papers.

On the third day of diving, one of the divers went unconscious upon surfacing after the first dive of the day - it was an uneventful dive with no issues even at the safety stop. He was brought onto the boat, given CPR and O2 all the way to the meeting point for the ambulance that had been called - but he was already gone. He had suffered a lung overexpansion and air embolism in his lungs as a result of diagnosed severe COPD which was not disclosed on his medical statement or paperwork. after he had passed, his dive group informed me that he had told them THAT morning that his Dr. had told him he could not dive, that it would kill him. No one said anything. Perhaps this is how he wanted to die - it's how I would want to go. Or perhaps he thought he would beat the odds. I don't know, none of us do - but THAT was irresponsible and selfish. He put his friends in a horrible position, he lied to me, he and as a result it affected my crew, his dive buddies, my other divers with us that week on the other boat, his family, and even the beach club where we were told to bring him to meet the ambulance. Not just on the day of the incident, but I spent weeks and weeks dealing with this. My boat was taken out of commission for a few days while the local authorities investigated. My crew was emotionally affected.

So how dare you propose to tell me what I would or wouldn't do and that I would KNOWINGLY allow someone to dive under my watch with a condition that was dangerous to them or others. You have NO idea! For God's sake, I am one of the dive ops that requires a private DM for anyone with less than 15 ocean dives! I take all kinds of precautions that other ops do not. Again, you have NO IDEA!

Some of your statements are so outrageous I have to think you are trolling. Well, if that's the case, I took the bait - but I'm done.
 
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Back to your original question of arranging future dive trips. It may be time to focus on shore diving locations only, such as Bonaire or Curacao, and avoid boat dives altogether. That way you are in control of your dive profile/surface intervals and would avoid the concerns about the possibility of inconveniencing any other divers. Alternatively, for boat diving, focus on wall diving trips with walls that start at the 20-40ft range. This would allow you to adjust the depth to your dive profile/medical requirements and still enjoy all the dives (depending on surface interval requirements).
 
Whatever the reason you are so prone to DCS, I wonder if taking a longer safety stop could help you? Say, 6 min instead of 3? This way you'll simply treat every dive as a deco dive. 3 extra min won't be a burden for the group if you are doing a group dive, nor would it take too much gas.
 
At the risk of repeating myself, we ALL bubble. Exertion makes it worse (see NEDU work on this), as does extra nitrogen.
The posts advocating conservatism are well intended, but (IF this is a PFO) they will only marginally decrease the risk of another unexpected hit.

The bubbles are there, due to tissue shear forces and microbubble nuclei. In many, many dives. In all of us.
If they cross to the left side of the circulation, the diver is at risk. How many and how big is indeed a function of N2 loading, among other things (I have markedly decreased my ascent rates in the last 30 ft as I have aged).
But the solution is to prevent the shunt, by closing the PFO, if that is the underlying problem.
 
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So from the silence it's safe to assume that if a diver told a dive operator they had been diagnosed with PFO and have had two undeserved DCS hits in less than 5 years, the last one in 2017 that they would be diving with them.
 
I don't think it's safe to assume that at all. The potential responsibilities of dive operators has been debated in other threads .
No, I think what people are generally saying is that this diver has an increased risk which he is evidently deciding to shoulder himself. If I were he, and a boat driver declined to take me, I might be upset. But I think the dive operator has some latitude in who he takes as his customer. It could go either way.
I think what people are saying is that it's this divers right to choose, just as it's the boat operators right to take him or not. What this diver isn't, is stupid. He's thinking about his issues in a responsible fashion.
He had the courage to post here on Scubaboard, and I don't think he should be called an idiot.
 
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