Just got checked for a PFO

[scoobydrew]

As the title says, I just got checked for a PFO. If you're not sure what that is then just briefly, its a hole in your heart that everybody has as a fetus which should seal up shortly after birth. An estimated one in four people's PFO does not seal up and those people may well have a perfectly normal life in complete ignorance to the condition. It can however create problems with diving as it can prevent a person from off gassing as nitrogen rich blood bypasses the lungs through the hole therefore removing the possibility for effective gas exchange. As the diver ascends having not removed sufficient nitrogen, they get a DCS hit.

Divers who have racked up thousands of dives have been known to be found with a PFO having never suffered DCS but I personally know a good few divers who got "undeserved hits" only to find out they had one. Adding helium to the mix apparently increases the risk of DCS as it is a thinner gas so able to slip through a hole easier.

Doug Ebersol offers some very good advice here https://www.youtube.com/watch?v=1-W54Z9GjXw

Having heard PFO's pop up in conversation over the years and as my diving is getting deeper, longer and more technical I grew more interested in them. Mark Powell says that symptoms of a PFO can include a heart murmur and/or persistent migraines, both of which I had in my younger years. So then I started to get the fear and those 30 minute deco hangs would often be spent wandering about it to the point where I decided to get it checked.

Turns out I'm clear. At the hospital, they put a saline solution in an IV and watched my heart through an echo cardiogram. They showed me the bubble content from the saline on the right half of the heart and how as it beat, no bubbles worked their way through to the left.

Now I'm 500USD lighter but a lot happier in my mind. I can go back to spending my deco time watching the shallow reef as opposed to imagining bubbles getting shunted around my heart.

 

[chillyinCanada]

Congratulations!

Where did you get it done? It crosses my mind now and again too because I've had skin bends twice, both after what appeared to be a well conducted profile.

 

[boulderjohn]

I am very interested in this because one of my tech students got bent on a routine dive (I was not there), and it as determined she had a serious PFO. I have another good friend who has been bent on dives that seemed pretty benign, including dives done with me as a buddy when I felt great. He suspects he has a PFO, but he keeps backing away from getting the test. I have had the test, albeit for a different reason, and I am glad to report I do not have one.

You can get it done at just about any cardiology practice. The test serves purposes other than diving, so it is a pretty normal procedure done for a number of patients. It is a shame that most insurances will not cover it. I would think the cost is money well spent for serious divers.

 

[TSandM]

Wow! Where on earth did you get a PFO test for $500? Even a transthoracic echo around here would be more than that, let alone a transesophageal.

I got a transcranial Doppler done as part of a research study years ago, and I came up clean. I don't know (and didn't at the time) what I would have done had it been positive.

 

[DaleC]

I'm curious about that last part. Drew, what would you have done if you had come out positive?

 

[chillyinCanada]

And there you have it. I don't know what I'd do eithrr.

Unlike John's friend though, I'd had hundreds of dives before it happened the first time, and the second time was not so many dives in between but strangely enough it was the same boat, crew and in every other respect a similar day. Now that said, I've had easily another hundred dives similar dives with that crew since, but no problems.

The first time, I didn't know what it was. I thought it was bcd bruising from backroll. Still something niggled at me and when I returned home after the trip, I looked up my symptoms and my heart popped into my throat.

The second time, I knew but still didn't have enough sense to get on oxygen or go to the chamber. I stayed out of the water for a few days as had done the first time and all was well.

But after that trip, I made some changes. I lost weight, got nitrox certified, always come up very slowly especially the last 15'.

Since then I've had another few hundred dives with no problems even though many of the dives have been more aggressive.

 

[ajduplessis]

@Drew: It's great to hear that the test was negative. Be aware though that your PFO status can change over time. Extreme excursion such as weightlifting can cause the PFO area to tear. Age, substance abuse and heart disease can also contribute damage.

 

[pisoiu]

I also wanted to check my heart for PFO, just to be on the safe side. However, all my enthusiasm went down when doc told me that I had to swallow something very big and very long, possibly under anesthesia, in order to do the test. She told me that was the only option, as the normal ecography from outside may not be accurate enough to see PFO.

 

[RJP]

Wow! Where on earth did you get a PFO test for $500? Even a transthoracic echo around here would be more than that, let alone a transesophageal.

I got a transcranial Doppler done as part of a research study years ago, and I came up clean. I don't know (and didn't at the time) what I would have done had it been positive.

Since he didn't mention TE I assumed it was an ordinary echo.

 

[scoobydrew]

Many thanks for responses.

Had I been told that I had a PFO then firstly I would have asked how much it would cost to get sealed. I work (as a diver) with people who have had the same operation and say it is pretty straighforward, yes of course there is always a risk but I would feel that was negligible. Depending on the cost, I would have either got it done ASAP or would have waited till I can either save up the money to get it done in Grand Cayman where I work or waited till I am next home (UK) where I can get free health care.

In the mean time, I would have adjusted the gradient factors on my computer to make then more conservative, put off helium for a while and modified my approach to my tech dives a little.

I used a health centre in Cayman called Health City, they seemed to know what they were talking about