Undeserved Hit, Question for Dr. D

[Ber Rabbit]

The way I was trained we were told that dehydration is the #1 pre-disposing factor for the bends followed by a list of other pre-disposing factors. I believe that's from D.A.N. accident analysis but would have to do some digging to know for sure. Like Snowbear said, undeserved hits are rare and I'll side with those who say this was not a true undeserved hit. Even staying in computer or table limits has risk, they are simply mathematical models and not everyone fits in the model the same way.

I hope she recovers completely and quickly and gets the PFO issue resolved.
Ber :lilbunny:

 

[liberato]

hmm... I searched for it and didn't turn anything up.

The search function here has been dumbified to such a degree as to be of little value other than seaching for single long words. It keeps the posting rate high that way.

Anyway, thanks to a tip from user KzooJason you can use Google to search Scubaboard. Type in: PFO site:scubaboard.com at google.com

 

[pasley]

Been there, done that. Those cigar tube chambers at Long Beach are small. Dehydration is very likely the cause at least in my case I thought it was, but I am not an expert. My DCI hit came after a single dive to 110 feet and no violations of the dive tables, but I was very likely dehydrated.

Follow the doctor’s orders, get the test, in the mean time limit diving to shallow dives of 30 feet or so. There are many places here to dive that fit that criteria..

DAN recommends no diving for 30 days. I would endorse that. I followed the LB Memorial Doctors advice and did a dive at Catalina 7 days after the ride, then went to Hemet (1400 feet elevation) two days after that. I immediatly returned in discofort to the chamber. So stay dry 30 days then with doctors approval, dive shallow until you get the test.

I continue to dive conservatively (Cobra SUUNTO set on P2) and watch my hydration, drinking water now as my principal beverage with occasional sodas and of course 2 cups of coffee in the morning (but none on dive days). I have logged over 200 dives in the 3 years since then with no further incidence.

Not a doctor or medically qualified individual, but I have been to LB Memorial and taken the chamber ride there (twice). Sorry to hear she took a hit, but it sounds like you got her into the chamber in short order and taken care of.

 

[Blackwood]

The search function here has been dumbified to such a degree as to be of little value other than seaching for single long words. It keeps the posting rate high that way.

Anyway, thanks to a tip from user KzooJason you can use Google to search Scubaboard. Type in: PFO site:scubaboard.com at google.com

excellent tip!

I eventually searched for patent foramen ovale and found some good stuff (including a post with Dr. Deco saying to search for "patent foramen ovale"...).

Thanks.

 

[Blackwood]

Been there, done that. Those cigar tube chambers at Long Beach are small. Dehydration is very likely the cause at least in my case I thought it was, but I am not an expert. My DCI hit came after a single dive to 110 feet and no violations of the dive tables, but I was very likely dehydrated.

Follow the doctor’s orders, get the test, in the mean time limit diving to shallow dives of 30 feet or so. There are many places here to dive that fit that criteria..

DAN recommends no diving for 30 days. I would endorse that. I followed the LB Memorial Doctors advice and did a dive 7 days after the ride, went to Hemet (1400 feet elevation) two days after that and then back to the chamber. So stay dry 30 days then with doctors approval, dive shallow until you get the test.

I continue to dive conservatively (Cobra SUUNTO set on P2) and watch my hydration, drinking water now as my principal beverage with occasional sodas and of course 2 cups of coffee in the morning (but none on dive days). I have logged over 200 dives in the 3 years since then with no further incidence.

Not a doctor or medically qualified individual, but I have been to LB Memorial and taken the chamber ride there (twice). Sorry to hear she took a hit, but it sounds like you got her into the chamber in short order and taken care of.

Indeed. Out of the water at 3PM. Symptoms started at 9PM. We were at the ER by 10:30PM. Unfortunately, the ER docs didn't really know what to do, so even with my pleading, they only had her breathing O2 for about 5 minutes. Hyperbaric Doctor got there around 1AM. Her first chamber ride was from about 3-4:30AM. Second was 3-4:30PM.

Yah, those chambers are very small. She was extremely freaked out the first time. Almost passed out... thought she was going to throw up... etc.. Second time around we put in a movie and that seemed to help.

The Hyberbaric RN's are all extremely nice, and the MD is a good guy. While she was "diving dry" for the first time, we were talking about diving, deco theory, algorithms, chamber treatment, etc.. Even though he was tired and could have better used the 90 minutes sleeping in his office, he took the time to speak with me.

 

[Blackwood]

She went to another doctor today who said she most definately does not have a heart murmur, and that it is highly unlikely that she has a PFO. He said the bubble EKG is excessive, and that he can see no reason she shouldn't dive after her symptoms subside.

 

[pasley]

Indeed. Out of the water at 3PM. Symptoms started at 9PM. We were at the ER by 10:30PM. Unfortunately, the ER docs didn't really know what to do, so even with my pleading, they only had her breathing O2 for about 5 minutes. Hyperbaric Doctor got there around 1AM. Her first chamber ride was from about 3-4:30AM. Second was 3-4:30PM...

When I went I told them I thought I had Decompression Illness or "The Bends" and the emergency room said "whats that". Then the doctor eventualy drew blood, came back and said I definatly had the bends and that I had to have a chest x-ray before my chamber ride to ensure no blocked nodes in the lungs. Then I sat for 3 more hours, no O2, no fulids no nothing, shunted off to a side room with the chamber calling down looking for me repeatedly. Over 4 hours after walking into the emergency room I was finally x-rayed (they admitted they forgot about me) and taken to the chamber for my ride. The emergency room is incompentent at best. I also learned that if there ever is a next time to be more vocal and let them know that just because they do not see blood or a flat line EKG does not mean I am not in a dangerous and even life threating situation and delay may mean life long injury or worse. I will also demand O2 and not that 2% stuff either.

The hyperbaric folks were great. Was you doctor young or the old retired Navy doctor who was a diver and has taken his share of rides?

 

[Rick Inman]

Because I had called DAN, the hyperbolic Doctor met me at the door. In less than five minutes there were five of them working on me, taking my vitals, my blood, an EKG, cleaning my ears, whisking me over for a no-wait upper GI, chest X-ray, whisking me back, all the while joking with me, asking questions about diving, behaving as if they were all excited about their sole purpose in life: to serve and help me. The two MDs that worked on me (the ER MD and the DAN MD) both insisted I call them by first name, and treated me as I was already one of their friends.

The DAN MD gave me his home phone and cell phone and said to call any time for any reason.

It was amazing.

Thank you, Deaconess Medical Center ER.

 

[MASS-Diver]

The way I was trained we were told that dehydration is the #1 pre-disposing factor for the bends followed by a list of other pre-disposing factors. I believe that's from D.A.N. accident analysis but would have to do some digging to know for sure. :

Ditto, it's a shame that this point is apparently not being driven home to some people.

 

[tb]

She went to another doctor today who said she most definately does not have a heart murmur, and that it is highly unlikely that she has a PFO. He said the bubble EKG is excessive, and that he can see no reason she shouldn't dive after her symptoms subside.

Maybe he thinks it's unlikely, but I don't believe he can say conclusively that she she doesn't have a PFO without testing for it. Does your friend ever have migraines preceeded by visual disturbances (aura)? There's some research that indicates a high percentage of people who do have that problem also have a PFO. A Boston biotech company has developed a transcatheter patch that can close a PFO without surgery. It's being studied now in the UK and one of the researchers said they first noticed the migraine/PFO link when they observed that divers (with PFO's and migraines) who underwent surgey to correct the PFO also stopped having migraines.