Another suspected PFO :(

[grimbob]

I recently posted on my suspected TIA (mini stroke) and how it might affect my diving. This is an update.

In the past 3 months I have been through many tests (brain MRI and CT), heart ultrasound (without bubble test) and a few others besides. The good news is that it is unlikely that I've suffered a mini stroke or other vascular problem. The most likely diagnosis is haema sensory migraine. I have a history of migraine with aura but have never had it officially diagnosed until now. I've only actually suffered from the aura once after a dive and only in a very minor way (passed after 10 mins or so). The dive was the Kyarra on 30th April this year and was 3 weeks and the last dive before my funny turn at work.

Although I have never knowingly been bent (after 60 dives or so) the chaps at e-med have decided that I can't dive until I have positively excluded a PFO. Bang goes my 23 September Scapa trip (2 places advertised elsewhere on this forum... come on chaps

Having not been at work for over 3 months now I cannot afford to pay for a bubble test privately... so.

My GP has discovered a cardiologist at Homerton Hospital who has an interest in PFOs (at this stage I'm not sure what form his interest takes). His name is Dr Kurbaan. I think he can do the bubble test on the NHS.

Anyone had any dealings with Dr Kurbaan? If so I'd be glad to hear your impressions.

My main worry is that he won't have the level of skill necessary to diagnose to the standard of say Peter Wilmshurst. With that in mind I've been bombarding my GP with YD links to PFO material in the hope that I might actually manage a referral direct to the great Dr Wilmshurst.

Anyway I can now for the moment only dream and read about diving (which is only slightly better than not thinking about it at all I can only hope the test will be negative so that I can back to see the fishies as soon as possible (without having to go to the aquarium

Ciao for now

Graham

[Fee]

grim
to be pedantic, its not a case of being able to "diagnose to the same standard as Wilmshurst". Dr wilmshurst is not the worlds greatest echocardiographer. The issue is: if you do have a PFO, what are your risks with regard to diving? That is where Dr W comes into his own. The "bubble test" is available on the NHS if your cardiologist feels its needed (which is obviously another sticking point). No doubt there will be people posting about ther own experiences re: PFO, but transthoracic echo (jelly on chest) is not always that good at picking them up this is not just dependent on the operator skills, but due to patient variables (some fat gits give great echo views and some skinny minnies don't).
Perhaps if you make this point to your GP -"If i have one I would like to know how it affects my diving" rather than "your local cardiologist is crap" (which immediately pisses them off - cardiologists generally were at the back of the queue when modesty was given out!!!

[Steve S]

As Fee said you need to know how a PFO if present, will affect your diving, people dive every day with a PFO, either diagnosed or unsymptomatic with no ill effect, there is no doubt a link between DCS and PFO but there is still so much that is not known check out this link if you haven't seen it already -

DAN Divers Alert Network : Patent Foramen Ovale: Is It Important to Divers?

Good luck.

ATB,
Steve

[grimbob]

Thanks for your input Fee. Points taken.

I assume that the results of a bubble test can be obtained and viewed by Dr Wilmshurst after the event so even if my cardiologist is not sure what to do with them perhaps Dr Wilmshurst will be.

Anyway I suspect a long and tedious road ahead

[grimbob]

Originally Posted by Steve S

As Fee said you need to know how a PFO if present, will affect your diving, people dive every day with a PFO, either diagnosed or unsymptomatic with no ill effect, there is no doubt a link between DCS and PFO but there is still so much that is not known check out this link if you haven't seen it already - http://[http://www.diversalertne...asp?newsid=462

Good luck.

ATB,
Steve

Thanks for your comments and the link Steve.

[Hellvet]

Originally Posted by grimbob

I assume that the results of a bubble test can be obtained and viewed by Dr Wilmshurst after the event so even if my cardiologist is not sure what to do with them perhaps Dr Wilmshurst will be.

Anyway I suspect a long and tedious road ahead

Thats what i did when my PCT told me 3 months after my bend that Dr wilmshurst couldn't offer me any more than my local cardiologist - my local cardiologist diagnosed the hole completely correctly - they couldn't give me any advice about my return to diving though! My local cardio test was videoed and i took the video with me when i went to see Dr W.

And yes potentially a real battle to get sorted...

[Nick Kay]

Take a look at the link below which I posted a while back

Transient Global Amnesia and PFO

Its also worth subscribing to the ScubaDocs forums (fora?)

[grimbob]

Originally Posted by Nick Kay

Take a look at the link below which I posted a while back

Transient Global Amnesia and PFO

Its also worth subscribing to the ScubaDocs forums (fora?)

Nick

Thanks for this info. I did not suffer from TGA (as far as I am aware) and there were other issues on my Kyarra dive (high stress levels kitting up, missing the shot line and finning against a strong current to arrive out of breath, difficulty clearing my right axiol (?) sinus on descent, oh and a lack of sleep the night before too).

However, Dr Jules at the London Diving Chamber decided this week to pop me in the pot just in case the symptoms keeping me off work were due to a neurological bend. 5 1/2 hours on Wednesday and 1 1/2 hours on Thursday and Friday finishing up with a consultation with Dr John King yesterday.

Just for the record I'm incredibly impressed with the guys at the London Diving Chamber based at The Hospital of St John and St Elizabeth in St John's Wood. What a fantastic service. Dr King was great too.

He does not believe that I have had a bend or that it is likely that I have a PFO. He believes that my problems are probably sinus based although he recommends further cardiological tests just to be sure (including the bubble test). As a result I have a few months of stuffing Flixonase up my nose and some further tests to undergo. Either way no more diving for me this season

Graham