Pfo check after a DCI ?

[MATTBIN]

On the Tech page, of Divernet, it has been suggested that following a hit on a moderate dive a diver would be well advised to get a PFO chewck. The diver concerned had buddies onthe same dive who did not get a hit, whilst I understand this is perfectly possible, as we are all individuals with different physical attributes etc I do not see the reason to rush off to hospital for a PFO check if this was a first hit. The hit was diagnosed as minor type 1.
Are there statistics available to show that DCI causes death even if treated quickly?
Matt

[Phill]

Fully agree that there's no point in tearing off for a PFO check. It's very rare that a fully researched diving history of the patient cannot (partially at least) explain the DCI, even after multiple hits. (Quite regularly multiple hits are caused by ignoring the advice given following the previous incident - but hey, it's your carcase !).
Stats, they exist in patients notes - but are so rare that you couldn't undertake a statistical trend exercise. If you make the surface, and a suitable pot, and your problem is DCI, (hmmm, 3 ifs) your chance of survival is higher than your chance of survival as a pedestrian in a city.

[Doug Parker]

The impression i got after my bend was, because my dive profile was ok and i'm reasonably healthy it must be a PFO that caused me to bend. I've got to harass my GP to get me referred to Wilmhurst now.

[MATTBIN]

Doug
sorry you took a hit, but I'd be interested to know the outcome of any PFO check, it seems at the moment that PFO's are being blamed for any hits where the profile was 'perfect'. It would be good to know if this is the case in most incidents or just a current theory.
Matt

[Beck]

About 1 1/2 years ago I was diagnosed with type I and II DCI.
I would consider myself a safe diver including relevant stops and following "correct" diving practices.

I would say that for all my diving life I have suffered from either headaches, muscle stretches post diving... But in no case did i ever really have a post dive symptom which I would not find another reason for...for example I always get headaches, I will admit I never drink my total 2ltrs of water daily on some occasions, which i usually considered my reason whether I was diving for not.
I used to be renound for carrying too much kit (twin sets etc) and I have a number of back, hip, and knee injuries from sports as a child.

None the less, for every symptom that I had i never considered it to be DCS as I have always had these type of symptoms since I started diving and never really knew any better I guess... (I suppose it could be considered as denial)

I am a nitrox diver and would always use as high a mix as I could relative to the depth. I will also admit a large majority of my diving was in a depth of 6-9mtrs.

So none the less I managed over a weekend of diving one day doing two dives in a day both to a depth of 9mtrs, second day two dives to a depth of 20mtrs. Reasonably cool water conditions (6degrees) and all relevant safety stops included and well within tables, again on sensible eanx mixes.

Post dive, I had my usual headache, so up toped up my fluids, felt fine...
I had a lovely walk in twin set and all to the top car park at a dive site in Leicester...
But none the less this was a usual weekends diving, nothing out of the ordinary, I would consider myself fit and healthy doing 5-8 dives a week, with a love for diving.

Anyway back to the bend, I had my normal headache and a little sore knee from the walk (note: I had an op on this knee as a kid and always have a prob with it) both otherwise felt fine...
Day after still a headache but otherwise feeling fine, knee felt muscularly sore. Had a shower that evening, got a rash (heat rash???), phone a particular insurance agency that suggest I sleep on it.
Day three went to chamber, diagnosed with type I and II DCS, still felt okay headache little worse then normal and knee still feeling muscularly sore....

So my options, It was the long walk back to the vehicle post diving? Not enough water during the day? Cold water conditions? fitness??? PFO??? well it could have been all of them...

None the less chatting to the Dr, he told me I was the worst case of DCS he had seen. All my symptoms were neurological and therefore had been dismissed. Every headache was likely to be another bend.. Every muscle stain was likely to be due to be damaged tissue which is a haven for bubbles.
So even though I could walk talk and act normally the continuous damaged that diving had caused was a problem...

So I had considered that I had had a PFO, since I was a premature baby and also a very ill baby.

The waiting lists were long and I needed to know, so I went private for a contrast echo which confirmed I had a sizable PFO, then about 4 months later I had an appointment to see an NHS surgeon, then in feb this year I had the op...

In the mean time I had sinus surgery, to realign a deviated nasal septum, just in case that could also be a cause for my post diving headaches.

So now I have a sealed PFO and all in all I shall see in good time if I am well post diving again.....

I chose not to dive post the bend due to the severity of my symptoms and also due to some residual neurological effects....

well if there is any info anyone needs feel free to mail me... hopefully I could shed a little more light on anything.....

rjv

NOTE: if there is anything I have learnt from this experience, that is even if you are not feeling well, a headache, small muscle pain, anything post diving phone your nearest recompression chamber and speak directly to the Dr, he can assess whether he/she feels you should need to visit them to see if you possibly have DCS…
What ever the case ensure you speak to a Dr, be wary of peoples advice, but still understand and acknowledge it….remember it is the dr at the end of the day who will decide if you are gonna end up in the pot….

[Beck]

Hi sorry for the long last e-mail, but if you need more info on getting a PFO check and NHS avalibilty or Private checks and surgury, just e-mail me and i'll see what I can do...

rjv2@ukc.ac.ku

[Mr T.]

Hi Beck,

No need to apologise - glad to have your input. Welcome aboard to YD as well.

So where do you live, dive and what type of diving do you do?

Cheers and dive safe,

[Beck]

Hi Bren, thanx for introducing me to the board, seems quite active with chat and little criticism like some of the other boards....some people are too quite to judge...

Anyway I am a scuba instructor who loves diving I am also a Tech Nitrox diver who was supposed to be doing her cave course and trimix couse before she got bent...
Love wrecks fish photogrpahy and video... prefer the UK to anywhere else i have been diving

Not been to yorkshire but as a keen caver (pretty new to it still) I may have to experience some diving in you area some time...
I had been diving for about 6-7 years pre my bend and can not wait to get back and divign again... about 28 days before my HSE medical and trying to get back to my optimum fitness level... but we shall have to wait and see what the season brings ah.....

Litrally I had the op two days ago so i am still feeling groggy from the anestetic but my trusty computer will keep me occupied for the time being...

l8rs
becks

[Beck]

okay maybe i should read my posts before posting so sorry for the spelling mistakes....I was supposed to say some people are too quick to judge not quite....durrr dumb blonde...

sorry guys

[Doug Parker]

Just to make matters worse, after getting past the medical on Friday, i dived at Firestone on Saturday and got a slight skin bend in my left shoulder and because i didn't go back to DDRC, i got called by the doctor and had to go back for a severe telling off. I know it's my own fault and i should've gone up there but it seemed trivial and i didn't even feel it( the wife spotted it when i went to bed) plus it had gone by the morning.