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Chris wrote: >Dear all, > >I thought after reading the correspondence about shoulder pain coming on >within 30 mins of a dive and the message about Kevin Gurr's skin bend >after a dive, I would make the following comments: > > 1. I am surprised that no-one has made any comments about > an arterial gas embolus. Generally, any effects like this > coming on within 30 minutes of surfacing could well be due > to gas embolus. > > 2. Why? you may ask. I would be prepared to put quite a lot of > money upon the fact that Kevin Gurr has a patent > foramen ovale and I think that it is not out of bounds that > some of the other people reporting symptoms may also have a PFO. > Wilmshurst et al. found a 100% incidence of PFO in those people > who get skin bends within 30 mins. of surfacing from a dive. > (Wilmshurst et al. Lancet 1990; 336; 1071-2). Moon has also > done research in this area. Yes, I am aware that 27% of all > people have PFOs but that 27% of all dives > 15 metres do not > result in bends but what is forgotten is that during a dive > (and especially some of the rather deep depths that are being > talked about here) the diver is getting dehydrated and this is > known to exacerbate the problems with bubbles (note I did not > say DCI). (If people wish, I can tell them a couple of stories > here that I have personally witnessed). > >For those of you determined to dive whether you have a PFO or not (and >you may prefer not to know) I would advise that you take fluids on the >dive with you and learn to drink underwater. The O2 saturation should >be as high as possible within NOAA limits at all times during the dive >(rebreathers here we come...) and I would make sure that you dive at all >times within the tables - for those of you wondering about tables etc. >Bill Hamilton of Hamilton Research in Tarrytown is probably the world >expert. > >The only other thing is to make sure that the bubbles don't get to >the brain or the spinal cord... :-) > > >Chris. >Chair, National Diving Medical Committee >Medical Advisor to Technical Diving International. > >*************************************************************** >* Dr. Chris. Edge * Tel. +44-865-275-338 * >* Glycobiology Institute * Fax. +44-865-275-216 * >* Oxford University * e-mail chris@gl*.ox*.ac*.uk* * >* South Parks Road * 100117.3646@co*.co* * >* Oxford OX1 3QU U.K. * * >*************************************************************** Chris, I've often wondered why some of us seem to be able to violate the tables (not intentionally), dive frequently and deep and never get bent, while others get bent well within the tables etc. If 27% of the population and diving population have a PFO then perhaps we really need two sets of tables -- one for those with this defect and one for those without? I'd also like to know how a PFO causes a problem on the aterial side when the normally fluid dynamics would seem to make this a remote possibility. Can you educate all of us? Hal Harold Gartner 6900 Via Alba Camarillo, California 93012 home: (805) 482-9743 office: (213) 487-6240 CompuServe ID# 71470,1423 Internet: hgartner@ra*.or*
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