Tom,
Oh, never mind.
Trout

----------
> From: Tom Mount <TOM.MOUNT@wo*.at*.ne*>
> To: Bill Wolk <billwolk@ea*.ne*>; wwm@sa*.ne*; Cavers List
<cavers@ca*.co*>
> Cc: Techdiver List <techdiver@aquanaut.com>
> Subject: Re: New Requirements
> Date: Sunday, May 03, 1998 3:07 PM
> 
> Bill
> I like your recommendation on warning and recommendation of PFo testing .
I
> will try to get that into the IANTD program but I would be opposed to
> mandatory testing
> 
> 
> Also on oxygen tolerance, a god way to avoid the need is to (let the
slams
> come) use eAN 80 on training dives begining at 30 feet. At this depth the
> po2 is less than 1.6 and the diver has to drop to 33 feet to hit 1.6.
That
> is the whole reason why IANTD tables use EAN 80 and for the dives they
were
> designed for they have through thousands of dives been proven safe.
> 
> Tom Mount
> -----Original Message-----
> From: Bill Wolk <billwolk@ea*.ne*>
> To: wwm@sa*.ne* <wwm@sa*.ne*>; Cavers List <cavers@ca*.co*>
> Cc: Techdiver List <techdiver@aquanaut.com>
> Date: Saturday, May 02, 1998 9:19 PM
> Subject: Re: New Requirements
> 
> 
> >On 5/1/98 1:36 PM, wwm@sa*.ne* wrote:
> >
> >>In speaking to a friend of mine who advises insurance carriers I
learned
> >>that some new requirements may be coming down on the tech diving
> >>industry.
> >>
> >>It seems that given the shocking record of accidents and fatalities of
> >>late one means of diminishing some of the risk may be to require Stess
> >>testing in conjunction with PFO and oxygen tolerance testing.
> >>
> >>In my opinion it is very wise to perform these tests regardless of
> >>whether they are a requirement or not.  The commercial diving industry
> >>considers this form of testing to be a mandatory prerequisite. Tell me
> >>why we shouldn't follow suit?
> >>
> >>Bill
> >
> >Bill -
> >
> >I was going to respond to this when Dan Volker first posted the idea of
> >mandatory PFO screenings.  In principal, it's a very good idea --
> >especially for any kind of decompression diving -- but lets put a
> >practical framework on the PFO issue:
> >
> >First, based on DAN statistics, PFOs are present in an estimated 10%-15%
> >of the population
> >
> >Second, diagnosing one requires -- at a minimum -- an echocardiogram
with
> >contrast (aka a bubble echo) which costs approximately $1,000.00.  (I
> >know -- I just had one done.)
> >
> >Third, even bubble echoes will not diagnose small PFO shunts because of
> >interference from the rib cage. (This was surprise info from my
> >cardiologist while the bubble echo was being performed.) To truly rule
> >out a PFO, you have to get an endotrachial bubble echocardiogram in
which
> >a miniturized echo device is actually lowered down your throat to
produce
> >an internal picture of blood flow through the heart.  I didn't look into
> >the cost of this procedure, but since it involves intubation and
> >anesthesia, I think it's safe to say that it won't be simple or cheap.
Do
> >you know of anyone who's taken it this far?
> >
> >That said -- it you can afford it or have medical insurance that will
> >pick up the tab, it's not a bad idea. I though it was important to do
> >before starting mix dives and squeeked mine through my PPO insurance,
but
> >it wasn't easy.  As for Ox tolerance testing -- not sure it would show
us
> >much since the ox tox threshold varies so much from day to day and dive
> >to dive even in the same individual.
> >
> >Perhaps rather than make it mandatory, a bubble echo should be strongly
> >recommended by the tech certification agencies and this recommendation
> >should be backed up with a full and medically graphic description of
what
> >can happen to a diver with an undiagnosed PFO on a deco dive. Think of
it
> >as an informed consent -- "we're recommending this procedure; it's your
> >choice not to get it; but this is what can happen if you don't" -- with
> >that, some divers will have the procedure done and those who don't will
> >at least have made a decision based on a clear sense of the risks and
> >benefits.  (Personally, I think the risks of most diving are underplayed
> >in order to increase the market, but that's another issue.)
> >
> >Based on the info you've posted in the past and the DAN accident reports
> >I've read, it seems like the vast majority of scuba accidents and
> >injuries are earned -- from improper training, poor equipment
> >configuration, bad gas planning, diving beyond limits, etc. -- and not
> >from unearned causes like undiagnosed PFOs. Certainly that much is
> >obvious about West Palm. It seems to me that we'd save lives and reduce
> >risks more by setting higher training and equipment standards -- as you
> >and George have been doing all along -- than by requiring expensive
> >medical testing.
> >
> >Just my $.04 -- Sorry about the length of the response -- it was a good
> >question!
> >
> >
> >
> >Best Regards --
> >
> >Bill
> >
> 
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