WEB EXCLUSIVE: Diver and his career survive PFO

While the Average Joe might expect ‘shark, shark’ to be top of the danger-word list for divers, there are few words the underwater community fears more than ‘the bends’.

This seemingly innocuous pair can mean little but bad news, and while some bends are minor and easily recovered from, many do prove fatal. As for ‘shark’, well, that’s a word that most divers associate with a feeling of glee, rather than a desire to flee.

The only thing that is perhaps scarier than a bend, is a repeat bend. And what if both had occurred on seemingly safe dives performed well within the victim’s diving ability? What if the said victim owned a dive shop and training centre and relied on diving for his livelihood?

This was exactly what happened to John Campbell (JC) of DiveStyle, the Reading-based diving centre.

A diver for eight years, JC suffered a skin bend while training a pair of divers out in Malta towards the end of the summer of 2009.

Prior to suffering the skin bend on his abdomen, JC had completed a 41m training dive on the Bombardier, the upside-down plane on Divewise’s house reef and a 34m dive on the P29 wreck.

A Suunto D6 dive computer on deep stops for two minutes made sure that the divers ascended from their dives safely. Plenty of water had been drunk too in order to stave off the effects of dehydration.

JC felt well enough in between dives to have a beer and undertake all the usual unpacking and repacking of kit. Up until the drive home it had been a typically awesome day’s diving in Malta.

About 20 minutes into the journey back to the dive centre, JC began to suffer from stomach cramps. These cramps got progressively worse and moved ever higher up his torso. On returning to his hotel room, JC removed his shirt ready for a shower and was met with an image no diver wants to see - a marbled torso down to his groin, with black thread veins streaked down his sides.

He immediately rang Divewise and informed them he suspected he was suffering from a bend.

He was placed on O2 and within an hour-and-a-half the pain had subsided. The marbled effect had been replaced by skin that was sunburn-red and sore to touch.

Incredibly, JC still wasn’t sure he was suffering from decompression sickness, so he rang the Reading Dive Chamber (RDC) to check. They confirmed that it was a skin bend. They also said he’d handled the matter appropriately.

It is what happened next that is perhaps most surprising. JC got back in the water.

Despite the fact he now openly admits his decision was “ludicrous”, at the time he felt duty-bound to ensure the two divers he was training got their money’s worth.

JC dived on a high-Nitrox mix (40 per cent) and played the dives super-safe.

When he returned to the UK and visited the RDC, he was met with a reaction that likely mirrors that of those reading this article - wide-eyed astonishment. He was also handed a serious lecture.

He was put on an extended Table 6 decompression programme. When on 100% O2 at 18m, his vision went. By the time he hit 8m, he was feeling fine and was well enough to order some sweet and sour chicken. That’s right, a mid-recovery Chinese courtesy of the RDC. Now that’s service!

The diagnosis? Despite JC’s belief that he had drunk more than enough water, the bend had most likely been caused by dehydration, the doctors said.

He was informed there was to be no diving for at least six weeks. JC duly followed the doctor’s orders.

Precisely six weeks later, an offer of a trip to Malta was made. Before he knew it, JC was back in very same waters that had caused him such trouble. This time, however, he had done his homework on the Malta dive chamber, jotting down all the essential information.

The first dive was on the Karwela. Diving on rebreathers, JC and his buddy enjoyed a 78-minute dive to 40m. On returning to the surface he waited for what he felt was an inevitable bend. Nothing happened.

Following a day’s rest, JC paid a visit to the Le Polynesian. Diving on rebreathers once more, the dive time clocked in at 80 minutes and a depth of 60m was reached.

JC about to dive Le Polynesian

JC and his buddy’s profiles ran ‘perfectly’ and while he admits there was a little bit of movement on their 6m safety stop, it wasn’t serious enough to cause concern.

However, when he ascended the ladders to the diveboat, he was overcome with exhaustion. Approximately 20 minutes later, while sat in a café, JC couldn’t resist the temptation to check on himself. On lifting up his shirt in the toilets he discovered a white spot. Ten minutes later, it had increased in size.

After 30 minutes on oxygen his condition had not improved and he was taken to the previously-researched dive chamber.

As before, he was placed on a Table 6 programme. The in-chamber service wasn’t quite up to that of the Reading chamber - not only was there no Chinese, 6.5 hours of Italian movies had to be endured. He had his health though. Or so he thought.

At 4am the following morning, JC woke with a ‘hammering heart’. He immediately phoned the RDC and was referred to Dr Mark Turner, who said he was 95 per cent certain he had a PFO.

Shortly after meeting Mr Turner, JC’s world fell apart - a bubble test confirmed he had a PFO. For a man who earns his living as a diver, there are few letters as daunting as P, F and O.

Following lengthy discussions with his wife, JC decided to have an operation to close up the hole in his heart. The decision was taken both from a diving point-of-view, but also a family one. A hole in the heart can also result in medical problems such as strokes in later life.

JC had a 6mm hole. The hole was to be covered with 18mm and 25mm mesh discs, which would be placed on either side of the gap. The mesh frames allow new heart tissue to grow on and over them, subsequently closely the hole.

Following the insertion of the discs, JC had to take blood thinners for six months. After three months, he revisited Mr Turner for a check-up. Five negative bubble tests revealed that the hole had been successfully closed.

X-ray of JC's discs

Since then, JC has dived approximately 70 times, reached 50m and has returned to Malta. He plans to dive the Le Polynesian again - the site of the second bend - in a bid to put his PFO demons to rest. At the moment, the discs are a constant concern. So much so, in fact, that he believes he can feel them, though he confesses this may be psychological.

Of course, the most important thing is that he is back in the water and can continue to earn his living doing the thing he loves most - diving.

And as for the kit-checking OCD he’s developed since; well, that’s no bad thing.

For a little more information on PFOs, click here.

And to check out JC’s DiveStyle, which he mercifully still runs, click here.