Ten Foot Stop

Please forward the below information to individuals you feel may be
interested.

I would like to invite you to attend the 2008 ocean exploration symposium
at Florida State University - Panama City June 5, 2008.  This year’s
symposium will fulfill FSU’s Advanced Science Diving Program’s charter
goal of inspiring and educating students and the community with research
relating to diving, ocean technologies, and studies that protect and
advance a better understanding of our ocean environment.

Panama City is the hub of Military, Recreational, Scientific, and Public
Safety Diving with facilities such as the Navy Experimental Diving Unit,
Naval Support Activity, Dive Lab, Museum of Man in the Sea, and Florida
State University.  That makes Panama City the ideal location for
underwater research, and consequently the ideal location to host our
annual symposium celebrating our ocean world. I look forward to seeing you
there; Did I mention that it is FREE to the publi.

Presenters:

Karen Kohanowich
Director of NOAA Undersea Research Program
NOAA’s Ocean Exploration and Research: Man and Machine Revealing the Secrets of the Sea

Marshall “Lew” Nuckols, Ph.D., P.E.
Senior Research Scientist
Department of Mechanical Engineering & Material Science at Duke University
New Technologies for Cold Water Diving

Capt. Philip Renaud, USN (Retired)
Executive Director
Living Oceans Foundation
Embracing Technology: Coral Reef Habitat Mapping and Resiliency Assessments

Christian McDonald
Scientific Diving and Small Boating Safety Officer
University of California, San Diego, Scripps Institution of Oceanography
U.S. Funded Polar Diving: Past, Present, and Future

Phillip Lobel, Ph.D.
Professor of Biology & Dive Safety Officer
Boston University
Embracing Technology: Coral Reef Habitat Mapping and Resiliency Assessments

Thursday, June 5, 2008
1:00 pm to 5:00 pm
FSU Panama City Auditorium

Best regards,

Michael A. Zinszer, Director
Advanced Science Diving Program

Florida State University - Panama City
4750 Collegiate Drive
Panama City, FL. 32405

Office (850) 770-2203

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Vnitr Lek. 2007 Feb;53(2):143-6.

[Paradoxical embolization and patent foramen ovale in scuba divers: screening possibilities]

[Article in Czech]

Honek T, Veselka J, Tomek A, Srámek M, Janugka J, Sefc L, Kerekes R, Novotný S.

Kardiovaskulární centrum FN Motol, Praha. tomas.honek@volny.cz

INTRODUCTION: The cause of decompression sickness (DCS) in scuba-divers is bubble formation in tissues and in venous blood during ascent. Divers with patent foramen ovale (PFO) have an increased risk of paradoxical embolization to the brain or other vital organs. The aim of our study was to assess the incidence of PFO in scuba-divers with DCS, to compare the group with asymptomatic controls, and to evaluate ultrasound contrast methods suitable for screening.

 

METHODOLOGY: We examined 28 scuba-divers (more than 100 dives). The right-to-left shunt detection was performed by bubble contrast transthoracic echocardiographic examination (TTE) and transcranial Doppler sonography over arteria cerebri media (TCD) in all divers. In divers with shunting, transoesophageal echocardiography (TEE) was performed to prove PFO.

 

RESULTS: 15 divers had DCS associated with the ascent. In this group, PFO was diagnosed in 53% (8/15). The symptoms of all of them retrospectively were of paradoxical embolization (neurological form of DCS). In the group of asymptomatic divers, PFO was proven on the basis of right-to-left shunt screening in 1 diver (8% 1/13). TCD proved right-to-left shunt in all divers with PFO.

 

CONCLUSION: DCS can unmask a so far asymptomatic intracardiac right-to-left shunting. PFO is a risk factor for paradoxical embolization in divers. TCD is suitable for screening; TEE is a gold standard in PFO detection. Our results showed that PFO detection is a useful clinical tool after repeated DCS and in all frequent divers and instructors.

Pearson Education, the world’s largest publisher of educational textbooks, recently published the latest edition in its Connect series. These English textbooks are used throughout the Caribbean to educate island children, using local examples and scenarios to make the lessons more relevant.

In this latest Connect text book, authors Orville and Vicki Aimey and Amaral and Samuel Soyer used an interview with Eric Douglas, originally published by the Cayman Compass, Cayman’s National Newspaper, to illustrate good interviewing techniques. Each unit in the text book features a different island in the Caribbean and the Cayman unit revolves around this interview.

The interview is about Douglas’ first dive adventure novel Cayman Cowboys. The book is a diving adventure set on Grand Cayman and prominently featuring Sunset House and My Bar as well. The story deals with diving, the environment and what happens when development and nature come into conflict, fueled by greed.

For more information about the textbook, or to learn more about the novel Cayman Cowboys, visit Douglas’ website at www.booksbyeric.com.

Eric Douglas
Author of Cayman Cowboys, Flooding Hollywood and Scuba Diving Safety
www.booksbyeric.com

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Hello fellow heath care professional,

Our next Introduction to Hyperbaric Medicine and Wound Care course is starting this Monday, May 5 !!!!!

The Department of Hyperbaric Medicine at Long Beach Memorial Medical Center is offering an upcoming 40 CME-hour program:

Introductory Course in Hyperbaric Medicine and Wound Care

May 5-9, 2008

This course has been approved by the UHMS Education Committee as meeting the rigorous standards of a UHMS Designated Co-Sponsored Introductory Course in Hyperbaric Medicine.

The primary purpose of this program is to use both didactic and practical chamber-side teaching formats to introduce and educate physicians, with a background in a variety of specialties, in the theory, principles, and practices of hyperbaric medicine and wound care.  Additionally, this CME program is designed to educate nursing, allied health professionals, and medical administrators who have educational interests or needs in hyperbaric medicine and wound care. 

This course is expected to provide the participant with core knowledge about the theory and practices of hyperbaric medicine and wound care and to be a solid base for which further education and training in hyperbaric medicine and wound care can be built upon. 

The faculty at LBMMC Department of Hyperbaric Medicine is uniquely qualified to provide this education. Members of our faculty include leaders in the field of hyperbaric medicine. We take advantage of our multi-specialty background (e.g., orthopedic surgery/wound care, emergency medicine, hematology/oncology, and pulmonary/critical care medicine) to provide a well-rounded perspective of the specialty.

The next course is scheduled to take place in Long Beach, California on:

                                             May 5-9, 2008

if you can’t make this class….we hope to see you in November.                                      

Discounted hotel accommodation information is available upon request.

If you are interested in attending this course or would like more information, please see the included brochure and fill out/fax the registration form or contact:

Shari Hart at:

Department of Hyperbaric Medicine

Long Beach Memorial Medical Center

2801 Atlantic Ave.

Long Beach, CA  90806

(562) 933-6950

Sincerely,

Department of Hyperbaric Medicine

Long Beach Memorial Medical Center

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Hey Everyone,

I don’t have any new trips to report, but some interesting news.

EDUCATIONAL FILM NEWS

ORG’s newest educational film Sharks: Predators with a Purpose won the documentary category at the Very Short Movies Festival, beating out several excellent films including one by Leonard Nimoy. If you haven’t seen it, go check it out on-line. You can watch the whole film on the ORG website!

http://www.oceanicresearch.org/education/films/predators.html

JONATHAN BIRD’S BLUE WORLD

In the Blue World, our big news is that Jonathan Bird’s Blue World is going to start appearing on public TV stations all across the country in May. We have been picked up by Public Television and already have confirmation in several states and are awaiting more confirmations. I am just finishing up editing season 1 and we are already shooting season 2 in High Definition.

We are looking for a corporate underwriter to support the series in exchange for sponsorship advertising in the show. I am working all my contacts to find people who know CEOs at large companies that might like to support a quality educational program about the ocean. Everyone on this list is an ocean lover….anyone know a “big wig” at Google, Apple, Shell or any large company like that? Please e-mail me if you can help us find a sponsor to keep Blue World going! Meanwhile, check out the latest episode about the wreck of the Prinz Eugen in Kwajalein:

http://www.blueworldTV.com/episodes.htm

SECRETS OF THE REEF

Don’t forget to attend the premiere of my new feature-length film about coral reefs Secrets of the Reef at the New England Aquarium SImons Imax theatre on May 31. It is completely sold out now, so if you reserved seats, BE THERE!

http://www.secretsofthereef.com

WHAT AM I UP TO?

Just in case you may be wondering why I have been hard to reach, I have had a crazy busy spring. I was in the Bahamas for two weeks with several of my dive friends doing Tiger shark trips. Then I was home for a week and off to Statia (St. Eustatius) in the Caribbean for Sport Diver Magazine. Then I was home for a week and off again to the Turks & Caicos for Sport Diver. Now I’m home and I have a month to get the house ready for all our guests who are coming for the Secrets premiere….I have a lot of work to do….some major construction of my daughter’s new bedroom. My new book Creatures of the Deep Blue has been printed and I just got an advance copy. I’m excited about it and I can’t wait to have more copies to show off! I have a story in Sport Diver Magazine this issue (St. Kitts) if anyone gets that. That’s about it for me.

One last bit of sharky news:

For you shark lovers out there in the Boston area I want to let you know about a film being shown at the New England Aquarium Simons IMAX theater on Monday May 5th at 7pm, “Island of the Great White Shark”. It’s 43 minute film about the great white sharks of Guadeloupe Island, Mexico. Here’s a description of the film.

Off the coast of Baja, Mexico, a remote island serves as one of nature’s dwindling sanctuaries to a fearsome ocean predator, the great white shark. In a race against time, marine researchers and eco-tourists have forged a unique alliance in the hopes of protecting these animals from potential slaughter. This film provides a stunning, realistic portrait of great white sharks that recognizes the sharks’ majesty and beauty and positions the animals as a crucial link in nature’s intricate balance of predator and prey.

Richard Theiss, filmmaker, and Mauricio Hoyas, shark biologist, will be at the showing to present their findings in this visually lovely and informative film. There will be a reception following the film.

It is free to the public but registration is required:

http://support.neaq.org/site/Calendar/1933680457?view=Detail&id=100561\
or
http://www.neaq.org/scilearn/lecture/

I haven’t seen it but it sounds pretty cool.

I hope you are all doing well and I’ll see many of you at the end of May!

Best,

Jonathan

--

Do you know the Secret of the Reef? http://www.secretsofthereef.com/
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Jonathan Bird
http://www.jonathanbird.net
Underwater Photography/Cinematography
978-664-9091
Jonathan Bird’s Blue World:
http://www.blueworldTV.com

Coming to public television summer 2008!

Underwater Photography Chat
http://www.uwphotochat.com/

Oceanic Research Group, Inc.
http://www.oceanicresearch.org
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Question: A 38 year old female asked if she should try diving again or hang it up for good. 4 years ago this April she was diving around St Johns, the fourth day of diving her max depth this day was 70 feet. Upon surfacing she experienced poss dcs symptoms. She was chambered for 4 days; she was advised she had suffered dcs type 2.
One day after release from hosp she flew back to the U.S. Upon descent of the air craft, symptoms reoccured she was again addmitted to the hosp. Boston Medical Center for 4 days and chambered. She was advised that if she had no further symptoms within 3 years she could dive again. Its been almost 4 years ?
Answer: There are those who would say that your diver probably should not dive again. Then there are those who feel that if she has no neurological abnormalities (as determined by the neurological examination), she should be allowed to resume diving.
One thought that you might consider - have her checked out for the possibility of a PFO (patent foramen ovale), Although it would be hard to imagine that this has not already been done- it would still be worthwhile having a bubble contrast echocardiogram.
There are few protocols and no case reports that guide the advice about returning to diving after a decompression accident. Clinical judgment has to be foremost in making this decision.
The main consideration is the worry that a diver with residual clinical and pathological neurological changes will have an increased risk of the development of bubbling in areas of deranged blood supply (scarring) in the brain or spinal cord. There is no clinical evidence that this occurs.
Because of the known increase in bubbling in low flow areas, divers with any residual manifestations of their neurological hit are best advised not to resume diving. If their DCS hit was caused by a non-provocative dive, they should by all means be checked out for a patent foramen ovale.
The closest thing to a protocol that I have found is that in Edmonds’ Textbook, Diving and Subaquatic Medicine, p. 196.(3rd Edit)
“For complicated type 1 DCS, neurological and other type 2 DCS it outlines the following:
1. Exclude other causes i.e., cardiac shunts, pulmonary barotrauma
2. Follow-up with full testing until complete recovery
3. Resume limited diving after the above has been achieved and at least 1 month has elapsed; as follows:

a. no-decompression dives with allowable bottom times halved.

b. maximum depth 15 meters (50 feet).

c. surface intervals in excess of 6 hours.
4. If sequelae (symptoms) persist and are stable after many months - as long as the diver’s psychological and physical fitness is not impaired, scuba diving may be permitted to 9 meters (about 30 feet) for short periods.”
The British Subaqua Club (organization that controls scuba diving in the UK) has the following to say about return to diving after gas embolism and severe neurological DCS. “Individuals who have had pulmonary barotrauma or neurological decompression illness are thought to be generally more susceptible to subsequent episodes as a result of pre-existing abnormal pathology, including lung disease and intracardiac right-to-left shunts. In addition, subsequent neurological insults in these individuals are thought to be more difficult to treat and are believed to leave greater residual disability. Therefore, any person who has suffered from pulmonary barotrauma or neurological decompression illness, should be carefully assessed to determine whether they should resume sport diving. The assessment will involve enquiry into the circumstances of the incident (including a precise dive history). Particularly when the episode of dysbaric illness occurred within the tables, assessment will often require tests to exclude the presence of an intracardiac shunt and lung disease likely to predispose to pulmonary barotrauma. The tests which may be performed include contrast echocardiography and sophisticated tests of lung function. The case should be examined by a Medical Referee who has obtained information from the treating physician. If the individual is permitted to resume diving, restrictions on depths, times and repeat dives may be imposed.”
Type I and neurological DCS that has responded completely to recompression without residua can be allowed to return to diving with the understanding by the diver that there is the possibility of increased risk of a decompression accident in the area of damaged tissue. Alterations in the dive patterns should be undertaken in order to reduce the risk of bubble formation.

http://www.scuba-doc.com/chrneur.htm

http://www.scuba-doc.com/riskdcs.html

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 Could a pediatric problem be a clue as to why some people have extreme difficulty clearing while diving? According to an article published in The Lancet (2002;359:493), glue ear may be a result of acid reflux, which occurs when stomach acid backs up into the esophagus.
Glue ear, medically known as otitis media with effusion, is a type of middle ear infection affecting about 20% of 2-year-olds and is a leading cause of hearing loss in young children.
For the Lancet study, ear fluid samples were evaluated from 54 children between the ages of 2 and 8 with glue ear who were undergoing ear surgery. Analysis of the fluid revealed that 45, or 83%, of the samples tested positive for pepsin, or its precursor, pepsinogen, at up to 1,000 times the concentration found in surrounding bodily fluids. The acid pH of the refluxate could damage the eustachian tube and the middle ear mucosa causing inflammation. This damaged state could be ideal conditions for bacterial growth and lead to the symptoms seen in glue ear and blockage. As a result of the findings, the authors suggested that anti-reflux therapy, like antacids that reduce acidity of gastric juice and the activity of the pepsin protein by targeting the stomach, could be used to prevent glue ear. This finding has not been extended into adults but offers an interesting thought. If it can be shown that new divers with extreme difficulty equalizing also have a high incidence of heartburn or reflux - then it might be helpful to place these individuals on some kind of H2 blocker or antacid prior to their dives.

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 Often, we get queries that have no answers that are backed by data. Rather than rebuff the diver or prospective diver, we will try to come up with a reasonable deduction that will provide a means whereby the person can dive safely - or not dive at all. Many times we have to use basic non-diving knowledge about disease entities and fit this knowledge into a pattern that will allow an answer that fits the main contraindications to diving, which are: –Disorders that lead to altered consciousness –Disorders that inhibit the “natural evolution of Boyle’s Law” –Disorders that may lead to erratic and irresponsible behavior. In addition, attention needs to be directed toward measures designed to specifically detect those conditions that place a person in jeopardy for the following:
1). decompression illness
2). pulmonary over pressure accidents
3). loss of consciousness
4). inability to mentally or physically handle the in-water environment because of Post-surgical or post-debilitating illness

Diabetes

Asthma

Age Related Problems (more…)

Dr. David Colvard, a diving psychiatrist in Raleigh NC has kindly offered to allow us to use his material that was presented to a DAN South Africa conference held in September 2007. The lectures are presented on his webpage at www.divepsych.com .and below.

“Understanding Stress, Anxiety & Panic in Divers

“Identifying Anxiety & Panic Risk in Divers”

“Prevention Strategies for Anxiety & Panic in Divers”

“Anxiety, Panic and Psychiatric Problems in Divers”

David F Colvard MD

www.drcolvard.com or www.divepsych.com

Raleigh NC USA 919-781-3141

Toll Free: 1-877-COLVARD (265-8273)

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