Dive Training Blogs
Five things you should know about PFO
By: Douglas Ebersole, MD
The relationship between decompression illness (DCI) and patent foramen ovale (PFO) has been popularized in the diving community over the past 5-10 years.
Here are five things you should know about PFOs:
- A PFO is NOT a disease. As a fetus, we all have a patent foramen ovale. It is a “flap” in the wall between the top two chambers of the heart which directs oxygenated blood from the placenta to the left side of the heart, thereby bypassing the lungs. Once we are born and begin to use our lungs to oxygenate blood, this “flap” closes in about 75% of people and forms a solid wall between the top chambers of the heart. However, in about 25%, it remains open and can be a pathway for blood clots or bubbles to get to the left side of the heart and cause a stroke or DCI.
- Having a PFO increases the risk of decompression illness by about fivefold. For sport diving, this increase is from about 2 episodes of DCI per 10,000 dives to about 1 episode per 1000 dives. For technical diving, this fivefold increase persists but is now 5 times a much larger baseline risk depending on the particular dive profile.
- PFOs are associated with certain types of decompression illness but not others. The types of DCI associated with PFO are cerebral (stroke), spinal (paralysis, urinary retention), cutaneous (a distinctive skin rash), and inner ear (vertigo). Joint pain as a manifestation of DCI is NOT felt to be related to PFO.
- The problem is the “bubble” not the PFO. The problem in DCI is with the inert gas load. Anything the diver can do to lessen his or her inert gas load such as fewer dives per day, shallower dives, shorter dives, “padding” decompression, etc., will lessen the risk of DCI – whether or not he or she has a PFO.
- Closure of the PFO is an option in carefully selected cases. If a diver has recurrent episodes of the type of DCI associated with a PFO (cerebral, spinal, cutaneous, inner ear), he or she has several options. First of all, the diver could stop diving. Most divers reading this would probably not choose this option, but it is always a consideration. Secondly, the diver could dive more conservatively. This approach has been shown to reduce the incidence of DCI in sport diving for patients with PFO. The restrictions include diving shallower than 100 feet, no more than one or two dives per day, no decompression diving, diving nitrox on air profiles, and long safety stops. For technical diving, though it has not been validated in controlled studies, the same considerations of fewer, shorter, and shallower dives along with “padding” decompression should be effective as well. Finally, divers could elect to have the PFO closed. This is an outpatient procedure done through a needle stick in the groin with a success rate of well above 95% and a complication rate of around 2-3%, the vast majority of which are minor complications such as palpitations and groin bruising. Serious complications are rare but do occur and must be considered when weighing the risks and benefits of PFO closure. After the procedure, patients are usually on aspirin and clopidogrel (Plavix) for 3-6 months.
Decompression illness is a poorly understood risk for scuba divers and especially for technical divers. Conservative diving practices are the best way to lower the risk of DCI. Despite these practices, some divers have recurrent Type II or skin bends – the types associated with PFO – and should consider being evaluated for PFO. The best screening test is a “regular” transthoracic echocardiogram with the injection of agitated saline (“bubble study”). If this is inconclusive and the clinical suspicion is high, a transesophageal echo could be performed. If a PFO is found, the diver could choose to stop diving, dive more conservatively, or, in selected cases, have the PFO closed.
Douglas Ebersole, MD is a TDI KISS CCR Advanced Mixed Gas Instructor Trainer and an SDI instructor as well as an interventional cardiologist specializing in coronary and structural heart interventions at the Watson Clinic in Lakeland, Florida.
To find out more about International Training, visit www.tdisdi.com.
Blogs
NovoScuba’s Game-Changing Approach for Dive Store Owners: WE PAY YOU!
The diving world thrives on passion and adventure, but for many dive store owners, the financial and operational challenges can be as deep as the ocean.
NovoScuba, an emerging force in the diving world, is on a mission to transform this landscape for the better. With a revolutionary approach to dive store and training agency partnerships, NovoScuba is setting new standards for how dive stores can thrive while keeping their focus on delivering exceptional diving experiences.
A New Paradigm: NovoScuba’s Bold Mission
NovoScuba’s mission is straightforward yet profound: to disrupt the traditional dynamics between dive store owners and training agencies. Traditionally, dive stores have been subjected to substantial fees charged by training agencies, for membership, materials and certifications. These costs have often placed a heavy financial burden on store owners, cutting into their profits and limiting their ability to offer competitive prices to customers.
NovoScuba flips the script by offering a model where dive stores earn money, instead of paying high fees. Dive stores receive commissions for every student they register, and their certification costs are covered. This new model not only boosts profitability but also ensures clients get top-quality training at unbeatable prices.
Financial Upsides: Earn From Student Registration
NovoScuba’s approach is simple yet revolutionary. Dive stores partnering with NovoScuba can earn commissions for every student they enroll.
Here’s how it works: For every student enrolled through NovoScuba, dive stores receive a commission. Each student enrolled will receive their e-learning materials and certification credit included in their subscription. This arrangement is a significant departure from the traditional model, where dive stores often struggle to manage high overhead costs related to training fees and certification expenses.
NovoScuba’s approach ensures that dive stores can focus on what they do best—providing top-notch diving experiences—without being bogged down by excessive financial burdens, and the need to carry large stocks of materials.
Quality Training at a Great Price
NovoScuba stands out by offering high-quality, ISO certified, training that doesn’t break the bank, in fact our students will pay less than with most competing agencies. Clients benefit from top-notch education and safety standards at competitive prices. Dive store owners can confidently promote NovoScuba’s programs, knowing they’re offering fantastic training at affordable rates. This balance of quality and affordability helps dive stores build a strong reputation and attract more customers.
Your Brand is Your Business: NovoScuba’s Commitment to Showcasing Your Identity
At NovoScuba, we understand that your brand is your most valuable asset, and we’re committed to putting it front and centre. Unlike agencies that charge high fees to promote their own brand, we believe in investing in yours. With NovoScuba, you won’t be paying to advertise someone else’s logo alone, — our focus is on showcasing your unique identity. Certifications prominently feature your brand, as well as the training agency, reinforcing your store’s image and brand every step of the way. We’re here to support and elevate your brand, ensuring that your investment directly benefits your business.
Affordable Membership: An Investment in Your Success
NovoScuba’s membership model is designed with dive store owners in mind. Membership fees are kept low and include annual Pro member fees for your team. Payment can be made monthly or annually in your local currency, avoiding the hassle of exchange rate fluctuations. NovoScuba promises no exchange rate changes without a six-month notice, ensuring financial stability and simplifying budgeting. With a membership lasting 12 months from date of joining, you’ll enjoy a full year of NovoScuba’s benefits and support.
Streamlined Operations: Simplifying Your Workload
Handling administrative tasks can be a challenge, but NovoScuba makes it easier. We’ve streamlined certification procedures and reduced paperwork to help dive stores operate more efficiently. Certification processing is quick and straightforward, allowing more focus on teaching and customer service. Our system minimises bureaucracy by storing necessary forms in student profiles, reducing paperwork and administrative delays.
Crossover Made Easy
For dive stores looking to transition to NovoScuba’s model, the crossover process is designed to be smooth and hassle-free. NovoScuba provides support to ensure that the transition is as seamless as possible, helping dive store owners integrate into the new system with minimal disruption. Experienced dive Pros don’t need to undergo extensive retraining. Our crossover is designed to familiarise Pros with NovoScuba’s user-friendly platform, standards and course structures, and not to waste time and expense re-training in water.
With just a few simple steps, you’ll be ready to offer top-notch training through NovoScuba.
Comprehensive Business Support and Training Included in Your Membership
NovoScuba goes beyond financial benefits by offering experienced support and training. This value added service includes:
- Business Training: Optimise your operations with guidance on marketing, customer service, and best practices.
- Marketing and Promotion: Access resources to attract new customers and boost your store’s visibility. Enjoy cross promotions with NovoScuba to gain increased exposure.
- Ongoing Support: NovoScuba’s commitment to its partners extends beyond initial training and setup. The company offers ongoing support to address any issues or questions that arise. This continuous support ensures that dive store owners have a reliable resource to turn to whenever they need assistance.
Embracing Digital Natives: Instant Evolution and Continuous Improvement
NovoScuba’s digital-native approach is a game-changer. Leveraging cutting-edge technology, we ensure our services evolve and improve swiftly. Dive stores benefit from instant updates, the latest features, enhancements, and effective solutions, keeping them ahead of the curve. This continuous improvement helps dive stores stay competitive and deliver exceptional services. Whether it’s a new course update, additional marketing resources, or improved e-learning functions, NovoScuba’s digital infrastructure ensures that dive stores are always equipped with the most current and effective solutions. This continuous evolution not only helps dive stores stay ahead in a competitive market but also ensures they consistently provide top-quality services to their clients.
Why Is NovoScuba Doing This? – Fair Profit Sharing for Greater Access and Growth
At NovoScuba, we’ve taken a bold step by paying commissions to stores rather than following the traditional model of training agencies charging high fees. Our mission is to make diving accessible to everyone and to foster a growing community of new divers and continued education. By redistributing profits more equitably between stores and training agencies, we aim to create a more supportive and collaborative environment within the industry. We believe this approach not only helps individual stores thrive but also stimulates overall growth and innovation in diving. Our commitment to fair profit sharing reflects our dedication to the long-term health and expansion of the diving community.
Getting Started: Join the NovoScuba Revolution
Ready to revolutionise your dive store experience? NovoScuba is here to support your journey toward reduced costs, increased profitability, and enhanced operational efficiency. Get in touch with our team to learn how NovoScuba can transform your business.
For more information, email info@novoscuba.com or visit www.novoscuba.academy.
Blogs
Are you ready to become a Cave Diver?
By Marissa Eckert
What are the requirements to start cave diving? What do I need to do to be prepared for cave training? These are all questions I get asked by so many potential students. There are many options when coming up with an answer. The first option, and the easiest, would be to go the training agency website and look up the requirements to take the class. However, this leaves a lot open for interpretation and doesn’t mean you will necessarily be ready. Like anything, there always needs to be minimum requirements. But is that enough? Maybe for some people it is, but for most people it’s not.
So, what are the requirements?
TDI breaks cave training down into three different levels. Those levels are cavern, intro to cave, and full cave. To start cavern the requirements state that you must be 18 years old or 15 years old with parental consent, have an Open Water Certification, and a minimum of 25 logged dives. This doesn’t sound like much. So, what do I tell my students when they ask me? First, I find out if they are only interested in cavern or if they are interested in potentially progressing into cave diving. If they are interested in progressing into cave diving, I always strongly suggest they get comfortable with a dual configuration first. This configuration can be side mount, back-mounted doubles, or even a rebreather. The main things I tell everyone they need to have down are buoyancy, good trim position, the ability to hover in place motionless without moving their hands or feet, and good overall awareness. This means awareness of oneself and what your body and equipment are doing, but also total awareness of what is going on around you.
So, what does all this mean?
Many times I’ve had students show up thinking they had all these things mastered only to quickly realize they have a long way to go. Which by the way, is okay! After all, we all start somewhere and progress at different paces. The most important thing is to be open to feedback. But there are also ways to prepare yourself better. First and foremost, when starting down this route it is critical to find a good instructor. Take time to look up instructors, ask questions, interview them, look at their past students, look at what type of diving they are doing, and most importantly ask questions! Find out what techniques they use during class.
I have found that video recording students when they are struggling with something gives them a great perspective to see what they are doing wrong and helps them visualize and correct it. Does the instructor look good as a diver? Whether you like social media or not, the internet can be a great place for research. When looking at a diver they should look in trim, almost like they are laying flat on a table. In videos are they finning with their hands? Are their feet constantly moving? Are there things dangling below their body? All equipment and hoses should be extremely clean and contoured to the body.
The most important question to always ask during training is WHY? There should always be a why behind everything we do. And it should never just be because I said so. Make sure the instructor knows why they are telling you to do something a particular way. Everyone can always learn new ways of doing things, instructors included.
How can you truly prepare yourself?
A good idea is to record video of yourself or have a friend record you while diving. Send it to your instructor ahead of time, so they can give you feedback and let you know if there are things you need to work on. There is no certain number of years to be diving, or a certain number of dives to have, that says yes you will be ready. Every individual learns at a different pace. If a class is only offered in a minimum number of days with a maximum number of students allowed, be aware that this means less time practicing each skill. For this reason, you might be better suited doing one-on-one training or having a regular buddy take the class with you. This ensures you are comfortable with each other and familiar with each other’s habits in and out of the water, and that you get along!
The most important thing of all is to come to class with an open mind, a readiness to learn, and no concern with whether you will receive a card, but with a concern that you will learn to be a better, safer, more competent diver. I always tell my students safety is the number one most important thing in cave diving, but fun is a close second! Sometimes, it may not feel fun. Stop and ask yourself does this instructor have your best interests at heart? I know I certainly do. I want to go to sleep each night knowing that I gave my students as much knowledge as possible to make them safe and thoughtful cave divers.
With proper training, proper equipment, proper experience, and a proper attitude I think cave diving can be done very safely. I often joke that the most dangerous thing about cave diving is driving to the dive site!
To find out more about International Training, visit www.tdisdi.com.
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