• Paul Cumbo

There's a Hole in My Heart

Sounds like the beginning of a country song. But I mean it for real. I have a patent foramen ovale (PFO), a small opening between two chambers of the heart that never closed the way it was supposed to after birth. About one in four people have this but most never know it. I found out about it, I suppose, in the typical way one finds out these things in his fifth decade.

I had to take myself to the ER a little over a month ago following a chest-pain scare. It was a wake-up call, but all turned out well. It was some combination of stress, dehydration, and vertigo. My cardiac picture is pretty good, maybe even a little better than typical for a guy my age with a congenital tendency for high cholesterol and hypertension. I still need to lose weight, but my arteries aren't clogged with plaque.

The interesting twist in this story is that the clinical followup revealed the PFO, which is directly connected to another stark reminder of mortality that happened twenty years ago. After a decade of scuba diving, with 500 dives under my belt and certification as a rescue diver and "divemaster" (an assistant instructor), I landed myself in a hyperbaric chamber for treatment of decompression sickness (DCS), more commonly known as "the bends."

During the few days I spent in the Cayman Islands, I did engage in a pretty aggressive diving schedule. It was a lot of diving--three dives per day, once four. I pushed the nitrogen-loading algorithm limits on my diving computer, but I didn't exceed them. I probably screwed up more by failing to avoid strenuous exercise--I went for long bike rides most days, which wasn't a good idea. More is known now about how heavy exertion compounds the likelihood of DCS.

In any case, I ended up airlifted to the main island, and I spent somewhere close to twenty-four hours across two sessions in a hyperbaric chamber undergoing oxygen therapy and hyperbaric treatment to flush the microscopic nitrogen bubbles out of my bloodstream. It was embarrassing, infuriating, humiliating, and more than anything else, humbling. Diving had been a huge part of my life up to that point, and that essentially put a hard stop on it. I was twenty-two.

I was advised to avoid diving or at least limit it to once per day. I was also advised to get checked for a PFO, because it makes one exponentially more likely to experience DCS. Being young and stubborn, I never did get checked. I did, however, mostly hang up the diving gear except for an occasional plunge. The sad part of this is that most of my family either stopped diving or greatly dialed it back, too. It had been a big part of all of our lives, with a lot of great memories.

So, when I learned last month that I do, in fact, have a PFO, I felt things. On one hand, when my cardiologist (who is also a diver) told me no more diving, ever, I was bothered. It was something I'd hoped to be able to experience with my wife and kids as they got older. But more than anything, I felt some vindication. For years, I'd rehashed my diving history and my profiles from that week, and assumed that I'd just pushed it a little too far, even though, on paper, I hadn't.

This is one more life event that has made it clear that we don't live forever. We're relatively fragile, imperfect machines, and there are limits. Some people have far more limitations, and their lives are painfully short. I am fortunate in this regard, for which I am grateful beyond measure. Nonetheless, I am even more grateful for the reminder of the preciousness of life. It's one of the reasons I try to embrace each day as a gift, full of possibility. Life is short.

#scuba #mortality #cardiac #lifeisshort

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