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by Michael Menduno
Header photo by Michael Thomas. Phil Short swims under Wookey Chamber 14.
With diving just beginning to resume in various parts of the world after what felt like an interminable shutdown, we thought it would be interesting to check in with some of our friends to see how they were approaching their return to the underwater world after such a long hiatus.
Ironically, it’s been the longest that 51-year old British cave explorer, scientific diving officer, exosuit pilot, educator and film consultant Phil Short, principal of Dark Water Explorations Ltd. has been out of the water in his entire 30-year diving career. How did one of tech diving’s indefatigable pioneers plot his re-submergence, and what would he offer up to colleagues about to take the plunge?
We chatted up Short just as he was booking his first dive project trip abroad; this is what the ardent caveman said.
InDepth: Maybe we can start with you explaining a little about the circumstances in the UK. I know you were on lock down as far as diving was concerned, and they are now in the process of opening up.
Phil Short: Basically, when the COVID-19 crisis began, the country went into lockdown for all nonessential activities. So obviously, any type of sport and recreation was included in that. And then, after about two months, they slowly started to reduce the restrictions, certainly for more normal activities and allowed certain sports to take place again. There was a lot of controversy over diving, because COVID-19 is a respiratory or lung-borne disease. So there was concern that it could create additional potential hazards with lung expansion injuries and embolisms.
In the UK, we have a group called the British Diving Safety Group, which is made up of various organizations including diving training agencies: the British equivalent of the Coast Guard, the Health and Safety Executive (HSE), which is our version of OSHA and the diving industry trade organization, and SITA (Scuba Industries Trade Association). I am a member, and we met to determine what the safest and most prudent, most expedited means were to get people back in the water. We consulted with the hyperbaric medical community, COVID-19 related medical experts, the agencies with the authorities that control charter boat operations, and with the HSE.
The first permissions were for small groups. Basically, you and one buddy could do shore dives. We adopted recommendations by the NSS-CDS as to how gas sharing should take place, and safety or S-drills so you are not breathing from each other’s equipment.
So when did you go diving?
As a member of the BDSG committee, I was very diligent not to go in the water until the evening we announced that it was permissible to go beach or shore diving. The next morning, 28May 2020, I left my house at 4 AM to go and do a beach dive on a landing craft from the second world war, a genuine World War II wreck. I descended at 6:23 AM and it was just heaven because I had been out of the water for 86 days because of the restrictions. And it was just great to get back in.
Where did you make your last pre-COVID-19 dive?
My previous dive had been on the island of Lanzarote in the Canary Islands off of West Africa teaching a trimix rebreather class. It was a 93m/303 ft dive. I got on the plane, flew home, and the lockdown started almost immediately. And then 86 days later, I was doing a 12m/39 ft dive off the beach in the UK. It was my longest break in diving in the 30 years I’ve been in the industry.
Let me ask you, did you have a conscious strategy or approach to getting back in the water? You didn’t start back in at 90 meters.
Yes, it was conscious. Certainly rebreathers, it’s not just like riding a bike. You do need to keep current. I recommend to my students to be doing at least one skill dive on the rebreather per month, minimum, to maintain currency.
So I decided that for the first dive, once the permissions had been given, to go make the beach dive on doubles. I’ve got a nice little twin 8.5L set that’s small enough for walking over the beach. It still had the redundancy, but it was simple scuba and a simple depth of just 12m/39ft. Basically, the first thing I did when I got in the water was descend just a few feet and made sure that I was proficient with doing a shutdown and isolation drill on the doubles.
Then I went for the dive on a good nitrox with a long no-decompression time and surfaced way before I was getting anywhere near decompression. I took it gently. First time back in 86 days, I took it gently, and then over the last six or seven weeks, I’ve started to build up from there.
I know you’ve talked and probably compared notes with colleagues and other divers. Do you think people there are approaching getting back in the water sanely or is it a bit of a madhouse? How would you characterize things in the UK?
I would say, as often happens, it’s mixed. So, based on recommendations of the agencies and their instructors, the majority of people are getting back into it gradually like I did myself. But there’ll always be those who say, “Oh, I’m a good diver. I don’t need to do that. I’ve not been allowed to dive for two or three months. I want to go do what I want to do.” And they go straight out and do a 50 or 60m dive, which I think is just foolish.
Even ignoring the COVID-19 situation, if you were out of diving because of having a kid, or experiencing a job change or anything like that, or after a big layoff, I think it would be prudent to get back in gently and then slowly build up. So, my first dive was shallow with open circuit doubles. My next dive was a very limited penetration, shallow cave dive on open circuit, side mount, again with redundancy. A no-decompression dive but back in my natural environment of caves for a little swim around.
Gradually over the weeks, because I had better access to caves than I did to the sea, I did more and more cave dives and slowly built up in duration and distance, but still on open circuit. I then got permission from the owner to access one of the inland lakes, and we did some pre-official opening work for the owners of the site. I got back in on the rebreather but again, no-decompression, relatively shallow, no more than 30m/100 ft. Next, I integrated stages and my DPV (diver propulsion vehicle).
My first teaching was a Level one, Mod One rebreather course that I team-taught with a fellow UK instructor. It was a perfect way to get back in gently because we were running 10 hours over 8 to 10 dives of constant skills for the students. So that was a real refresher. And then finally last weekend, a group of us that had all been doing that type of gradual build up got out on a boat off the south coast of the UK, on a 33 m/108 ft deep wreck on Saturday. On Sunday, we dived a very well-known wreck, the SS Salsette, in 45 m/147 ft of water in beautiful conditions. Calm sea, good visibility, and a real wreck. So I had made a gradual buildup over seven or eight weeks to get to that point, rather than jumping straight back in.
Sweet. You mentioned rebreathers (CCR). Currently, there is a global shortage of oxygen sensors underway as a result of the pandemic. Oxygen sensors are being diverted to the medical industry, which is under siege right now from COVID-19. Any concerns or worries that people will go diving with out-of-date cells? Do you think that’s an issue?
It definitely concerns me. I’ve been a CCR instructor at all the levels, almost exclusively for the last 15 years, and I’ve seen people go out and happily spend five, six, seven, 10,000 pounds on a brand new rebreather and the training and then go out and be cheap on a £16 fill of Sofnolime or a £16 fill of oxygen. And you’re like, what are you doing? You paid £10,000 for this equipment and you’re risking your life on a £16 refill of consumables? People are so desperate right now to get back to their hobby; they feel like it’s been taken away from them, that I worry they may not always act sensibly.
It’s been a battle over the last five or six years to get people to really wake up and pay attention to the fact that these sensors are your life support. There was a very high-profile accident that was caused by overrun sensors a few years back with a quite-well-known person in the industry. He effectively died on the bottom, was rescued by his buddy, then was helicoptered to the hospital where he was put into an induced coma. He came out of it several days later and he was very, very lucky to survive. And very, very lucky to come back to actual diving again. But that was all caused by old, overbaked sensors.
So what do you see happening?
I think what’s going to happen, you know, is that some people ran out of fresh sensors a couple of months ago so now it’s 14 months, 15 months, 16 months. And some may be thinking, “It’ll be okay, it’ll be okay. They’re reading fine, they’re working fine.” Some people might be doing linearity checks, doing oxygen flushes at 6 m/20 ft to check if they read high when appropriate.
But really, the companies like AP Diving, JJ-CCR, Vobster Marine Systems, and others have put a lot of time, a lot of effort, and a lot of money into researching and independently testing these life-support machines for functionality, with certain parameters. Much like car manufacturers do so you can drive your family and your kids in a safe car. [Hammerhead CCR developer] Kevin Jurgenson summed it up once brilliantly when he put out a statement saying, ”Okay, people are questioning the duration that a sensor can last. Some people would say 12 months. Others would say 52 weeks. Some would say 365 days.” And he carried on to include hours, minutes etc. Basically saying, a year is a year. Whichever way you try to stretch it, it’s a year. No more.
Personally, I would not violate that because those three simple galvanic fuel cells that represent probably somewhere between $200 and $300 depending on the manufacturer and the unit, representing a tiny percentage of the expense that I’ve outlaid to become a rebreather diver, is not worth my life.
As I mentioned, I am now back on my rebreather after starting on open circuit, and if my sensors eventually pass their 12-month date, I’m very happy to return to open circuit for as long as I have to while I wait to buy some new cells.
I have always believed in my educational career of thirty years in the diving industry to lead by example. Those are my feelings. I know from experience when you make comments like that, and it’s effectively the same as raising your head above the trench in a warfare situation. People are going to take shots; but bring it on. If you’ve got a sensible, scientific argument for extending your cells past 12 months, then I’m happy to discuss it. But I don’t think there is one.
So the moral is, if you have sensors that are past either one year, 12 months, 365 days, 8760 hours, 525,000 minutes, or 31.5 million seconds, then you need to go back to open circuit, or not dive until you can get some new ones?
I believe so. The manufacturers whose rebreathers I have dived and taught on over the last 10 years are people that were passionate about rebreather safety. And much like [Sheck] Exley, who focused on improving cave training and cave safety by writing Basic Cave Diving: A Blueprint for Survival, these manufacturers—people like Martin Parker at AP Diving and Jan Petersen at JJ CCR have gone the extra mile to improve safety.
You know full well from the aquaCORPS days, if you look at the safety record of CCR diving now, versus 15 years ago, we made a difference. It has become safer. Why ruin it, because of impatience and a short-term, relatively short-term, restriction on availability of consumables?
Right. In fact, I have talked to Nicky Finn at AP and also Jakub Sláma at Divesoft who have been in touch with sensor manufacturers regarding shortages, and it seems that the situation may be stabilizing and or easing up, assuming we don’t have a second wave of COVID-19 infections. So hopefully, the situation will improve.
Actually, I’ve heard that from several manufacturers, and I think it will improve quicker than was first anticipated. And that’s even more of a reason for not doing anything foolish and being a little bit patient with this to be safe.
Last question: What’s next for you? Got any big projects coming up?
I just booked my first flight to travel out of the UK again. This time to Croatia. I’m going to be designing and building a water dredge system for recovering and capturing sediment on an archaeological site for a project that we are going to do in October. This is a follow-up project from one we did in 2017 to recover a US World War II pilot from a wrecked B24 bomber that ditched in the Adriatic Sea. We’re going back to do another recovery on a different wreck.
The dredge system will be designed to work at the appropriate depth level so that we can basically recover the sediment without losing anything. Specifically, we’re not going to miss any of the crew that are found through that dredging. So, I’ve got a 10-day trip to build that system, test it in the same depth of water, and have it ready for the project.
When I come back from that, I’m flying out to Switzerland to train on the Divesoft Liberty sidemount with a good friend and former student of mine, Nadir Quarta. It will be my first sidemount rebreather. I’ve got no intention of moving away from my JJ as my primary rebreather, but I’ve got quite a few cave projects that require a side mount that I can’t do in my back-mount JJ. They don’t offer a sidemount, and because of distance and depth, I can’t do it on open circuit. I put a lot of thought into which unit to use, and am very impressed with Divesoft’s engineering and build. They’re also very courteous and professional to deal with. I like working with people like that.
After training, I plan to attend a Swiss technical dive conference, Dive TEC! in Morges as a speaker, where I will be talking on my 30-year journey as a cave diver and explorer.
Fun times ahead! Thank you, Phil. I look forward to talking to you again soon.
Michael Menduno is InDepth’s executive editor and, an award-winning reporter and technologist who has written about diving and diving technology for 30 years. He coined the term “technical diving.” His magazine “aquaCORPS: The Journal for Technical Diving”(1990-1996), helped usher tech diving into mainstream sports diving. He also produced the first Tek, EUROTek, and ASIATek conferences, and organized Rebreather Forums 1.0 and 2.0. Michael received the OZTEKMedia Excellence Award in 2011, the EUROTek Lifetime Achievement Award in 2012 and the TEKDive USA Media Award in 2018.
Undergoing PFO Surgery as a Team: Deana & Bert’s Excellent Adventure
People like to give GUE a hard time for their uncompromising focus on team diving. But a pair of divers from GUE Seattle has taken it to a new level: getting their PFOs fixed together. The team that bends together, mends together? Instructor and tech diver James D. Fraser willingly tells the tale.
by James D. Fraser
Header photo courtesy of Dr. Doug Ebersole
This is the follow-up to the story that ran in InDepth December, 2019: No Fault DCI? The Story of My Wife’s PFO
It has been a year since my wife Deana had a decompression illness (DCI) hit in Bonaire requiring her to do a Table 5 recompression profile in a hyperbaric chamber. At the time of my previous article’s publication, Deana had a Transthoracic Echocardiogram (TTE) bubble study and found out she did have a small to moderate patent foramen ovale (PFO). Two physicians offered similar options for Deana to consider when it came to her diving activities:
- Stop diving, as this eliminates any risk of DCI in the future.
- Modify her dive profiles to be more conservative: diving only once per day, diving nitrox 32 using air tables, and/or extending her decompression profiles and safety stops.
- Have the PFO repaired, knowing it is not a guarantee, and continue diving as conservatively as possible.
Deana had initially decided to wait on doing a PFO closure until after our daughter’s wedding in March 2020, but she realized very quickly that being “conservative” was not in her nature. Deana had already returned to diving within 12 days of her hyperbaric chamber ride. In the 46 days since her treatment, Deana had already done another 15 dives to depths of 90 feet; being conservative really was proving to not be an option for her. Diving was just too much a part of her life.
In mid-November, Deana reached out to cardiologist and tech diving instructor Dr. Doug Ebersole for a second opinion on the bubble study and his advice about her options. Dr. Ebersole gave Deana the same response as the other physicians; but, knowing Deana and her passion for diving, he suggested that she have her PFO fixed, since her plan was to continue diving.
Deana also spent time talking to other divers who had been diagnosed with PFOs—some who had them repaired and some who had decided against it—in order to get a more complete picture from both a patient and a doctor point of view. One of the final conversations that pushed Deana to have her PFO repaired was with a coworker who was a nurse practitioner in cardiology with knowledge of PFOs and diving. Her coworker was pretty blunt, stating, “Why are you playing Russian Roulette? You have worked in cardiac and know the risks.”
Some of these risks include Arterial Gas Embolism (AGE), Venous Gas Embolism (VGE), and cerebral embolism. That was the final “Aha” moment to tip the scale and get Deana to schedule her PFO repair, since “Russian Roulette” was exactly what Deana was doing based on her diving activities following her DCI hit.
Team Approach to Treatment
Bert Berzicha, one of our GUE Seattle community members, also completed his TTE as a result of having had some symptoms of DCI in the past. The test confirmed the presence of a large PFO. Deana and Bert compared notes initially and discussed diving as a team on future dives using more conservative decompression profiles than other teams, allowing the other teams to get out of the water sooner. Deana, however, related what she had learned from talking with her coworker and changed her mind about diving conservatively and instead decided to get the PFO repaired.
Deana did not want to take the risk of neurological deficits that could be irreversible. Deana suggested to Bert that he come with her to have his PFO repaired at the same time. Bert continued to research the subject, looked at his work schedule, and decided doing a “team” procedure made sense. Just as a dive team shares a plan, resources, and emergency procedures, a medical procedure shares similar benefits when working as a team.
It was time to plan a date for both of them to have the procedure. Deana and Bert both live in the Seattle area. Dr. Ebersole lives in Lakeland, Florida, so logistics included time off work, pre- and post-surgical care, flights, hotels, and transportation. Deana arranged to have her sister Jessica fly into Tampa from Dallas, prior to them arriving, so she could pick them up from the airport to make it to the hospital in time for the procedure. I was going to be in Australia on a business trip at the time, so I was not able to be there pre-surgery. I ended up reworking my return trip and flew from Canberra, AU to San Francisco, then on to Tampa, to land just an hour after their surgeries were finished and meet them back at the hotel.
Even though Deana and Bert could fly home 24 hours after the procedure, they decided to stay the weekend just in case there were any complications and to take it easy. Deana, however, had a different take on “easy.” The morning after surgery, Deana was invited by Dr. Ebersole to watch a procedure that he and his team perform called the “WATCHMAN” procedure (less than 24 hours after post-op). Then we picked up Bert and Jessica, and jumped into the truck to do a 300-mile, five-hour road trip to High Springs, FL, to take a tour of the Halcyon facility and say “Hi” to Orie Braun, Lauren Fanning, and Mark Messersmith; stop in at Global Underwater Explorers (GUE) HQ to buy some swag; and drive down to Ginnie Springs to see where Cave 1 may take place in Deana’s and my near future. Not bad a day after surgery.
It was at Ginnie Springs where Bert came to Deana and stated he thought he had active bleeding. We all paused and turned pale, knowing we were not in a great location for this to be happening, but after being assessed by Deana it turned out to be post-op bruising from the surgery. This did, however, make us stop and think, “We just drove 300 miles away from the hospital we had decided to be close to in case of complications.” I am sure Gareth Lock would find a really good human factors story in there somewhere.
Deana’s PFO adventure Timeline
- OCT 8: 47 m/153 ft technical dive resulting in a DCI episode requiring recompression.
- OCT 20: First dive post-chamber ride to 16 m/52 ft
- OCT 29: TTE Bubble Study; “Deana has a small to moderate PFO”
- NOV 17: Dr. Ebersole receives Deana’s TTE study for a second opinion
- NOV 21: Deanna dives now to 28 m/90 ft
- DEC 4: Last dive before PFO repair. In the 46 days since her hyperbaric treatment Deana made 15 dives: “Conservative Not”
- DEC 12: Deana and Bert have PFO procedure
- DEC 13: Lakeland to High Springs road trip
- JAN 27: First dive post closure—15 m/49 ft and spaced dives 2-3 days apart
- FEB 15: Started doing multiple dives daily no greater 15 m/50 ft
- MAR 8: PFO follow-up; OFFICIALLY cleared by Dr Ebersole to dive
- MAY 7: Dives now pushing 30 m/100 ft
- MAY 31: First Tec dive to 33 m/110 ft
Since May, Deana has done 120 dives in 2020 with a max depth of 52 m/170ft, which she did on September 12. Deana has gone back to no-restriction diving and has completed 16 technical dives since this summer. Some of these have been assisting with photogrammetry dives.
- 46 m/150 ft to 52 m/170 ft: 3 dives
- 40 m/130 ft to 46 m/150 ft: 5 dives
- 30 m/100 ft to 40 m/130 ft: 8 dives
Getting Personal With PFOs
COVID-19 has prevented us from doing a dive trip this year, which is the one main test we still have yet to do: repeat the scenario that always led to her getting DCI, which was three consecutive days of recreation and tech dives, to see if she experiences any recurrence of DCI symptoms. 2021 will hopefully open up this opportunity, or by that time Deana will already be training for GUE’s Tech 2 course. In either case, Deana and Bert are both very happy to have had their PFOs repaired; both have seen improvements in their health in other areas such as endurance, no longer being easily winded, and, in Bert’s case, less headaches, which he had prior to the PFO closure.
To get a PFO repaired is a personal choice, and no one should ever take surgery lightly as it has its own risks. Divers with PFOs need to do their own research and consult an interventional cardiologist, such as Dr. Ebersole, who understands diving. Only then can they make an informed choice based on their own unique situation whether or not a PFO closure is right for them. This article is meant to show the process and outcome of two very experienced and ambitious divers who made the choice to have their PFO repaired and the results of that decision.
Diving and Hyperbaric Medicine: The effectiveness of risk mitigation interventions in divers with persistent (patent) foramen ovale by George Anderson, Douglas Ebersole, Derek Covington and Petar J Denoble. 2019 Jun 30.
Alert Diver: PFO Study Update by Petar J Denoble
Alert Diver: Cases studies of divers who had their PFOs closed with transcatheter-applied occluders: Divers with Holes in their Hearts by Petar J Denoble 2010
James D. Fraser is a GUE Fundamentals and Rec 1/2 Instructor, PADI MSDT, and NAUI Scuba Instructor, and has been diving in the Pacific Northwest for over 30 years. James currently lives in Seattle, WA, with his wife and dive teammate Deana Fraser. As a member of the GUE Seattle Board of Directors, James is able to share his experiences and work with Deana at growing the local diving community sharing their passion with all who are interested. James recently embraced technical diving, becoming certified as a Technical 1 diver with GUE. James and Deana have had opportunities to travel all over the world to experience their passion in amazing places such as Egypt and the Maldives. James currently works as a Cyber Security Director with a Fortune 500 Defense Contractor and has been a residential construction business owner and Emergency Medical Technician (EMT).
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