Fatality in Sardinia

Mike Ferguson

WTF is that?
Just heard that Paul Towning died on a 90m dive on the SS Bengasi in Sardinia on Monday. I'm still stunned. We're going to miss Paul and 'Doris the Boris'.

There was a brief article in the Telegraph that indicates he may have had a heart attack. Does anyone have any more information?
 
I met Paul last year on the MV Salutay at Malin Head and dived with him and Doris. I was very much looking forward to doing so again this summer.

Top bloke.

Like Mike I'm stunned.

Sent from my HTC One using Tapatalk 2
 
I saw several reports of this last week in the UK press and was nervous to post as I wasn't sure who it was... Sadly I only spoke to Paul for the first time the week before this accident, I sold him some spare parts for his DSMB, in fact his name still pops up whenever I open my accounting software as his invoice is still on the desktop, each day last week it hit me this "hobby" has a dark side.
Am rather shocked at his passing and greatly saddened to hear he had family on the shore waiting for him (according to the report)

RIP Paul
 
I know what you mean, I've got an email in my inbox from last weekend telling me he's in sardinia at the moment, diving wrecks on the south coast and will be back on the 30th. Seeing it reminds me of the high price that is sometimes paid for those few minutes underwater.

Paul's the third guy I know who has died whilst diving over my 30+ years of playing this game. All three have been on a rebreather and it appears that two of the three suffered a heart attack. Is there something about rebreather diving that increases the risk of a heart attack or is it syptomatic of an ageing diving population?
 
Is there something about rebreather diving that increases the risk of a heart attack or is it syptomatic of an ageing diving population?

I know Nothing about this incident but I think we would be unfair to place the coroner in Sardinia under scrutiny, he/she may not be an expert in diving.

"Heart Attack" has been discussed in the past as a verdict from diving/CCR accident postmortems that may or may not reflect the cause of death, the coroners only option given the evidence and that it is not the "answer" we might be looking for- as in, its the Result, not the cause as such. Does that make sense?
(Simon Mitchell is probably the man you want to discuss this question with)

With regard the latter suggestion, divers who want and can afford CCR are "often" middle age plus males of the Powerfully-built-Company-Director type and I'm fairly sure that puts them (us) at higher risk of cardiac events anyway.
 
Very sorry to hear about Paul's death. From what I understand he was a kind gentle man.

With regards to CCR divers suffering more heart attacks than other types of OC diving, I think you would be hard pressed to find any data that supports this. I agree that average age of CCR divers tends to be on the older side of technical divers. I suspect this has more to do with heart attacks on CCR than any type of physiology related issues.
 
Is there something about rebreather diving that increases the risk of a heart attack or is it syptomatic of an ageing diving population?

Yes. More breathing resistance, higher workload on your cardiovascular system than on OC for the same exercise. more load on your lungs due to the effort of moving the gas in and out of your lungs and the units lungs.

Higher average P02's in the bloodstream can lead to C02 retention in the body for some of us as the brain is 'tricked' into thinking all is OK and ventilation isnt increased to deal with it.

Dr Simon Mitchell will hopefully come on and explain better than I can :)
 
I've never met Paul, just exchanged a couple of emails with him but for me, it was one of the most devastating news regarding someone's death while diving. Something that it can't be explained... He wanted to join me last December for a trip to SS Maidan, he couldn't do it but we've planned to dive together in September for a week of diving. After I've sent him the last details of the trip, a few days ago his cousin called me and he gave me the sad news. I've lost 3 diver friends within the last 12 months but Paul's death f...ed me up in such a way that for the first time in almost 20 years of diving, I am contemplating with hanging up my fins. Like I said, we never met but I have the feeling that I've lost a good friend...
R.I.P. Paul
 
Like others who have already posted above, I had the pleasure of meeting and then spending a week with Paul diving the Malin Head wrecks last year on MV Salutay. He was due to come tie up with many of us again in 2 weekends time in Eyemouth for a weekend of tec wreck diving, story telling and beer drinking that I had arranged. We will now attend this weekend without him and it will sadden us all that he will not make it but we will raise a glass on his behalf. Although we did not know him well, I would describe him as an absolute gentleman who I am sure will be missed by many. Thoughts to close friends and family at this sad time.
 
Awful to hear about Paul. My best wishes to all who knew him.

Mike, to answer your question,

Is there something about rebreather diving that increases the risk of a heart attack or is it syptomatic of an ageing diving population?

No, not that we know of to the former, and possibly to the latter. In a recent landmark study the DAN group found that a cardiac event was the disabling injury of 27% of recreational diving deaths (mostly open circuit scuba). There is no evidence that this is any higher in rebreather divers. Nevertheless, your comment about the demographic of the typical rebreather diver is probably on the money.

The cause of heart attacks in diving is undiagnosed coronary artery disease and the way to prevent these deaths is to detect and treat it. This simple truth has been irresponsibly obfuscated in recent years by an agenda-driven claim that it is high work of breathing and consequent CO2 toxicity that precipitated heart attacks in rebreather diving. There is absolutely no evidence to support this. Those of us older than 45 (males) or 50 (females) should consider undergoing some sort of screening test for coronary disease; especially if we do not have a clear history of outstanding functional capacity (regular heavy exercise) and / or obvious risk factors such as hypertension, hypercholesterolemia, diabetes, smoking, or a close family history of coronary disease at a young age. I do exercise heavily on a regular basis and have no risk factors, but I still chose to have a stress ECG a year or so ago.

Simon M
 
I agree completely with Simon above. There is no data that CCR diving increases the risk of heart attack. However, the demographic of CCR divers -- frequently middle aged men, and a lot who are not in the best of physical condition -- is at significant risk of having undetected coronary artery disease. Unfortunately, coronary artery disease often presents with sudden death or a heart attack without preceding effort-related angina.

What can you (we) do? Keep your risk factors under control -- smoking, hypertension, diabetes, cholesterol -- and consider stress testing, especially if you don't do a lot of aerobic training.

Just my 2 cents as a cardiologist.

Doug
 
"Those of us older than 45 (males) or 50 (females) should consider undergoing some sort of screening test for coronary disease; especially if we do not have a clear history of outstanding functional capacity (regular heavy exercise) and / or obvious risk factors such as hypertension, hypercholesterolemia, diabetes, smoking, or a close family history of coronary disease at a young age. I do exercise heavily on a regular basis and have no risk factors, but I still chose to have a stress ECG a year or so ago."

Hi Simon where do I start with these test...
Do I just go see my GP and he can arrange for the test or do you know of someone here in Brisbane?
Tony
 
"Those of us older than 45 (males) or 50 (females) should consider undergoing some sort of screening test for coronary disease; especially if we do not have a clear history of outstanding functional capacity (regular heavy exercise) and / or obvious risk factors such as hypertension, hypercholesterolemia, diabetes, smoking, or a close family history of coronary disease at a young age. I do exercise heavily on a regular basis and have no risk factors, but I still chose to have a stress ECG a year or so ago."

Hi Simon where do I start with these test...
Do I just go see my GP and he can arrange for the test or do you know of someone here in Brisbane?
Tony

Further, Simon, is stress ECG the best place to start for us nearish 50 males or would anything else be "best practice" in this demographic for this risk (heart attack wrt. diving)? Eg would PFO evaluation be a useful precaution - although not sure if PFO has been linked to age challenged male heart attacks (just DCI).

Mike
 
IIs there something about rebreather diving that increases the risk of a heart attack or is it syptomatic of an ageing diving population?

oops, missed the heart attack bit (not sure how) thought we were talking about CO2

Is it clear that it was a heart attack then?

Doug, Simon - If someone had heart disease, could increased ventilation / WOB from either stressful conditions or a other factors cause a cardiac event?
 
cholesterol & heart attack

Cholesterol is innocent and before to try to low your cholesterol , please read this ( sorry in french ):
COMMENT L' ATHEROSCLEROSE TUE ! - Site du Dr Michel de Lorgeril

Tell your Doctor that Cholesterol is Innocent, He Will Heal You Without Drugs by Michel de Lorgeril, MD / Reference / Foreign Rights / Accueil - Thierry Souccar Editions

“Cholesterol Controversy” has become “Great Cholesterol Myth” : Diet Heart News

And don't take statines drug ( very important Side Effects and one of them is to increase the narcosis)


To reduce your risk regrading AVC or heart attack :
Mediterranean diet
[ the base guide : no Cow milk or cow product only goat's milk or sheep; only olive oil or rapeseed oil 'colza' ;no butter at all or margarine; eat a lot of vegetable ; eat fat fish like sardines, mackerel, haren, etc ; eat poultry meat ( like chicken) , reduce red meat as possible; eat a lot legume (chickpea , etc) ]
Practice a sport of endurance 3 time by week minimun of 30 mm
Don't smoke
Reduce stress (work , daily life, environement)

Regards,



I agree completely with Simon above. There is no data that CCR diving increases the risk of heart attack. However, the demographic of CCR divers -- frequently middle aged men, and a lot who are not in the best of physical condition -- is at significant risk of having undetected coronary artery disease. Unfortunately, coronary artery disease often presents with sudden death or a heart attack without preceding effort-related angina.

What can you (we) do? Keep your risk factors under control -- smoking, hypertension, diabetes, cholesterol -- and consider stress testing, especially if you don't do a lot of aerobic training.

Just my 2 cents as a cardiologist.

Doug
 
Sorry, but I have to STRONGLY disagree with the references provided. There are a multitude of very well done double-blind, randomized, placebo-controlled trials (the absolute best design possible from a scientific standpoint) that show dramatic effects of decreasing cholesterol, both in primary prevention (no known vascular disesase) and in secondary prevention (those with a history of vascular disease).

There are side effects from statins but the incidence of SERIOUS side effects is extremely low, especially given the incidence of death from cardiovascular disease in the western world.

That having been said, there is a lot of merit in adopting the Mediterranean diet but "in addition to" and not "in place of lipid lowering therapy" if your cholesterol is above target levels.

As always, I would advise deciding on a course of therapy after discussing it with your physician, not an internet forum! :)
 
Hello

I STRONGLY disagree with you and believe me I very concerned about this problem

A lot of persons in my family died of heart attack
with very low cholesterol and under statine !!!!

Better to check your Lipoprotein(a) Lp(a) instead of cholesterol

I repeat cholesterol is innocent, it's only a business story. One day most of the actors of this business you be shame

Don't take personally. Most of the data trials ( are coming from drug company ) most of them lie of their reports .........only business pupose

Lipoprotein(a) - Lp(a)
Desirable: < 14 mg/dL (< 35 nmol/l)
Borderline risk: 14 - 30 mg/dL (35 - 75 nmol/l)
High risk: 31 - 50 mg/dL (75 - 125 nmol/l)
Very high risk: > 50 mg/dL (> 125 nmol/l)

Attached an article ( pdf)

other links :

A NEAR-PERFECT "SEXUAL CRIME": STATINS AGAINST CHOLESTEROL

Cholesterol lowering, cardiovascular disease... [Arch Intern Med. 2010] - PubMed - NCBI

https://www.statineffects.com/info/index.htm

Cholestérol, un business qui rend malade - rts.ch - vidéo - émissions - 36.9°

The International Network of Cholesterol Skeptics

http://www.1stvitality.co.uk/pdfs/Frenchcardio%20report.pdf

Dr. Serge Renaud and Dr. Michel de Lorgeril receive the Grande Covian Award for their promotion of the Mediterranean Diet | FUNDACIÃ***8220;N DIETA MEDITERRÃNEA
Elsevier
Statins: lowering cholestorol, raising debate | euronews, science


I agree, it's not the right place to talk about it..........not an internet forum



Sorry, but I have to STRONGLY disagree with the references provided. There are a multitude of very well done double-blind, randomized, placebo-controlled trials (the absolute best design possible from a scientific standpoint) that show dramatic effects of decreasing cholesterol, both in primary prevention (no known vascular disesase) and in secondary prevention (those with a history of vascular disease).

There are side effects from statins but the incidence of SERIOUS side effects is extremely low, especially given the incidence of death from cardiovascular disease in the western world.

That having been said, there is a lot of merit in adopting the Mediterranean diet but "in addition to" and not "in place of lipid lowering therapy" if your cholesterol is above target levels.

As always, I would advise deciding on a course of therapy after discussing it with your physician, not an internet forum! :)
 

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Hi Simon where do I start with these test...
Do I just go see my GP and he can arrange for the test or do you know of someone here in Brisbane?
Tony
Hi Tony

Your GP is the place to start. Blood test, and general health checkup. He/she will be able to inform you if there are any tell tale indicators from the test.

If needs be or you desire, get a referral to a cardiologist [insert name of appropriate specialist] to get the next step done.

If you have a health industry connection that can suggest a great specialist, get their advice. (My wife is a OT NUM, so she has her finger on the pulse so to speak and knows many of the local surgeons / specialists. Her advice has proven to be a boon to both sides of our entire family.)

As a thought, it's probably time to go back and get the once over. Last time I did a stress test - after reporting chest pain - I was quizzically asked why an elite athlete* is doing on the treadmill...

The pain was traced to running full tilt into a concrete bollard with the (enthusiastic) dog one morning. 2 cracked ribs...

cheers

Andy

*those who know me can now stop laughing, lest they wet their panties and get all embarrassed!

:haddock:
 
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