It has been two long years since my last dive and heart attack, but I am going to try to start diving again soon.
I am still waiting for my physician to sign my release, but at least now he is saying that he will sign it. In the meantime while I wait on him I will try to get everything ready to go.
Since it has been so long since my last dive, I have a lot of work to do to get ready to begin diving again. First off I have to get all of my equipment checked out and have all the normal routine maintenance done on the regulators, hoses, connections, lights, BCD, etc.
I also have to have the tank inspections completed on all of my tanks because they have been sitting for the past two years unused. I am hoping that it will not cost me too much to get my gear back into diving condition.
I will try to pull everything out over the next couple weeks and go through it all to see what all has to be replaced and/or serviced. Then we will go from there.
I apologize for being away for so long. I got extremely busy with teaching first aid & CPR classes and have been working long hours 7 days a week trying to get all the classes completed so I have not had an opportunity to dive in months now.
Apparently I worked a little too hard and it finally caught up to me. On September 10th I suffered a massive heart attack also known as a STEMI (ST-elevation myocardial infarction) while loading our CPR training equipment for classes the next day.
Since I did not have the typical symptoms it went unrecognized for about 7 to 8 hours before I finally recognized one of the common symptoms, profuse sweating. I then added up the other minor “unrelated” symptoms that I had been having all day and knew immediately what was happening.
It was a very hot day and the humidity was unusually high. We had just received a new cargo van from the dealership and I was preparing it for the next days classes by loading 10 sets of CPR manikins, 5 dog CPR manikins, airway training manikins, oxygen tanks, and other training equipment into it.
Somewhere around noon I noticed that the temperature inside the back of the van had reached 125 degrees while I was working inside it, so when I started feeling slightly nauseous I assumed it was from the heat and that I was getting dehydrated. When I stopped to cool off in the shade the nausea would stop, but when I started working again in the heat it came back.
This continued for several hours and then I noticed a slight tingling in the fingers of both hands. Since this was not a familiar symptom I continued to work getting the equipment loaded and organized in the van.
About 7:00 in the evening I started noticing that my chest was getting a little tight. I had asthma as a child and it felt as though I was having a very mild asthma attack due to the humidity. Actually an extremely mild case, one that I would not even need to use an inhaler to treat. Since the symptoms were so mild and I was almost finished with getting the van ready I continued to work.
A few minutes later I noticed a pain in the middle of my back right between my shoulder blades that felt just like I had to stretch and pop my back. Since I had been doing a lot of lifting and bending all day I had expected some back discomfort, so it was not a shock to me. I tried unsuccessfully for several minutes to relieve the pain by stretching and shrugging my shoulders to get my back to pop, but the pain just would not go away.
Then the one symptom that I recognized started. It had started to cool off outside but all of the sudden I began to sweat profusely. Almost at once my clothes were dripping with sweat. It was almost like I was standing inside a shower.
I immediately recognized this fatal symptom as a heart attack and immediately reached for the first aid kit to retrieve the 81 mg chewable aspirin that was kept inside. I chewed two of them quickly and let them dissolve in my mouth and under my tongue as I teach in the first aid classes. I also grabbed an oxygen training kit and placed myself on high-flow oxygen (15 liters /min) with a non-rebreather mask. I then called 911 for an ambulance.
When the ambulance arrived I was hooked up to an EKG to monitor the electrical activity of my heart and the Paramedics immediately recognized a significant elevation of the S and T waves on the monitor signifying a STEMI heart attack with complete blockage of at least one of the arteries supplying the blood flow to the heart causing significant damage to the heart. A normal heart attack does not show any change to the EKG however a STEMI heart attack affects a very large portion of the heart and will affect an EKG reading.
Instead of staying on-scene to stabilize me as they normally would have I was immediately rushed to the emergency department for treatment. Blood tests were performed to measure the amount of damage to the heart by looking for chemical markers in the blood.
Troponin is a protein found on the blood that relates to contraction of the heart muscle. Its level in the bloodstream are used to detect heart muscle damage. Troponin levels are normally between 0.0 and 0.10 µg/mL. On my first test the result was .98 µg/mL which showed that a massive heart attack had occurred and that extensive heart muscle damage had resulted from it.
I was rushed into the cardiac catheterization laboratory to evaluate the status of my heart, arteries and the amount of heart damage. They found that my heart had about 50% productivity right now, which means that I was only able to pump half the amount of blood that I should be pumping.
One of the arteries was completely blocked so an angioplasty was performed where they basically run a wire with a balloon on the end of it from your groin up inside your arteries until they come to your heart where the blockage is at. Then the balloon is inflated to breakup the blockage in the artery. A stent was placed in the artery to prevent it from collapsing.
The cardiologist performing the procedure also noted that a second artery had a 90% blockage in it, and a third had a 50% blockage in it. Unfortunately since one artery was completely blocked and this was an emergency procedure they could not risk performing an angioplasty on the other two arteries and I would have to come back after I healed to have them done and have two more stents put in those arteries. I was kept in the hospital for observation and had to wear an EKG transmitter so they could monitor me all the time.
On Friday the 13th I was finally released from the hospital and was glad to get back home. I had classes scheduled all week that I needed to get ready for, the first of which was the next morning when I had a class of 7 students for CPR certification. Wanting to take it easy after the heart attack I had the students carry the equipment in for the class so I did not have to exert myself, however during the class I did have some minor chest pain with sweating which was quickly relieved by placing a nitroglycerin tablet under my tongue.
The next week went about the same, a couple very minor incidents of chest pain on exertion relieved with nitroglycerin. On Friday I had a 1-on-1 class to teach and had to park farther away from the building than I would have liked (about a block). I walked to the apartment building pulling the CPR manikins behind in their wheeled case.
Upon reaching the apartment and starting the class I began to feel chest pain, felt nauseous and started sweating profusely once again. I placed a nitroglycerin tablet under my tongue and the symptoms were relieved, but came back in a few minutes so I took another one. When the symptoms started coming back again I postponed the class and called for an ambulance. Back to the hospital that I had only escaped from one week before.
3 nitroglycerin tablets later and after receiving high-flow oxygen again the symptoms left just about the time the ambulance was getting me to the hospital. After 6 hours in the Emergency Department I was sent to the Telemetry floor to wear the portable EKG transmitter once again.
The Emergency Department doctors were stumped because my Troponin levels did not rise from 0.2 like they expected which would signify another heart attack. They stated that I could take 6 to 8 hours for the levels to increase in the blood, so I would be admitted so that could continue testing me. I agreed to stay for them to run 3 more tests to verify if the Troponin levels were increasing or not. If they increased I would stay in the hospital, if they did not I would sign myself out AMA (Against Medical Advice) and go back home.
At 1:00 in the morning the results finally came back from the third test, my Troponin levels were still at 0.2 and showed no indication of any further damage to my heart. Since the Troponin levels did not rise, they could not classify this episode as a heart attack because there was no evidence of a heart attack. Since there was no indication of further damage to the heart and I already had a followup appointment scheduled for Monday with the cardiologist I kept my word and signed myself out of the hospital against their advice. I could not see any benefit of staying cooped up in the hospital all weekend when by the test results, clearly I did not have another heart attack.
It will be awhile before I am able to dive again, and I will have to limit my activities to boat dives as shore dives will be too demanding and exhausting for me, at least for now.
The breeze rustles through the palm trees as you store your gear on the boat and get everything ready for today’s dive. Once in the water you have the feeling of almost being weightless as you glide effortlessly and gracefully through the warm tropical salt water.
As you enter the open-top Sea Cave you start to watch three playful Hawaiian Monk Seals swimming overhead. As they watch you they become curious, and finally venture down from the surface to investigate.
For what seems like hours the playful seals gracefully glide past, seemingly performing an underwater ballet with you. They rub their whiskers on you to investigate you almost like a dog sniffing you. They stare inquisitively at you only inches away, cocking their heads from side to side. From time to time sipping off of the air bubbles released from your scuba system so that they can stay down longer with you. You then realize that you are one of the fortunate few that will ever have the opportunity to swim with or even see the endangered Hawaiian Monk Seals this close in person.
Scuba diving is an experience like no other. Once you become comfortable underwater, you start to feel at one with nature. On a Drift Dive, the feeling of floating where the sea takes you underwater is like no other, it is one of the most free feelings I have ever experienced.
Unfortunately living in Hawaii everyday you start to take it all for granted. You begin to just think of it as just another day like any other. You no longer notice the breeze as it gently drifts through the palms, or the slight salt mist in the air. You no longer appreciate the gentle tropical flower scents all around you.
I have lived in Hawaii for the past eleven years, and I do not know when this transformation happened to me. I did not even realize that it had happened until I started scuba diving this year. The more I dive the more I start to take notice of things again, like a veil is being lifted off of my senses. I start to appreciate again that yes, I truly do live in Paradise.
There is no better summer grilling protein than a beef steak. No matter which cut you prefer — porterhouse, ribeye, tenderloin — we have a great recipe for a go-to marinade that is inexpensive, simple to prepare, and tastes great on steaks that have been seared over an open flame.
“The grill is just a source of heat. Just like a stove, it is very user-friendly” — Bobby Flay
Remember that this is a marinade, and should be prepared well in-advance of actual cooking of the meats. Recommended marinade time is 2-12 hours.
- 1/2 Cup of Brown Sugar
Get The Ingredient We Used
- 1/3 Cup of Extra Virgin Olive Oil
Get The Ingredient We Used
- 1/4 Cup of Red Wine Vinegar
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- 1 Bunch of Green Onions (Chopped)
- 3 Cloves of Garlic (Crushed)
- 1 Teaspoon Chili Powder
- 1 Whole Bay Leaf
- Juice of 2…
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I recently found out about Meetup.com and while searching the list of local Meetup groups I came across the Honolulu Dive Club which has over 170 current members and organizes various diving events on Oahu for its members to get together.
And the best part is its FREE. I almost couldn’t believe it, a dive club that doesn’t cost anything to be a member of, and that organizes free dives for its members, what could be better than that?
I joined the group and signed up for a dive that was posted in the club which was this past Saturday morning at Makaha Caverns. When I arrived I started meeting several of the members while we got our gear ready for the dive. On this particular dive 14 members had made it for the dive. It turned out to be a great bunch of people and a lot of fun to be with.
Right away a mask strap broke and I heard one of the divers asking the other divers if they had a spare mask strap, which no one brought with them. She was just mentioning that she would have to miss the dive when I handed her one of the spares that I keep in my dive trailer – problem resolved.
At the end of the dive Tom, the Organizer of the club asked if I would become an Assistant Organizer and help them by organizing some dives for the members. Sure, since I will be diving myself anyway, I may as well post my dives for the group and see if anyone else wants to come along for the dive.
I am also a member of DiveBuddy.com so we added the Honolulu Dive Club on DiveBuddy so that other DB members can also find the dive club and join us for dives.
Date: July 13, 2013 Repetitive Dive: 1 of 1
Time In: 08:43 Time Out: 09:29 Time: :46
Dive Location: Makaha Caverns, Makaha, Hawaii
Dive Shop: N/A
Purpose: Honolulu Dive Club Event
Dive Type: Shore Environ: Ocean / Salt
Conditions: Mild Current Weight: 14lbs.
Air Temp: 82 Bottom Temp: 78.2
Max Depth: 35.2′ Average Depth: 21.0′
Safety / Decompression Stops: None
Start PSI: 3,080 End PSI: 522 Air/EANx: 21%
Exposure Protection: 3-Mil Full Wetsuit, Hood, Boots, Gloves
Equipment: 30cf Pony, iGills, Dive Light
Today was my first time diving with the Honolulu Dive Club, a group of divers that I met on Meetup. This was also my first time diving at Makaha Caverns.
Unfortunately for some reason my iGills only recorded the first part of the dive and the end of the dive and showed me at the surface for the majority of the dive. I have no idea what caused that, so I also attached a snapshot below from my Suunto Vyper Air wrist computer DM4 software that recorded the whole dive.
We did not know exactly where the caverns were, just a general idea and so we finally found the “caverns” right at the end of our dive so we only got to see a small part of it. Will have to come back for another dive now that we know how to find the spot. We did see one small Hawaiian Green Sea Turtle and some fish, but not nearly as plentiful as Sharks Cove. Saw several moray eels and one lobster.
This graphic depicts only confirmed unprovoked incidents, defined by the International Shark Attack File as “incidents where an attack on a live human by a shark occurs in its natural habitat without human provocation of the shark. Incidents involving…shark-inflicted scavenge damage to already dead humans (most often drowning victims), attacks on boats, and provoked incidents occurring in or out of the water are not considered unprovoked attacks.”
As you can clearly see from the graphic above shark incidents are clearly on the rise in Hawaiian waters on recent years, but an unprecedented 10 non-fatal shark incidents occurred in 2012 alone, more than any previous year in over three decades. 2013 started off with 3 incidents before the end of February and two of them occurring at different locations off the island of Maui on February 21st at 6:00pm.
It is not known exactly what is causing the sudden increase in shark incidents in Hawaii. Even though incidents of sharks biting people are rising they are still relatively low, averaging only 3 to 4 per year.
One factor may include changes in the weather due to seasonal changes. As you can see from the chart at the right, more incidents occur between October and December than any other time of the year.
Our activities in the water may also be a factor. Certain water activities have a higher than average number of shark incidents, like surfing and swimming as this chart shows.
One theory is that many sharks “hunt” from underneath and attack prey at the surface of the water like seals. With swimmers and surfers on the surface of the water, this makes them prime candidates for this type of hunting behavior.
But what about scuba diving? Does scuba diving lead to higher or lower shark incidents? Are diver vs. shark incidents more fatal?
According to the International Shark Attack File – a compilation of all known shark attacks that is administered by the American Elasmobranch Society and the Florida Museum of Natural History, approximately 20% of shark attacks on divers are fatalities.
This is a surprisingly high percentage when comparing it to other water activities, however the number of shark attacks on divers is extremely low compared to other water activities. One reason that more of the incidents result in fatalities could be that they happen when the diver is under water which could have lead to drowning. The diver vs. shark incident reports and statistics do not state how many of the divers died as a result of drowning because diver drowning is not asked on the ISAF reports being filed.
So, with all of this information, what can we do to make ourselves safer when diving? The Hawaii Department of Land and Natural Resources offers the following Shark Safety Tips:
- Swim, surf or dive with other people, and don’t move too far away from assistance.
- Stay out of the water at dawn, dusk and night, when some species of sharks may move inshore to feed.
- Do not enter the water if you have open wounds or are bleeding in any way. Sharks can detect blood and body fluids in extremely small concentrations.
- Avoid murky waters, harbor entrances and areas near stream mouths (especially after heavy rains), channels or steep drop-offs. These types of waters are known to be frequented by sharks.
- Do not wear high-contrast clothing or shiny jewelry. Sharks see contrast very well.
- Refrain from excessive splashing; keep pets, which swim erratically, out of the water. Sharks are known to be attracted to such activity.
- Do not enter the water if sharks are known to be present. Leave the water quickly and calmly if one is sighted. Do not provoke or harass a shark, even a small one.
- If fish or turtles start to behave erratically, leave the water. Avoid swimming near dolphins, as they are prey for some large sharks.
- Remove speared fish from the water or tow them a safe distance behind you. Do not swim near people fishing or spear fishing. Stay away from dead animals in the water.
- Swim or surf at beaches patrolled by lifeguards and follow their advice.
Remember, shark incidents involving scuba divers are extremely low. If you look at worldwide averages, of the average of 5 fatalities worldwide that happen each year, only 1 in those 5 worldwide would have been a diver (20%).
Now lets put that into some perspective. According to the National Safety Council, in 2000 alone in the United States 46,749 people died in “Transport Accidents”.
Looking at those kinds of numbers, I think I am a lot safer in the water with the sharks.
I always believed that scuba certifications from the various mainline agencies were basically all the same, just depended on which agencies name you wanted on the card. That is, until today.
I just found out that the Master Scuba Diver certification from NAUI is nowhere near the same level of training and experience as the Master Scuba Diver certification from PADI.
To achieve the PADI certification you have to have Open Water Diver, Advanced Open Water Diver, Rescue Diver, and 5 specialty diver certifications which take an additional 1 to 4 dives each to complete, and at least 50 logged dives.
For the NAUI Master Scuba Diver certification qualifications I looked it up on the NAUI website. Their course requirements are shown below, copied directly from their website:
“A minimum of eight open water dives is required. A maximum of three dives per day shall be applied toward course requirements. No more than one skin dive may count toward the eight dive minimum.
- Emergency procedures and rescue
- Deep/simulated decompression diving
- Limited visibility or night diving
- Underwater navigation
- Search and recovery – light salvage
- Skin diving
- Review of basic scuba skills
- Environmental study or survey
- Air consumption (practical application)
- Boat diving
- Shore diving
- Hunting and collecting
- Special interest
Prerequisites For Entering This Course
- Age – Minimum is 15 years.
- Diver Certification – NAUI advanced certification or the equivalent is required. The instructor is to ensure adequate student knowledge and capability before any open water training and shall use skill or other evaluations to do so.
- Equipment – Students shall furnish and be responsible for the care and maintenance of their own diving equipment. The instructor shall initially assist the student in checking all student gear to insure it is adequate and in proper working order.”
So in other words, if a NAUI Advanced Open Water Diver wants the MSD rating, he can do it in just 3 days time with only 8 more dives? Thats less than ¼ as many total dives when you add up all the various specialty class dives required by PADI.
That is a HUGE difference in diving experience between NAUI and PADI certification requirements for the Master Scuba Diver rating. I thought the PADI MSD rating was quick to get, I should have just gone for the NAUI one, I could have had it months before I earned the PADI one.
This will make me take a good hard look at the qualifications for all of the other “mainline” certification agencies out there before I choose to dive with someone from another agency again. Apparently their Rescue Diver certification only takes one dive to complete instead of three days and multiple dives.
I clearly see that all certifications are definitely NOT the same.
Date: July 9, 2013 Repetitive Dive: 2 of 2
Time In: 16:49 Time Out: 17:19 Time: :30
Dive Location: Kea’au Beach, Oahu, Hawaii
Dive Shop: N/A
Purpose: Solo Kayak Dive
Dive Type: Kayak Environ: Ocean / Salt
Conditions: Strong Current Weight: 14lbs.
Air Temp: 86 Bottom Temp: 76.4
Max Depth: 58.6′ Average Depth: 33.6′
Safety / Decompression Stops: 3 Min / 15′
Start PSI: 3,015 End PSI: 2,213 Air/EANx: 21%
Exposure Protection: 5-Mil Full Wetsuit, Hood, Boots, Gloves
Equipment: Spare Air, iGills, DPV, 2 Dive Lights
Wanted to try a new dive site today that I have been looking at for a while. Getting out to the dive spot in the kayak was a bit harry today with the surf, but I finally made it after two attempts, just before I was going to give up for the day.
Lots and lots of fish, especially Tangs, Triggerfish and Barracuda and several Hawaiian Green Sea Turtles. Inside one of the swim-throughs I saw a HUGE moray eel that must have been at least 5 or 6 foot long and fat. He definitely hasn’t missed many meals. Will have to come back and do this site again when I have more time.