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My Comeback

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.

Recovering From A Massive Heart Attack

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.

Living in Paradise

Hawaiian Monk Seals at Play

Photo by Larry Hogan, taken March 8, 2013 while we were diving at Sea Cave, Oahu, HI

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.

Summer Grilling 2013: Best Steak Marinade Recipe

International Bellhop Travel Magazine

Best Steak Marinade Recipe -- ibellhop.com

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

RECIPE:

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.

INGREDIENTS:

  • 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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Honolulu Dive Club

HDCMeetupI 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.

So now I am banging my head trying to figure out how to juggle everything that I have going, and planning future dives for the club at the same time. I am a gluten for punishment.

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.

Refer a Friend – Win 2 Tickets to Fiji

All Diving Certifications Are Not Created Equal

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.

Required Dives

  • Emergency procedures and rescue
  • Deep/simulated decompression diving
  • Limited visibility or night diving
  • Underwater navigation
  • Search and recovery – light salvage

Elective Dives

  • 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.

Possible Dive Shop Employment Opportunity

IslandDiversHawaiiI was visiting Island Divers Hawaii, the new dive shop on Schofield Barracks yesterday and while talking to the store manager he mentioned some staffing issues that they were having and that they were looking for someone part-time for weekends.

I have thought about working part-time at a dive shop to get more experience with and knowledge about the various brands of dive gear that I am currently unfamiliar with. This may be the opportunity that I have been waiting for to get just that.

If I take the job, I would be running the dive shop from 6:00 in the morning until 5:30 in the evenings every Saturday and Sunday. It will be long hours, but the work is not very difficult or stressful. Unfortunately that would prevent any weekend diving for me though.

I mentioned that I may be interested in the position, and he is going to speak with the owner about choosing me instead of the person they just hired for the position and let me know if they can make the switch or not.

Perhaps if I take the job I can persuade them one day to consider cold-filling tanks instead of the dry hot-fill method they are currently using. Yes it takes just a little more time, but there is less stress on the tanks, and the customers get perfectly filled 3,000psi tanks every time that way instead of a range anywhere from 2,600 to 3,200 that I have gotten from them in the past.

And the thought of a 30% Employee Discount on equipment purchases doesn’t hurt either.

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