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Re: Chattanooga 70.3 swim death [Slowman] [ In reply to ]
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Thanks for compiling the list of articles, Dan. Good reading.

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Larry Creswell
http://www.athletesheart.org, @athletesheart
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Re: Chattanooga 70.3 swim death [Terra-Man] [ In reply to ]
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Thinking about the numbers....

I'm aware of 109 triathlon (not other forms of multi-sport) fatalities in individual (not relay) participants since 1985 in the USA.

Over that same period, I'm aware of 13 additional participants who survived an episode of sudden cardiac arrest (SCA), including some notable swim rescues in the past couple seasons.

The survival rate for SCA at a triathlon is obviously low....but the survival rate for out-of-hospital SCA is low in any setting. At long distance running races, the survival rate is ~40%....but of course those races don't have the special challenges of water rescue.

Like you say, we can often learn a lot from "near misses." I'm hopeful that we can study what happened in this group of SCA survivors and learn things like: relevant past medical history, details of the rescue/initial treatment at the scene, and any new cardiac diagnoses and their treatment.

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Larry Creswell
http://www.athletesheart.org, @athletesheart
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Re: Chattanooga 70.3 swim death [Terra-Man] [ In reply to ]
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Terra-Man wrote:
One thing that is perplexing is that there are very few "near deaths" in our sport, swim or otherwise. I can't recall any instances where someone was pulled from the water and resuscitated successfully. And in some cases, the athlete has received very prompt attention.

I had an athlete pulled with pulmonary edema. Not sure what qualifies as near death.
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Re: Chattanooga 70.3 swim death [uclamutt] [ In reply to ]
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uclamutt wrote:
there is something about the swim itself that provokes an underlying condition.

As Larry mentioned water rescues are a big complicating factor.

If you pass out from laryngospasm on land, you will probably be OK. If you do the same in the water, probably not. Same for heart issues, if you lose consciousness face down in the water, much worse than on land.

Though you might also say that you rarely hear of someone losing consciousness during the run portion due to cardiac issues, so maybe it's something else about swimming.
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Re: Chattanooga 70.3 swim death [TriTamp] [ In reply to ]
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TriTamp wrote:
arby wrote:
The latest news reporting says that while being a great athlete he had medical issues related to high blood pressure and high cholesterol. He was taking medication and had expressed to his wife that he was concerned about the swim. It was his first race of that length. So even though he was a diver, he was concerned about a 1.2 mile swim.

not having ever done any scuba diving does that translate at all over to any sort of endurance swimming? I know it translates to not fearing water. Same with the lifeguard. Lifeguards I know go through training but does a typical lifeguard at a pool have the training for longer swims?

There is ZERO crossover from your average SCUBA class and OW swimming. I wouldn't even give you "not fearing water" based on the number of panicking SCUBA divers I rescued back in the day.

A pool LG... probably not a lot of crossover, but they typically come from a swim background and have to pass a more rigerous swim than the joke that SCUBA classes require.

Ocean Lifeguards? IME, they are fine. Varies dept to dept, but most do something on the order of a 1-2000 yard OW swim and have a reasonably fast time requirement. The logic being that to be an effective rescuer, you have to be able to actually get to the rescuee in time and said victim may be hundreds of yards or more off the beach, at times through rough conditions.. Pool guards dont have this issue.
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Re: Chattanooga 70.3 swim death [TriTamp] [ In reply to ]
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TriTamp wrote:
arby wrote:
The latest news reporting says that while being a great athlete he had medical issues related to high blood pressure and high cholesterol. He was taking medication and had expressed to his wife that he was concerned about the swim. It was his first race of that length. So even though he was a diver, he was concerned about a 1.2 mile swim.


not having ever done any scuba diving does that translate at all over to any sort of endurance swimming? I know it translates to not fearing water. Same with the lifeguard. Lifeguards I know go through training but does a typical lifeguard at a pool have the training for longer swims?

pool guard only needs to do 300yd to pass the test... 100 yd front crawl, 100 breast, 100 free , and not that fast. open water guards for ocean have stricter standards, basic is 500m in 10 minutes then only top 10% time finishers are selected.
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Re: Chattanooga 70.3 swim death [ChrisM] [ In reply to ]
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I was one of the first to voice my concern of no swim warm up at Florida. 70.3 last year. This year they had a pool open at the park to use in the morning and you could do a short warm up before your wave start. 100 percent better. For me I need to get my face in the water and stroke a little. Nothing on land helps with swim start
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Re: Chattanooga 70.3 swim death [Kevin in MD] [ In reply to ]
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After researching for a few days, I think I have learned a few things. Instead of a long post, I'm only sharing key points and references here. It goes without saying, I would be more than interested in any critical feedback.


Key points:


1) The cause of death is not fundamentally a "need to warm up" or SIPE.
2) The reason is a psychosomatic mechanism that eventually leads to fatality during stressful moments or developments.
3) Social isolation: There are several reasons that lead us to first start in running/cycling, among them is that we feel isolated. It is something that may not even be our fault or associated with a personal decision. The main point is that it is something common among endurance athletes. And let's be honest, it does not really get any better after you join a tri club.
4) Self-inflicted mental/physical stress: We all have been asked "why do you do triathlons?", "do you get a prize?", "do you win races?", "if it is such a personal/financial investment, what is the reward?" We need to accept what those questions contain with a bit more care. There is something to them that is realistic and basic. There is something that individually justifies what we do, yes, but yet, it does inflict a lot on us mentally, physically, and socially.
5) Long term development/build-up leading to a moment of self-perceived high stress: That would be one way to describe a 16-week training plan and the start of the event. Isn't it?
6) Cognitive belief that death is near is not sufficient, nor necessary: It happens beyond our control. Insects, fish, mammals, all demonstrate similar mechanisms. None know from fact they will die, by definition. When a race starts, rationally, we know we will not necessarily go through a painful process that will invariably lead to death. It is not about what we think.


We die because we scare ourselves to death. The wetsuit, the open water, the crowd, the physical contact, the mammalian reflex, the stress of training and looming "judgement day", each one by itself is not necessarily capable of triggering a sudden death. But together they can. And do, for some of us.


How can we minimize the chances of it happening to us?


References:


a) Influence of social isolation: http://www.ncbi.nlm.nih.gov/...239448?dopt=Abstract
b) Influence of self-perceived psychological stress: http://www.ajconline.org/...(91)90189-R/abstract
c) Cerebral cortical hyperactivation in response to mental stress: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27794/
d) Influence of psychological stress on timing of death: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC61045/
e) Death of former Enron CEO, Kenneth Lay, could have been the result of fear of a looming prison sentence according to Dr. Samuels: https://en.wikipedia.org/wiki/Martin_A._Samuels
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Re: Chattanooga 70.3 swim death [TriTamp] [ In reply to ]
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TriTamp wrote:
Would a light jog on dry land be as beneficial as in water warmup? Or at least have some benefit?

Even worse in some respects - you're warming up the body further, only to jump into cold water, so the 'shock' of temperature differential is even greater.

29 years and counting
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Re: Chattanooga 70.3 swim death [Jorgan] [ In reply to ]
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Jorgan wrote:
TriTamp wrote:
Would a light jog on dry land be as beneficial as in water warmup? Or at least have some benefit?

Even worse in some respects - you're warming up the body further, only to jump into cold water, so the 'shock' of temperature differential is even greater.

Please take ten minutes to read this:
https://en.m.wikipedia.org/wiki/Finnish_sauna


After millions of years of selective breeding, here we are!
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Re: Chattanooga 70.3 swim death [Irix] [ In reply to ]
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Granted. But how many habitual Sauna users are doing Triathlons?

We once went on a run in late October which involved jumping into a river at various points. After about 25 min running we do the first jump in. I swear I haven't panicked like that once in a tri; I could hardly breathe. It got easier the more we did it... a bit like saunas :)

29 years and counting
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Re: Chattanooga 70.3 swim death [Jorgan] [ In reply to ]
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Jorgan wrote:
Granted. But how many habitual Sauna users are doing Triathlons?


Not that many I suppose. But I think we are taking different approaches to this. Here is one way to look at this: imagine we are actually trying to commit suicide by triggering that mechanism. How can we be most effective?

I think the Finnish have proven with a very large data set that getting your body/core overheated and immediately jumping into a freezing lake (literally), is not going to be a very effective suicide method.

On the other hand, knowing that the brain makes use of the heart to deliver the fatal blow, we would want to make our heart as STRONG as possible before our suicide attempt, so the brain can most effectively do its job. Considering how strong our endurance athletes' hearts are, it would not be surprising to find pulmonary edema after the fact.

Think the brain takes over and from then on it is its job to kill the body. Whatever triggers that in the brain is what one would want to do in such a suicide attempt. And I'm arguing that Finnish sauna/freezing bath, habitual or not, cannot be an effective way to trigger it. That's because I believe the Finish would have found evidence of that by now.
Last edited by: Irix: May 26, 16 14:44
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Re: Chattanooga 70.3 swim death [Irix] [ In reply to ]
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We die because we scare ourselves to death. The wetsuit, the open water, the crowd, the physical contact, the mammalian reflex, the stress of training and looming "judgement day", each one by itself is not necessarily capable of triggering a sudden death. But together they can. And do, for some of us.



So dead on. To coin a phrase.
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