The factors that are mentioned as contributing to SIPE are really common I would say among race participants. Should we not be hearing more about others racers having SIPE without total collapse? (and being able to get assistance, stop before the tipping point, etc...) But then again, how is a warm up going to prevent the issue? If it was going to happen, would it not take place anyway? Or maybe make SIPE even more likely since extremeties would get more time cooling down before the burst of more intense physical exertion?

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After millions of years of selective breeding, here we are!

Humans have what is called the mammalian reflex to cold water against the face (specifically the face). It is present in water temps up to about 69 degrees but the reflex is more severe the colder the water gets. The reflex will slow HR in humans between 10-25% when cold water hits the face. This accounts for our inability to breathe normally AND the inability to get necessary oxygen under stress of a race start without prior exposure. Imagine your HR slowing by 25% right when you need oxygen. You may see a 50% drop. Little wonder we may panic and gasp.


SOLUTION:


Just dunking your limbs will no stop the reflex. You have to submerge your face in a warm up if possible. At a minimum, throw cold water on it for a few minutes to stop the slowing of the heart. I suggest you get on the race course where possible, get your face in the water until this reaction is gone. Once it is gone start swimming and use some brisk efforts to raise your HR. Get cold water in your wettie suit so that your body can warm it up when you get out pre-race, then exit the water and wait. Five minutes is enough time on shore to warm the water in your suit, preserve core temps and still over come the reflex. On swim start you will have no or lesser reflex issues. Without the reflex you will be okay missing a breath or two early in the swim without panic attack.


Sounds like the death was not due to the reflux as the water was relatively warm.

The problem is we all start speculating as to causes, so we don't really know what to do to prevent it. There are what 4 or 5 various Alcatraz races every year plus numerous other bay swims, all with jumps into very cold water and very few incidents like this. One person died at the Alcatraz challenge a couple years back but percentage wise it's very low. So maybe cold water has less to do with it?, and it's just personal health issues?

I'm under the same impression as ChrisM. Kevin, the way you put it makes it sound like what the first human making it to Mars will have to go through during landing. I have been jumping in cold water and dashing for a long time. There needs to be way more to it than just that reflex. I get the disconfort part and even some symptoms of SIPE. But that is different than a body totally collapsing. If all my body's reflexes were that extreme I would be dead by now, times a hundred.

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After millions of years of selective breeding, here we are!

This sucks. Same thing happened 3 years ago at IMKY which is a single file jump off the dock no warm up start. They pulled a guy out right in front of us before we got in the water. He passed away. He could not have gotten more than 40 yards. The water was warm, no wetsuits allowed. I started that swim very slowly.
I always do a warmup if possible before all races. That helps me avoid that whole panic/hyperventilating feeling that sometimes I experience. One possible solution, have the start line/timing sensor 40 yards from where you jump in suspended over the water. Maybe even showers that you walk thru (if desired) before the start. I think just being wet would help.

I agree with you and ChrisM. I was just answering the question you posed about getting breathless at first exposure, not death :-)

I lifeguarded beaches in Santa Barbara County for seven years and ran into water with purpose down to 54 degrees and am still alive.

I am guessing with swim deaths at races there may be a number of underlying physical issues.

On a side note, I have had SIPE and was coughing up pink phlegm a couple times, but never from racing or at work. It was a result of swimming 25,000 to 30,000 thousand yards a week for weeks on end during training with masters squads in a pool that was 76 degrees. My two cents, two different subjects.

The water temp at my first triathlon was around 60 and the RD told everyone he wouldn't start the race until we had dunked our faces. People laughed at him but he sat their on the beach with his microphone waiting (Kenny at 3D). I raced in another one of their events a month or so later and the water was slightly warmer and he didn't have us dunk our heads. I should have learned from my first event and done so anyways. I had a panic attack in the water and almost quit. I even held onto the jet ski for awhile. After that I came home and did some research and learned about the mammalian reflex and now try to get in and get my head wet for every race I can. My big race for the year is Louisville (my first) and I'm nervous about not being able to warm up.

Thank you, Kevin. And I'm sorry if I sounded acusative. It seems like we are all here for similar reasons and maybe one way to summarize it would be: fear of death. I want to play. I want to be outdoors and fall in love with it every spring. I could even settle to dying that way. But not whenever it hits me just because it is a Saturday the 14th. I want my kids to have a dad. Why does this happen to some people? And how can we minimize the chances of it happening to us? If the medical doctors can't determine it, maybe we are the next ones in line better positioned to figure it out.

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After millions of years of selective breeding, here we are!

If you are nervous at louisville, jump off the left (most downstream) dock and head towards the island or even a bit downstream to tread water and/or warm up before joining the crowd. You'll be fine!

No problem at all, pally. I could write an entire article on sports, our fitness, health and death.


Combined they aren't linear. We do have guideposts but we are still learning. I have a hell of a story from over the course of the last year to share someday.


Which is to say I completely empathize with your comments. One thing for sure (my view), eating right, excercising and limiting alcohol work most of the time. Have fun with it!


Here's a the best blog on the planet ... it may keep you busy for weeks ===>


http://www.athletesheart.org/



Coach KP

From the studies/articles I've read on sudden death with tri's, it's usually due to cardiac and not pulmonary causes. Here's a recent expert's blog entry: http://www.athletesheart.org/...riathlon-fatalities/

Kevin P talks about the vasovagal response, which can cause syncope (passing out) and/or arrhythmias. Also, endurance athletes are more likely to have arrhythmia (hypertrophy of the heart, low resting heart rate or what ever reason). I suspect this is a more likely cause. Many things can cause this besides cold water like holding your breath, swallowing water, bearing down, etc.

Odd are still fairly low with 1/70000 participants. This reminds me a little bit of the high school kids who suddenly dies during a basketball game due to undiagnosed cardiac issues. There are some people who think high school athletes should get cardiac exam, but literature doesn't support it (low yield, very costly for something fairly rare, etc.). However, if I had family history of cardiac issues, it might be worth seeing a cardiologist.

http://www.timesfreepress.com/news/local/story/2016/may/24/brother-teachers-remember-mwho-died-ironmchat/367222/




Very interesting to find out the athlete was just that, a superb athlete.

Ironic that he's a certified first responder, life guard and scuba diver.

Then that is perfect for me. Because every race, my HR is very high before I even toe the line. Resting is low 50s. Before the race 100-110. The excitement and adrenaline is pegged.

This isn't meant to be harsh or mean to you, but NO, a bunch of internet posters, most with little to no medical background, speculating about an athlete's cause of death, are in no way shape or form qualified or positioned to figure it out. Opinions on shoes, bikes, power meters, training, etc. Sure. Even that is questionable here sometimes. We can share with each other techniques or things that make the swim start more comfortable for one another which may or may not work. We could be part of a research study of athletes in triathlons that maybe assist doctors in figure out what triggers these deaths, which may not be one single thing.

I agree though about this. This is the answers we're looking for

Here's my recommendation for no in water warm-up races. Bring a gallon of ice water with you to the race. Suit up, then dump the water over your head and inside your suit. Add some jumping jacks and arm rotations. I'm not kidding. I did this with race supplied water last year and I swear it helped ease that initial shock of hitting the water, b/c I was already wet. Just don't count on the race site having enough water for everyone to do this.

Side note - how hard is it to set up a water recirculation sprinkler system for athletes to pass through at swim start? I've seen them at some swim exits...

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To breathe, to feel, to know I'm alive.

I was thinking something similar; a big metal trough filled with ice water near the swim start so that swimmers could dunk their heads into before the swim.

"The water temp at my first triathlon was around 60 and the RD told everyone he wouldn't start the race until we had dunked our faces. People laughed at him but he sat their on the beach with his microphone waiting (Kenny at 3D)"

brilliant. good for kenny.

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Dan Empfield
aka Slowman

"I do all of my early season races with zero swim warmups. I jog and do other things to stay warm and get my heart rate up. Have never had an issue"

most everyone who's ever died in the swim in a triathlon could have written exactly what you just wrote.

there is really no good reason to argue against an in-water warm-up. that there are workarounds in lieu of a warm-up, that's fine, but you can't come back from the dead and testify about how you wish you'd have done things differently.

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Dan Empfield
aka Slowman

So sad that we lost a fellow triathlete this way. I'd say "Rest in Peace", but as much as his family stated how he loved being active, "Rest" just doesn't seem appropriate. I'll just leave it at "Peace".

I sat next to Gene on the bus to the swim start. He saw my girlfriend's Oak Barrel Half Marathon shirt and since he had done it back in April, we struck up a conversation. I did Chattanooga last year so he was asking me what to expect. He seemed to be a very personable and genuine guy.

We shook hands and parted ways when we got off the bus, he to the bathroom line and me to go join my tri team.

THAT is the BEST blog on the planet for this stuff.

I personally think Sipe is overblown. the sad reality is that many of these situations are likely undiagnosed heart ailments.(how many people go back and read a few months later what the cause of death was in these?) http://www.mensjournal.com/...letes-dying-20121203

There are many ailments that the first sign of a problem, is well, death. I was mis-diagnosed with a cardiac Ailment, hypertrophic cardiomyopathy, in 2012. I went to the doctor to get the slap on the back that all was ok. you know, "consult with your physician before participating in a strenuous exercise program." I had ZERO symptoms.

Long Story short, it took me a year, three specialists, 3 cardiac MRIs & a committment to "detrain" to figure it out. One of the catalysts to get checked out was Chris Gleason's death in the 2011? philly Mary. Guy was in excellent shape, died in mile 26 after throwing down a 10 o'something in LP that year. His wife never had a full blown autopsy done on him. His cause of death was listed as "unknown Cardiomyopathy"

For me, this was a long, arduous, emotional journey. I reached out to Dr Larry Creswell who writes the blog, and he was my guide throughout my journey. Generous guy who truly loves what he does. As an aside, he is on the Board of directors for the Ironheart foundation (which also helped me) and is the Go to guy for the USAT cardiac studies.

If you're up to it, visit (http://www.ironheartfoundation.org/...line-to-finish-line/) and donate $10 to see their movie when it releases later this year. VERY worthy cause for our sport!

just a side note...Larry Creswell used to post on the USMS forums. There was a thread on heart, swimming and nutrition issues, Larry offered some opinions, and one of the posters said something like "I manage a GNC, who the hell are you?" Larry didn't reply but someone looked it up and was like Johns Hopkins med school, residency Washington University, chief surgical resident, surgical fellowship in cardiothoracics, 11 publications in JAMA. Kind of like the classic Gary Hall Sr. post here...

You were not harsh. You were realistic. And I appreciate the approach. I'm under a different impression than you though. My professional background is not medical. I have however professional experience using data to revise concepts/models describing different types of systems. One aspect of it is the educational background with respect to the concepts/models that describe the target system. But that alone does not always suffice when looking for ways to refine it. Particualrly when you need to make use of statical data to gather more insight about the target system. Medical doctors are at a privileged position, I don't deny that. But that fact does not take us all out of the equation automatically. We not only have a lot of insight on the data that is available, our asses are on the line. We have a very fundamental interest on figuring this out and that sometimes trumps any time you may have spent flipping through bibliographic references and specialized practice. You continued on in your post to acknowledge the questions I asked as being relevant. A lot of times it is more about asking the right questions than having a lot of knowledge. Plus, if I die at a swim start and then after that you all figure out here on ST that all we need to do is to maintain salt intake level stable in the days leading to the race, then you will feel really sorry. :-)

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After millions of years of selective breeding, here we are!

After my previous post I read the news article. There I found out is not impossible for an individual to be simultaneously over educated and under prepared, even doctors. Dr. Harris seems to be as clueless as any random poster here:

"Cardiologist Dr. Kevin Harris also studied the issue and told Scientific American there are several reasons why this might be the case. The swimming portion is the first leg of the event, and the athletes' adrenaline is pumping hard. Often, the athletes competing in triathlons are stronger runners and bikers than they are swimmers — though Basir insists that wasn't the case with his brother."

Started my own search: http://www.slowtwitch.com/..._Edema_SIPE__45.html

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After millions of years of selective breeding, here we are!