Login required to started new threads

Login required to post replies

I almost drown-my search for what happened.
Quote | Reply
I have been hesitant to post this but there is alot of non medical opinions posted lately. I had a close call in the Heat Wave Triathlon back on June 2,2012. Heat Wave swim was a half mile in calm water but on that morning was wet suit legal. I chose not to swim in a wet suit because after 30 years of doing triathlons I still can't strip that thing off very fast. Heat Wave is now a time trial start. I signed up late and they were seeding per sign up date. That may of been lucky. I wasn't overly excited at start but was going to do a medium to hard effort to start. I was about 4 min into swim when I felt WOW I don't feel very good. I slowed down to kinda get my composer. I was breathing really hard but heart rate wasn't sky high. I looked at my watch to see if i had gone out too hard and I was where I wanted to be at turn around. I was still near a training partner. At this point I was gasping pretty hard. I thought about quiting because i really wasn't feeling very good but thought I'll get out of the water and figure out what the heck is going on. Right after turn to head to shore kayaker hears me wheezing and ask if I'm ok. I say NO. I thought to my self just finish the swim. BAD call. I started to breast stoke to be able to breath more air. I would guess with about 100 yard to go I was thrashing pretty hard. Enough that friends on shore were worried. I was cramping and lost my legs. It took a huge effort just to get to shore. I had people meeting me in the water. My head was blue and I couldn't stand without help. The race director and i swam together at the early morning Memphis State(Dick Fagen) swims so he knew I swim. Wyndell Robertson came up to me at was trying to talk to me. I couldn't talk much but was telling him I couldn't breath and was crampimg. I was really blue at this point. Wyndell later told me he thought I was having a heart attack. I was being held by my arm but things were getty really fuzzy. I was now by my bike. But thats all I remmember. I went lights out. Fell on ground. I woke up a couple of minutes later with a Emt over me with a mask on me. I was gasping still. I could not breathe. I had really good EMT's according to all the doctors I've talked to. I'm pretty fuzzy but what ever they did had me breathing better within the hour. I was sitting up. I refused the trip to the hospital. Wyndell was worried and made me promise(as a friend) I was going to see a doctor..I had friends calling that afternoon asking what the heck that was about. Monday morning my doctor(Dr David Wheat) sees me early just to make sure it wasn't a heart issue. I'm asking him about SIPE and he rules it out almost before I can say it. He after checking me out is pretty sure I had a exercise induced asthma attack. I have no history of anything like this. Dr Wheat tells me not to do anything till I get a stress test done. I go to Jackson Heart Clinic and Dr Flecher test me and tells me I'm in really good shape. He is happy both cholestorols are good. I have a had people in the medical community telling me that US old guys(I'm 52) are pushing our bodies past our limits. I ask him point blank if he feels that is what happened and did my heart show any damage. He told me after looking at test results that whatever we are doing is good for our hearts. He is thinking Dr Wheat is right about what happened. I'm asking everyone i can get my hands on what the heck caused this. I have talked to people at Miss Dept of Air Quality and they said that day was a good day except for some Pecan pollen(not a good one I understand). I'm not sure if any of the recent deaths are Asthma related but the more medical people I speak to the more they have stories of well trained athletes having asthma attacks. There seems to be some connection to swimmimg but no one has tied these together yet. If any Asthmatics have any known trigger points(ie pecan pollen) It might help me understand what happened. I don't want to do that again. I was probably pretty close to drowning. If i had passed out in the water I might have been a triathlon death with no known reason.
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
Couldn't read your post. Paragraphs are your friends.






Take a short break from ST and read my blog:
http://tri-banter.blogspot.com/
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
Fesh water lake? I wonder if it was pollen or other allergen in the water, may not correspond to "air quality". I can't swim in lakes without getting terribly congested, though for me, it doesn't show up until hours later. I use a nose clip, i don't know if it would help in your situation. If recreational swimming is allowed at that lake could you try a quick swim and see if you get a reaction?
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
If your doctor told you it was exercise induced asthma attack, that's prolly what it was.
The question arises, how commom is this and will it happen again?
You'd better do a bit of research about this before your next race

res, non verba
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
Thank you for the post. Did your Doctor prescribe anything for the exercise induced asthma?

I believe many competitive swimmers have this issue.
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
Sorry to hear of your episode, must have been scary for sure. Like the other poster I have to use a nose-clip when swimming in one particular lake, (but not others) due to the symptoms I will suffer post swim, but not during. The only time I have come close to passing out was due to a combination of de-hydration, swimming in that lake and also having completely blocked sinuses, which they thought could have led to an increased blood pressure. Could that have been a contributing factor also?

I realize these statements were from different people, but you might want to clarify with the doctor:

Quote:
telling me that US old guys(I'm 52) are pushing our bodies past our limits

Quote:

whatever we are doing is good for our hearts

Hope you find resolution.
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
Thanks for your post ... maybe it will encourage others to share similar experiences. You had an episode that could have been fatal easily enough with a drowning .... but you were resuscitated and evaluated and a presumed diagnosis made.
I personally think events like you had are the key to understanding why others died .... they obviously can't tell us what exactly happened to them and their autopsy may not be conclusive either.
Hopefully Slowman is keeping these survived episodes for his data base about swim deaths.

Dave
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
i have been recently plagued with asthma since the age of 40. I can swim at the pool and occasionally my asthma will flare up within the first 500 yds or so. I get a panicky/shortness of breath/cold sweat. Treated with a inhaler, it usually subsides within a few minutes. Thanks for the post, I am scheduled for another IM this year, I think I need to come up with a way to carry my inhaler on the swim! Your post is pretty spot on, when the wheezing truly starts your aerobic ability is probably 10% and you could get into trouble very quickly. Think I will have a inhaler with me and start my swim way wide so I can get assistance from boat if my asthma starts up.
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
Welcome to the club, exercised induced asthma is pretty common, you were lucky that your 1st episode(you may have had others and not realized them) did not kill you. Asthma is one of those things that is really not understood as to causes, but there are a lot of them and it varies with individuals. I got my 1st attack in my early 30's, and it continued until i moved to a desert environment. Mine got really bad at times, and i was on 2 different medications. At times i could not sleep at nite as it progressed into more than exercise induced. At 46 i moved to a dry clean climate and it all went away. I have since been drug free and the only episodes are when i stay in old hotel rooms for more than a few days. I suspect it is the carpets, so my entire houses are all tiled these days.

I have heard that some factors in adult onset asthma are where you grew up as a kid. Smoggy areas and household smokers were the two big ones, and i had both of those in spades. LA in my younger days used to close down due to smog, and you could barley breath outside and it hurt. Both my parents smoked until i was 8 too, so double whammy for me..

I suggest you get a rescue medication and carry it with you at all times during races. Slowman's ex wife was a top pro that won iron mans, and more than once she was pulled from swims just like you were. She then attached the medication to her wrist in the water just in case. Once you lungs start to close down, it can get ugly very quickly, especially like in your situation where you don't know it is an asthma attack. Now you know, make some changes. Don't assume this was a one off.
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
Do you remember why he ruled out swimming induced pulmonary edema?

Did he know about that condition? I hate to monday morning quarterback the thing, but you can see in the post from klauthp in a separate thread that she was with the pulmonary specialists at Johns Hopkins and they didn't put it together either.
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
just, for my own edification and as a data point, can you describe what sort of warm up you might have done prior to the start of the swim?

Dan Empfield
aka Slowman
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
I live in Jackson and missed the Heatwave race this year because I had to work.

I'm a heart surgeon at UMC, I have an interest in the broad issue of triathlon race-related safety, and I've been involved with USAT recently in its effort to understand the causes of swimmer distress during races. I'd love to learn more about what happened to you.

I'd buy lunch if we could get together to talk about it. Send me a private message or email me at lcreswell@umc.edu.

Larry Creswell
http://www.athletesheart.org, @athletesheart
Quote Reply
Re: I almost drown-my search for what happened. [Tri-Banter] [ In reply to ]
Quote | Reply
Tri-Banter wrote:
Couldn't read your post. Paragraphs are your friends.


+1
Quote Reply
Re: I almost drown-my search for what happened. [Carl L] [ In reply to ]
Quote | Reply
Carl L wrote:
Tri-Banter wrote:
Couldn't read your post. Paragraphs are your friends.


+1

+2
Quote Reply
Re: I almost drown-my search for what happened. [matto] [ In reply to ]
Quote | Reply
matto wrote:
Carl L wrote:
Tri-Banter wrote:
Couldn't read your post. Paragraphs are your friends.


+1


+2

For Christ's sake you two, surely the subject matter is more important than your pedantic whining.

I'm the biggest grammar Nazi around, but sometimes you just have to let it go.
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
That post sounds familiar. Except in my case it didn't go quit that far. I had entered the water for a Sprint Tri, only 650m or so. Did real fast 1 minute warm up, dunked my head etc. the klaxon went off and I started swimming. I am a slow swimmer at the best of times but stayed with the back of the pack for about 250m, then my breathing went to shit. Like you, couldn't catch my breath, and started wheezing. This was my first wet suit swim so I wasn't sure what was going on. I finished the swim DFL. I walked to T1, left on my bike but still couldn't get air in. Finally, 2nd from DFL, I get to T2, change and start to run. Have to stop and walk. As soon as my HR hits about 130 I am gasping for air and have to go back to a slow walk. I finished the Tri.

Went to the doc and they were concerned about Heart. But, I figured Asthma (I've had some experience with the disease before). So, got an inhaler which I now use before wetsuit swimming and at start of all Tris.

I now also warm up for 5 minutes or so with a gentle jog ro "wake up" my Heart and body before the Tri starts.

I'm not sure what my trigger points are for the attack at this time though.

Good luck.

BC Don
Pain is temporary, not giving it your all lasts all Winter.
Quote Reply
Re: I almost drown-my search for what happened. [TNFeDad] [ In reply to ]
Quote | Reply
I think I need to come up with a way to carry my inhaler on the swim!

I always take a shot or two of my inhaler before the race starts.

Quote Reply
Re: I almost drown-my search for what happened. [Tri-Banter] [ In reply to ]
Quote | Reply
I'm old have poor vision and I could read it. If you can't get eyes checked my bet is it has something to do with being very low on the nice scale or high on the ass-hole scale get that checked
Quote Reply
Re: I almost drown-my search for what happened. [RoYe] [ In reply to ]
Quote | Reply
RoYe wrote:
If your doctor told you it was exercise induced asthma attack, that's prolly what it was.
The question arises, how commom is this and will it happen again?
You'd better do a bit of research about this before your next race


I have been diagnosed with exercise induced asthma also.

At first, my doc gave me a Ventolin inhaler to use when exercising. A couple of weeks ago, I went back to report that Ventolin was primo and could I get more, as I'd run out. She was aghast! She said, only use it when you're exercising. I explained that I'm a trigeek and I cycle commute to work, so was taking it 3-4 times a day! She immediately reached for her prescription pad and prescribed a preventer and told me only to use the ventolin sparingly.

I use Seretide twice a day, and ventolin sparingly (ie hardly ever), and I can now breathe when I excercise, and focus on the suffering, not the all encompassing need to get just one more breath before I die! :-)

TriDork

"Happiness is a myth. All you can hope for is to get laid once in a while, drunk once in a while and to eat chocolate every day"
Quote Reply
Re: I almost drown-my search for what happened. [dennis] [ In reply to ]
Quote | Reply
dennis wrote:
I'm old have poor vision and I could read it. If you can't get eyes checked my bet is it has something to do with being very low on the nice scale or high on the ass-hole scale get that checked

Possibly a little bit of both. Or, that I just didn't have the patience to plunder line by line of the post. I read most every post on ST involving swimming and tri-deaths (for some reason, I'm interested). I couldn't get through this one. I admit that many people are better than me, yourself including. However, I suspect that had the OP done some better formatting, there would be a higher level of interest in people in terms of both reading and responding to the issue.






Take a short break from ST and read my blog:
http://tri-banter.blogspot.com/
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
Quote:
I have been hesitant to post this but there is alot of non medical opinions posted lately. I had a close call in the Heat Wave Triathlon back on June 2,2012. Heat Wave swim was a half mile in calm water but on that morning was wet suit legal. I chose not to swim in a wet suit because after 30 years of doing triathlons I still can't strip that thing off very fast. Heat Wave is now a time trial start. I signed up late and they were seeding per sign up date. That may have been lucky.

I wasn't overly excited at start but was going to do a medium to hard effort to start. I was about 4 min into swim when I felt WOW I don't feel very good. I slowed down to kinda get my composure. I was breathing really hard but heart rate wasn't sky high. I looked at my watch to see if i had gone out too hard and I was where I wanted to be at turn around. I was still near a training partner. At this point I was gasping pretty hard. I thought about quitting because i really wasn't feeling very good but thought I'll get out of the water and figure out what the heck is going on. Right after turn to head to shore kayaker hears me wheezing and ask if I'm ok. I say "NO".

I thought to my self "just finish the swim". BAD call. I started to breast stoke to be able to breath more air. I would guess with about 100 yard to go I was thrashing pretty hard. Enough that friends on shore were worried. I was cramping and lost my legs. It took a huge effort just to get to shore. I had people meeting me in the water. My head was blue and I couldn't stand without help. The race director and i swam together at the early morning Memphis State(Dick Fagen) swims so he knew I swim. Wyndell Robertson came up to me and was trying to talk to me. I couldn't talk much but was telling him I couldn't breathe and was cramping. I was really blue at this point. Wyndell later told me he thought I was having a heart attack. I was being held by my arm but things were getting really fuzzy. I was now by my bike. But that's all I remmember. I went lights out. Fell on ground.

I woke up a couple of minutes later with a Emt over me with a mask on me. I was gasping still. I could not breathe. I had really good EMT's according to all the doctors I've talked to. I'm pretty fuzzy but what ever they did had me breathing better within the hour. I was sitting up. I refused the trip to the hospital. Wyndell was worried and made me promise(as a friend) I was going to see a doctor. I had friends calling that afternoon asking what the heck that was about.

Monday morning my doctor(Dr David Wheat) sees me early just to make sure it wasn't a heart issue. I'm asking him about SIPE and he rules it out almost before I can say it. He after checking me out is pretty sure I had a exercise induced asthma attack. I have no history of anything like this. Dr Wheat tells me not to do anything till I get a stress test done. I go to Jackson Heart Clinic and Dr Flecher test me and tells me I'm in really good shape. He is happy both cholestorols are good. I have a had people in the medical community telling me that US old guys(I'm 52) are pushing our bodies past our limits. I ask him point blank if he feels that is what happened and did my heart show any damage. He told me after looking at test results that whatever we are doing is good for our hearts. He is thinking Dr Wheat is right about what happened. I'm asking everyone i can get my hands on what the heck caused this. I have talked to people at Miss Dept of Air Quality and they said that day was a good day except for some Pecan pollen(not a good one I understand).

I'm not sure if any of the recent deaths are Asthma related but the more medical people I speak to the more they have stories of well trained athletes having asthma attacks. There seems to be some connection to swimming but no one has tied these together yet. If any Asthmatics have any known trigger points(ie pecan pollen) it might help me understand what happened. I don't want to do that again. I was probably pretty close to drowning. If i had passed out in the water I might have been a triathlon death with no known reason.

I threw in some random paragraphs to appease the clowns who can't read without them. OP, thanks for posting this. It is an interesting insight and I'm glad you are still around to post it.
Quote Reply
Re: I almost drown-my search for what happened. [bazilbrush] [ In reply to ]
Quote | Reply
Well it looks like the punctuation police busted me. I just banged my story out really quickly this morning. i don't know about some of you but if I don't tell stories like this it starts to look like a sales report. I think Dan had ask about my warm up. I have always warmed up pretty much the same way for years. I get the bike out of the car and go for about a twenty minute ride with two hard sixty second efforts to get heart rate up. I let my heart rate come down while I'm putting everything in transition. I then try to go for about a twenty minute run. I try to get my heart rate up for about five minutes of the twenty. The morning of Heat Wave I was cutting it pretty close since I knew I was going late due to signing up late. I wasn't nervous and was pretty excited because it was a cool morning. Looking back maybe if I had swam some the day may have been uneventful.
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
Wow glad you are okay. I've not had anything like this happen but I do have a post exercise annoying wheezy cough - usually after running. Numerous trips to the doctor and yes exercise induced asthma - l have Ventolin which I take after a long run to stop the coughing but I don't think the dr realised the extent of my exercise regime - I think I need to go back for a preventer.

This has never happened to me in a swim nor on the bike seems to be run related and I wonder if it is also pollen or pollutants that contribute too. I'll probably never know but reading this has inspired me to get back to the doc for the preventer before the ows season starts here in Melbourne
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
After reading your post I would suggest you see another doctor - if possible a specialist. IMHO, this doesn't sound like exercise induced asthma to me. See if you can find a good cardiologist.

The only other thing I could think of is perhaps something heat related (heat exhaustion)? Even if the swim was under 78 degrees, a warm and muggy morning can make swimming hard with a swim cap very difficult.
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
oh cool ... did you type out the rosetta stone ?
Last edited by: lacticturkey: Aug 23, 12 5:34
Quote Reply
Re: I almost drown-my search for what happened. [dennis] [ In reply to ]
Quote | Reply
dennis wrote:
I'm old have poor vision and I could read it. If you can't get eyes checked my bet is it has something to do with being very low on the nice scale or high on the ass-hole scale get that checked

lol, good one
Quote Reply
Re: I almost drown-my search for what happened. [Rambler] [ In reply to ]
Quote | Reply
Rambler wrote:
Fesh water lake? I wonder if it was pollen or other allergen in the water, may not correspond to "air quality". I can't swim in lakes without getting terribly congested, though for me, it doesn't show up until hours later. I use a nose clip, i don't know if it would help in your situation. If recreational swimming is allowed at that lake could you try a quick swim and see if you get a reaction?

Huh, this happens to me too. After OWS I end up with a congested nose and often that evening when I go to bed I need some nasal spray to be able to sleep. I never have even thought deeply about what it all meant.

I breathe out my nose when swimming, so to use a nose clip I'd have to change my breathing habit. Does a nose clip really work though? I mean, can't whatever is causing it get in via the mouth anyway?
Quote Reply
Re: I almost drown-my search for what happened. [squid] [ In reply to ]
Quote | Reply
squid wrote:
I think I need to come up with a way to carry my inhaler on the swim!

I always take a shot or two of my inhaler before the race starts.

I take a hit before the swim start as well, but I have also had episodes throughout the swim. I usually just roll over on my back and kick, which keeps me moving forward, while I try to focus on getting my heart rate down (and, you know, getting air in.) It can get a little scary on occasion, but I've always been able to keep going.

More than anything I try to get a good warmup before the race. Most of the time when I have breathing issues it's because I either wasn't able to get in a good warmup, or due to colder water. If a swim warmup space isn't available and I have to go for a run, it doesn't help as much as being able to acclimate and swim easy for a bit before the start.

If anyone knows of a way to carry the inhaler during the swim as keep it dry and accessible, I'd love to hear your suggestions. It's too...angular to go in the cap.
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
my question is, then, did you do no warm up at all? i'm not judging you. i'm just asking you. just as a data point.

Dan Empfield
aka Slowman
Quote Reply
Re: I almost drown-my search for what happened. [Slowman] [ In reply to ]
Quote | Reply
It looks like he did a bike and run war up but no swim. Cold water, but no wetsuit has triggered my EIA symptoms before after staying in an environment that aggravated my allergies (i.e Dogs), same with extremely hot water. It seems like a shock to the system either way. (cold: <65, hot: >85)

__________________________

I tweet!

Quote Reply
Re: I almost drown-my search for what happened. [ZackC.] [ In reply to ]
Quote | Reply
"It looks like he did a bike and run war up but no swim"

i'm not reading it that way. what you note is what he typically does. but not necessarily what he did for this race, because he was running late. lord knows that happens to all of us. sometimes i've raced with little or no warm up because i just ran out of time. so i'm wondering what happened on this particular day.


Dan Empfield
aka Slowman
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
This happened to me and I totally 100% understand what you said.

I carry a Pro-Air inhaler with me on the bike and run, but I use it to pre-medicate prior to swimming in races. I also use QVAR as a preventative during allergy season.
Quote Reply
Re: I almost drown-my search for what happened. [downesy] [ In reply to ]
Quote | Reply
downesy wrote:
matto wrote:
Carl L wrote:
Tri-Banter wrote:
Couldn't read your post. Paragraphs are your friends.


+1


+2


For Christ's sake you two, surely the subject matter is more important than your pedantic whining.

I'm the biggest grammar Nazi around, but sometimes you just have to let it go.

+1
Quote Reply
Re: I almost drown-my search for what happened. [Slowman] [ In reply to ]
Quote | Reply
Slowman wrote:
"It looks like he did a bike and run war up but no swim"

i'm not reading it that way. what you note is what he typically does. but not necessarily what he did for this race, because he was running late. lord knows that happens to all of us. sometimes i've raced with little or no warm up because i just ran out of time. so i'm wondering what happened on this particular day.
_____

I'm comfortable that Larry Creswell and his associates will work through all this ..... but now look at all the people who are taking beta agonist asthma inhalers before races and even on long acting beta agonists (serevent). These are known to be arrhythmogenic and associated with sudden cardiac death .... thats in addition to the breathing issues. FACTS will come out and I suspect there are a lot of cases like this persons that are available through race records and even a number like this already on ST ..... we had the neurosurgeon associated with a water save earlier. It will get interesting.

DAve
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
Not sure if this fits, but it's often misdiagnosed as exercise-induced asthma. It's called Vocal Cord Dysfunction: http://www.nationaljewish.org/...info/conditions/vcd/
Quote Reply
Re: I almost drown-my search for what happened. [dcsxtri10] [ In reply to ]
Quote | Reply
dcsxtri10 wrote:
Slowman wrote:
"It looks like he did a bike and run war up but no swim"

i'm not reading it that way. what you note is what he typically does. but not necessarily what he did for this race, because he was running late. lord knows that happens to all of us. sometimes i've raced with little or no warm up because i just ran out of time. so i'm wondering what happened on this particular day.

_____

I'm comfortable that Larry Creswell and his associates will work through all this ..... but now look at all the people who are taking beta agonist asthma inhalers before races and even on long acting beta agonists (serevent). These are known to be arrhythmogenic and associated with sudden cardiac death .... thats in addition to the breathing issues. FACTS will come out and I suspect there are a lot of cases like this persons that are available through race records and even a number like this already on ST ..... we had the neurosurgeon associated with a water save earlier. It will get interesting.

DAve
My asthma attack in the water occurred out of the blue. I did a short swim warm up, I am MOP typically but that day I was DFL and backstroked almost the entire leg. I was fortunate to have the Pro Air at the bike and hit the inhaler in T1. I had to take it again at the finish because I was wheezing again after the run (thank you Southern heat and humidity).

The increase in heart rate is why I take QVAR and not the combination products. I think if more people were put on the preventatives earlier into this cycle instead of handed the rescue inhalers, it might be a different data point. They make neoprene holders for inhalers that have little clips on them. We had a kiddo at the school where I was the nurse for years prior to the career change that had one.

Slightly OT,
I have worked with parents and primary care MD's over the years to help them with getting athletes on preventatives and not just hand them the rescue inhalers to use as a pre-med. I have been able to cut back on the Pro-Air from three times a week when I swim regularly, to only on race days when it is going to be hot and humid. Asthma education for the providers and parents/athletes is key and can have a lifelong impact. Some MD's are great with this and others are not.
Quote Reply
Re: I almost drown-my search for what happened. [Kevin in MD] [ In reply to ]
Quote | Reply
Ditto Kevin in MD's question. Was wheezing your only symptom? Any coughing? did you experience any wheezing during exercise in days just before this event?

Kevin in MD wrote:
Do you remember why he ruled out swimming induced pulmonary edema?

Did he know about that condition? I hate to monday morning quarterback the thing, but you can see in the post from klauthp in a separate thread that she was with the pulmonary specialists at Johns Hopkins and they didn't put it together either.
Quote Reply
Re: I almost drown-my search for what happened. [chemsmith] [ In reply to ]
Quote | Reply
My sinuses have gotten pretty sensitive these days. I use a nose clip almost all the time including in the pool. It was a little weird to start with. The worst for me was in between hard intervals when I find myself pulling it off because I feel like I can't get enough air. Never an issue at race pace. The nose clip does not completely eliminate the congestion but it helps. I think some of the allergens/ irritants may even be absorbed through the skin.
Quote Reply
Re: I almost drown-my search for what happened. [Rambler] [ In reply to ]
Quote | Reply
I say, "Don't Try This At Home!"

In other words, during the OWS, it's important to get in as much oxygen as possible. Using a nose clip would just impede your swim and ability to get air.
Quote Reply
Re: I almost drown-my search for what happened. [TriBeer] [ In reply to ]
Quote | Reply
Practice. Don't try anything new on race day. Really, it's not a problem for me.
Quote Reply
Re: I almost drown-my search for what happened. [Rambler] [ In reply to ]
Quote | Reply
Rambler wrote:
My sinuses have gotten pretty sensitive these days. I use a nose clip almost all the time including in the pool. It was a little weird to start with. The worst for me was in between hard intervals when I find myself pulling it off because I feel like I can't get enough air. Never an issue at race pace. The nose clip does not completely eliminate the congestion but it helps. I think some of the allergens/ irritants may even be absorbed through the skin.

Interesting. And yes even the pool can cause nasal problems (again, later in the day), if I do a longer swim in it. At the very least, I'm glad to know it's not just me.
Quote Reply
Re: I almost drown-my search for what happened. [Rambler] [ In reply to ]
Quote | Reply
I'm glad it works for you. I just like to keep the swim simple and I think the most important thing: Get in as much oxygen as possible, breathe at the start; breathe in the middle; breathe in between the middle & middle; and breathe at the end of the swim. I also breathe through my mouth and nose, so that nose clip would hurt my swim strategy.

Thank you for sharing.
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
I thought you might find this story interesting (see below). Bill Weaver told his story on ST last year (I'm sure a search could find it), but he basically died during the Kansas City Triathlon in 2011, but was revived at a local hospital. St. Luke's has been running this commercial in the local TV stations. Pretty amazing story. His son is a regular poster on ST and is a very good triathlete.

https://www.saintlukeshealthsystem.org/bill

John Snyder @URNotAsCoolAsMe
Quote Reply
Re: I almost drown-my search for what happened. [BCDon] [ In reply to ]
Quote | Reply
" . . .I am a slow swimmer at the best of times but stayed with the back of the pack for about 250m, then my breathing went to shit. Like you, couldn't catch my breath, and started wheezing."

At this point in the swim, did you worry about breathe control?

When you do take a breathe, is it short & quick or are you deep breathing?
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
"I wasn't overly excited at start but was going to do a medium to hard effort to start. I was about 4 min into swim when I felt WOW I don't feel very good."


Again, thank you for sharing, but I'd like to know if you worry about breathe control in a race. Roughly, how often did you take a breathe in this first 4 minutes of the swim? Did you keep you head down and not breathe at the start?
Quote Reply
Re: I almost drown-my search for what happened. [dcsxtri10] [ In reply to ]
Quote | Reply
And how many of them are using ventoline and co. without proper asthma testing...Breathing is off? No worries, 2 inhalations of ventoline
and I'm good to go...
Quote Reply
Re: I almost drown-my search for what happened. [Snyderman] [ In reply to ]
Quote | Reply
Personally I don't think this phenomena is due to allergies or points to any diagnosable medical condition. It almost mimics the taser-related deaths I've read about.

The human body is kind of a low-tech control system - body temperature, heart rate, blood flow, cranial pressure and temperature, oxygen demand & transport and so on. The brain uses temperature, pressure & demand to control blood flow to the skull space. So if the face/skull sees high temp, high pressure or the muscles are taking oxygen, flow to the brain is lowered. This is why people lose conciousness due to overheating, or say late in a game like hockey start to lose cognitive ability.

So you take an older person, not only exerting in water but racing which causes over-extension of resources/capacity. The water environment also invokes instinctive reflexes (ie the mammalian diving reflex, respiratory & survival reflexes). I think it's this mix & shortness of breath that puts people at risk. If you were to hang onto something like a life ring, or stop and stand then there can be a recovery.


I used to be able to swim quite the distance underwater. Not so anymore all that breath reserve is gone (age 52) . I would like to get it back.


Training Tweets: https://twitter.com/Jagersport_com
FM Sports: http://fluidmotionsports.com
Last edited by: SharkFM: Aug 23, 12 11:54
Quote Reply
Re: I almost drown-my search for what happened. [SharkFM] [ In reply to ]
Quote | Reply
"So you take an older person, not only exerting in water but racing which causes over-extension of resources/capacity. The water environment also invokes instinctive reflexes (ie the mammalian diving reflex, respiratory & survival reflexes). I think it's this mix & shortness of breath that puts people at risk. If you were to hang onto something like a life ring, or stop and stand then there can be a recovery."

Combine the above with the older swimmer holding their breathe at the beginning of the race, so they can get out front or taking shallow breathes or using breathe control, i.e., trying to breathe every three or five strokes. This puts the racer in oxygen debt.

I say take deep breathes whenever you can in an OWS and don't worry about keeping your head down for speed. Breathe every other stroke for pacing. Let your arms do all the work and use your legs for balance, not power.



Last edited by: TriBeer: Aug 23, 12 13:26
Quote Reply
Re: I almost drown-my search for what happened. [TriBeer] [ In reply to ]
Quote | Reply
For the record, I'm one of the sensitive people to allergens in the water/air as well. My sinuses go crazy in almost any/all OWS. It's manageable as long as I'm moving, but if I stop (even to pause for the group to gather at the turnaround buoy of our practice swims) I start sneezing like crazy. I can usually start swimming again & clear it out again, but once we get back to the dock I'll start sneezing again. It'll be a constant drain throughout the day interspersed with much sneezing. As evening goes it will get pretty severe, sinuses will be completely blocked, ears will fill, full-on mouth-breather....I'll be about 85% clear by the next morning, improving throughout that day. The only reasonable combatant I've found is taking Zyrtec the day/night prior, hitting the sinus spray & usually taking a Sudafed right after I get back (before napping) and typically another Zyrtec later in the day. I get a little sinusy after pool swims (always have) but nothing like the OWS reaction.

It's happened in TN, AL, GA & IN, both salt & fresh water. Nashville is pretty much the allergy capital of the world though, so it doesn't surprise me to have the elevated reaction show up my first year here.

I breathe both in and out using my mouth and nose while swimming. I've tried the noseclip, does hinder my exhale a little, but it is easier after one swim & a smidge of practice. Doesn't diminish the amount of oxygen I'm able to take in. Doesn't seem to slow down the allergic reaction enough for me to really deal with it though.

AW
Quote Reply
Re: I almost drown-my search for what happened. [AWARE] [ In reply to ]
Quote | Reply
Sorry to hear about your allergic reaction in the OWS. Doesn't sound like fun, but sounds like you're persevering. I applaud you.
Quote Reply
Re: I almost drown-my search for what happened. [TriBeer] [ In reply to ]
Quote | Reply
I'm sure this can phenomena be flowcharted, and as a result lead us to what we are after - how to avoid.

Swim and Exceed your VO2 Max
Leads to Hypoxia and/or
Leads to Hyperventilation
Incorrect and out of control CO2 levels in the body -> Hypercapnia

Either way, the respiratory system and CO2 is now out of control and this results in Vasoconstriction of different types. Perhaps Hypoxic Pulmonary Vasoconstriction where the lungs won't function properly, the legs are going to be the first muscles to shutdown (as witnessed). I think something is going on with the lungs because in this state you feel like you need ridiculous amounts of air and can't get it.

And then the blood chemistry changes too, further contributing to the ( total) system shutdown.

To stay concious blood flow to the brain needs to be maintained so I think a tight swim cap is a bad thing as is over-temperature. Cool water over the head is OK.
What else can be done I wonder...

Also - http://scuba.about.com/...And-Scuba-Diving.htm

Training Tweets: https://twitter.com/Jagersport_com
FM Sports: http://fluidmotionsports.com
Last edited by: SharkFM: Aug 23, 12 14:52
Quote Reply
Re: I almost drown-my search for what happened. [SharkFM] [ In reply to ]
Quote | Reply
Thank you for your thoughtful and knowledgeable response.

I'd like to learn more on how the OP managed his swim start strategy. Did he remember to breathe? Also, in the excitement of the moment, did he go out for 4 minutes with only taking in a few shallow breathes? It's also not clear if he had a good warmup.

Thank you again for your response. You've raised some valid points. Also, wearing a wetsuit would only add to these problems.
Quote Reply
Re: I almost drown-my search for what happened. [TriBeer] [ In reply to ]
Quote | Reply
TriBeer wrote:
" . . .I am a slow swimmer at the best of times but stayed with the back of the pack for about 250m, then my breathing went to shit. Like you, couldn't catch my breath, and started wheezing."

At this point in the swim, did you worry about breathe control?

When you do take a breathe, is it short & quick or are you deep breathing?

Well, in my case I started with about 180 folks. Maybe started close to MOP but drifted to BOP pretty quick. I bumped into a few people but nothing serious. As I recall, I was breathing to both sides for about 25 m although I was also looking up a lot. I then switched to breathing on 1 side, every stroke (or is that every 2nd stroke?), in any case every time my right arm went back I took a breath on that side. This is a normal breathing pattern for me.

Was unable to breath deeply although I'm not sure what it was like at the start but once the wheezing started, no deep breaths for the rest of the day. At that point I didn't have any Ventolin, now have an Rx for it and for the last couple of wetsuit practices I did I used that first. Did not have a repeat attack - just lack of fitness causing me to stop and rest but after doing so I could swim normally again.

So in summary, I suspect a series of things triggered an attack. Tight wetsuit, first Tri in it, insufficient warmup. I used the same wetsuit yesterday but did more swimming warmup (still only 50 to 75m) and took a shot of Ventolin before going out. Only Practice swimming but was able to start feeling stuff in the water (fit of wetsuit, how it felt when extending my arm etc.).

BC Don
Pain is temporary, not giving it your all lasts all Winter.
Quote Reply
Re: I almost drown-my search for what happened. [rustyproject] [ In reply to ]
Quote | Reply
I don't know how to say this nicely, but some of the responses above are ludicrous. I think you know you should trust your own doctor's opinion and advice far above any guesses suggested by us, the peanut gallery.

Now getting back to the subject at hand, I wonder if most/all of the recent [swimming related adverse health events in triathlon] are related to swimming simply because it is the first leg of triathlon, and the events are more likely exercise-induced rather than swimming-induced.
Quote Reply
Re: I almost drown-my search for what happened. [ductus] [ In reply to ]
Quote | Reply
I don't agree, i suspect they are swimming induced and to simply discount them as first leg events is as you mentioned "ludicrous". I did some rough tests in my 2nd swim today and do I believe this is all starts as CO2 driven.
Also:
1. Breathing out under water goes into about 0.4 PSI greater pressure than atmospheric. Therefore if you breathe "normally" like you would running, then you are exhaling (removing CO2) at a slightly slower rate. Compound to this the natural response to "hold breath" and you are building up CO2.
2. The body's trigger, sensory call to breathe, or the respiratory function is based on CO2 not O2. This has been called a glitch in the human programming.
3. Dehydration, (air travel, caffiene, soft drinks) amplify blood-gas(CO2/O2) related issues. So does the production of lactic acid for that matter.

Here's what I have done my past two swims anyway, but based on the above is really a must do:

Be very well hydrated at the start of the swim & no caffeine
15-20 minute full body warmup/workout to prime the arms, legs & core >> jog, TRX it or pushups etc. I think this is important to start lactic acid production & elevate CO2 responses as it is to kick start blood flow.
Be mindful of CO2 levels during the swim and exhaust CO2 harder - that is exhale more forcefully than "normal" atmospheric.

I think this can happen and has happened to perfectly healthy and well trained athletes, and will continue to do so unless education and protocols are put in place.

Training Tweets: https://twitter.com/Jagersport_com
FM Sports: http://fluidmotionsports.com
Last edited by: SharkFM: Aug 23, 12 21:45
Quote Reply
Re: I almost drown-my search for what happened. [SharkFM] [ In reply to ]
Quote | Reply
There is still some question about my warm up. I did my usual warm up(bike and run) I normally will swim a little bit probably 300 yards. I don't call that swimming its mainly done to check goggles and get a feel for the temp of the water . I didn't get in the water because it was a little cooler than usual. Heat Wave is usually a really hot race. I went no wet suit and was fine in the water temp wise. I started pretty slow. I was shooting for a 17:00 to 18:00 swim (even flailing around I think it was 23:00 swim) I used to be faster but am still really comfortable in the water. My question about the swim is why wouldn't this have happened back in the day in Memphis swimming with Dick Fadgens Triathlete group. I used to max out all the time trying to get better with those guys. Coach Fadgen wasn't overly critical of my technique. The group he had swimming(Frank Rennelt-Renn Wheels,Corry Horton,Wendell and Pam RobertsonRichard Larrimore,Lucia Colbert) kept all of us motivated. If I was going anerobic all the time shouldn't something have showed up then?
Quote Reply
Re: I almost drown-my search for what happened. [BCDon] [ In reply to ]
Quote | Reply
Thank you for the detailed response to my question.

The first time wearing a wetsuit is uncomfortable. I've had similar experiences with a wetsuit.

Again, thank you and hope this never happens to you again.
Quote Reply
Re: I almost drown-my search for what happened. [TriBeer] [ In reply to ]
Quote | Reply
TriBeer wrote:
Thank you for the detailed response to my question.

The first time wearing a wetsuit is uncomfortable. I've had similar experiences with a wetsuit.

Again, thank you and hope this never happens to you again.

Yup, I've found that spending time to make sure that the wetsuit is on properly and pulled up properly makes a big difference, especially with lower priced suits that aren't as stretchy. I need someone to give me a really good wedgie once they've helped me zip up, then I pull the front up,a lot. Plus I need the sleeves pulled up good.

I'll be using Ventolin at the start just in case so I doubt if this will happen.

But, being a "water baby", I don't have any issues with water, regardless of what it is like. Weeds, muddy, deep, it's all the same. Without a wetsuit a can "sorta" float on my back although my legs sink. With a wetsuit, no problem having a nap on my back :).

BC Don
Pain is temporary, not giving it your all lasts all Winter.
Quote Reply
Re: I almost drown-my search for what happened. [BCDon] [ In reply to ]
Quote | Reply
I water-ski everyday with a multi-disciplined senior doctor at our hospital. We did discuss previously but I ran the specifics of my "diagnosis" (ie CO2 etc.) past him this morning. He added that elevated CO2 also causes vasodilation in the brain, which in the fixed volume on the skull increases pressure on the brain (swelling). When CO2 is high, the nervous system assumes O2 is low and the body shuts down blood to the limbs, diverting flow the brain. They use this feature in head trauma cases where they administer O2, to cause vasoconstriction & reduce pressure (swelling) on the brain.

So by letting CO2 levels get out of hand you are negatively affecting the brain - which can lead to confusion (bad decision making) and unconsciousness.


I asked him why this affects people mid 40's and up so much. He said there is so much more of a safety margin in younger bodies, circulatory systems etc. He said in young people it's hard to tell for example they are bleeding out until they outright lose conciousness. I totally feel this - I've lost my breath safety margin and training swim twice a day (1-2 hours per day since June) it is getting better but will take some time maybe another year, to learn how to ventilate with more efficiency.


Now about wetsuits. These damn tight wetsuits will encourage or help along the vasoconstriction of the limbs and add internal resistance that comes with moving in the paint-on suit, which will also produce more CO2! I had to upsize my Blue70 the first one I got was crazy tight in the arms and legs. (I have a M B70 fuzion for sale). I am in a ML Reaction now 170lbs 6'2". What I have been doing is using Armour All to lube the inside of the suit. In the race I lathered that stuff on like crazy, to reduce the internal resistance that comes from using the suit. It works great. You should use diver's lube though from McNett Corp.


My opinion is the w/s is safer that without, provided it is properly fitting and treated & fit to reduce the restrictive nature of it. With the understanding of the above, the last couple of days my breathing priority now is exhalation. So I focus on not how much air I take in but the timing and force of my exhale. When you swim hard you need to purge a lot of CO2! So at no time should the flow OUT of the lungs stop during swimming, unless you are on the intake.







Training Tweets: https://twitter.com/Jagersport_com
FM Sports: http://fluidmotionsports.com
Quote Reply