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Re: Are swim deaths preventable?is there anything pre screening can do? [jonp9576] [ In reply to ]
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we went all through this, first in 2008, then in 2012/13:

first triathlon swim scare article in 2008
interview with WAPO author on spike in triathlon swim deaths
panic attacks during the swim
best practices
USAT swim death study
2013 recap, part 1
2013 recap, part 2

and my feeling about all of this, every time it comes up

triathlon occasionally sees a spike in open water deaths. once a decade or so. something gets posted in WAPO, NYT, sports illustrated. the world freaks. we study it. turns out our sport has about the same number of deaths as marathoning.

my advice?

1. watch free solo. great movie. and then comfort yourself that you're in an exceedingly safe sport, that gives life much more frequently than it takes it.

2. everybody has opinions about things that matter to them; almost nobody's opinions are backed by any investigation. i could say, "read what monty writes about open water swim behavior." this is monty, with whom i first raced in 1980, and we were both in the hawaiian ironman in 1981. he's not dead yet. nor am i. and we'll both be living in wild danger today, engaged in... wait, wait... swimming!

even tho monty has a pacemaker, and even tho my family history is rife with heart disease, and i've already outlived most of my relatives. i could say, "read what monty writes about how to survive and prevail in triathlon, esp in the swim." but you won't. you say you will. you'll lie, and say you have. but you won't.

why? because you'd rather live in your silo of disinformation. that's more fun. and by "you" i don't mean you, jonp9576, or any of you, individually, who're reading this. i'm saying that, in general, it's more satisfying (in a twisted way) to imagine triathlon, or the swim leg, is dangerous than to actually have your behavior guided by fact, reason, science, logic, best practices.

your problem is your proximity to news, near and far. fear of hiking in the mountains because of your proximity to the story that a mountain lion killed someone. the 1 per decade in north america. fear of open water because you read about a shark attack. fear of a triathlon swim because someone died. the 1 in 75,000 race occurrences per year.

your fear of the swim is your fear of the mountain lion and the shark: because it's almost tangibly imaginable, it's palpably scary when you envision it, and because you can't see it coming. you're not in control. no remedial action you can take. you're defenseless.

but you're not defenseless. actually... read... what... monty... says... about open water swimming. about best practices. but if your time is up, if it's your ticket, if you have a heart defect, then switching to pure running or cycling will not save you. switching to judge judy all afternoon in front of the tube may buy you a few extra years.

Dan Empfield
aka Slowman
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Re: Are swim deaths preventable?is there anything pre screening can do? [Xatefrogg] [ In reply to ]
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Xatefrogg wrote:
Allow AG athletes to warm up in the water before the race for one. St. George 70.3 didn't allow it and were threatening anyone that was in the water with a DQ.

I had my first ever DNF are StG in 2018. I had jogged a little to warm up, but obviously no warm up swim.

Within the first 300 meters I was on my back backstroking because I could keep my face in the water to breath.

Next thing I knew, I was coughing up reddish foamy stuff. It took me 1:13 to get out of the water. I should have pulled the plug. I hopped from kayak to kayak, trying to get myself home.

FWIW, I’m 35, typically swim 28-29 minutes in a wetsuit legal 70.3, and have a 4:37 HIM PR.

Being able to warm up in the water and have a chance to acclimatize has to be a focus. It absolutely has to be. These rolling starts are bogus.

I will no longer do a race that doesn’t allow for a swim warm up. Ever. That likely means no more mdot events, and I’m ok with that.

Merge Multisport Founder & Head Coach
USAT Level 2 - Short & Long Course
Ironman Certified
Brevard, NC
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Re: Are swim deaths preventable?is there anything pre screening can do? [T.Skelton3] [ In reply to ]
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T.Skelton3 wrote:
I will no longer do a race that doesn’t allow for a swim warm up. Ever. That likely means no more mdot events, and I’m ok with that.


this is what has been written here for a decade. i wrote about it here. an expert on panic attacks in the water wrote about it here. i've written about it a bunch of times, in a lot of articles. it's listed in the best practices that USAT's commission on swim deaths recommends.

i'm with you. i don't know that this is incompatible with rolling swim starts. i don't know why you can't both have a warm-up area, and a rolling swim start. i like rolling swim starts. but if i can't warm up in the water before the swim start, i'm not entering your race.

Dan Empfield
aka Slowman
Last edited by: Slowman: Jun 5, 19 9:14
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Re: Are swim deaths preventable?is there anything pre screening can do? [Slowman] [ In reply to ]
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Slowman wrote:

i'm with you. i don't know that this is incompatible with rolling swim starts. i don't know why you can't both have a warm-up area, and a rolling swim start. i like rolling swim starts. but if i can't warm up in the water before the swim start, i'm not entering your race.


It's clearly not. I did an OD race two years ago, with a "swim stream" start, where we were allowed to warm-up---I did, not many other's did, though. Not that most people wanted to, because I think everyone was secretly hoping they'd cancel the swim due to the rather nasty weather (coldl air, drizzle, rain, and 20mph headwind on the long leg).

The rest of the race was horrible, and has since been canceled---good ridance, even if they did cancel it last year on Wednesday of race-week. No one wants to run 10km, in 4 laps up and down the frontage road of I-30.
Last edited by: Tom_hampton: Jun 5, 19 9:26
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Re: Are swim deaths preventable?is there anything pre screening can do? [jonp9576] [ In reply to ]
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I happened to write the article about overcoming anxiety in tri swims to which Dan refers.

Few comments:
1) Disclaimer: I am not a cardiologist. It is possible that pre-competition cardiac testing can alert an athlete to an underlying medical condition. However in a medical clinic setting it is not possible to replicate the sheer sympathetic overload (adrenaline) that occurs at the beginning of a race. The tachycardia (high heart rate) that results from the start of a tri puts large demands on our coronary arteries to provide myocardial blood supply. If the arteries are already blocked, a myocardial infarction could result due to the sudden demand. Furthermore tachycardia can trigger an arrhythmia that would not have been triggered at a lower heart rate. It's akin to the out-of-shape middle aged couch potato with underlying cardiac disease, who is asymptomatic on the sofa, but has a heart attack when he starts to shovel snow. Experts like Larry Creswell have expertise in this area and if he is reading this may provide comment.

2) Open water is an unforgiving environment. I guess that goes without saying. If your heart is not functioning properly, or if you have an acute pulmonary problem (e.g. asthma attack) in open water, you may lose consciousness, and if the acute condition is not fatal itself you may drown; unlike if the medical emergency occurs on terra firma. Also in open water it is very difficult for life guards to: recognize someone has a medical emergency; to get to the victim quickly on water; and to get the victim off the water to receive proper care. Getting recognized as having a medical emergency and treated quickly is much easier on land.
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Re: Are swim deaths preventable?is there anything pre screening can do? [Slowman] [ In reply to ]
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Slowman wrote:
T.Skelton3 wrote:
I will no longer do a race that doesn’t allow for a swim warm up. Ever. That likely means no more mdot events, and I’m ok with that.


this is what has been written here for a decade. i wrote about it here. an expert on panic attacks in the water wrote about it here. i've written about it a bunch of times, in a lot of articles. it's listed in the best practices that USAT's commission on swim deaths recommends.

i'm with you. i don't know that this is incompatible with rolling swim starts. i don't know why you can't both have a warm-up area, and a rolling swim start. i like rolling swim starts. but if i can't warm up in the water before the swim start, i'm not entering your race.

I completely agree. I know I usually have "Diver's reflex" when my face first hits the cold water. I've gone as far as laying on the shoreline with my face in the water to acclimatize. With more than 60 years of swimming experience including college scholarship, to not allow warmups is simply not workable. Get in the water....the shorter the race, the longer the warmup; just like running.

Gary Geiger
http://www.geigerphoto.com Professional photographer

TEAM KiWAMi NORTH AMERICA http://www.kiwamitri.com, Rudy Project http://www.rudyprojectusa.com, GU https://guenergy.com/shop/ ; Salming World Ambassador; https://www.shopsalming.com
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Re: Are swim deaths preventable?is there anything pre screening can do? [jonp9576] [ In reply to ]
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Good article in Triathlete Mag on latest thoughts on SIPE (vs cardiac arrest).

https://www.triathlete.com/...ow-about-sipe_380986
Last edited by: b_rad: Jun 26, 19 9:03
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Re: Are swim deaths preventable?is there anything pre screening can do? [b_rad] [ In reply to ]
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b_rad wrote:
Good article in Triathlete Mag on latest thoughts on SIPE (vs cardiac arrest).https://www.triathlete.com/...ow-about-sipe_380986[/quote[/url]]

Anyone care to speculate if tadalafil "should" have similar effects for SIPE as sildenafil?
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Re: Are swim deaths preventable?is there anything pre screening can do? [ In reply to ]
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I just tell my friends if I die during the race or training, I died doing what I love to do, so don't worry about me. I just try my best like going for check up two times year, eat right and workout on a regular basis. Sometimes terrible things just happen without any warning unfortunately.
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Re: Are swim deaths preventable?is there anything pre screening can do? [s13tx] [ In reply to ]
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All of the drowning accidents would have been prevented if they just cancelled all the swims.

No one died in Cork this weekend....
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Re: Are swim deaths preventable?is there anything pre screening can do? [jla] [ In reply to ]
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jla wrote:
I happened to write the article about overcoming anxiety in tri swims to which Dan refers.

Few comments:
1) Disclaimer: I am not a cardiologist. It is possible that pre-competition cardiac testing can alert an athlete to an underlying medical condition. However in a medical clinic setting it is not possible to replicate the sheer sympathetic overload (adrenaline) that occurs at the beginning of a race. The tachycardia (high heart rate) that results from the start of a tri puts large demands on our coronary arteries to provide myocardial blood supply. If the arteries are already blocked, a myocardial infarction could result due to the sudden demand. Furthermore tachycardia can trigger an arrhythmia that would not have been triggered at a lower heart rate. It's akin to the out-of-shape middle aged couch potato with underlying cardiac disease, who is asymptomatic on the sofa, but has a heart attack when he starts to shovel snow. Experts like Larry Creswell have expertise in this area and if he is reading this may provide comment.

2) Open water is an unforgiving environment. I guess that goes without saying. If your heart is not functioning properly, or if you have an acute pulmonary problem (e.g. asthma attack) in open water, you may lose consciousness, and if the acute condition is not fatal itself you may drown; unlike if the medical emergency occurs on terra firma. Also in open water it is very difficult for life guards to: recognize someone has a medical emergency; to get to the victim quickly on water; and to get the victim off the water to receive proper care. Getting recognized as having a medical emergency and treated quickly is much easier on land.

Thank you Dr. Anders for the article and for the follow up commentary. It seems to confirm a theory I have on how panic attacks can lead to grave consequences in the swim -- please let me know if I'm on the right track. I have limited medical knowledge from my days as an EMT, but I certainly understand the role of adrenaline in cardiopulmonary system. I believe that the onset of a panic situation in swim (whether it be from sudden cold-water immersion, claustrophobia, or simply getting kicked or jolted by another swimmer) causes an adrenaline response which has the immediate response of increasing HR. But with swimming, we cannot immediately increase our respiratory response to the increased heart rate which then exacerbates the panic attack and may even produce another adrenaline response. In that short time, SpO2 drops and then if there are any underlying cardiac issues, they become exposed just as you describe above with the couch potato who suddenly shovels snow. Therefore, if we can teach both the swimmers to recognize when they're having a panic attack and how to deal with it while in the swim, and we can teach rescue personnel how to identify people having potential panic episodes, we'd be getting rid of at least one of the etiologies of swim deaths.

USA Triathlon Level 2 Coach
Slowtwitch Master Coach
Head Coach, TriCoach Colorado, LLC
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Re: Are swim deaths preventable?is there anything pre screening can do? [TJ56] [ In reply to ]
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TJ56 wrote:
Anyone care to speculate if tadalafil "should" have similar effects for SIPE as sildenafil?

And might bring new meaning to hearing "You are an Ironman!" as you cross the finish...

"I'm thinking of a number between 1 and 10, and I don't know why!"
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Re: Are swim deaths preventable?is there anything pre screening can do? [Warbird] [ In reply to ]
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Warbird wrote:
TJ56 wrote:
Anyone care to speculate if tadalafil "should" have similar effects for SIPE as sildenafil?


And might bring new meaning to hearing "You are an Ironman!" as you cross the finish...

Both drugs give the means to those of us that need them to be a man; no matter if needed due to cancer or other ailments. If another benefit is the prevention of SIPE so much the better!
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Re: Are swim deaths preventable?is there anything pre screening can do? [jonp9576] [ In reply to ]
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I did my First Ironman in Lake Placid in 2017. I was 54 years old. My reason for doing the race was to celebrate life, you see my father died of a massive heart attack at the age of 54 and I decided that was not a legacy I needed to repeat. These days I try to spend my time enjoying life not fearing death. Simple but it works for me.
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