Four years ago ST posted an article written by Dan about swim deaths and SIPE, so this is not a new phenomenon. (go to the Training section on the opening page)
As an experienced competitive swimmer and OWS (recreational) as a teenager right through to my sixties I would never have considered myself a candidate for any form of swimming problem and I can say, honestly, that I have experienced symptoms which I would consider consistent with SIPE. They were mild enough that on the day were ignored, although I might be more carefull now. I also believe that many do the same and have a mindset that does not allow them to back off.
I have to believe that wetsuits are a principal cause, along with the habit of wearing a full, zipped up race suit and HRM exacerbating the situation.
Without doubt a warmup (in or out of the water), and a sensible swim attitude, for any distance from sprint to IM would help. The conditions for tragedy will always exist, whether we like it or not.
While I can’t certainly point to a pile of evidence, I know of a person who had diagnosed swimming induced pulmonary edema after being pulled from a triathlon swim.
Or rather, I know a person who had pulmonary edema after being pulled from a swim, that evening when I heard from her husband that she was at Hopkins with pulmonary edema and they had no idea what had happened I sent them information on SIPE and at that point they realized that’s what it was.
In the interest of confidentiality and all that I won’t post her name, but I can absolutely confirm it, this is someone I know well.
So no, I can’t say that it is a factor in any death, I can confirm that it has happened at least once in a tri that I have personal experience with.
I dont blame the ny ironman. i only think that this further exacerbated the situation. it didn’t help, that’s all. it wasn’t the only cause, for sure. but, wearing a wetsuit increases constriction of blood vessels in your legs and pools the body’s blood to the core. wearing it for longer makes this process of blood pooling happen for longer.
IMNYC said many months ago that regardless of the water temperature, wetsuits would be allowed, presumably in the interests of swimmer safety in light of the prior deaths at the NYC Triathlon. Presumably also, this was based on the theory that wetsuits offer buoyancy as an aid to weaker swimmers, therefore safer.
However, is it possible then, that allowing wetsuits regarless of the water temperature could in fact be more dangerous? The buoancy benefit for weaker swimmers is surely outweighed by the more serious risks of constriction, assuming tight wetsuits are a contributing factor to some of these swim deaths?
Kevin, thanks for sharing that story with us. It is very similar to the stories of SIPE in non-triathlon settings.
Not to push if it would concern you about confidentiality for the athlete, but we could learn from this.
Any chance you could share more details about how things unfolded at the race? The sequence of events leading up to being “pulled”? How she was recognized as being in distress? How she was rescued? The initial on-site care…or thinking about the cause of her problems?
I read the article from 2007- now I have questions. Main question how is it treated?
What happens once they figure someone experienced SIPE & taken to a hopsital, give them oxygen, make sure everything is okay & go on your way?
Its to scary to think, that many of us probably experienced some form of SIPE while racing but did not know or at the time & still do not know now.
Is it something that will go away on its own over time? There has been a few questionable swims, that I shrugged off as a panic attack but could have been more serious.
My wife experienced SIPE at IM Hawaii2010, no wetsuit swim BTW>>>>She was able to continue with the bike and her shortness of breath continued to the point she had to walk and then eventually was coughing up aveolar fluid. DNF, trip to the med tent, pulse ox low 90’s, chest xray was complete whiteout. She has since been able to compete as a top national AG athlete and excel despite this single episode.SIPE is not a cause of acute deaths in a triathlon…and if it is it is very very rare, these deaths are all likely cardiac in nature…
Hi,
I am an athlete who, in the midst of an Olympic tri swim, I experienced SIPE. I am a veteran triathlete of more than 10 years and had even completed IronMan CDA. The tri where I experienced SIPE was one I had done 8 times before, so I was very comfortable with the swim course, conditions and everything. That is why, when I was halfway way through my swim and my legs felt like I was dragging kettle bells, I was perplexed. I thought I might have gone out too fast, I thought I might have been too “jazzed” up. And I was convinced it was in my head. So I switched to pulling. When my arms started to shut down is when I knew something was wrong. I sighted to see if I could make it to the buoy to just “hang on” and gather my wits. I realized I couldn’t make it because I had developed a cough where I couldn’t seem to get any air in. At that point I waved my arm to get attention. And even that was difficult. When I got pulled in, I was asked where my albuturol was, and I said I didn’t use it, b/c I didn’t have asthma. The doctor in the tent put me on oxygen when he saw my lung capacity was dramatically low- I can’t recall what it was, 30%? He thought I was in the midst of Congestive Heart failure and off I went to the emergency room. The ER doctor did a CAT scan and it showed “snowflakes” or should I say, a blizzard in my lungs. He thought I inhaled water. When I told him quite emphatically, I did not inhale water, I was transported to Pulmonary Specialists at Hopkins. The doctors could hear the “roar” in my lungs for the next 24 hours but all other signs and symptoms disappeared. In fact, I was the healthiest person on the ward and when I was released 36 hours later after going through countless tests where everything was “normal” I was told I was fine.
Since SIPE is a condition that we know very little about (indeed I was the very first LIVE AND IN PERSON Specimen at Johns Hopkins) I hope my experience helps to shed light for other athletes out there. I strongly urge you to listen to your body. If something doesn’t feel right, it is not right, and remove yourself from the situation. I know first hand how difficult that is to do. This was my first DNF. But I was lucky. I was experienced enough to know my body well - and even then I was questioning if my symptoms were all in my head. I am very fortunate to be here and say, to this day, listen well to keep yourself safe. And yes, I have done Open water swims since my SIPE episode with no reoccurrence. Why it happened when it did, I will never know.
I hope my experience can help keep others safe and returning to a great sport.
Thanks so much for sharing your story here at the Forum. It’s really very kind of you. Please pass along my thanks to Kevin as well.
There’s obviously a lot to learn about SIPE and accounts like yours can really help us to understand things better. As you must know, there’s no “clearinghouse” for things like this, so we really must rely on accounts like your own.
Recognizing that many athletes might be bothered by SIPE for the first time (ever) during a race…and seeing that the diagnosis probably can’t be established beforehand without invasive testing (if then), what advice would you give to athletes? To event organizers? To USAT?
pulmonary edema causes cardiac arrest. so you literally just proved the point you sought to disprove! (“all of (100%) of the deaths 2003-2011 were cardiac arrest”)
Hi,
I am an athlete who, in the midst of an Olympic tri swim, I experienced SIPE. I am a veteran triathlete of more than 10 years and had even completed IronMan CDA. The tri where I experienced SIPE was one I had done 8 times before, so I was very comfortable with the swim course, conditions and everything. That is why, when I was halfway way through my swim and my legs felt like I was dragging kettle bells, I was perplexed. I thought I might have gone out too fast, I thought I might have been too “jazzed” up. And I was convinced it was in my head. So I switched to pulling. When my arms started to shut down is when I knew something was wrong. I sighted to see if I could make it to the buoy to just “hang on” and gather my wits. I realized I couldn’t make it because I had developed a cough where I couldn’t seem to get any air in. At that point I waved my arm to get attention. And even that was difficult. When I got pulled in, I was asked where my albuturol was, and I said I didn’t use it, b/c I didn’t have asthma. The doctor in the tent put me on oxygen when he saw my lung capacity was dramatically low- I can’t recall what it was, 30%? He thought I was in the midst of Congestive Heart failure and off I went to the emergency room. The ER doctor did a CAT scan and it showed “snowflakes” or should I say, a blizzard in my lungs. He thought I inhaled water. When I told him quite emphatically, I did not inhale water, I was transported to Pulmonary Specialists at Hopkins. The doctors could hear the “roar” in my lungs for the next 24 hours but all other signs and symptoms disappeared. In fact, I was the healthiest person on the ward and when I was released 36 hours later after going through countless tests where everything was “normal” I was told I was fine.
Since SIPE is a condition that we know very little about (indeed I was the very first LIVE AND IN PERSON Specimen at Johns Hopkins) I hope my experience helps to shed light for other athletes out there. I strongly urge you to listen to your body. If something doesn’t feel right, it is not right, and remove yourself from the situation. I know first hand how difficult that is to do. This was my first DNF. But I was lucky. I was experienced enough to know my body well - and even then I was questioning if my symptoms were all in my head. I am very fortunate to be here and say, to this day, listen well to keep yourself safe. And yes, I have done Open water swims since my SIPE episode with no reoccurrence. Why it happened when it did, I will never know.
I hope my experience can help keep others safe and returning to a great sport.
KAP
KAP, your experience is very important for unraveling this problem. Thanks for reporting it so thoroughly and glibly. We all should note that you had a growing cough.
Can you remember what if anything was different on that day? What about warm-up or starting too fast (an “adrenalin-rush” has been described by some with similar symptoms). Did you drink more fluid before the event than usual?