Swimming Induced Pulmonary Edema (SIPE)

rasubach

Hi Everyone! 

At Ironman 70.3 Racine, I made an early exit from the water for what I think was swimming induced pulmonary edema (SIPE).  I had all the "classic symptoms" and was treated to an ambulance ride to the hospital... but by that time, symptoms resolved (thankfully) but an on the spot diagnosis wasn't possible.  They gave me an inhaler and antibiotics... (I wasn't sick)...

Here's a quick Wikipedia link: http://en.wikipedia.org/wiki/Swimmi...nary_edema

of the risk factors, I had most of them:

Water immersion ^{- well, yeah...}
Excessive pre-swim hydration ^{- I had about 3-4 liters the day prior and about 20-24 oz in the am}
High blood pressure (no)
Long course length in the case of triathlon (half ironman or greater) ^{- yes}
Female gender ^{- yes}
Antiplatelet agents such as aspirin and fish oil ^{- no}

 

And each time I felt distressed, I got "vertical" in the water, making the compression worse.

I got out of the water quick enough that I didn't have "copious" sputum, but it was orangey-red 2x and the coughing was really hard to stop!

I did a warm up in the water before the race, thinking that would be helpful, given the chilly conditions.  I didn't notice any issues there, nor was I stressed while waiting for my group to start.

Anyway - while my local doc works on figuring stuff out... what do you all know?  Anyone know a doc who specializes in this?  Just curious.

Thanks!

 

Jenn Edwards

HI Ruth,

I just went to post my own experience with SIPE this morning and found your post. I too am looking for answers.  The links of what I’ve found in addition to the Wikipedia reference are below.  I’m on a call with this gal: http://www.endurancetriathletes.com/sipe.html    and reached out to the researcher at Duke she references.  I’ll keep you posted on what I learn but if anyone in the EN community has any insights I’m all ears as well.

I’ve (hopefully) attached a short video of what I sounded like after my (expedited) exit from the water during my walk of shame back to my car.  My lungs are pretty crackly and fully of fluid from what I can tell.    

Thanks! 

Here’s an actual study:   http://www.endurancetriathletes.com/AJEM_oct_2010.pdf

Here’s the clinical trial: http://clinicaltrials.gov/ct2/show/NCT00815646

And a ST discussion:  http://www.slowtwitch.com/Training/...E__45.html

rasubach

Hi Jenn,

Sorry so long to reply.  No diagnosis here.  Doc thinks maybe asthma?   Problem is "it resolved quickly" before i got to ER... so, i'm just going to work as if I have it for prevention purposes, and race smart!

 

Thanks!

Ruth

 

cgres123

@ Ruth Ann nice picture a wow moment good job!

Cyclingmaniac

Jenn and Ruth Ann, 

Sorry to hear about your difficulties!  The one thing I learned when doing triathlons is safety first.  After all, participating in triathlons is suppose to be fun.  I don't translate potential life threatening situations as fun.  I think you both did exactly what you needed to do.  You listened to your bodies and took prudent action.  I hope that you are able to figure everything out and find solutions.

Blessings!

 

Jenn Edwards

Hey Guys,

I posted my experience and what I've learned including a video of my breathing and the research study I'll be a part of on my blog here: http://jennifermaeedwards.blogspot.com/

Hope it helps someone and will keep ya posted.

Swim safely!

rasubach

Rich,

They say racing is 90% mental... yep... need to use your brain to know when to call it quits for a medical issue / developing injury.  Sometimes it's best to get out of the water / off the bike / stop the run, and "live" to race another day.

I had a successful swim in terms of medical during IMWI, although i missed the cut-off by several minutes... 

never giving up!

Ruth Ann

rasubach

Team... it happened again...   I guess I'm not a lucky one... related I think to cold water... I had 4 other OWS so far this year, one that was 2 miles, with no issues... Anyway... I'm going to head back to the docs and see what we can figure out.