SIPE Swimming Induced Pulmonary Edema, with Dr Ruth Williamson
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- Опубліковано 31 лип 2024
- SIPE or Swimming Induced Pulmonary Edema is a very rare, but potentially fatal condition which swimmers should be able to recognise. I asked Dr Ruth Williamson, and open water swimming medic, who been briefing Channel Pilots on the topic, to give us an idea about what to look out for. It was fascinating to find out about what happens when the delicate pressure balance in our lungs is upset and some simple things we can do to deal with it.
Thank you to Ruth for a brilliant conversation.
0:00 introduction
0:30 Dr Ruth Williamson
1:14 what is SIPE?
1:31 what is actucally happening in the body?
2:38 what are the symptoms?
4:10 what is the first aid for SIPE?
7:17 who is it most likely to affect?
9:44 how well known is SIPE in the medical profession?
11:16 how long is the recovery from SIPE?
11:26 what are the long-term effects?
12:39 what is the first aid on a support boat?
Filmed on a GoPro Hero7 and 10 edited on an ipad using Lumafusion app.
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Riveting Rachel!
Brian Cox just lost his title as 'the best explainer'. SIPE was brilliantly articulated by Dr. Williamson; described and discussd in a logical and absorbing manner👏.
Hopefully we will not need her advice, but immensely important we are all educated & ready just in case. Swim safe & happy everyone🏊♀️
You’re not wrong. Cakes, drizzle cake, popping candy, sitting up and breathing out through pursed lips are all things we can understand. She was brilliant!
I just suffered from SIPE while swimming in the ocean. I have hope I can recover and get to swimming in the ocean. I’m thankful the paddle boarders knew what was happening and how to handle it. Thank you for your video!
I’m sorry to hear you suffered this. Great that the paddle boarders knew what it was. Good luck getting back to the sea x
I experienced this while swimming a 2 mile swim alone in the ocean once- I thought my snorkel was malfunctioning then realized the water build up wasn’t salty. This was a real lesson to me on safety
Such a horrible shock, I hope it hasn't put you off swimming altogether.
Dr Doctors getting this as a mild version swimming 1 hour sea coast temp 16 July, symptoms breathless tight chest wheezing... Get out and have a tight chest for hours ... Light headed headache.
Urinating more which is ok. 40s.. I have been told after 4 attacks.. not to swim cold water??? Please help..
I usually swim pools and warm water. I am also have asthma. Mostly chlorine induced.
Any comments will help?
Great video really amazing
I also get SVT.. if dehydrated exercising and bend down.
Hope you can shed any light. SIPE mild many times now.. worried
I’ve had SIPE twice. Once 475 m into a swim, today 175 m in. On both occasions, I didn’t get into freestyle breathing normally, though entered water slowly, wore full wetsuits which felt tight around neck, shoulder area, and didn’t warm up, for example by running to the venue. 2/72 OWS this winter affected. First time had worn wetsuit for an hour in car, had been shouted at by safety person for being later than some of the group, but not all, and had drunk 500 ml electrolytes on route. Second time had completed 24 hours of hilly cycle training the previous few days, and had swum in skins in water 3 degrees warmer on those same consecutive days no issue. Each time, I noticed my breathing rate had become faster than level of exertion, then crackling at bottom of lungs on inhalation, which progressed rapidly to fighting for breath whilst swimming ability/ progress declined rapidly - it’s hard to swim from middle of swim course to exit lake, and came close to drowning, today shouting for help, and being towed in on back. Both times resolved within hours, leaving a tight chest for a couple of days. Am very fit, have developed high blood pressure and gained weight during Pandemic. My swim venue have not been , thus far, supportive, rather fear adverse publicity if I drown. I’ve asked for empathy and paddleboard support to continue, plus a cardiology review, plan to lose the weight and perhaps try sildenafil and stick with my shortie wetsuit or skins in warmer water, but upset I may not be able to compete in tri in open water safely, as fear there isn’t much empathic support for those affected by SIPE. I’m a lifelong endurance athlete, 55, female, started OWS last summer and have swum twice weekly all through winter, mostly in shortie, occasionally skins, and more rarely in full wetsuit. Would welcome support and happy to be a research subject to further understanding and support for affected athletes.
Blimey, if you drop me a direct message on instagram or Facebook I'll send you Dr Ruth's contact details. The Channel Swimming Association might be a source of help and advice too, as might British Triathlon.
Thanks for this, extremely informative. I have had 3 or 4 episodes of SIPE only really recognising it as such after the last one. Crackling lungs occurred every time. Really scary. NHS weren't much help due to their ignorance perhaps because it is so rare. I feel much better versed after watching this video in precautions to take and what to do if it happens again. I am a triathlete and worry if it does happen during a race. I have swum in the sea on many occasions and it hasn't happened. I definitely think fluid intake beforehand is a factor. A perfect storm I guess of wetsuit and cold water in addition contributes to increased blood pressure. My blood pressure is generally low so this did surprise me.
I'm pretty sure I had this on my one and only Alcatraz swim. I was unnaturally winded the entire time and couldn't catch my breath for 2-3 hours after getting out of the water, which struck me as abnormal. I even went to my doctor a few weeks later and asked her to check my heart. didn't know what SIPE was at the time and neither did my doctor, but I'm going to do a lot of research about this before my next long swim.
Thanks for sharing your experience Ellen, it must have been really scary. Good luck with the next big swim :)
yes I am getting the same symptoms in cool UK waters in June 1 hrs swim. Mild ...but got out of the water
This is the first time SIPE has been explained to me in a way that makes sense. I've had this a couple of times on channel swim attempts. The first time, it happened when I was a mile off France - I knew I was in trouble but the doctors labelled it as 'exercise induced asthma" - with the added comment of "well you will spend 14 hours in the channel". .The feature that always mystified me was how fast it came on, which you explain. The first time, I had an x-ray and had water in my lungs but the second time there wasn't any. At the time this didn't make sense - now it does!! Thank you so much!
I'm pleased Ruth was able to clear up the confusion for you Sue.
very informative and so well explained. thank you Rachel for another great video.
Thank you for another great video, very interesting and important.
Thanks for watching Alison 🏊♀️😀
Fantastic video and topic. I’m sharing it with my open water swim buddies. Thank you
Thanks Mark, the more we can do to raise awareness of SIPE, the less people we will lose to it 🏊♀️😀
Thank you for this very informative and useful video. I'll keep it in mind.
Good to hear you enjoyed it.
I learn so much from your videos. Thanks so much.
You’re welcome, thanks for watching 🏊♀️😀
Great information Rachel, thank you.👍🙏
Thanks for watching! Dr Ruth was fascinating, glad you enjoyed it.
Really useful and very well explained!
Glad you think so! I thought Ruth was excellent!
Another great informative video Rach, never heard of SIPE but this video has given a clear and precise description of symptoms and how to help if needed. Thank you both for taking the time to make this video and sharing your knowledge.
Hi Alison it’s good to hear that we’re raising awareness of SIPE. Here’s hoping none of us are predisposed to it.
Really interesting, I had never heard of SIPE before, thank you - really informative.
It is really rare but good to know what to do or when to suspect it 🏊♀️😀
I know exactly how it feels and sounds! I had Covid Pneumonia last year and was in A&E. Your blood oxygen levels will also fall below 90%...many smart watches have this monitor built in so it maybe also worth a check.
Fortunately, I am fine when swimming! Thanks for this video Rachel and Dr Ruth. Very useful and helps to alleviate a bit of panic that the media have created recently..
Thank you ! Last year I did my first Triathlon, and during the OWS (61F) within the first 10 strokes I could not breathe. I did not have enough breath/oxygen to tread water or doggy paddle. All I could was float on my back (wet suit on). I tried to back stroke but I did not have enough air, all I could was float and move my wrists. This was during an official Triathlon so there were kayaks in the water. One came up to me and asked if I was ok, honestly at the time I was so embarrassed I thought it was just a panic attack, since I never heard of SIPE, I told them I was fine and I just needed to catch my breath. After to drifting to the shore, I just sat in transition for about 30 minutes, when I went to breath I coughed every time and there was chest pain and burning pain in my lungs. Foolishly, I still thought it was panic attack or anxiety, so I moved onto the bike, every time I had to peddle I had to dismount and walk because I could not catch my breath. Since I exerted no effort on the swim or bike I tried to run but could not. On my way home I had to pull over and take a nap because I was so exhausted. After I got home, I napped for another 3 hours, and was still completely out of breath. After Googling my symptons I read about SIPE, I went to Urgent Care they even did a chest x-ray that came back as abnormal and said that I did not have SIPE. They then sent me to the ER since they could not diagnose me, not because they thought I was in danger. After waiting 6 hours (about 16 hours after the OWS) in the ER, my breathing was back to normal with mild chest discomfort, the Dr told took some blood work and said that they were going to release me since my vitals were fine, and they could not diagnose me, I asked if could have SIPE and they said no. When they went to discharge me they said that they had to keep me, not because of SIPE but because they thought I may be having a heart attack because my Troponin Levels (the protein your heart release when people have heart attacks) were more then double the normal. (I am a healthy 46 year old training for Ironman). This then lead to 4 days in the hospital not because I was in distress but because they could not figure out what was wrong after they concluded that I was not having a heart attack. Day One I had to perform a stress test which I was fine. Day 2: they did a CT scan to get a better clarity of my abnormal chest xray I had in urgent care, they concluded that I had fluid in my lungs, and that I had pulmonary edema , I asked if I had SIPE, they were not aware of what that was. So then they did a COVID test which was negative. Day Three: I had to wait for an EKG to determine if I had a defective heart or valve which would of caused the fluid to get into my lungs. Day 4, finally had the EKG and heart and valves were fine, and I was then officially diagnosed with SIPE. Treatment: None, I was told to stay away from cold water or not to wear a wet suit because the compression, or swim but do not submerge my head in cold water. I no longer where a full wet suit, I use the wet suite pants and sleeves. The point is there is no cure and there are too many factors that may trigger SIPE, but the more awareness and education can make a difference to those who are experiencing it or for those who see someone in distress. I hope that Triathlon Even Coordinators should be trained, to know what the symptons are and to realize the difference between anxiety and potential respiratory problems. And most importantly provide awareness to emergency staff and Hospitals. Thank you so much for sharing the video.
You’re welcome J. I’m sorry to hear you had such a terrible experience it must have been so frightening. I made this video because the knowledge on SIPE is so low. Thanks for watching, Rach
Thank you this most informative video. I’m sure this happened to me last year. I’m going to check it out.
I hope you find some answers Maisie 🏊♀️😀
Very informative video. never heard of it before.
Thanks Gary, I’m glad you enjoyed it 🏊♀️😀
Thank you. I've never heard of this. So well explained. Useful to know and maybe we can help those who get in trouble
Glad it was helpful! I hope raising awareness will reduce the more serious cases.
Really useful and practical advice thanks, shared with our swimming groups in Moray, Scotland
Thank you for sharing!
Thank you,Rach.
You are so welcome!
I used to get this when I first started open water swimming whilst doing triathlons. I haven't had an episode for quite a few years since discovering about it. I got a better fitting wetsuit, practiced calm breathing before getting the water and got out the water the moment I felt the cackle in my lungs. From experience the cackle happened on the exhale rather than the inhale as asthma tends to be.
Great that you recognised it and found a strategy that works for you. Thanks for sharing
Wow, how interesting, I had never heard of SIPE, thanks Rachel 😊
Fingers crossed you’ll never need the info in the video, but I’m keen to raise awareness. Thanks for watching.
Thanks Rachel, thank you for this video. I've never heard of sipe before.
Appreciate it 🙏☘️
I've only ever heard of dry-land drowning but the symptoms sound very similar..
In our conversation Dr Ruth did mention that this happens on land at altitude too. That comment was lost in the edit.
I’d never heard of SIPE before, now I know what to look for! Thank you!
Great! The more of us that know about it, the better off the swimming community will be. Thanks for watching 🏊♀️😀
@@EverydayAthleteRach is it something that shows up in particularly cold water?
Really really useful. Thanks, I've a triathlon client who has reported this a couple of times. Calling NHS helpline was useless apparently, the lack of knowledge within the service explains that then.
Hi Adrian I'm pleased you enjoyed the video. I have quite a lot more footage, but needed to edit to keep it within the realms of watchability! It does seem like knowledge of the condition is patchy.
Ohhh...SIPE sounds very grim.
Good to know about it.
Very well explained.
The more of us that know about it, the less people we'll lose to it.
Thank you !!!
You’re welcome
May you live long happy and healthy my great friend! Lot of love and great respect from a solo mountain hiker friend from the Lower Chitral District of Pakistan.
Hey there lovely to hear from you this week. I hope all is well in Lower Chitral.
thank you for sharing this, I had not heard of SIPE before - it certainly would explain the only time I failed to finish a swim in a triathlon (out of > 100 events). It was a river swim but after heavy rain, so the water was colder than usual and the current stronger. I was just about managing on the downstream leg, but as soon as I turned for the upstream leg I just couldn't get enough breath to make any forward progress. Very scary, particularly when all the safety craft were on the other side of the river and wouldn't cross the stream of swimmers. I was left hanging on to the mooring chain of a moored boat until one came across and towed me to an escape point. Now at least I understand what was happening to me. I do have a tendency to high blood pressure, so that combined with anxiety over the strong current could well have triggered an episode of SIPE.
Wow! I bet that was a scary. Hope knowing what to do if it happens again gives you some comfort.
Yep, really insightful & great advice before the big influx of swimmers new to OWS over the next few months; I really want to know what to do if somebody gets in a pickle! Take care everybody and listen to your bodies (and Rach!).
Glad you enjoyed his one. Ruth was absolutely fascinating, I learned heaps filming this one 🏊♀️😀
The seagulls are back… I have missed them!! Of course… I am referring to the colourful painting on the back of the beach hut. On a more serious note…once again we are reminded of the importance of being fully aware of the body’s normal condition, and then being prepared to take action when things don’t seem right. This video was really informative. I like that Dr. Ruth explained the difference between treatment for shock and treatment for SIPE. Thanks for keeping our swim smarts up to date Rachel. PS - I see you are really closing in on 10K now. Whoop!!. Whoop!! PPS - I checked out my lake this past Sunday… it’s still covered in ice, and the trail down to the lake is thigh deep in snow. It’s going to be a little while yet before I can take the plunge. (Hoping for mid-April.) 🌎💦Ⓜ️ary🌸
Here’s hoping your lake starts to warm up soon so you can get a dip in. I thought it had been a while since the seagulls made an appearance. I’m pleased you enjoyed this week’s video Mary. Hope you had a good spring break.
@@EverydayAthleteRach I’m still on Spring Break for 1 more week (an advantage to living in the North is that people have to travel to get to anything such as sports tournaments, shopping, medical appointments, etc.) so we get one extra week at Spring Break to accommodate our remote location and the need for travel at this time of the year. Loving live the seagulls… looking forward to seeing more of them this summer swim season🤣. Thanks for all the awesome content Rachel 🌎💦Ⓜ️ary🏊♀️
Really interesting video, thank you. May I ask where you are on the video as it looks lovely with all those beach huts!
Hi Karen it is Calshot Beach, swimable around high water.
Great explanation, Does this ever happen in a pool or is it only in cold water?
I can see from another comment response that Dr Williamson says this about the pool:
"the pool environment - warmer environment, with often shorter swim sets with standing up in between and wearing only a swimsuit all reduce the risk. Having said that I have seen it in a pool but only after 17 miles of swimming a mile on the hour every hour so not your typical training set."
Hope that helps :)
Very informative video !
How rare is it ? Percentage wise ?
Dr Ruth wouldn’t put a number on it as not all incidences are identified as such. She just said that it was rare.
@@EverydayAthleteRach Thanks 😊
Thanks for this video. Now I understand more what is Sipe is. But do you know if you can hear the cracking sound if it is with an other person than your self. For example with someone your swimming with?
Thanks Rachel for the answer.
Hi Ida, you may find this article useful www.slowtwitch.com/Training/Swimming_Induced_Pulmonary_Edema_SIPE__45.html
I experienced this a number of times, since childhood. I just found out my 18 yo son does, too. We are not long distance swimmers. I'm wondering if it might be related to Ehlers-Danlos Syndrome or POTS for us.
Oh wow, that must be quite scary. Have you asked your doctor about it. I am not medically trained so can't comment on a possible link.
This has happened twice now. Once in a 1.9k event and once just easy training in the lake when at the weekend. What can I do to prevent this happening?
It seems like once you have had it it's likely to recur, but being aware of it and what to do to reduce the severity will be key.
I had it. I didn't know what it was until days after my swim. It was in a 10-hour swim and the last hours I had a lot of cough and blood in my expectorations.
Blimey, that sounds frightening. Did you recognise it at the time?
@@EverydayAthleteRach Not at that time. A couple of days later, a friend/doctor was concerned and found information about SIPE. I was two months away from crossing Río de la Plata and got worried. Every doctor I visited for what had happened told me something different: “ if you swim again you will die” or “it is nothing you hurt your throat and that's where the blood came from” 🤷♂️I didn’t knew what to do Finally, this friend/doctor suggested “Do Río de la Plata, but if you have symptoms get out of the water” I never had symptoms again and crossed Rio de la plata in 14 hours. Many long swims after and still no syntoms. Your video was very useful. Became a subscriber Thank you
Is there anything to do before getting in the water to help prevent? I have experienced SIPE 3 times in the last year - yeah, I keep trying to finish my Ironman races!
It does not happen to me in the pool - any reason?? Thanks!
Thanks for your interest in this complex subject. I dont have all the answers but the pool environment - warmer environment, with often shorter swim sets with standing up in between and wearing only a swimsuit all reduce the risk. Having said that I have seen it in a pool but only after 17 miles of swimming a mile on the hour every hour so not your typical training set.
If you have suffered from recurrent sipe it may be worth getting checked out by a cardiologist as some people are naturally more predisposed to it than others.
I have asthma and sometimes have to have antibiotics, is cold water swimming safe for me?
I have asthma too. Stay in your depth and just stand up if you don't feel right, rolling on to your back to float and get your breath will help. If you're worried speak to your doctor. 🏊😀
what causes it? swallowing water?
That is explained as well as is known in the video 😀
Я проживаю в Украине и просто люблю плавать на речке. Думала, что могу плавать без остановки сколько угодно. Я любитель, плавая больше часа, я выходила из воды и никогда не было одышки или усталости. Даже серцебиение было, как в состоянии покоя. Вчера произошло нечто, что заставило меня испугаться и сомневаться в своих силах. Это было вечером после 20 ч, солнце спряталось и вода была чуть прохладнее, но спокойная и полный штиль.
Я плавала больше часа и возвращалась к берегу, оставалось совсем небольшое расстояние ( минут 5-10 плыть ). Резко, мне стало не хватать воздуха и появилась одышка и мокрые хрипы на выдохе . Казалось, что мой купальник сдавил мне грудную клетку и из-за него я не могу дышать, его хотелось развязать. Я перевернулась на спину, чтоб отдышаться, но это не помогло. Рядом никого не было, на спине я попыталась потихоньку ногами гребти к берегу, но одышка из-за этого усилилась. Тогда я просто лежала на спине, ничего не делая, но одышка и хрипы не проходили. Звать на помощь не было сил и я подумала, что если попробую кричать, начну задыхаться еще больше.
На берегу был муж с детьми и я их видела, но пыталась как-то доплыть, чтоб не испугать их.
Когда оставалась до них совсем небольшое расстояние, я , лежа на спине и надеясь, что меня услышат, сказала мужу, что " Я устала ". Он понял, что что-то произошло, подплыл ко мне и вытолкал на берег.
Находясь в воде и зная, что я физически здоровый и крепкий человек, я не знала об этом заболевании и не поняла, насколько это серьезно.
Это не простая одышка. Я не поняла, почему это со мной произошло, но в этот день я немного устала и не выспалась.
Пишу об этом, чтоб все, кто совершают такие заплывы понимали, что такое может с ними произойти и что они будут делать в таком случае, чтобы выжить. Действительно было ощущение, что я нахлебалась воды и не могу дышать из-за этого. Это не паника, это что-то происходит с Вашим организмом, помимо Вашей воли и здоровья, причем внезапно.
Люблю плавать, но пока думаю в ближайшее время только в бассейне буду потихоньку пробовать. Очень страшно было перенести такое состояние.
Hi there! Thanks for watching, I'm touched that you have messaged me from Ukraine - I hope you and your family and friends are fit and well and coping with the challenging situation that we see on the news and that I can only imagine being part of.
I'm sorry to hear that your swimming got interrupted by feeling ill in the water. It does sound like you may have experienced SIPE. You seem to have done all of the right things though - rolling over on to your back and taking it easy trying to get to the shore. Would it be possible to swim along the shore of the lake, maybe within your depth, so that if you experience it again you could stand up and get out?
I hope you've made it back to the lake to swim, let me know how you are getting on. Rach x