Dealing with Swimming Induced Pulmonary Edema
"In the days after, my lungs ached and felt bruised for over a week. With my first half Ironman looming I went to visit my doctor. My first two doctors told me to quit triathlon all together."
My first ocean OLY (Olympic-distance triathlon) did not go according to plan. I have an irrational fear of swimming in the ocean but I had a solid plan of hanging on the backs of women from my tri training group. I could not have asked for better circumstances. No waves or anything to dive underneath. I just had to walk into the Pacific and swim. Halfway into my swim, I began struggling to breathe. I tried swimming on my back. I tried floating on my back. I even stopped and hung on a guards surfboard. The lifeguard told me they were repositioning, would not be able to watch me any further, and plucked me from the ocean. I was devastated and cried the entire jet-ski ride back to shore. I felt defeated. I felt like I had given up. I asked myself, “What could I have done differently? Should I have just tried to continue on my own?” I felt like a failure. After speaking to the guard, they passed me to the on land crew, and I asked if I could continue on. He looked at me and said "It's not like you're going to the podium and if you're okay with that, and you feel good, go grab your bike and enjoy your Sunday." I responded with "I'm good with that, I just want to finish!" I was still out of breath walking to T1 and took my time to get there. I knew I would feel better once I got back on my bike.
I started off slow but I started coughing again with my legs feeling heavy and tired. I kept telling myself to take it easy, enjoy the view (I was just outside of Santa Barbara after all) and just go for a ride. There were a few climbs that under normal circumstances would not have been as challenging, but today, it was my Everest. I was coughing still with foam occasionally collecting in my mouth but at this point I ruled out an anxiety attack. I do not have asthma and no known allergies. I felt like my body was just giving up on me but I pushed on with Loop 2 now complete and T2 insight.
I arrived at T2 still coughing and winded. I felt very weak and dazed. My head games during the ride had started to get the best of me. "What am I doing?! Do I really think I can do a half Ironman in December? You've trained, Monya, and this is all you can do? THIS is all you've got?!" I was slow to get my shoes on and I didn't want to run. I was still having issues breathing. My coach checked on me because she saw the look of defeat in my eyes. She knew I wanted to give up. She knew if she walked away I would throw in the towel. At that moment she believed in me more than I did. She grabbed her running shoes and said “Let’s go, you’ve got this Monya!” She walked with me for the first 2.5 miles and it felt like it took a lifetime. I was still struggling to breathe and would often stop just to try and catch my breath. We eventually moved on to a 2/1 split. It was hard. It was painful. But I was moving at a 13:30 pace, it was all my body could muster up. At the turn around I needed to stop again in an attempt to breathe. My coach took her shirt off and had me breathe into it. It helped and I was able to pick up the pace to a 10:30. As we turned the corner and saw the finish line she told me she was going to jump out and that I need to finish strong. I got emotional and choked up as I slapped high fives and crossed that damn finish line (FINALLY!) my entire training team cheering me on. This was not the race I had envisioned. In fact it was very much the opposite. I’ve had an amazing race year. Not just setting new PR’s in each race but crushing them.
In the days after, my lungs ached and felt bruised for over a week. With my first half Ironman looming I went to visit my doctor. My first two doctors told me to quit triathlon all together. They explained to me that the sport was too dangerous. "Don’t you want to be around for your children?" I was told. Then, magically, the stars aligned and I met with a new doctor. I explained my symptoms and re-lived my race with him. He replied "I know what you have and I know how to fix you. We will get you to the start line of your HIM." I was ecstatic. I was diagnosed with SIPE (Swimming Induced Pulmonary Edema) and prescribed Viagra. You read that right, Viagra.
Here's what happens to your body when dealing with SIPE. Fluids from the blood leak abnormally from the small vessels of the lung (pulmonary capillaries) into the airspaces. Causing constricted breathing and possibly pinkish foam in the mouth. In other words, your lungs begin to fill with fluid. Your heart will not race like a panic or like you’re overdoing your cardio. You just feel like you are unable to expand your lungs and take in air. It appears to be more common when wearing a wetsuit (which I was). Another qualifier is being a female over 40. After doing more research and reading more posts in tri groups, SIPE appears to be fairly common but it's often misdiagnosed or not diagnosed at all. I'm writing this because I want to bring awareness to it. It's a simple fix. When you're in the throws of an episode, it's extremely scary. A part of me thought I was going to die or that I was possibly having early signs of a heart attack or stroke. The only way to stop an episode is by removing yourself from the water, removing your wetsuit, and any other restricting items before it worsens. My doctor informed me that there are no links to death with SIPE at this time but when left untreated, or if you're trying to push through that swim when you should have stopped, that could have lead to a heart attack and possible drowning. With what I now know, when I hear of deaths during swim portions of a triathlon, I always wonder if that person had SIPE and never knew it or was told it was something else like a panic attack. I feel very fortunate that my new doctor had studied outdoor medicine and had seen this many times in his extreme climbers. He knew how to fix it and how manage it. So now, an hour before a wetsuit swim, I pop a viagra and head for the waves. I finished that 70.3 with zero issues. I was over the moon ecstatic and thank my lucky stars for my new doctor.
Written By: Monya Rukavina, Tri Sirena Siren Luminary
Follow Monya on Instagram @mamasandmuscles
Have you ever had issues with SIPE? Let us know in the comments below!
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