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USAF PJ trainee lung squeeze

Thread Status: Hello , There was no answer in this thread for more than 90 days.
It can take a long time to get an up-to-date response or contact with relevant users.

quam

New Member
Aug 31, 2012
2
0
0
Hello Deeperblue,

I am not a freediver but in our training we do underwater training. While I know everyone here is in love with freediving, our training instructors basically use underwater training as a torture method to make the less committed trainees quit. Reading the exploits from the site members here has inspired to take a different attitude to our water confidence training.

My reason for posting is because during the last 3 weeks I have been occasionally spitting up blood after we do our water confidence training. Initially, I was thinking it was blood vessels in my sinuses bursting and draining down my throat. However, during an especially rigorous training session I spit up more blood along with the symptoms of wheezing and discomfort in my chest when taking a full breath. I continued that days training and trained for another week before seeking medical treatment. This essentially eliminated me from the current class but I will be able to repeat it in 6 weeks.

After receiving a CT scan the doctor noted "diffuse ground glass opacities throughout the lungs". I later had a bronchoscopy where any strange diseases or problems were ruled out. The pulmonary specialist said that the likely cause was blood vessels bursting in the lungs during the training. Conducting internet research has led me to this site. Where I see that this is called a pulmonary edema or a "lung squeeze".

I've read that a squeeze happens when lung's reach residual volume. But I think this seems unlikely in my case. The blood spitting would usually occur during "underwaters" (basically 25m dynamic apnea (no fins) with a freestyle sprint back on a timed interval). The two pools we use are only 9 ft and 12 ft deep, so this depth seems very shallow compared to the depths I've read from others experiencing a pulmonary edema. I've also read that contractions could contribute to a pulmonary edema. 25 m is probably no problem to most people on this forum but the training has caused me to get quite hypoxic. As stated, my worst episode occured during a more intense training session.

From the communities perspective, I know this is "just another squeeze post". And I have read many of those threads, but I am seeking some specific advice regarding my situation. Once the next class starts, if I were to have another pulmonary edema I would not be able to rest as many threads recommend doing after experiencing a squeeze. I would have to continue training or face elimination.

So here are my specific questions:
If I were to experience another blood spitting incident, how dangerous is it to continue to perform underwater training? (our course is 9 weeks long)
What can I do to avoid getting another pulmonary edema? I've read that stretching of the rib cage area could help?

Completing this course is very important to me, but my long term health is of more concern. I appreciate anyone would could take the time to read this post and supply an answer. I already have learned a lot on both my condition and on how to improve my training from this site.
 
Quam,

"Swimming Induced Pulmonary Edema (SIPE)" may be a subject you may want to read up on, it could be related.

I am not a physician but I have seen countless squeezes over the years that were all 'initially' depth related. The squeezes involved inadequate depth adaptation, stress, stretching of the trachea 'at depth' (looking up or down) and strong contractions. SIPE is the only occurrence I am aware of at shallow depths. Some athletes are predisposed to immersion edema.

The only pool injury I am aware of was sustained during a dynamic performance (distance) but was related to a previous depth injury. Strong diaphragmatic contractions were believed to be the cause of the bleeding in this case.

Exhalation diving with reverse packing (depth adaptation) in a pool can result in squeezes as well. I doubt the USAF PJ program teaches this type of diving. There is a much higher risk of injury with this type of diving, the risk increases with the amount exhaled, reversed packed and the depth of the pool. Stress can factor in as well.

When it comes to coughing up blood from the lungs, it's best to stay out of the water and allow healing the healing process to occur. The time out of the water will be determined by the seriousness of the injury. I always error on the side of caution and safety and recommend a month of rest (nothing strenous in or out of the water) then starting back slowly and building back-up. Those that prematurely dive again usually encounter problems (my observations).

Performance Freediving International (PFI) has had USAF PJ instructors attend courses in the past, funded by the USAF.

I wish you the best of luck with your training. I wish I could have been of more help to you. I am sure you will receive great feedback from other DB members. Keep the faith.
 
Last edited:
Yes, Delphino is right, this looks much more like SIPE, than the typical barotraumatically (depth) induced lung squeeze. If you did not read these following two threads, you may find interesting relevant information there:

http://forums.deeperblue.com/safety/69802-immersion-pulmonary-edema-lung-squeeze-help.html
http://forums.deeperblue.com/freediving-science/83004-new-study-lung-squeeze.html

Besides the mentioned predisposition, some additional factors may play a role - hypothermia, insufficient muscular relaxation, hypertension, the use of fish-oil. Also the use of Aspirin or other blood thinning agents may contribute to the lung oedema.

If you start caughing blood, it is not very safe to continue diving, not only because of agravating the situation, but also because with lung oedema the blood does not oxygenate sufficiently during the recovery, meaning you can blackout much easier, and before the CO2-induced urge to breathe kicks in.

Read the mentioned threads, look-up SIPE on the web, and/or consult an expert physician - there are some precautions available that will reduce the risk of SIPE.
 
Thanks for the two replies and the links gentlemen. I will bring up SIPE to my physician as this does seem to be a more likely explanation. Trux, do you know specifically some of the precautions one could take to reduce the risk of SIPE. I will stop taking aspirin and kick the caffeine as well. Do you know of any other measures I could take?

Thank you
 
Are you taking aspirin regularly for some reason? That for sure is quite strongly linked to SIPE. I mentioned some of the precautions, others are talked about in the threads linked above: avoiding blood thinning / antiplatelet agents such as fish oil or aspirin, avoiding excessive hydration prior the swim (but in the same insufficient dehydration will make the dives more difficult), avoiding products increasing high blood pressure, keeping warm (if you can, wear a wetsuit), staying as much relaxed as possible (avoding muscle tension, especially trying to relax the diaphragm), ...

Some basic info about SIPE, including preventive measures, is also available in the Wiki: Swimming-induced pulmonary edema - Wikipedia, the free encyclopedia
 
I would also advocate relaxing as much as possible. There an an aspring USAF rescue swimmer who trains in the pool here. The training methods - you mentioned 25m u/w followed by surface swims - he uses are very conducive to straining and tension. I've advocated that he focus more on relaxation - Train relaxation first - before exertion. I've found this approach tremendously helpful - the more strenuous stuff I do is MUCH easier if I train relaxation first. Then I keep the intention to remain as relaxed as possible during the strenuous stuff.
 
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