Well that didn't go to plan. Instead of recovering from a celebratory Babycham in the White Horse in Dover I found myself in a hospital bed in Ashford on Sunday morning. My attempt to swim the English Channel was foiled in French inshore waters by Swimming Induced Pulmonary Edema (SIPE). I'd been airlifted from my support boat and was in a resuss bed.
The First 11 Hours
I started my Channel swim just after 7am on Saturday morning. The training had been done, it was a beautiful morning and weather was forecast to be improving. I had the pilot and crew that I wanted. I was raring to go. I was greased up in the mixture of sun cream and udder cream which it’s basically a mix of Vaseline and lanolin (good for cows and Channel swimmers and even better for Channel swimming cows). Over the side and a short swim to the beach at Samphire Hoe for the official start. A few Pilates moves on the beach and some wise motivational words to myself about not stopping until I hit France and I was off.
I fed every 45 minutes for the first six hours then every 30 minutes thereafter. As is normal on long swims it seemed to be an age until the first feed but then time weirdly starts to lose its meaning altogether. The White Cliffs slipped away slowly but I was pleasantly surprised when I was told sooner than expected that I was in the middle of English shipping lane and this encouraged me to plough on. My stroke rate remained constant and I was just starting to feel that I'd really settled into the swim when I reached the Separation Zone, the area between the English and French shipping lanes.
Apparently the collective noun for jellyfish is a smack. There were plenty of them in the middle of the Channel and I remember swimming through two large smacks of Blue Jellyfish but also saw lots of Compass Jellyfish and a few Mauve Stingers. Most passed harmlessly beneath me and I only picked up two or three stings which weren't too painful. I have to admit that I hadn't been looking forward to the Channel Jellies but on the day I enjoyed seeing them: they're really beautiful and give you something to focus your mind on. I'd add that I didn't see any of the large thug-like, but harmless, Barrel Jellyfish that the papers would have you believe terrorise swimmers along the South Coast.
My stroke was constant and I was really happy, swimming well until around the 11 hour mark. The swell had settled down in the separation zone but appeared to pick up again as we progressed through the the French shipping lane. I had a fantastic crew who knew how and when to encourage me. In fact their methods of encouragement were perhaps unorthodox but I should let them explain that themselves - what occurs in the Channel stays in the Channel!
Onset of Breathing Difficulties
I started to feel short of breath as we cleared the shipping lane and entered inshore waters. The conditions were now much rougher and I felt like I'd been swamped several times. I kept my stroke rate up and maintained speed but it felt progressively harder to catch a breath and I'd developed a rattling wheeze. I remember stopping, hoping that a good cough would clear the fluid on my lungs. It seemed to help at first but what I wasn't realising was that the fluid was coming from within my lungs rather than from the sea. My condition continued to decline as fluid from my blood stream flooded my lungs. In layman's terms pulmonary edema is fluid on the lungs and as it practically affects a swimmer in the water it's like secondary drowning.
The more my lung capacity decreased, the harder my heart had to work and the worse things got. It was probably a vicious circle that couldn't be reversed. In retrospect I should have quit at this point as it was never going to get any better. It felt like I was suffocating and I now know that technically speaking this was because I was. But the mind of a determined swimmer who has trained hard and made sacrifices for three years to achieve their goal of swimming to France is not rational! I was frustrated as up until recently I'd been swimming well and making good progress. I could see French shoreline ahead and remember thinking that it just needed a solid hour or so swim and I'd have broken the tide and would be within spitting distance... There was no way I was quitting and was determined to carry on... I'd have to be dragged out.
I was dragged out five minutes later after 12 hours 32 mins. Hypothermia can cause a confused mental state but my crew reported that I'd been fine and totally responsive right up until the final few minutes when hypoxia really set in. Once back on the boat my condition was assessed and swimming induced pulmonary edema (SIPE) was immediately suspected. The pilot assessed our position and it was decided that even if an ambulance was waiting on the dock then there may not be enough time as we were pretty much 1.5 hours from any major port.
I was on the edge of consciousness and it was decided to request assistance from the coastguard. The helicopter arrived within minutes and evacuated me from the deck of Sea Leopard. They immediately gave me oxygen before airlifting me to Ashford Hospital where I was further treated with oxygen and administered diuretics to clear fluid from my lungs.
I spent four nights in hospital. My blood tests revealed high levels of troponin which can indicate heart attack so I was admitted to the cardiac care department where they ran several tests and procedures including an angiogram. In the end the consultant seemed satisfied that although my heart had been severely stressed I hadn't suffered a heart attack but non-cardiogenic pulmonary edema.
Is SIPE More Common Than We Think?
One of the reasons that's I'm writing this in as much detail as I can remember is that I feel that there is some ignorance about the condition in the long distance swimming community. It's often reported as being rare but I think that it's probably just under reported. This may be because it happens at the end of a long swim and doesn't reach a critical stage. But if untreated and allowed to progress it certainly has the potential to be fatal. Since my story was mentioned on social media I've had several swimmers contacting me already suspecting that they’ve suffered from it. Also the consultant at Ashford hospital said a patient presented with it just a week before me after a training swim in Dover.
I've been truly humbled and moved by the messages that I've received from family, friends and even people I've never met. Although I'm never going to be able to reply individually to you all I hope that if you get to read this you will realise how appreciative I am.
My crew kept me entertained and made the first 11 hours of my swim a lot of fun. When the chips were down they made the right call at the right time. Without them I'd probably not be around. On top of this they've all been fantastic since and really helped me with the disappointment of not achieving my aim of landing in France. Any negative thoughts have been offset with the joy of still being here to write about it. I know naming them will embarass them but I'm going to do it anyway as they all deserve medals!
Stuart Gleeson (Cold Wet Pilot)
Gary Clark (Cold Wet First Mate)
André Roberts (Cold Wet Official Observer)
Tom Watch (Old Wet Bloke)
Marc Newman (Fast Wet Bloke)
Sarah Pascoe (Funny Wet Girl)
Karen Rees (Cold Wet Bon Jovi)
Sarah Oldrey (Cold Wet T-shirt)
Katja Tribbeck (Cold Wet Wife)
The helicopter crew were Martin, James, Garry and Ian. They arrived swiftly, assessed the situation and evacuated me to safety whilst administering first aid and preventing further deterioration in my condition. Proud to be be British but I guess I shouldn't have expected less. All done in a calm, efficient and friendly manner, even with a smile. Total credit. Thanks guys.
This was my longest ever hospital stay and I found myself fairly bemused. You spend all day with no idea what's going on then get 10 minutes with the consultant during which you forget to ask all the questions you've been saving up for the last 23 hours and 50 mins. I spent most of my time looking forward to mealtimes and the highlight of the day was to guess what I was eating. Systems and admin aside, the medical staff were fantastic. I had a brilliant consultant and fantastic nursing care. Special thanks to David who made me smile every day and the woman who come around with the tea trolley.
I learnt that I'm not immortal. That actually came as the biggest shock to me. I would still like to continue within the sport of long distance swimming but will not do so before I've answered some questions. I need to know if I'm prone to SIPE or whether this was a one off. I also hope that I can help raise some awareness of this phenomenon which I suspect happens more often than we think.
My training regime, crew selection and pilot selection all proved to be spot on and if I was able to go again I wouldn't change a thing in those respects. After preliminary reading it doesn't seem that there's total agreement on the exact cause of SIPE, other than it could be a "perfect storm" of a several contributory factors. There are some things we can't change such as vasoconstriction due to cold water and long term exertion, but other variables that have been suggested are over hydration, hypertension and even fish oil supplementation.
I'd also urge all other long distance swimmers to learn about SIPE, it causes, symptoms and first aid. There are degrees of severity but it seems that once a swimmer has begun to suffer the effects it can only be reversed by treatment. If you suspect SIPE, you must and without delay:
- Remove swimmer from the water
- Sit patient upright
- Seek urgent professional medical attention. (Oxygen is not normally carried on board pilot boats as it is a prescribed substance but professional treatment will probably include administration of oxygen and diuretics.)
If you're thinking of putting a team together for a Channel swim I'd urge you to make sure that your team is educated and knows the correct first aid procedures. If you are the swimmer don't fool yourself into thinking that you'll know your limits! I knew when I was going downhill and knew when I probably should have got out. But as Channel swimming has totally consumed all rational thought processes of late what I lacked was objectivity. The type of endurance that an English Channel swim demands makes it an extreme sport which requires extreme preparation.
I really hope that SIPE can be more fully understood. It would be a good thing if we were even able to build up a risk profile so swimmers could self-assess and minimise their personal risk factors. I was lucky as I had a great personal crew and a great pilot and boat crew. They were empowered by knowledge and skill and did everything right.
Don't let my recent experience put you off open water swimming! Whether you're interested in long distance swimming or fun dips, join your local club or Facebook group. If you're in the Bournemouth area I'd recommend East Dorset Open Water Swimming Club, Beyond The Blue, Durley Sea Swims and Just Swim. I regularly swim with all these groups and membership ranges from lunatics to World Champs! All the nicest people you'll ever swim with.