Monday, 30 November 2009

World Champs, Bahamas

After three and a half months of travelling I arrived back in the Bahamas for the third time. Everything here is so familiar now: the tiny airplanes, the blue hole (the dark, weedy, full of current version), the narrow winding, pop-hole ridden roads, the left hand steer cars (they drive on the left, doesn't make for great visibility), the friendly people, the fact that I have to ask myself over and over if the locals are actually speaking English (yeah man, dey are, but it aint pwerfic), the need to disregard how much everything costs (or you'll have a nervous breakdown), the menu at Rowdy boys (the waitress remembered my name – can I just ask for the usual?), not having to lock anything, endless white sand beaches, turquoise water, slow internet, extreme boredom (not so bad this time because I've come from Dahab and am used to filling in time with very little). We managed to luck into a house on the hill in Turtle Cove. It's big and has a stunning view out to the sea. It doesn't have windows in the living area, just bug mesh so it's cool and breezy, and occasionally it rains inside, but even that is a bit refreshing after Dahab. The great thing is that I can see the sea from my bed. When I wake up in the morning I don't even have to sit up to be able to glance out and see what we expect of the day ahead. There are three rooms so I'm sharing with Chris (NZ) and Junko (Japan).


Fortunately Dean's blue hole was just going through it's morning high tide phase while we were training and conditions have improved immensely for the competition. I arrived a little over two weeks ahead of the world champs to ensure some time to adjust to the hole and recover from jet lag. My training was going pretty well. Initially I felt some fatigue during dives, which was to be expected, but I was still going fairly deep without squeezing or packing. I had a few issues getting my head around using my monofin, but managed to get back to my personal best after a couple of attempts. I was diving happily and not squeezing.

Kiwi team

Dean's Blue hole set up for the World Champs

Three days before the world champs I did a deep monofin dive and it went well. I did not squeeze, black out or suffer from much lactic. I did feel a bit of pressure on my chest and trachea, but it all seemed fine and nothing out of the ordinary. The next day I did what I thought was a conservative no fins dive that was meant to be a confidence dive. I had a small squeeze and a bit of a shake on the surface. The next day I rested and nominated a little less (51m) for the no fins heats the following day, thinking that was an easy dive and that a day of rest would make everything fine, since I'm always much stronger in my dives after a rest day. Then I got the sore throat. I tried to ignore it and hoped it would go away. I slept particularly well. On the morning of my dive it was very sore. I did a little negative warm up dive that hurt a lot, but must have loosened thing up a bit as a second one was much better so I decided to go for it and just try to keep my chin well tucked in. I managed to suffer a fairly sizable lung squeeze and then a small black out on the surface. The rest of the dive was fine apart from the fact that the safety were really deep and I started trying to glide up to the surface a bit early. It was still only about 2:05 dive time. I was pretty disappointed. The sore throat got worse and now I have no voice, plus I feel the mucous is starting to form. I'm hoping it stays in the throat and does not spread to the sinuses or chest. I managed to not get sick in Egypt so it's pretty annoying to have problems here. It's quite reminiscent of the cold I had in Arhus earlier this year, however in the pool I do not need to equalise so can get away with a bit more. I'll see what tomorrow brings as it will affect my constant weight announcement for the following day. I really hoped that I would not get squeezed here and was planning nice clean conservative dives, but once it starts it just seems to get worse and it doesn't seem to matter how much I pull back, I really need a week off to repair. I don't even feel like I did anything stupid to deserve it this time...

Update from following day:
after three days of sore throat I lost my voice and it's turned into intense amounts of mucous. I'm not sure if I'll even be getting in the water tomorrow.

Lung Squeeze clarified

Lung squeeze is a shy topic among freedivers. There is very little information available either in books or on the internet and little scientific research seems to have been undertaken, as if it is a rare and uncommon problem. However, when asking around it seems most freedivers have suffered from it at some point in their diving careers, coughing up varying amounts of blood. Some continue diving and seem to get over it. For others it never goes away and they eventually retire from deep freediving with great frustration. Not coming from a scientific background, I struggled to find good explanations describing what happens and why and still am failing miserably to solve the problem despite giving myself time to try many different things that have worked for other people. I am also slowly learning from my mistakes. Here is some information that will hopefully help others to avoid what I have been experiencing.

You do not have to be a particularly deep diver to experience lung squeeze. I have heard of divers experiencing squeezes after dives as shallow as 4m (in a swimming pool), especially if they are diving on FRC, negatives or passive inhales. You do not actually have to cough up blood to be suffering from a lung squeeze. You may just be able to feel a little bit of fluid in your lungs after a dive and take a while to recover while breathing heavily. If you continue to dive after this then you will most likely make it worse and end up coughing up blood, requiring a longer time to recover.

There are two things that can happen. The first is that as you reach residual volume (the volume of air remaining in your lungs once you have fully exhaled) the negative pressure in the lungs will cause the lung walls to stick together and cause damage as they peel apart (essentially grazing the inside of your lungs) and the blood vessels can swell up and burst, causing bleeding inside the lungs (pulmonary edema). This creates a cough reaction to remove the fluid (blood) from the lungs. The likelihood of this happening is increased by diving deeper than your residual volume, the occurrence of contractions at depth or the use of the valsalva method of equalisation (pushing air directly from your lungs to equalise your ears), all of which create a huge negative pressure within the lungs and tension on the chest. Once a squeeze has occurred there will be scarring on the lung tissue and the chance of it happening again is greatly increased over the next few days and possibly weeks.

Other factors that could contribute to a squeeze are fatigue, discomfort and fear, tension or lack of flexibility through the chest/ribcage, or lack of elasticity in the lungs, which seems to be the case with a lot of pool divers who have stretched out their lung with a lot of packing. Over hydration can be a factor in blood spitting as there is already more fluid around the lungs which may not be retracted into the body after blood shift, however dehydration can make equalisation more difficult and cause the diver to tense up the chest area. Jet lag can make “easy” dives very uncomfortable and tiring. Careful adaption dives are fine while the body is jet-lagged however deeper dives should be delayed until the body has recovered. A general rule is that jet lag, whether you consciously feel it or not, lasts about one day for every hour difference.

There may be more blood if the squeeze occurs near a capillary where there is more blood available, so the quanity of blood is not a good indication of the severity of the squeeze. There may be a lot of pain or no pain at all depending on where the squeeze occurs, as there are no nerve endings in the lungs.

Trachea squeeze should also be noted. Sometimes divers come up with a sore throat and spit a little blood, usually just a small amount and only once. This is often after looking down at down at depth and creating a negative pressure in the incompressible and delicate trachea, which can also result in burst capillaries. It is possible to increase the flexibility of the trachea to avoid this.

The second issue is the potential for over pressurisation of the lungs (pulmonary barotrauma) on the ascent once bloodshift has occurred, which would suggest that full packing for deep diving is problematic. A freediver who packs on the surface will use a little air in equalisation and metabolism during the dive, however the overall quantity of air in the lungs does not decrease a great deal for the ascent. If there is blood remaining in the lung capillaries from the blood shift then there is again the potential for the already swollen blood vessels in the lungs to rupture near the surface and the diver experiences overpressure. Barotrauma is normally identified by foamy blood.

Lung squeeze can be serious. If your lungs are full of fluid, the alveoli are not able to pick up the oxygen from your lungs to transport it through your body to where it is needed for metabolism. Your oxygen saturation levels are low and can remain that way for a long time. In an extreme case this can cause secondary drowning. If it occurs at sea you may not be physically capable of swimming back to shore or the boat. You may not have the energy to remove your wetsuit or walk to the car. Fatigue and wheezing from serious squeezes have been reported to last up to a month in extreme cases.

Remember to always dive “one up, one down” with your buddy and ensure that they understand the potential dangers of squeeze. I often black out when I suffer a lung squeeze, even if the dive is much shallower than what I am usually capable of. My body is unable to absorb the remaining oxygen in my lungs to complete the dive and it is slow to recover when I begin breathing on the surface.

To try to avoid lung squeeze you should consider the following:

  • Avoid stretching out at depth with arms or neck. This includes looking downwards, taking large strokes/pulls at depth and swimming or freefalling with arms stretched above your head.
  • Try warming up if this reduces your contractions at depth
  • Work on your ribcage flexibility and stretch this area before diving deep
  • Turn before you experience contractions at depth
  • Progress slowly each time you start diving to depth
  • Avoid deep dives after travelling, especially if you have changed time zone or feel tired. Allow time to recover from jet lag prior to competing.
  • Only dive as deep as you are comfortable with to avoid panic at depth
  • Learn to relax at depth and release any tension from around the chest area prior to going to great depths. This can include tension from equalisation and learning to just keep the eustation tubes open during mouthfill equalisation may help or finding a very relaxed and streamlined body position that suits you.
  • Learn the frenzel/mouthfill technique of equalisation
  • If you are warming up and can feel the previous squeeze, do not continue with your deep dive
  • If you have a history of squeezes, in competition nominate depths much less than the sucessful (no squeeze) dives you have completed in training and do not try for a personal best in the 3-4 days before
  • If you have a history of squeezes, rest the day after a deep dive (even if you do not squeeze) as the potential for squeezing the second day seems to increase even if the second dive is much shallower.
  • Maintain regular depth training sessions, even in the off season
  • Start exhaling just before the surface (however this should be practised in a controlled environment)

If lung squeeze occurs you should:
  • Stop diving and exit the water
  • Stop any physical activity. Ask your buddy to tow you to shore and carry your equipment
  • Breathe pure medical oxygen, if available
  • Seek medical advice promptly, preferably from a designated dive doctor. They will quite likely give you some antibiotics to ensure you do not get a lung infection or pneumonia
  • Drink plenty of fluids
  • Take iron and vitamin C to help repair and reduce risk of colds
  • Rest at least for several days before diving or putting any pressure on the lungs

travels cont...

After my final lung squeeze in Dahab (a fairly decent one), I decided to spend my last week not doing any deep diving and instead finally do what I'd planned to the whole time but had been rather distracted from and spend some time relaxing and playing with fish. I managed to persuade buddies to come with me to some of the local dive spots to finally get a feel for the place outside the big hole.

I discovered the timid little eels at eel garden. It was a bit of a cheap thrill. You have to practise very quiet duck dives to get down there before they notice you and become shy, retreating back under the sand. While out of the sand they just look like grass really, so not particularly stimulating. However the dive spot was quite pretty with lots of fish and colourful coral.

Wendy came with me to the Caves which boasted some interesting lighting effects for photography and had a couple of moments of pretty coral. The caves actually went back in under the beach which was quite odd. There was a curious barracuda and some Russian mermaids.

Lighthouse (aka Light Howse) was full of incompetent scuba divers doing intro dives with dive masters swimming above them holding their tanks. It's actually quite scary to watch them as they have absolutely no idea what they are doing.

Wendy and I also dived the canyon. I'm absolutely scared of doing swim throughs. It really doesn't matter what depth they are. Fortunately we had a brilliant day. The sun was shining, although that's really a given for Egypt, there was no wind whatsoever and the sea was so flat it was reflective. We struggled to find the canyon after poorly selecting and following some random scuba divers who strangely enough obviously did not intend to dive the canyon despite diving at the site. The surround area is fairly dead an uninspiring so I don't know what they were thinking. Eventually we found the big split in the rock below us. It was 18m under and we could see it perfectly from the surface. The part of the canyon that we managed to have the nerve to swim through is about 25m deep and roughly 10m long. Being me, I completely screwed it up. I swam very close to the bottom worrying about hitting my head so was 28m under. I'm used to dynamics so started swimming along and hit the end. Now instead of then swimming up I looked up and couldn't see the hole to get out, thought I hadn't gone far enough (but had actually gone a little too far) and that I just couldn't see clearly (my eyes are useless and it was a little dark), so I turned around and went back the way I came. Luckily Wendy recorded the evidence on video so my stupidity can be retained for all eternity. I then had to do it again properly and almost did the same thing again, but I'm pleased to say I did manage to do it sucessfully eventually! There was some nice coral nearer the shore where we were a bit out of the way from where the destructive scuba divers would swim to. Wendy and I agreed that coral and goldfish get a bit boring though.

I'm proud to say I made it out of Egypt without really getting sick. OK, I did have 8 hours of fever and headache, but it made me stay in bed (note bedroom, not bathroom) for my rest day, so it wasn't all that bad. Patti managed to accidentally drink some fresh nile water and not get sick, which was just as well since she was on a feluca, which tend to not have toilets.

My last week in Dahab was a bit up in the air. I didn't know when I was leaving as my flight from Cairo to Madrid was cancelled and I'd been moved to the next day, which was just one of the worst things in my world at the time as it would leave me with only one day in the western world prior to entering back into another backward sandy place. Plus there is too much fantastic art in Madrid to get around it all in a single day. Fortunately my travel agent managed to get me out of Egypt earlier rather than later and I was saved with three days in wonderful Madrid. I'm still unsure if Madrid was so wonderful due to the contrast with Dahab or because it's actually a fabulous place. I arrived at about 4am and got ripped off by a taxi driver who I didn't have the willpower to fight with and I didn't think my 2 Spanish lessons (one done in the airport in Cairo late at night) would help me much for this argument. Once the hostel owner had figured out who I was and actually let me in and I'd climbed the three flights of stairs with my 40kg of gear I went to sleep and managed to sleep right through the changing of the guard at the royal palace, which is special because it only occurs on the first Wednesday of each month, while I happened to be there, sleeping obliviously through the whole thing.

I had great plans for my extra day in Madrid including some me time and pampering (I'm in desperate need of some work on my hair and unfortunately still am). Anyway, I ended up spending three days walking all over Madrid, truly exhausting myself with no time to stop at all. Madrid is a beautiful city with a lot of interesting history. I did a couple of walking tours of the city (the centre isn't all that big, similar size to Wellington). I visited the palace which has a very awesome armoury. I got my Picasso fix for the year at the Museo Reina Sofia. I saw so many of the masterpieces I studied in art history at uni at the Prado. I visited the Caixa Centre, a hovering brick building by reknowned architects Herzog & de Meuron. I went to the compulsory tourist flamenco dance show. Plus I visited a few other galleries that seemed significant. As I was on my own I took up a challenge I found at the tourist information centre to take snapshot photos of a list of random monuments around Madrid. Being me I took it to heart and did both of the tours on offer and saw a few more things than I would have otherwise and ended up walking all over Madrid and exhausting myself a little more. They gave me a couple of free gawdy t-shirts in the wrong sizes for my efforts (more stuff to carry). I wish I'd had a few more days there, but definitely intend to head back to Spain at some stage in the future.

After just about killing myself carrying my gear back down the stairs, up the road to the subway, through the very narrow entry onto a train, up and down some stairs, onto another train, then yet another walk and another train I made it to the airport, which is new and very flash and thankfully, where there are trolleys. It was designed by Foster and Partners (the airport, not the trolley) which unfortunately has nothing to do with the firm I work for (Foster Architects – Ang and me vs Sir Norman with his hundreds of staff in offices around the world). After surviving the first of many interrogations (because I was flying to the USA and EVERYONE now wants to bomb them because Americans are just so annoying) I was hoping there would be some shops where I could buy some nice Spanish couture with my remaining 20 euro, but I was departing from a satelite terminal which was much less exciting and only gave me boring chocolate and alcohol options. Neither of which are particularly condusive to freediving training, yet everyone knows that freedivers consume vast quantities of preferably dark chocolate while no one is watching – full of anti-oxidants – we ignore the fat. Most freedivers could do with a bit of fattening up anyway, then they'd stop complaining about how cold it is when the water is “only” 26 degrees. We're lucky to have air warmer than that in New Zealand.

After my three days in Madrid I was already suffering water withdrawals and despite immense fatigue I managed a swim, spa and bath in my flash airport hotel in Miami before passing out.