Fancy A Dip?

Christmas Santa Claus SwimDay morning.  I can nearly guarantee that here in the UK, it won’t be crisp, white and even outside, but in a lot of kitchens up and down the country, the air will be turning blue with the language, due to the stress of producing the most important meal of the year.  For some people, the lure of the sea is greater than that of the kitchen and will meet in either fancy dress or just their swimming costume on the beach for a dip.  This is an event that has become a firm tradition, that is now sadly under threat due to health and safety.

SAFETY FIRST

Now as a swimming teacher, I am expected to cover basic water safety with the children that I teach and from this perspective, I would definitely tell them not to enter open water during the winter months, especially as children are not very good at regulating their body temperature unlike adults.  However, adults should be allowed to make their own informed decisions and not by health and safety bodies that don’t actually know what they are talking about.  So the obvious ones are don’t drink alcohol and don’t over-eat before the dip.  Check the weather forecast and the sea conditions, as even experienced outdoor swimmers have encountered problems, like Jane Hardy, member of the Alnwick Sea Swim group who acts as coastguard by checking the tides and sea conditions, as well as one of the administrators for their Facebook page.  “We did a new year dip last year and discovered we were in a tidal surge!!  Didn't get much swimming done - struggled to stand up.  I think kids need to be educated about the shock of cold water.  How to spot a rip, stay calm in a rip and get out of one.  If you get them early enough in the national curriculum you could save lives.  It's lack of knowledge (and possibly alcohol) that causes deaths - jumping into quarries in the hot weather, deciding to swim across rivers etc.  You look at Scandinavia and whole communities wild swim in the summer safely because it's a way of life.  Ban them and they'll jump in anyway - they're kids.  Educate them and they have a chance to make an educated decision.”

White Christmas DipThe annual Christmas dip brings people together, creates memories and fun.  These types of events can also raise money and awareness for a good cause.  The White Christmas Dip, which has taken place on Bournemouth beach next to Boscombe Pier since 2008 raises “much needed funds for Macmillan Caring Locally supporting the Macmillan Unit at Christchurch hospital, which is a Specialist Palliative Care Unit for patients in the local community.”  It is a minimum donation of £5, but participants are encouraged to approach friends, family and local businesses for sponsorship.  Spectators are more than welcome to join in with the festive merriment and to encourage the participants.  The White Christmas Dip takes place in controlled conditions and should be whole heartedly supported, likewise with the Brighton Christmas dip, that traditionally goes back 150 years.

BAH HUMBUG!

Unfortunately, Brighton and Hove council have banned it this year due to the fact that a man got into difficulty earlier this year in the sea and another man, 3 years ago, had to be rescued whilst participating in the Christmas dip.  This is a complete overkill.  The first incident did not even happen during the event and whilst the second one did, both men were rescued.  Accidents happen, life should be about an element of risk and not so cotton wool wrapped as is preferential by local government. 
For more information on The White Christmas Dip, please visit: http://www.whitechristmasdip.co.uk

CHD Warrior

CHD Warrior

Lucy, 7, started swimming with her primary school in year 2 in the term after Christmas 2013.  She also suffers from CHD.  I asked Lucy’s mum, Amanda, what CHD is and how does it affect her life and in particular, her capability to participate in swimming lessons.

CHD Is A Serial Killer

WHAT IS CHD?

Coronary heart disease is slightly different to congenital heart disease, which is what Lucy has.  So congenital means that she was born with an abnormal heart.  The word disease, does conjure up an image of the heart being decayed almost.  People tend to say congenital heart disease, but we also say congenital heart defects, because that then paints a slightly truer picture in people’s minds then of what’s going on.  So defects explains it a lot better than disease, so disease does sound wrong almost, conjuring up the wrong image.

Lucy’s CHD wasn’t discovered until after she was born.  Even though she had the twenty-week anomaly scan done twice, due to the fact the first scan couldn’t find any heart valves and a face.  Oddly at the time, I remember thinking please let my baby have a face, as they can fix her heart.  They repeated the scan, I think it was either a week or two weeks afterwards, probably a week and they said everything was fine and Lucy had a face and the heart was fully formed and wonderful!  But after I had her, it turns out she wasn’t.  Lucy wasn’t fine, couldn’t maintain temperature, had what was termed a tremendous heart murmur, which I think was the one thing I think that saved her life, because if they hadn’t found the heart murmur, they wouldn’t have known about her CHD and she wouldn’t have gone to thrive like she has.  So the CHD in itself affects her on a daily basis.  From the outside she looks like a normal child, happy, fit, healthy.  It is quite an invisible disease and anything that would be normal to you or I, such as a cold, can affect her more, as obviously anything that is upper respiratory, can affect her breathing, oxygen getting to her outer limits etc.

Lucy still has a heart murmur, she has two holes in her heart, one of which was patched and the other was just left because it was compared to the other one, it was nothing.  Heart murmurs are made up of holes.  But there’s lots of different types of heart murmurs, a lot of people have heart murmurs don’t even realise they have them.  People are also born with heart murmurs and then they go!  But there’s innocent heart murmurs which people live with quite happily and then there’s the type of heart murmurs that Lucy had, which point to something being a bit more sinister and so, on discovering her heart murmur, that’s when they found all the other anomalies with her heart and that’s when we got the diagnosis of Tetralogy of Fallot.  Which to put it in it’s simplest terms, the Tetra part of it, Lucy had four anomalies with her heart, except she had, normally in a textbook case, it contains one hole in the heart, whereas, she had two; so she was slightly different.  But even with a textbook case, there really isn’t such a thing, because every child is different, everyone copes with things differently.  Even the repairs that the surgeons do can be slightly different because you never know what you are going to find until you go in there and see what’s what and what you think maybe you are going to do, maybe you can’t do.

Lucy And Her Sister Katie Meet Mr Hearty From The British Heart Foundation.
Lucy (Left) And Her Sister Katie Meet Mr Hearty From The British Heart Foundation

CARE PLANS, SWIMMING AND MORE CARE PLAN MEETINGS

So a special meeting about swimming lessons was arranged between us and the school, just like an additional care plan meeting really, just to make sure that everyone was on the same page, we knew what was what.  The main issues were really that breathlessness can be a big issue when exercising anyway, but I think it was more temperature controlling.  Lucy does have a tendency to go blue in her extremities and is naturally quite blue around her mouth.  But also, interestingly, she has a vascular birthmark that runs the entire length of her right leg, which for her, is like an inbuilt thermometer.  So if Lucy’s warm, you can’t really see this birthmark, if she is really really hot, it goes white. 

So for example, if she has a slightly warmer than it should be bath (we are all quite tempted by those aren’t we at times?!), then it will go white and you can see it visibly white.  Then normal, you can’t really see it and then as she gets colder and colder, it goes sort of pinky and then purple and then blue.  The birthmark is on the outside of her leg and it’s quite veiny and looks like your legs are when they are cold - quite mottled.  It is kind of like that, but on a much grander scale and because of increased blood flow and therefore increased oxygen, we were warned when she was a baby that the leg could grow quicker and therefore be longer or indeed, wider than the other leg.  But as Lucy seems to be walking quite sensibly, there’s not any issues.  Having that birthmark is quite useful, so it has always been incorporated into the care plan, but it’s quite useful for the swimming as well.  So then the school can see at a glance then whether she is cold or whether she is comfortable.

The care plan itself, is basically a step-by-step guide on how to care for Lucy really.  It’s broken down into sections, so it details emergency contacts and who her doctors are and cardiologist and what have you.  It details Lucy’s condition; it details what to look for on a daily basis.  It explains her food intolerances and explains a bit about what to do in PE with regards to exercise tolerance and whether she’s breathless or whether she starts sweating and basically covers everything.  It details who needs to be told about what, how long she can stay outside in the snow and if she’s cold outside, she can come in and she’s allowed to have a friend with her and basically everything.

When she started swimming at school, it was scary.  Trying to maintain temperature as well, getting in and out of the pool, obviously being wet, how are we going to control that, how are we going to make sure that she stays warm and that she doesn’t go blue.  So Lucy has quite a robust care plan with the school anyway for day to day, for PE and what have you.  We just had to make it slightly more robust for swimming.  Lucy’s monitored quite closely, she has somebody with her all the time.  Not in the water, but someone on poolside, that I don’t think is specifically for her, but they tend to hover round her more, because I know that there are other children that have issues, such as asthma, so I don’t think she has literally a one to one.  She doesn’t need to have a special swimming costume to keep her warm.  What they tend to do is keep her in the warmer pool, so they have said as she goes into her next lot of swimming at school (which will be at Easter time) that even if she is more advanced, they will still keep her in the smaller pool, so that she is nice and warm.

Even though Lucy doesn’t need a special swimming costume, she seems to maintain her heat quite well.  She has two towels, a wet towel and a dry towel, so that she is not sat around in a soaking wet towel for the whole time and yeah, she puts the fear of god into the teachers I think to be honest.

SWIMMING LESSONS, GOOD FOR THE HEART

Swimming wise, I think Lucy’s progressing ok.  I personally don’t take her swimming, but I have taken her swimming when we’ve been on holiday and she’s certainly not afraid of the water.  Lucy enjoys it; obviously it’s a good form of exercise.  Arguably, maybe it’s a good form of exercise for somebody with her condition, in some ways.  I mean, it doesn’t work for all children with CHD, because obviously there are issues with cold and going blue and what have you, but I think for somebody that’s in the warm water and somebody that’s reasonably healthy with it, if that’s the right term, it’s probably quite good because it’s not like a high impact kind of sport.  It’s not like Lucy’s got to go cross-country running or play rugby or anything like that.  It’s a nice form of exercise where her heart can be exercised, because obviously it’s a muscle and it needs to be used and she can use that without it being too high impact on the rest of her body.

For more information on CHD, please visit: www.bhf.org.uk/heart-health/conditions/congenital-heart-disease.aspx