Monday, March 4, 2013

The Challenge of the transfer from Swimmer to Casualty

“Our limitations and success will be based, most often, on your own expectations for ourselves. What the mind dwells upon, the body acts upon.” - Denis Waitley

I know there is a lot of judgement on this but the challenges of life and swimming have taught me humility & to be honest with myself and those around me. 
"The last hero died in 1944" a woman once told me. The situations we find ourselves in, by our making or otherwise, if we can't change we need to keep moving..Decisions were made mainly as continuing would have caused more difficulty. You never risk the team. I took my time on this blog. I have debriefed to minutia with at least 7 member of the rescue who were present and my crew and this is as much their information as it is mine. We can focus on moments as being a "bad experience" or we can focus on the amazing way we internally step up to the bar. In swimming & life there are experiences that force us to be much greater than we were at that moment. Not an any point in the hour lying down did I feel I was in trouble-and again as like a few times before in my life being where I was and seeing who I am and seeing the people around me is a privilege not a negative. I have learned loads about me and not that I made the wrong decision but that I have a fight in me that was like a "light bulb" coming on. 

The wind was ripping, it has lifted so much since I went into the lake.  I was cold but the cold really wasn't important. My insides were fine, my hands and feet were freezing but my belly was warm. Siberia was -30 deg air a few weeks ago so this was acceptable. I had so many clothes on me and even though it was the right decision to sit down and not walk any further, the ramifications of saying "I can't" was creating a huge internal struggle. For anyone who struggles with internal conflict and chats, will know the fights and battles are of Sparta Levels. All else pales. Frances said that I was quite aggressive at one point. 

If I struggle down will it compromise my core?  Siberia was a huge learning curve. Seeing what was necessary to finish, the recovery and not just the distance. The weather was changing my plan, time was not with me today. My team needed urgency but it is difficult to rush an Ice swimmer.

I knew that it was 110 times more important to focus on my recovery. I knew about the after drop and I could feel my team were worried. I knew not to push too hard, not to ask too much of myself. I wanted to help them but I couldn't. My thermals were on, my survival immersion suit was on, my Ice Swim was completed and the team were ok and I would be OK I needed a moment.
Just like in life when a moment of trauma happens, the only way you can regain a perspective is for everything to stop, to get off the bus.  
A part of me felt that I could control my descent. I remember glancing at Frances and thinking Frances can't fall. She has work tomorrow. I knew what I wanted, I wanted to move but there was a blip in my thinking, it was 90% certain and 10% nervous. There was so much activity, so much movement around me. 
I wondered if I slid down on my bottom, but every avenue I went to in my mind all I could think of was " I can't".. I can't.. That 10% of uncertainty was enough to say no.

At this moment I was 100 feet from the road. My team were brilliant, that's why I asked them to support me. They have crewed and been part of my adventures for going on 10 years and they knew me inside and out. They knew what I can handle emotionally and today was not my day. 

I tucked my face into myself and closed my eyes.. if i'm not 100% then I'm out of the game. 
One of the greatest challenges for me as a person is that I am very independent in my thinking, in my organisation, in my swims. I have a huge expectation of myself and sometimes others. I am very particular to detail, I genuinely am not great at saying" I need help". It's a fault (& I don't have that many!!!) 

An image from Tyumen landed into my brain-a moment in the airport (those there will know)-where we was grappling with a trauma situation, a prestigious Ice Swimmer trying to help me with my bags was getting advice from another Ice Guru -"she's an Alpha female.. " is all I heard as I walked away with my bags... I giggled out loud hmmmmm Ram!! 

Back to my rock, this Alpha female needs to suck it up today. "I'm sorry" kept falling from my lips,I must have said it 10 times,  Carol leaned in and said "I'm going to put my face next to yours.." OK I thought. I was sorry that people had to be displaced. One by one faces appeared, all faces I knew. John leaned in and said "I'm just going to find your pulse"
pressing his hand on my neck. 
"You won't find it" I said quietly. 

The HR is so slight and difficult to find when I am in this state of hypothermia. My body is not moving too much blood and it's work rate is low in the cold. There were a lot of people around me and even though I would have liked a bit of space, they had to do their job. Inside I was very busy, very busy. I had a full rolling list flashing before my eyes, of stuff that I had to sort, sometimes the list would not work so I had to go back to the start again. My HR, my BP, My details, my night before how do I explain that. 

I knew I looked like crap, I have been a spectator to at least 10 extreme swims, where swimmers exited in an rough condition, my eyes would be distant, my face slightly stressed, I would inhale deeply at times when I wanted to organise my thoughts.  BUT no worse looking that a swimmer after 10-12 hours in the sea. I knew that I would be uncooperative mainly as my mind is operating at a slow speed. When there are so many voices, I can only process one at a time, their questions meant very little to me, every now and then something did matter and I  answered but mainly there was no need. They would do what they needed and for me I concentrated on my myself. 
"Where am I?" I asked. 

A few voices started to ask me my name, I knew my name, I knew what I was doing but once in the tent I didn't know where I was?
I started to think what I would say to people so I dug deep back into my thoughts.
Fu*k it.. I said so many times as I wondered what Ram Barkai would say, what the SA's would say? We work so hard to be safe, I needed people to not judge this. It was consuming my mind. It was the recovery I misjudged, the walk. If I was put into a car directly I would have been just like the others. They weren't able to walk either. 

Maryann reached in to try to get a pulse again, then I heard her say.
"Don't tell her about the Helicopter" I jolted upwards.
Not the helicopter-Carol saw the stare in my eyes and whispered into my ear "Helicopter is 8 mins out" 
I ranted and raved inside, this is a whole new ball game-lights were flashing, what info do I need for the Helicopter. 
I heard voices discussing to elevate my legs and Maryann said no..It was hard for me to determine if they were elevated or not, I was on uneven rocks. BUT the cold blood would run back to my core and reduce the body temp again, dilute the hard work of the last hour. I didnt need my legs and they are all wrapped up, please don't elevate them. So I relaxed again knowing that Maryann had deflected that. As Carol was trying to warm my hands I was calculating that I don't need the blood there either so I tried to pull them back.
"Just my organs I tried to say" If the freezing cold blood goes back up my arm to my upper body then that will cool my heart. I was aware that I was starting to fight them so I wanted to relax a little. I was trying to take control. 
Me heading up.. 

"Where's LJ?" worried about the dog. 
"Does Maryann have the keys of my jeep?" 
"Maryann has everything" Carol confirmed, "She's gone down with your dog. 
Closed my eyes again to focus on the next hurdle. 

At one stage I became very aware that my right arm was pink fleece, my left arm was black, I had a red sock on my left hand, and my red glove on my right. 
Where exactly did I get to? Where did I sit down? What has to be done now? do I need to be lifted up or down? 
"Where am I physically in my plan?"  
Frances reached in with a cup of hot choc, I sipped it. "What were you doing with bloody lemon and ginger tea" stuffing jellyies into my mouth, Frances said. 
Afterwards she told me that she hurled the Lemon and Ginger tea across the rocks in the search for chocolate. That will tell you my mental state approaching the swim.. NO chocolate-now I did have bakewell tarts!! 

Mike Shea stuck his face into the tent. Mike had loaned me the big expedition suit for Siberia for recovery.Not to get it wet was the thing. On the way up this morning, Maryann discussed me putting it on. We decided against. As I stared at Mike,& thought "I'd have knocked myself on the head with a rock if I was wearing your suit, I was covered in peat bog.. "
If this suit was lying in the peat bog I'd
have hit myself with a rock when Mike
appeared in front of me.!!! Mike is
presently walking across Lake Baikal. 
I could hear the helicopter hovering. Into my vision the helmet and suit of a winchman. He leaned in and said his name. "I just want to check a few things" a calm smiling voice. 
I took the lead. 
"My name is Nuala, I am swimming an Ice Mile, water 3.9deg, can't remember time in the water, My dog died, I had little sleep, little food, a pint of warm water with some maple syrup. I am probably dehydrated, not on any medication, I have marked my veins & my BP & HR are normal. I had 2 difene tablets last night. I have communicated with your fellow winchman Adrian O Hara on hypothermia so you can tell him you lifted me.. " exactly as I practiced in my mind. 
The underside of the helicopter 
"She's lucid" is all I heard as I tucked back into my world. This was very difficult for me. 
To be an official casualty is tough, I felt that I did well. 

"I'm going to take off your blankets and transfer you to our stretcher to lift you" Philip said. 
"I'm fully dressed" I replied, thinking why would he tell me that-
There were some funny comments followed-I closed my eyes again.. 
I had to be lifted higher on the rocks so the airlift could happen. 

The lift was great, I was airlifted before in training with the Rescue services many years back so the approach to the underside of the helicopter can be daunting but I was grand. I focused on Philip and once underside we spun around a few times. The cliffs were amazing. 
Once inside I wanted into the communications. I got my head phones and my mouth piece. 
"What are my stats?" I asked. 
150/100 BP, HR 75 and Body temp 34 deg. 
That was perfect. Over the radio I heard the comms to the hospital, just the sentence that "her core was protected by a survival suit" brought a smile to my face. 
My team did good, I was recovered in those adverse conditions. We don't intend to cause any displacement of people, rescue services or friends. Things happen and my plan was perfect to the rescue. The team were brilliant and each event we plan to the rescue. 

Once transferred to the hospital. The medical staff striped the damp clothes from me. I was chatting to the nurse when I pointed that my veins were marked. She was trying to raise a vein on the right, my veins are on the left. They gave me saline solution. The winchman asked me for my next of kin number.. !!!!!!!!
OMG thanks be that my sister had not changed her number in years, as I had it on the top of my head. another to add to the to do list.. 
The Doctor approached and said "So you fell into the lake? " as she wrote my stats-BP was now down to 130/90, I suddenly became aware of the cold for the first time. 

"I just completed my Ice Mile, swimming a mile in water under 5 deg, I'm the 9th woman in the world to have taken on the challenge" I replied, somehow not being able to make eye contact. 

A few faces stared at me-I couldn't make eye contact as she said "Why?" I knew the answer would be lost so I just smiled. 

They only held me 30 minutes-I was transferred to the open section and an hour later once my clothes arrived from Dingle with Maryann, I chatted with Frances, mainly debriefing. 
My family members landed in to see me en route to college in Galway. 
" Mom said could you get some psychiatric help".. my niece said-I could only smile. 

I suppose who I am as a person is not someone who views anything as trouble, just experience-good or bad we got through and I am incredibly grateful.  
It was a fantastic learning experience. The transfer from swimmer to casualty required a lot of adjustment and work from me. I have been involved in 2 serious rescues of casualties at random moments, one in the water, one on the mountains from the rescue side, both were acutely severe so I used that experience to be the casualty myself. Life teaches us more than we can know. 

But that's another blog.. 

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