Long Q Interval Any swimmer's out there who have this?

I read that article out of interest and took from it that its more the fear and panic of the water that can disrupt the heart than the exertion itself. Also the fainting when in the water bit was kinda scary..... but...... you are a swimmer and don't (I assume) panic on a daily basis when you workout at the pool. And (I also assume that) there are a number of trained lifeguards at the pool, should you faint while swimming. And I would think that as an experienced swimmer, you know your body and would know when something isn't right and now given this diagnosis you would slow down or stop the workout if necessary. Take it easy :) (easier said than done, I know) and hope those results come through soon for you! Thanks couldbebetterfly! I am taking it easy in the water. I am starting to feel like I've tapered, will I guess I have in a way.

Thanks Pendaluft. I don't want to be naggish but my anxiety is starting to depress me. I have a short break tomorrow afternoon and I'll call them. Am I over-the-top if I ask them to e-mail my ekg to me. The SADS organization offered to have a Q-interval expert take a look if I could send it to them. I just don't want to piss them off. You paid for the test. It is absolutely your right to get a copy. If they get prissy about emailing it, ask them to put a copy in an envelope and arrange to go pick it up. I doubt they will get prissy, but if they do, they don't have any legal right to keep it from you. The people at SADS told me the correlation with water is very strange. They have documented cases of a child walking in the water on a beach and dying of sudden cardiac arrest, kids in bathtubs, and divers too. It almost seems the water plays a bigger role than the exertion level. Sometimes I wish I could unplug my brain. There are reasons to suspect that water exercise is different from land exercise. When that Stephen Blair study came out a few years ago, showing that swimmers had greater longevity than runners, even though swimmers were not as lean as the runners, he told me that he thought this was a fluke of relatively small portion of swimmers compared to runners in his data base (from the Cooper Center for Aerobics Research). He did acknowledge, however, that swimming places different physiological demands on the body. Gravity does not impact swimmers as much, the body is in a horizontal rather than upright position, and moderate temperature water is much more suitable to cooling muscle heat than even cold air. There is also the mammalian dive reflex, which Wikipedia describes thusly: The mammalian diving reflex is a reflex in mammals which optimizes respiration to allow staying underwater for extended periods of time. It is exhibited strongly in aquatic mammals (seals, otters, dolphins, etc.), but exists in a weaker version in other mammals, including humans. Diving birds, such as penguins, have a similar diving reflex. Every animal's diving reflex is triggered specifically by cold water contacting the face – water that is warmer than 21 °C (70 °F) does not cause the reflex, and neither does submersion of body parts other than the face. Also, the reflex is always exhibited more dramatically, and thus can grant longer survival, in young individuals. The first step in the reflex: Bradycardia is the first response to submersion. Immediately upon facial contact with cold water, the human heart rate slows down ten to twenty-five percent. Seals experience changes that are even more dramatic, going from about 125 beats per minute to as low as 10 on an extended dive. Slowing the heart rate lessens the need for bloodstream oxygen, leaving more to be used by other organs. Again, I am just an armchair speculator here, but it would seem to me that if cold water on the face is capable of inducing dramatic plummets in heart rate, it must be impacting the heart's electrical system is some way. Perhaps those with Long Q have an electrical system that is already, in some sense, cranky--and this additional insult can be enough to tip it over the edge? It would be interesting to see how much more common sudden drownings are in colder water. Another world class researcher in your neck of the woods is a very nice guy at U Indiana, Dr. Joel Stager. He is a masters swimmer himself and an exercise physiologist (and parenthetically the guy who became famous for finding that chocolate milk is an ideal post workout recovery drink:(1) Karp, Jason R.; Johnston, Jeanne D.; Tecklenburg, Sandy; Mickleborough, Tim; Fly, Alyce; Stager, Joel M (2004). The Efficacy of Chocolate Milk as a Recovery Aid. Medicine & Science in Sports & Exercise. 36(5) Supplement:S126.) Perhaps if you run into him at a meet in the future, you could ask him if he knows Gull's referral, Dr. Douglas Zipes. The combination of a cardiology researcher with expertise on a condition known to be particularly risky to swimmers, and an exercise physiologist and director of U. Indiana's Counsilman Center for the Science of Swimming, could make for a fascinating double-barreled study of this condition.

Well, that's a pressure we all feel. As a pediatric subspecialist, I currently give new patients an hour -- and usually fill that time. My adminstration is trying to push that to 40 minutes. We are resisting but I don't know how successful we will be. Will patients feel short-changed with shorter appointments? Maybe - of maybe I am over estimating the value of the education I do. Certainly to talk about a serious diagnosis, like the one in question here or (in my case) chronic lung disease, I would need a fair amount of time to do the job reasonably well. interesting. At this point I am 1 week and 1 day out from my appointment. I have heard nothing from anyone. I still haven't recieved the result of my echo-cardiogram although I have recieved the bill. Perhaps no news is good news. I am still waiting to hear if my insurance company will pay for genetic testing. I presume the office is doing this. i hate this waiting. I see over 750 students per week at my school. If I take over a week to grade an assignment I'd get fired. Oh, and the governer of Indiana thinks teachers are over-paid.

I read that article out of interest and took from it that its more the fear and panic of the water that can disrupt the heart than the exertion itself. Also the fainting when in the water bit was kinda scary..... but...... you are a swimmer and don't (I assume) panic on a daily basis when you workout at the pool. And (I also assume that) there are a number of trained lifeguards at the pool, should you faint while swimming. And I would think that as an experienced swimmer, you know your body and would know when something isn't right and now given this diagnosis you would slow down or stop the workout if necessary. Take it easy :) (easier said than done, I know) and hope those results come through soon for you!

Indianapolis has some of the finest electrophysiologists in the nation, including Dr. Douglas Zipes who literally wrote the book on electrophysiology.

Not really adding much, but as a 58 year-old, I expect to have roughly similar issues in the next coupla decades. Bobinator, I want to thank you so much for posting this and motivating this excelent discussion. And thanks to all the thoughtful posters, too. Great stuff here.

Hey Robin-- When I first started going through this, I actually contacted the woman who was filmed at short course Nationals talking about having been diagnosed with Long QT. She went to the Mayo Clinic where she was seen by Dr. Michael Ackerman (who is supposedly the leading Long QT researcher/doctor). That was where I was going to go if I was told I needed a defibrillator implant. Do call and get your results. I had to finally call to get the doctor's office to take blood and send it in for the test. It was nice knowing that the genetic testing process was at least in motion. The waiting is difficult but worse when you don't know if anyone is doing anything productive. I just came upon this article while googling Dr. Ackerman this morning. I haven't seen it before and am not even done reading it. But I'll link anyway. www.physorg.com/news99834889.html Take care and hang in there :) Amy

It's strange how the questions really don't pop into your head till the next day or so. I suppose it's some form of being shell-shocked. Maybe in part, but I also think it's because the information is so new, and outside your own expertise. I often have to think about a problem for a while, and talk it over with other people who can offer fresh perspectives, before I figure out what questions I need to ask to understand or solve the problem. Now that you have some more information you'll be able to make the most of your next fact-finding appointment. Hope you can get it soon and that you and the doctor(s) can have a good talk.

You paid for the test. It is absolutely your right to get a copy. If they get prissy about emailing it, ask them to put a copy in an envelope and arrange to go pick it up. I doubt they will get prissy, but if they do, they don't have any legal right to keep it from you. There are reasons to suspect that water exercise is different from land exercise. When that Stephen Blair study came out a few years ago, showing that swimmers had greater longevity than runners, even though swimmers were not as lean as the runners, he told me that he thought this was a fluke of relatively small portion of swimmers compared to runners in his data base (from the Cooper Center for Aerobics Research). He did acknowledge, however, that swimming places different physiological demands on the body. Gravity does not impact swimmers as much, the body is in a horizontal rather than upright position, and moderate temperature water is much more suitable to cooling muscle heat than even cold air. There is also the mammalian dive reflex, which Wikipedia describes thusly: The mammalian diving reflex is a reflex in mammals which optimizes respiration to allow staying underwater for extended periods of time. It is exhibited strongly in aquatic mammals (seals, otters, dolphins, etc.), but exists in a weaker version in other mammals, including humans. Diving birds, such as penguins, have a similar diving reflex. Every animal's diving reflex is triggered specifically by cold water contacting the face – water that is warmer than 21 °C (70 °F) does not cause the reflex, and neither does submersion of body parts other than the face. Also, the reflex is always exhibited more dramatically, and thus can grant longer survival, in young individuals. The first step in the reflex: Bradycardia is the first response to submersion. Immediately upon facial contact with cold water, the human heart rate slows down ten to twenty-five percent. Seals experience changes that are even more dramatic, going from about 125 beats per minute to as low as 10 on an extended dive. Slowing the heart rate lessens the need for bloodstream oxygen, leaving more to be used by other organs. Again, I am just an armchair speculator here, but it would seem to me that if cold water on the face is capable of inducing dramatic plummets in heart rate, it must be impacting the heart's electrical system is some way. Perhaps those with Long Q have an electrical system that is already, in some sense, cranky--and this additional insult can be enough to tip it over the edge? It would be interesting to see how much more common sudden drownings are in colder water. Another world class researcher in your neck of the woods is a very nice guy at U Indiana, Dr. Joel Stager. He is a masters swimmer himself and an exercise physiologist (and parenthetically the guy who became famous for finding that chocolate milk is an ideal post workout recovery drink:(1) Karp, Jason R.; Johnston, Jeanne D.; Tecklenburg, Sandy; Mickleborough, Tim; Fly, Alyce; Stager, Joel M (2004). The Efficacy of Chocolate Milk as a Recovery Aid. Medicine & Science in Sports & Exercise. 36(5) Supplement:S126.) Perhaps if you run into him at a meet in the future, you could ask him if he knows Gull's referral, Dr. Douglas Zipes. The combination of a cardiology researcher with expertise on a condition known to be particularly risky to swimmers, and an exercise physiologist and director of U. Indiana's Counsilman Center for the Science of Swimming, could make for a fascinating double-barreled study of this condition. Hmmm, great idea Jimby! I am a friend of Dr. Zipes daughter-in-law, I used to teach with her. She told me he's not accepting new patients. I just finished goggling him and according to his site on Krannert Center he is. I have met Joel Stager a couple times at the IU meet. He's a nice person. I participated in his study at Nationals in Indy a couple years ago. I wonder if he still has my records? I'll e-mail him tomorrow.

Here is a link for genetic testing, which should be widely available: www.familion.com/.../ FYI I generally schedule patients for an office visit to discuss test results (like echocardiograms) in person rather than over the phone. Just a personal preference.