What About Now?

All too often as we glide through life, we hear about this unfortunate circumstance or that one and quite quickly, it disappears from our thoughts. Why? Usually it is due to the fact that whatever it was, had no bearing on the observer. So why bother, right? Wrong!

For our regular readers and followers on Twitter know, we take the concept of firefighter health very, very seriously. It's a subject that were are very passionate about. Why? That's a valid question and it's also a tough one to answer. 

Your author has been disabled since 1992 when I work up one morning with, what I thought was a run-of-the-mill backache. After seeing several doctors, I finally had an MRI and found out that I had a herniated disc at L4-L5. The question of how was more difficult to answer. I had been out of active service with a fire department since 1985. I was in a relatively sedentary job and was not required to move or life heavy objects. Today, 23 years later and after five back surgeries, too many injections to count and having a medication pump surgically implanted, the consensus of my doctors is that the underlying injury occurred in June 1978 when one leg fell through the floor of a house being used for fire training. At the time of that fall, I blew out my left knee, but I had no idea about my back. However, that was an on-the-fireground accident that could happen to anyone. So, no - my passion does not come from that occurrence. 

Even though I have been out of the fire service since 1985, it has and always will, have a role in my life. And I read Firehouse Magazine every month.And each month, the first column I read is the list of LODD's. A recent report regarding the LODD's in 2014 indicates that nearly fifty-percent (50%) of firefighter LODD's are caused my preventable health conditions. PREVENTABLE!!! No, I did not know any of these firefighters in any way, nor did I know any active firefighter with serious health risks...until this past week.

One of my neighbors is a career firefighter for a department about an hour north of where we live. He's a real nice guy, loves what he does and was working to put his "20" in, with just a couple of more years to go. However, my friend, whom we'll refer to as "Tom," is a big man, both height-wise and weight-wise. So each time I'd see him outside and wave or stop in to chat for a few, I never said a word to him, but inside, my guts were churning. Before me stands a guy who loves what he does, is good at it, but not taking care of himself with the same passion he uses to fight fire.

Two weeks ago I got a cal from his wife to come over to help them with a computer problem. I saw Tom's car in the driveway and assumed he was on an off-day. When I got inside, he's walking all bent over and I asked what happened. He said he threw his back out on a call a few days before, but he wasn't that concerned as the next Monday, he was going to have knee replacement surgery. I fixed the computer, wished them both good luck and told him I'd check in on Monday night or Tuesday morning to see how the surgery went. 

Early Tuesday morning, I get a call from his wife and I asked her how the surgery went. She said, "It didn't!" She then explained to me that when he went for his pre-op clearance, the doctor observing his EKG saw traces he was not happy with and scheduled him to undergo a supervised stress test that Monday (the day before her phone call) with a pair of cardiologists. Tom was upset, but more about missing the knee surgery than anything else.

He underwent the stress test and suddenly, the doctors told him to stop. They sat him down and helped him through the recovery phase. The doctor came over to him and asked, "Tom you're a firefighter, aren't you?"
"Yes, sir," he answered with the pride he had in his work.
"Not anymore, you're not!" the doctor said. "You're firefighting days are over."

Stunned by the news, Tom asked for an explanation. The doctor told him that his cardiac output was in the mid-30% range, where normal for someone his age should be in the 60's. There was evidence of ischemic damage, most likely caused by a silent MI. Finally, they were concerned about the condition of part of the septum.

That was that. Of course, as I said to his wife, the good thing is that these conditions were caught in advance of a non-survivable incident. He had an angiogram on Tuesday and came through it well. Moreover, he is beginning a course of medication and lifestyle change to get him healthy again. No doubt, it's going to be a long, slow road. None of us gain a great deal of weight overnight and we are not going to lose it that way either.

So, when's a good time for YOU to take stock of your personal medication condition?
WHAT ABOUT NOW?
  

A Picture is Worth a Thousand Words & A Big "Thank You!"

First, I must thank my youngest daughter for a wonderful surprise. We were visiting her in NYC and we went out to lunch. She had wanted me to attend a show, but there was nothing that really called out to me. So, she, her boyfriend and my wife were going to the show after lunch and I was headed back to her apartment via a NYC cab.

After we finished lunch, we started walking so she could show us a couple of sites and, I presumed, to grab my cab. But we kept on walking, crossing this block and that avenue.Finally, she said, "We're here!" I looked around and found myself in front of the FDNY Store! That was the real reason why she shlepped me along. She wanted me to see the store. It was like taking your kid to a Toys 'R Us! So, thank you, my sweet Miryam for helping your Dad enjoy his visit even more!

As we were traveling this past week, I was able to catch snippets of news here and there. Several of the stories dealt with fire departments around the country. A couple were humorous and some very serious. Speaking of serious, it was great to see Fresno CA Captain Dern on television, after undergoing more than a dozen surgeries to treat his 2nd and 3rd degree burns he received when he fell through the roof of a blazing garage! We wish him a speed and full recovery!

I'm not addressing the actual news stories in this post. Rather, I want to talk about the several PIO's that addressed the press after various events. In the first case, the PIO was an older gentleman, with a full head of snow-white hair. Unfortunately, he must have weighed nearly 300 pounds. "Well, he's only a PIO. What are you bitching about?" you may be asking yourself. The viewers have no idea of the difference between a PIO and any other firefighter other than, perhaps, the chief. What they see is a fat fireman.

On another story, the person speaking to the reporter was quite obese and he was a lieutenant, a front line officer. Now, let's add 60 pounds of PPE, gear, tools and some heavy exertion. Hmm?? Any ideas?

We recently discussed the number, "40%," the percentage of FF LODD's that are caused by mostly preventable health problems. Obesity, HTN (hypertension or high-blood pressure, diabetes, asthma, elevated cholesterol levels, etc. are just a few of the causes being listed by those fighting this scourge of the brave men and women who put their lives on the line. 

Listen, we all know that almost anything can, will and has happened on the way to or from a call, and during the call itself. However, for the most part, we can reduce the number of LODD's due to health causes by taking better care of ourselves. When did you take your last CPAT test? Two years, three years, four years ago? Longer? What if on your next duty day your captain tells you that you have two days and will take it again? Can you do it? Can you even do part of it?

None of us can answer for anyone else. The only one you have to answer to is the man/woman in the mirror, because he/she never lies!

So, ready for that test?

How Much is 40% to a Firefighter?

This post that you will read here, encompasses an extremely important issue that many first responders, especially, firefighters, EMT/Paramedics and Police Officers, must be made to read!! "Why?" you ask. Because for the year 2012-2013, forty percent (40%) of the firefighters who died either during or subsequently to responding to and/or working at a major, physically exhausting call, did so as a result of a medical condition.

I approach this important issue from three levels. I was a volunteer firefighter at two departments, one in NC and one in NY from 1977-1981 until an injury took me out-of-service. I earned my EMT-I and II in NC and also worked for the county EMS there for eight months, before we moved up to NY. Finally, I spent twelve years as the administrator of a medical practice, where the doctor used me for "other" duties, as well.

Throughout the entire time and even til today, I have never stopped reading FireHouse Magazine. For many years, other than visiting firehouses wherever I went, the magazine was my key connection to the fire-rescue service. And every month, I would read the LODD dedications and wonder why...why were so many firefighters dying? Not just dying, but dying from what looked like conditions unrelated to the last call or calls they had been on. 

You see, I guess I was lucky. Because during my brief years of service, I did not experience a LODD either in my own or the surrounding departments. We had some close calls in both locales, but no fatalities.

On the other hand, I've never been considered "svelte," at least not since I was seven years old. I started packing on extra pounds at that age and yo-yo'd the rest of my life. I was the last kid chosen by the others to be on a team in neighborhood sports. I had the cheeks that all of my late aunts loved to pinch. Finally, in college, I started to drop some weight by playing softball with friends. 

I've now been married over forty years and my wife is a terrific cook and baker. So through most of those 40 years, my weight has fluctuated, but it was always my decision to lose weight. I never waited for my doctor to tell me. I knew it myself when it was tough to button a pair of pants or my suit jackets were getting too tight.When that happened, I'd go "back on the wagon," and drop 15-25 pounds. I'd keep it off for several months, sometimes longer. But then the extra pounds renewed their attach and started to creep back on.

Finally, partly due to determination and partly due to meds that I have to take continually for my severe back condition, I've lost about 30 pounds and kept it off for almost a year now. Funny thing is, my back injury doesn't allow me to walk as much as I used to, so I exercise my bending my elbows....and pushing myself away from the dinner table!

As I'm sure you'll agree, we are part of a wonderful family. No matter where we serve, no matter if we're volunteers, career folk or paid-on-call responders, a firefighter is always a firefighter. Thus, as I read the LODD bulletins that come through my email or I read the articles online, in the paper or watch them on the news, every loss saddens me, especially those that might have been prevented. For some are simply not preventable and that's the first fact that we have to acknowledge, whether we like it or not.

However, we see that the rate of LODD's caused by health problems is nearly 40% of all LODD's, it must give us pause. As a popular commercial for heart disease demonstrates, no one really knows when they will have a heart attack, an aneurism or a stroke. What we can and do know is if we are out of physical conditioning to do our jobs. Sure, you may have passed a PAT test 15 years ago, but where are you now, especially if you're in a smaller department, that doesn't require annual or semi-annual physical exams? Do you still smoke or chew tobacco? What is your resting blood pressure? Pulse? What is your weight today compared to what it was when you entered the job? Has an officer, your spouse/significant other or doctor told you you need to lose weight? If so, have you heeded their call or brushed them off.

Remember the old TV show, "Home Improvement," where Tim Allen played the host of a TV show aimed at "real men," with "real power tools!" The more power, the more Tim howled and growled. While that was funny on TV, it can all too often lead to a tragedy in real life. Your doctor tells you to drop 25 pounds. "Yeah, Doc, sure," you reply, knowing full well that the doctor has no idea how hard you swung the sledge earlier that day to take out a heavy door. You tell yourself that those 25 pounds that he/she is complaining about is really what gives you that extra bulk, that power, to do your job! Horse shit! And you know it!

There's no doubt in my mind that over 90% of us love what we do. We love the action, we love the thrill, we love the services we perform and we don't want anything to get in the way of that. But ask yourself, "What else do I love?" Think about that for a moment or two. Then make a list of what else you love, i.e. your wife, your kids, your parents, your significant other, your siblings, your friends. Which ones are you ready to cross off the list first. What's more important to you, the job that you love or the people that you love and love you?

Remember, we can't control when and where the Devil wants to dance, but we can decide what kind of a "dance partner" he's going to face!

Stay Safe and let's make sure, "Every One Goes Home!"

The Sadness of Coincidences

I've been writing this blog plus another for several years now. I don't write every day or every week, and usually, not every month. But as it turns out, I'm writing this post one month after my last. So, what would bring me to this point?

Some of you may know that under our Twitter handle of @DalmatProd. All too often, my Tweets begin with the hash-tag, #LODD (Line Of Duty Death). I send out the info only upon confirmation of the loss and it includes the person's name, age, department, date of last alarm, and a compressed URL with details of the notice.

Sadly, all four of the line-of-duty-deaths that have occurred over the past five days have been health-related. No one died while battling a massive blaze; no one died in a collapse. Apparently, all four of our brothers were lost due to medical causes. And this is exactly what I wrote about in last month's column. For goodness sakes, just a month or so ago, we lost a firefighter who was 22 years old, to a health-related cause. 

Last week I was watching, "The View," and actor Kevin Sorbo, who used to play Hercules in a show of the same name, was appearing as a guest host. And during his segment, he mentioned that near the end of the show's sixth season, he suffered  several small strokes, due to a ruptured aneurism near his shoulder. He talked about having to relearn to coordinate his motor skills so he could walk again and speech therapy to help him re-tune his speaking ability. He considers himself one lucky guy and has even written a book about what he has been through, "True Strength: My Journey from Hercules to Mere Mortal & How Nearly Dying Saved My Life."

For at least a decade many of us connected with fire-rescue and EMS, along with many in various specialties of the medical community, have worked hard to promote stroke awareness through the re-phrasing from "stroke," to "brain attack." And the reason is simple. Almost everyone older than 13 knows a little about the symptoms of a "heart attack." However, ask them, "What is a stroke?" and many will be lost. However, most of the time, a stroke is exactly the same medical occurrence as a heart attack, except that it happens in the brain, to wit, a blockage of blood flow to the organ. 

Now in Sorbo's case, his stroke was caused by an rupture in an artery near his shoulder. When the artery ruptures, it allows blood to escape its normal path. When that happens, the blood cells don't have the "flow" behind them to push them along. The cells start to "crowd up" and eventually, like the proverbial snowball rolling down the hill, a mass of these loose cells get sucked up back into the blood vessel. The problem is that the vessel is built to handle a certain size cell, the like lanes on a highway. When this "clump" of cells re-enter the vessel, the clump is too big for the vessel and stops it up, like your bathroom seek. That stoppage, interferes with the blood flow the brain needs and BANGO! you have a "brain attack!"

While aneurisms can occur on their own due to a weakness in the blood vessel's walls, they are often the by-product of HTN or "hypertension," which we know is a curable and preventable medical condition. You can't walk into most supermarkets or pharmacies and not see one of the blood pressure machines. While they are not always the most accurate readings, they can provide you with a range that you may want to advise your doctor of. Additionally, brain-attacks are often a sign of CAD (Coronary Artery Disease). But all too often, people often relate CAD to heart disease, not brain disease. 

Worst of all, too many of us, male and female alike, still suffer from this "macho" image that we are invincible and that the only danger to us is on the fireground. Do you still fight a fully-involved car fire without wearing SCBA (Self-Contained Breathing Apparatus)? Or a dark, smoke-charged 2nd story window  of an apartment building? Why are you willing to take care of yourself on the fireground, but fail to care enough about your health to do so off the fireground?

If you have a family, do you make sure your kids get their shots? Take their vitamins? Do you call the doctor if their running a fever and complaining about ear pain? If so, why? Because you want the best for your children, the best for your family. Are you not a member of that same family? Are you not one of its very leaders? Then don't you owe yourself the very same diligence for your own health that you demand for your significant other and children!

It's time for us to put on our "big-boy" pants and schedule a visit with your family doctor or the department surgeon. Find out what your blood pressure is; learn what your total cholesterol is and if you need to change your food and alcohol intake, as well as salt, exercise, etc. to get it under control. If you are already on blood pressure or cholesterol meds, you owe to yourself, your family, and your colleagues, to do what you need to do to clean up your physical act and get as healthy as you can!

I never want send a Tweet about you!