[TrevorJ]

Asking because I am genuinely curious, if you are willing to share: What mindset do you have where you keep doing an activity that normally results in you coughing up blood? I know that sounds like a super disrespectful question, it's just the sort of thing I think about a lot due to having some health related activity restrictions that I've had to negotiate with myself. Always interested in what other people's journeys are in this space.

[netaustin]

Ha, fair. I love open water swimming and triathlon, and I can do it in not-cold water or a pool indefinitely, plus the Sildenafil entirely prevents it in cold water. Even without Sildenafil all I have to do is stop swimming and I'm fully better after an hour or so.

[TrevorJ]

Well that's good! I imagine the first time it happened must have been disturbing.

[netaustin]

Yes. The first time it happened was in the Hudson River in the NYC triathlon. I thought for sure that I'd just ingested some sludge, and I went on to complete the race, after which I was sent to the hospital (I walked). My pulse ox was 86. Most triathlon deaths occur during the swim portion of the race and are attributed to cardiac events, often SCD, but pulmonary edema may actually be the primary cause. A teeny bit of education (chest congestion? get out of the damn water!) could save lives, but nobody in the business of triathlon wants to scare off new participants, since the amateur fee-paying end of the sport is really the whole game.

[TrevorJ]

Wow, I had no idea. That would not have been on my list of potential dangers from long swims at all!