Mitigating the myocardial mayday

When I was a kid, there was a commercial made by The Partnership for a Drug Free America that went something like this: A young man is being chased by the police. A voiceover of a little boy says, “When I grow up, I want to be a track star!” A young woman staggers around intoxicated before collapsing to the ground while the voice of a little girl says, “I want to be a ballerina.” A grief-stricken mother beats the chest of her unconscious, presumably overdosed son as we hear, “I want to be a nurse.” The screen fades out, and the voice of wisdom states, “No one ever says, ‘I want to be a junkie when I grow up.’”

I only saw that commercial a few times as a child, its impact on me was REAL. To this day, if I hear someone ask something about what they wanted to be when they grew up, I still hear that voice saying, “No one ever says ‘I want to be a junkie.’”

Perhaps, if we had a Partnership for a Healthy Fire Service, we could stop burying our brothers and sisters from preventable diseases, such as heart disease and hypertension. Do we need a PSA like this to hammer home the message?

The weight problem we ignore

The American fire service, much like the American public, has a weight problem. Research from the National Volunteer Fire Council (NVFC) reports that as many as 70% of firefighters are overweight. This statistic leaves little to the imagination about why we are losing nearly 60 firefighters per year to sudden cardiac arrest and heart attack.

We must do better.

I didn’t think that I would be the person to bring this topic to light. I am approximately one year post-op from weight loss surgery. I still struggle with my weight, and I am still considered overweight. I felt that I had no business telling other firefighters to lose weight or to get into better shape. But then, I realized that none of us is the person to bring this up, because all of us could do better. And the kicker is that we all know this, but day in and day out, we simply talk about getting better without ever making the actual changes.

But why? Why don’t we make these changes when we know that not doing so makes us far more likely to become another statistic?

If you have ever a chance to talk with an addict, you will most likely find that they have tried in some way or another to get well. No one wants to be addicted and watch their life slowly slip away into something that isn’t even recognizable. They often quietly go through phases of enjoyment to dependence to a controlling need to life-destroying misery.

The same is true when you compare this to the way we approach our health. We slowly step ourselves closer toward our own mayday with every poor diet choice and passive approach to exercise. We don’t wake up one day and suddenly find that we are overweight and out of shape. This is a slow and steady decline that leads to a final fatal outcome.

So how do we stop this cycle? How do we change a trend that has been holding true for years? Like recovery from addiction, the first step is admitting there is a problem, then taking steps to change the problem.

We are all at risk

I recently surveyed 50 participants about their views on how they would perform in a mayday situation. This survey was presented with a bit of an ulterior motive. I asked simple questions in an attempt to see how those who responded felt about their own health, and about their own chances of becoming a mayday themselves.

Although 77% of those surveyed stated that they were either very confident or somewhat confident that they could successfully perform a rescue of a mayday firefighter, and 62% of participants report that their current health would not hinder their ability to successfully perform a mayday rescue, the NFPA reports that 44% of line-of-duty deaths (LODDs) are caused by sudden cardiac arrest or heart attack. The shocking truth seems to be that although we as a fire service are aware that we are losing around 60 firefighters a year to cardiac events, and despite sudden cardiac arrest being the leading cause of LODD in the fire service, we are not yet ready to admit to ourselves that we are the reason that these numbers have not significantly changed in decades.

Take a moment while you are reading this to think about the members of your department. Think of the member who is a mayday waiting to happen. Did you picture yourself? Did you picture your best friend, your brother or sister, your captain or your probie? We are all at risk. We all have the potential to become the next mayday.

If we can agree that we are all at risk for becoming a mayday, then we can agree that we need to work together to decrease the number of LODDs caused by sudden cardiac arrest and heart attack. We need to own up to the issues we are facing and start taking steps to ensure that we are not setting ourselves up for failure.

Contributing factors

When a firefighter dies in the line of duty, the National Institute for Occupational Safety and Health (NIOSH) investigates and then issues a report about the death. In the report, NIOSH lists factors that contributed to the LODD. Similarly, if we were to look across the country at firefighters, we can see a list of contributing factors slowly transmitting our own myocardial mayday.

1. Diet: Meal prep is one of the most important, and easiest controlled, factors affecting firefighters; however, it does require some work. We struggle not only with finding the right meal but also the right time to eat. Given that our day can change at any moment, we often find ourselves eating what we can when we can. The problem with this is that we often choose things to eat that are high in sugar and fat. Choosing convenience over health and flavor over functionality slowly adds up and eventually will cause irreversible consequences.

We must make a conscious effort to make better meal choices, and plan ahead for when calls happen during our mealtime. Placing healthy snack options – protein bars, nuts, or other similar options – on the apparatus to help curb your hunger until you return to service is a helpful tool. Having the same healthy options at the station instead of doughnuts, chips and candy bars is another option. The easy (although not always enjoyable) answer is that we need to make better choices about what we are putting into our bodies, and to do that, we need to have a plan to overcome the adversities of the job.

2. Exercise: I understand. Exercise is tough. I have heard and, in truth, used many of the common excuses for not exercising. No one wants to expend all of their energy working out when they could be called at any time to go to work at an emergency. However, we are doing more harm to ourselves in the long run by not making our cardiovascular physical health a priority.

We should commit to spending one hour of our day dedicated to physical fitness. This does not have to be going to failure on the weight machine or running a half marathon. It could be as simple as going out and walking after dinner or some other simple form of exercise. In a perfect world, exercise can be incorporated into training. Spending some time every day pulling lines, throwing ladders, or participating in some simple search and rescue drills will go a long way to improving our overall fitness.

3. Mental health: Finally, we must acknowledge that the fire service takes a toll on our mental health. I can say from personal experience that anxiety, depression and PTSD can lead to poor physical health. When we are not in a good place mentally, we try to fix that feeling with other things. We use things like food, alcohol or drugs (yes, even nicotine) to help us to feel better. However, these things are only masking the problem, not addressing the underlying issues.

Firefighters need to know that it is OK to not be OK. We need to know that it is OK to ask for help and, if needed, it is OK to step away for a bit to get ourselves in the right headspace. Poor mental health leads to poor physical health, and poor physical health leads to poor mental health. If you find yourself in a bad place, reach out and get the help you need. We are a family and should be ready and willing to help each other get through the dark days.

Commit to change

The statistics show that we are losing nearly 100 firefighters a year in the line of duty. In my time in the fire service, we have made tremendous improvements on training and education toward making sure that our brothers and sisters are not dying in fires due to a lack of training or inexperience. However, every year we are seeing the number of firefighters that die from sudden cardiac arrest and heart attack remain virtually unchanged. Too many firefighters are losing their battle with a mayday that they started calling years ago. It is time for us as a family to hold each other accountable for our shortcomings. It is time that we make a commitment to reduce the number of deaths that we see each year from cardiac related events. Together we can mitigate the myocardial mayday.