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Permalink Reply by Mike Schlags (Captain Busy) Retd on February 27, 2010 at 6:46am

Ok... I've been kind of in and out on this post, noting the trend of folks with a lot of medical educations sparing over the pros and cons of being fat or thin. I have a very different take on this and am basically calling bullshit on anyone here who advocates that being the least bit fat is acceptable. The answer is no.

This is a very serious issue in the fire service that deserves taking the gloves off and telling it like it is. I am just recently 56 years old and found out that I have serious coronary artery disease, something that was only spotted through a recent full body scan.

Judging a book by its cover... What a concept and again, don't be fooled here. No one has brought up genetics. We are all different, so you can't compare a story about someone being a huge or small person and how good you feel and do the job. It's irrelevant and very subjective. Some guys no matter what shape they are in, and regardless whether they are big or small, are energizer bunnies... they just keep on moving on. The problem here is that no one really knows how long your batteries are going to really last, so you do things like stay in shape to increase your odds toward longevity.

You also have to compare the types of calls. If your a fat guy, your going to get your butt kicked on a wildland fire. Structure fires are usually short in duration compared to a full on initial attack wildfire. What you might be able to get away with is dependent upon how much physical work you actually do. Not everyone gets to stay at the engine, pumping or shuttling water.

If I sound like a weight nazi, please allow me to explain. I started my career out in 1973 as a paramedic. I even taught paramedic school and majored in bio-chem. I have a pretty good clue, maybe not as well versed as Paul who I believe is a RN or Ben who has yet to be wrong about anything. As a Hazmat Fire Captain, I've been getting intensive physical exams since our team was first started in 1984. These physicals include blood panels, and in my case indicated too many triglycerides but the cholesterol ran about 165, which is considered not really high, right? (help me here Paul...). I never looked at myself as being a cardiac risk and no else did for that matter. I don't smoke and rarely drink. Still, for years, my bloodwork never indicated cardiac issues or even the potential.

Having the radiologist tell me to immediately seek counsel from a cardiologist isn't something I was planning on hearing... I was expecting cancer from exposure or lung problems, but nope... cardiac. They called what I had a widow maker. This is the left descending coronary artery that is plugged up enough to cause sudden death should a piece of plaque become dislodged. "Poof"... and I'm history.

Stress translates to increased cardiac risk factors, which we get a lot of with this profession, especially when you are sound asleep and the alarms go off. You go from zero to 60 in seconds... This stress can have something to do with cardiac plaque development. Are you a ticking time bomb? Have you ever had any testing to see if your heart and carotid arteries are happy and clean?

I ended up making the appointment with the cardiologist and spent the day undergoing several tests. After all the testing, including blood work, I met with the doctor. He told me that the number one risk for cardiac insult revolves around both your level of cardiac fitness and percentage of body fat. He strongly recommended my losing additional weight if I wanted to live. To date now, I have lost almost 30 pounds, with more to go. I'm not to keen on becoming a FFN memory quite yet. I was also put on medication that stabilizes the cardiac plaque and slowly dissolves it over time.

Your body is not designed to handle extra fat on your frame. Your vessel size is designed for your muscles and other vital organs, not excess fat. Overweight conditions add the burden to the development of plaque that in itself can compromise your cardiac health. Couple that with an overloaded system and you too could be toast.

I for one have no pretense about being overweight. Being fit and lean is my goal but it's a personal decision that often times requires a complete change in lifestyle. If you are a firefighter, this is even more critical because of the high potential for sudden stress, which for some people could result in sudden death.

CBz

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Permalink Reply by Jeff Cole on February 27, 2010 at 9:40am

Allen
Don't get too worked up over Ben's comments on this subject. "Statistical evidence" ...we all know how numbers (which is what stats are) can tweaked to support or discredit debates depending upon what side your on. I've drawn the conclusion fom this, and another thread regarding firefighter fitness, and heart disease that he doesn't feel phyiscal fitness is, or should be a priority for firefighters.

Assuming we are all in the same business, and have all actually performed the WORK required to locate, confine/control, and extinguish fires, you would think the need for maintaining the best possible level of individual fitness is obvious. Of course we all know there are those who can actually manage to avoid FIREFIGHTING, (as in climbing, stretching the hose, working the roof, making the hallway, etc.) by hiding behind permenant driver status, tailboard sitting, and finding the best places to hide.

It's always the same old argument. As in the use of the discription of what I assume to be a physically fit firefighter being reffered to as a "model". And the "fat" vs. "skinny" discription.

"20 years experience and officer" and the "model was a proby"...and "people" were asked "which one they would want to save them" ??? Personally I'd pick either of them, who ever was in the best position to make the "save". That's actually a very interesting analogy. For the "fat" firefighter I would dare to say it would depend upon how fat he was, and more importantly, how FIT he was, and how well he could handle his size, and how much work was actually involved in making the "save".

As for the "model" it would likely depend on the actualy conditions involved that would require experience to pull off the "save".

"Skinny" does NOT equate to being fit. There ARE "skinny" firefighters who are physical wrecks as well.

Fortunately I have had the oppurtunity to be trained in firefighter fitness and risk profiling. And believe me it is NOT a very popular topic with many firefighters. You can probabaly figure who spends more time arguing against the need for fitness than they do in finding time to actually try to better themselves.

You may not be able to alter your genetics, but you CAN achieve a better level of physical fitness by having routine physical exams, and engaging in a personally structured, monitored fitness program that includes certain changes in lifestyle and personal habits. It is NOT necessary to meet "model" standards to be an effective firefighter. And appearence alone is NOT an indication of an individuals level of fitness.

However you can pretty much be assured that excessive body fat IS a helth hazard and a hinderence in perfroming your firefighter duties. The same goes for those who are rail-thin with little muscular strength.
Add in a sedentary lifestyle, smoking, and excessive alcohol indulgence, a poor diet, and lask of any continuity in lifestyle and you ARE a "ticking time bomb".

The fact that the author of this threads Son is 350 lbs. does not automatically relegate him to the physical wreck/liability group.

The bottom line IS that a firefighter who is physically active, follows a structured, regular fitness and exercise program, has a disciplined diet, and balances his/her exercise routines with both cardio/endurance training and muscular strengh/resistence training, AND gets the appropriate rest between each workout (meaning someone who does NOT live in the gym everyday for hours at a time) WILL ALWAYS be a better conditioned firefighter, and therefore, provided they are properly trained, will always perfrom at maximum capability.

But it's NOT just about having the look of a "model". And not everyone is capable of living the extreme physically fit lifestyle. However as a firefighter, the goal should be about being the best YOU that you can be. Increasing YOUR levels of fitness, decreasing your body fat, improving your endurance, aerobic capacity, and muscular strength and stamina IS possible for anyone providing they put in the effort.
Eliminating the negative factos, such as poor diet and smoking ARE all within the achievable goals of the individual.

I do NOT , however, support the theory of judging "the book by it's cover" There ARE individuals who are in exceptional condition that may just not havat body beautiful "model " look, and ARE perfectly capable of doing the job of a firefighter.

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Permalink Reply by Auxman on February 27, 2010 at 9:56am

I didn't say anything like that at all. If you're FAT, you're a unnecessary potential problem for the others on the team. You don't have to be fat.

Folks that are heavy because they're all muscles will be harder to carry out, but they're probably less likely to need carrying out than the guy that weighs the same but is 30% body fat.

I suppose I'm saying that there is a difference between heavy because of muscle and heavy because of fat.

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Permalink Reply by Paul Montpetit on February 27, 2010 at 10:54am

Captain...I'm in your corner Brother...cholesterol less than 200 is considered ok BUT...you have to have the full lipid panel done...that will give you both the good cholesterol and the bad cholesterol levels...They actually did some research back in Vietnam era..and found surprising number of young men had significant plaque build up in their vessels (and these men were only in their late teens and early 20's)..I have been busting my ass for the past several months trying to get the excess weight off...I'd like to be around in 5 or 10 years...I am NOT saying "You are fat get out of the Fire Service" I am saying lets get in shape and help cut down on our LODD's...I know some people will refuse, some will choose to ignore this...It is a decision that they must make...just as some still refuse to wear seat belts...they can refuse...but not on my truck they can't...we don't roll till everyone clicks in....We have to stop killing ourselves......PLEASE.........Paul

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Permalink Reply by Capt. Slim on February 27, 2010 at 2:13pm

As one of the youngest Captains at my dept. and the second smallest person working there, I have had the priviledge of working with guys of all sizes. I have been told at times that im too small to do certain jobs but as always im not one to give 110% no matter how big the job may be. If I cant do something at least I gave my best shot. I myself am this small because of genetics. Im 125 lbs but have the heart and determination to provide the safest and best working enviroment for my crew. For a 23 yr old, it is weird telling a guy who is at least 12+ yrs older to do something and be as small as i am. My guys respect me and may joke with me about my size at times but they all know that I can & will do anything even the strongest or biggest guy here

Dont think that a big guy is out of shape either. My DC is at least 350 lbs but is very much in shape. He works out and swims almost everyday he's not on duty. Dont let a guys outward apperance fool you into thinking they are not in shape at all. The ones u think are not in shape may be able to outdo you on the fire scene be it: Shuck down a SCBA bottle in less time, Be able to do an agility test quicker, Two minute drill faster, or even be the one to pull u out of a bad spot.

The main thing is to come up with some kind of work out regiment to determine where your limits are and work to improve on it.

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Permalink Reply by Ben Waller on February 27, 2010 at 7:54pm

And Paul, what I'm saying is that getting in shape won't necessarily get rid of the LODDs, and that assuming that's so provides a false sense of security.

There are scientific studies that show that dehydration and exposure to cyanide in smoke (even non-inhaled cyanide) are major contributors to the heart attack LODD problem.

Further, the USFA heart attack LODD statistics lump four completely different things together as "cardiac related" and only one of those four things is affected in the least by exercise, diet, and smoking cessation.

The four things are:

1) traditional heart attacks, caused by coronary artery disease and blood clots.
2) dehydration heart attacks, caused by expoosure to heat, inadequate rehab, thickening of the blood, and blood clots. Physical condition won't affect this at all.
3) cyanide-induced heart attacks, caused by inhaled or absorbed cyanide that is a byproduct of incompletely combusted plastic. Overhauling in full turnout gear and a mask and frequent turnout gear washing will help reduce the instance of this LODD type. Physical condition won't affect it at all.
4) cardiac dysrhythmias, which are generally caused by genetic causes. Physical condition doesn't affect this LODD type at all.

The problem is that the autopsies required for LODDs don't do enough to distinguish the differene in the LODD types, and the USFA stats are not adequately sophisticated in how they report those statistics.

That leaves us with opinions about how getting in better shape will prevent LODDs, but that can indeed give firefighters a false sense of security. Most firefighters are actually in a lot better shape than those with whom I worked 20 years ago, but the heart attack LODD rate hasn't changed. My belief is that's because the physical fitness push isn't having any effect on the LODD rates due to 2, 3, and 4 above.

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Permalink Reply by Ben Waller on February 27, 2010 at 7:57pm

Ax, What I'm saying is that with the evidence that RIT isn't rapid, it isn't really intervention in most cases, and that most firefighters that go down in a fire will require 15 to 20 firefighters and at least 15 to 30 minutes to rescue, the "harder to carry out" isn't as much of a factor as you might think.

RIT saves are so rare that they're front-page news here when they occur.

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Permalink Reply by DUST on February 28, 2010 at 12:35am

When I took my water rescue tech. class we had an ocean swim test. Some of the guys that looked the fittest were the ones that couldn't make the swim and had to be picked up by the boat. There are guys with the 6 pack abs and what I call beach muscles that look good but don't have real functional strength or endurance. We know that health and fitness is a part of the job and we need to be committed to it just like any other part...we owe that to our fellow ffs, the community we serve, and our families.

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Permalink Reply by John Crabbe on February 28, 2010 at 1:19am

2) I disagree with using a four-minute anerobic "fitness test" like CPAT or the Combat Challenge as a measure of anything that really happens on the fireground. We need firefighters that can perform for the duration of the incident, not one that is completely lactic and useless five minutes into the incident.

Ben,
I agree with you here, but using this portion of your reply to make a point.
I mentioned in my first post about a physical agility test and mentioned I believe a PAT should be geared to that of the job vs one which focuses on situps, pushups, mile and half timed run, that some depts still use. It is easy to belive such a test would be a good indicator of fitness, and they can be, but like mentioned this job is about endurance.

Now there are schools of thoughts out there about CPAT, and being too easy etc, and I can agree with some things, but overall I agree the CPAT is a good test to get a diversity of the job duties that are asked. I just don't agree with the length of the time given to complete the test. However, I have done the combat challenge as a PAT, which ecourages a faster time as a measure or fitness, and I don't agree with that either, because it doesn't account for endurance and duration. Personally, I felt the best PAT I ever took was administered by Cedar Rapids, IA Fire Dept. The test was the combat challenge, but instead of time being the determining factor, endurance was. You had to complete at least 2 and half circuits of the test in 15 minutes. This meant you could pace yourself, but still had to keep going. If you completed the circuits within the time frame, you still kept going until the 15 minutes were up.

Point is that a PAT geared towards the reality of the job requirements may be better than those based off of cardio and basic strength like what the military does. The tests could be altered to be based more on an endurance aspect than a time aspect. (although I understand the issues involving CPAT)

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Permalink Reply by Billy Dale Smith on February 28, 2010 at 1:43am

Amen Brother, I'm old and fat, also stove up, but that ain't gonna stop me.

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Permalink Reply by Ben Waller on February 28, 2010 at 3:39am

Jeff, your conclusion about me is simply wrong. You know what we get when you "ASSUME", right?

I firmly support physical fitness for firefighters. My department has a mandatory health and wellness program based on NFPA 1584, including mandatory annual medical evaluations and physician-directed clearance for duty.

What I disagree with are the following:

1) I disagree with using firefighter LOOD statistics as scare tactics when those statistics clearly show that firefighters experience LODD heart attacks in much smaller percentages than the cardiac death rate among the general population. That's not spinning statistics, it's ensuring that there is scientific evidence to back up what we do for physical fitness and how individual departments approach it.

2) I disagree with using a four-minute anerobic "fitness test" like CPAT or the Combat Challenge as a measure of anything that really happens on the fireground. We need firefighters that can perform for the duration of the incident, not one that is completely lactic and useless five minutes into the incident.

3) I disagree with the lack of anything scientific to support the "physical fitness gurus' opinions". You have offered only your opinion to support your position.

4) I disagree with people that think that improved physical fitness will protect you from a LODD heart attack. It might, or it might not, depending upon your genetics, your predisposition to dehydration, your exposure to cyanide in smoke, or your heart's predisposition to dysrhythmias. If I'm wrong, why do so many relatively young and "physically fit" firefighters show up in the LODD stress/heart attack statistics...you know, the scientific evidence???

5) I disagree with people that listen to part of what someone says, then draws erroneous conclusions based on an incomplete read of the situation, and then who posts generalizations as if they applied to that specific person. In this case, Jeff, I'm talking about you and your comment about me above. In that other thread, I clearly stated that I'm in favor of firefighter fitness and I agreed with your statements about firefighter fitness, as they relate to improving aerobic capacity and stamina. However, the bottom line generalizations you make about "You can probabaly figure who spends more time arguing against the need for fitness than they do in finding time to actually try to better themselves." have no basis in science." In scientific terms, that is assuming that a single variable is the cause of an outcome in a multivariate problem where correlation can't be shown, let alone causation. If you're going to make the claims that you do here, you need the science to back it, not just opinions.

My point here is if you're going to advocate for fitness, do it based on the scientific evidence, not just your own opinion. And...if you can't show any scientific evidence - the kind backed up by the actual statistics - then those who have actual evidence to support their opinions are going to be able to poke holes in any theory that you may produce, no matter how passionate you are about that opinion.

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Permalink Reply by Michael Bates on February 28, 2010 at 6:57am

it not just the interior jobs that are phisically demanding. I think draggin hose around and running for tools and hey we need a halligan quick over here, all of these scenarios lead to serious physical exertion. just packing hose takes alot of effort sometimes (wet,frozen, muddy)What we as FF's sometimes lose sight of is that every part of this job is physical in nature. And it is up to us to police ourselves on what we can and can't handle. i think the biggest problem is our adrenaline starts pumpin and we over due what we can handle.

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