This has been bugging me for most of the day. My fire department was featured on a regional newscast and of course everyone showed up. Well my son who is 350lbs was in the background and someone made  a comment about his size on Delawarefirefighter.com. It didn't bother me that the comment was made because of the person who made. What bothered me was the fact that as a large person he was automatically discounted as a fire fighter. I've always been a lagre guy and I've always been able to do the job. When I wasn't I stopped.

 

But what about the skinny guy. Is he in shape or just skinny. Just because you don't have a big gut doesn't mean your in firefighting shape. It just means you have genetics that make you a certain size. My best friend always look like he was in shape until we raced once. He couldn't go telephone pole to telephone pole.

 

There was talk about giving physicals to FF's. My issue is what are they checking for, high blood pressure, good heart, eyesight, hearing? How about endurance, stamina and agility. You would be surprised how many people can't carry a role of hose 1000 feet.

 

Years ago on talk shop that I can't recall the name had a large FF and a model looking FF. And they asked people which one they would  want to save them. Of couse almost all picked the model looking FF. Well the fat FF had 20 years experience and was an officer of his department and the model was a proby. He even said he would pick the fat guy because of experiece.

 

Basically what I just spent 4 paragraghs writing is never judge a book by its cover.

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Ok so we have a firefighter with a BGL of 300, and he is working interior, exterior, or even shuttling water. He is at risk of going into Diabetic Coma. That FF should be taken out of service and stopped from physical activity until he has recovered.
More activity means more blood sugar, leading to Coma if activity is not stopped. I am thinking this is a pretty good way to flop as well.

Our firefighters are taken off the floor if insulin dependant.

You keep citing statistics, but the effects of our current lack of fitness will only present themselves in future years. I can't figure your thought proccess out... you say you are all for a fitness program, but then you say fitness doe not seem to be changing the statistics... well let's look at this again in 10-15 years when the fitness culture has had time to permeate the fire service. Both career and volunteer.

Our department requires a PFT yearly, plus blood work for exposure, and a yearly fitness test standardized by height weight age and consisting of static strength tests as well as a VO2 test.

Is this perfect... not even close, and far from it actually, but it is a consistant test program that gives both the firefighter and the command staff a good idea of where we are physically.

Instead of blasting everyone’s comments with statistical evidence to the contrary, Let's look at how we can give our firefighters a fighting chance against both sudden death and chronic preventable diseases.

I don't expect my program to lengthen my life, but I do expect it to make it more productive and enjoyable. On the other hand, I firmly believe that continuing on the path I was on would have and did make me a liability to my department and the community I protect.
Activity burns blood sugar - it doesn't create more. Excercise is the best way for Type II diabetics to control their blood sugar, along with diet control and if needed, medications.

A BGL of 300 might make a Type II diabetic at risk for dehydration, but it doesn't put an active person into a diabetic coma. I've been a paramedic for more than 25 years, I've treated thousands of diabetics, and the total number of them in a diabetic coma with a BGL of 300 equals zero.

There has been a fitness culture in the fire service for at least 20 years already. The LODD statistics haven't changed much in that time. That tells me that better fitness isn't translating to a reduced LODD rate.

That also tells me that pushing fitness as a way to reduce LODDS isn't working, likely because the LODD heart attacks are resulting from other causes than poor fitness.

If well-intentioned beliefs in fitness programs really affect LODD rates, we'd have seen the impact by now. Lots of firefighters act as if it's a big mystery why the years of improving the FD fitness culture hasn't reduced the LODD heart attack statistics. The studies are showing that's because most of the heart attacks are caused by something other than poor physical fitness.

Nothing personal, but I'll put my faith in the science, not in a well-intentioned belief that can't be supported by the evidence.
Your 25 years as a paramedic do not counter what the American Diabetes Association has to say about continued stress when there are Ketones in yuor urine (highly likely in 300+ BSL). It does go the wrong way, just becasue you have not seen it does not make it so.

From American Diabetes Association

How do I treat hyperglycemia?
You can often lower your blood glucose level by exercising. However, if your blood glucose is above 240 mg/dl, check your urine for ketones. This can lead to ketoacidosis.

Exercising when ketones are present may make your blood glucose level go even higher. You'll need to work with your doctor to find the safest way for you to lower your blood glucose level.


And your fitness culture for the past 20 years is pushing it.

Yes 20 years ago the push was on to get fitter. But no it was not a culture in the fire service. Maybe in pockets of the country, or in select departments. But, the culture that exists now is not the one I came into in the late 1980's. For that matter when I left the fire service in 2002, it was still nothing like it is today. The fire service I came back to is vastly different than the one I left.

And even at that there are as many if not more who do not "work out" as there are who do. When this changes, the Sudden Death rates may change.

We have better gear, better fire finding equipment, better training, ALS on scene at structure fires, and yet we still kill about the same number as 10, 20, 50 years ago, and we fight less fire!

In my 25 plus years I have buried 4 who were under 45 years old from heart attacks. One was the picture of health, no excess fat on him, yet he ate fried food 3 times a day. Lot's of fish, of course breaded and fried, and he was 43. Another was much heavier, and didnt exactly subscribe to the fitness culture that was supposed to be present in 1992, yeah he's gone too.
Then there was my first captain who nearly died with me on a routine fire alarm. Massive MI coming down from the roof. 4-5 packs of Raleighs a day, that was until the quad-bypass. He changed his life and became a devout walker.

Ben you are right , there are more causes for heart attacks than just lack of fitness, but even if fitness plays a role in 25% of the Heart Attacks that are LODD's, we could save on average 10 firefighters a year by assuring that all of our firefighters are relatively fit.
Fit enough to do the job over a sustained period.

You like statistics... How many wildland firefighters die from Heart Attacks?

They spend more time on average in contact with live fire, smoke filled environments, and are physically taxed beyond what most structurally based firefighters will ever see. they work in an environment where rehab is a fallen log they can rest on. Camp can be hours away by foot, and where we fight fires on a bad one for a few hours, they fight fires that last from days to weeks.

These firefighters are fit, truly fit, and you can't even get your basic red card without passing a pack test that is challenging. (the 2 LODD from 2001 were during this pack test)
Why do we not hear about these firefighters dying from heart attacks? Wildland Urban interface fires encounted many of the same toxins structural firefighters deal with, and rarely will you see a forestry firefighter wearing SCBA.

A total of about 10% of the Wildland LODD are from apparent Heart Attacks vs as much as 50% of ours.

Go research it and prove me wrong.
25 years as a paramed eh....? Well goody goody for you.....I have held my EMT (advanced) since I was 17 and I have a Maters Degree in Nursing....young people do die every day from Cardiac conditions related to risk factors....call what you will, hide from it if you feel more secure....But it does happen....Statistics in themselves are worthless...if you have ever taken a Stats class then yuo know that one can stter the numbers in whatever direction they choose....there is never only one cause for a cardiac...it is several causes that contributes to it...
We've got tall guys, short guys, ex CFL/NFL guys, marathon runners, and couch potatoes.
Sadly, you can not tell by looking at someone, how strong they are. Some of the couch potatoes may even surprise the hell out of you. One of my best memories was of my 59 year old, very slender, grey haired, capt. Fire on the 9th floor, doofus crew ahead of us left the elevator on the fire floor (that's another story) and we hoofed it. I can admit I was huffing, my crewmate was puffing and our capt hadn't even broken a sweat. One of the fittest men I know, and you could never tell to look at him.
There's also another woman in my department who is a few sizes smaller than I am and shorter. She could likely kick my ass. You just never know.
All of that being said. If we worried about ourselves as much as we worried about others, we would all be in tremendous shape and wouldn't have to worry a moment about it.
"Go research it and prove me wrong."...OK.

There are something like 10,000 wildland firefighters in the US.
There are something like 1.1 million structural firefighters in the US.

With around 5 wildland firefighter heart attack LODDs per year, that's a 0.0005% chance that any single wildland firefighter will have a heart attack LODD in a given year year.

With 1,100,000 structural firefighters and around 50 heart attack LODDs per year, that's a 0.000045% chance that any single wildland firefighter will have a heart attack LODD in a given year.

When compared to the number of total firefighters in the given populations of each, structural firefighters actually have a reduced cardiac LODD rate compared to the wildland firefighters.
Paul, I'm not hiding from anything. My entire point here is that the physical fitness proponents are pushing a variety of specifics as ways to reduce the heart attack LODD rate.

There have been years of improved firefighter fitness and fewer fires, yet the LODD heart attack rate remains essentially unchanged. That tells me that just getting in better shape is creating a false sense of security when it comes to heart attack LODDs. In other words, get in better shape as a way to improve strength and stamina, but don't think that it will protect you from other common causes of heart attack LODDs including dehydration, cyanide absorption, and genetic factors including predisposition to dysrhytmias.

I'll take scientific evidence with good statistical explanations over "it's just someone's opinion" any day when it comes to reducing firefighter LODDs.
Weight in itself should not be that much of an issue. Obesity and poor physical fitness is the big one.

There are a couple of coworkers who are as big as the rocky mountain, and chisled out like some of it's peaks, and they don't have very much body fat. To me, it's impressive to see them take part in the Crossfit workout of the day and do really well.

Then there are those who weigh just as much the two I speak of, are obese, and are out of breath by the time they step out of the cab. We all have them. They make every excuse in the world at not taking charge of their lives, dropping the fat, and becoming better, physically fit firefighters.
Allen, from the link you posted...

"Exercising when ketones are present may make your blood glucose level go even higher."
(Emphasis mine)

I'd be interested to hear if that "may" has been borne out in a single documented case of a firefighter having an elevated BGL and "doing the flop" while fighting a fire. I haven't read every LODD report ever written, but I'd think that if this had occurred even once that it would be front-page news. It isn't...maybe because it has never occurred??

If it hasn't, that's another case of some of the supposed risks not being born out by the results, and more "Ready, FIRE....aim?"
Agreed, but did anyone stop to think that maybe the super-physically fit firefighters have an overly-confident sense of their own abilities, while the moderately physically fit have a better sense of their own limitations? If that's the case, it might help explain why so many seemingly fit firefighters die from LODD heart attacks.
Obese actually has nothing to do with fat . obese means that your weight is above the averge man, look at pro body builder ronnie coleman (who is a police officer as his job) weights around 350 pounds has 7% body fat technicaly he is obese, 265lbs is obese, thats how much your pro football players weight. look im not a firefighter i just graduated and am currently triying to get on a call fire dept to join, im 300 pounds and im 6'0ft and yes i do have fat on me, but i can also bech press more than my own weight ans squat double my weight, i actually lift 4 times a week, my father is a personal trianer and i can kick his ass in any physical thing, i have run 3 miles at 350lbs body weight and did a time of 26 mins thats 3mins off the usmc requirments, i also love doing physical demanding jobs, so go ahead and say firefighters who are big are unhealthy and blah blah blah bullshit, i will and can keep up with anyone at 300 pounds , i have 120 over 80 for my blood pressure , and im obese yeah my gear may be bigger but you may have to take 25 swings with an axe were i can take 10 you may need two guys to carry something were i can do it myself, and for all of you that will hate on me for not being a firefighter your right i dont know the job but ever since i was a kid a firefighter is what i wanted to be , and i will become one as soon as i am hired and i will keep working out every day so that i wont ever let my physical condition of being fat ever hinder me in this line of work, or let me down or the men i will work with one day

Dear brother and sister firefighters,

I have had these same thoughts and have begun a website to honor the unsung hero that is the Fat Firefighter! Please check it out and let me know your thoughts about what the site should become.

Be safe!

http://www.fatfirefighter.com

 

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