What Lessons Can We Learn to Avoid the Same Fate?
Last night I forgot to ask my wife to join me in the Jacuzzi. I was really in hot water.
Ok, perhaps it isn't the best idea to start a blog about Matthews Perry's death with a Jacuzzi joke.
Yet I feel Chandler Bing would have approved. "If meeting my maker can be used to bring a smile to thousands of people, I say go for it- plus I wish I had thought of that joke!" This is what I suspect he would say.
By now, we have all heard the news; Matthew Perry-AKA Chandler Bing- drowned while in his Jacuzzi at age 54.
With no evidence of drug or alcohol ingestion as the cause, the world awaits the toxicology results and the final autopsy findings.
Assuming it wasn't due to those factors, what could cause someone to drown taking a dip in their hot tub? How likely is this a possibility for you and me?
A year ago, a 57-year-old acquaintance of mine died swimming in the ocean. Autopsy - acute heart attack- that allowed her to drown. The death was from the drowning, not the heart attack itself.
In fact, drowning after a cardiac event or by substance use is not rare. Last year there were 4000 deaths from drowning, and about half were related to cardiovascular factors. 15% were due to alcohol or drug use, and the remaining third were accidental--maybe a boat accident. And let’s not forget riptides.
A couple of years ago, another 50- year- old acquaintance suffered a drowning while snorkeling. Autopsy? An acute stroke that caused a loss of consciousness and subsequent drowning
Was there something Mr. Perry could have done to prevent this tragedy? And perhaps more important-are there steps WE can take to avert an avoidable drowning?
To determine this, we should look at the top three probable causes of loss consciousness while in a pool or Jacuzzi, or even snorkeling in the ocean.
1. Mr. Perry may have suffered a stroke or heart attack, which caused a temporary loss of consciousnesses. If it had occurred out of the water, it may not have been fatal. But going underwater while unconscious is pretty much a game ender.
Mr. Perry was a former smoker, and of course a known drug abuser. It is reasonable to think he was at a higher risk than a person who never took up those habits. He may have had warning signs such as angina or TIA’s but not necessarily.
Actor Joe Flynn - a heavy smoker- died at age 49 while doing laps in his pool. Baby Boomers may know him as Captain Binghamton on McHale’s Navy in the 60's. By the time he was pulled from the pool, he had drowned. He had been swimming alone. Autopsy- Heart Attack. But the cause of death was drowning.
2. Mr. Perry may have experienced an arrhythmia---an issue with his heartbeat. This is statistically more likely, and falls in three categories:
a) He may have had a "Sick Sinus Syndrome" (SSS) where an issue with his internal pacemaker slows the heart down--even into the 20's . It usually will speed up with consciousness regained. But after a minute underwater, death is probable.
b) He may have suffered with A Fib-where the heartbeat is irregular and fast- which can lead to a fainting spell.
It is possible to have A Fib and not be aware- until it goes into a fast rhythm. Both SSS and A Fib are not uncommon after 50, and more common in smokers or with enlarged hearts, which Mr. Perry was likely to have. Both conditions are relatively easy to diagnose if we are looking for them.
c) He may have been faced with ventricular arrhythmia, AKA PVC’s. If he had several in a row, a fainting spell was likely.
Orville Redenbacher also drowned in his Jacuzzi. He was 88--a victim of a heart attack. He was a shrewd agricultural scientist who experimented with different strains of popcorn and became a millionaire in the process of revolutionizing the popcorn industry. Although an octogenarian, he had shown no signs of ill health or cardiac disease prior to this Jacuzzi incident.
3. A third possibility is that Mr. Perry simply fainted as he was entering the Jacuzzi or while sitting in it. With the hot temps of Jacuzzis and saunas, your blood vessels become larger. Blood falls from the brain via gravity, and you faint. If he were already hot and possibly dehydrated from playing two hours of pickleball, add the 104-degree temps of the Jacuzzi, and a loss of consciousness that proved fatal is certainly possible. This can happen to almost anybody at any age, but people over 50 do not tolerate temperature extremes as well as the youth.
Of course, we also recall singer-actress-diva Whitney Houston too was a victim of drowning- albeit in her bathtub. Her toxicology results revealed cocaine and Xanax that most likely led to her losing consciousness while soaking in her tub, and then drowning.
So, what conclusions can we make about Mr. Perrys' death? Was it preventable?
If you feel you may be at risk, here are some steps you can take to avoid a premature death thru drowning:
1. If you smoke, stop. If you are hypertensive or diabetic, see your doctor to get them under tight control. If there is any doubt about you having hardening of the arteries (thus leading to heart attacks and strokes), consider a treadmill stress test. We do several types here at Caduceus and insurance will probably cover them. If not, the cash price is $205. Mention this blog, we will do it for a flat $200.
2. If you get palpitations, or have a personal or family history of arrhythmia, see your doctor. Or self-order an event monitor-there are a few different types. Insurance usually covers, but if not, the cash price is less than $500. These monitors will track every heartbeat over days or weeks and analyze them. If you are prone to SSS, A Fib, or PVC’s this test should help pick it up.
3. If you have a history of fainting spells, even from seeing a snake, do not use a sauna or Jacuzzi alone. Especially if you are over 50. (Please see joke that began this blog, ha ha!).
Be sure you are hydrated beforehand. Dip in a pool or lukewarm shower before entering the sauna/Jacuzzi. There is a reason most hotels post signs warning against using the sauna/Jacuzzi alone, especially with a cardiac or diabetic history.
Oh, and a trivia question-Who named the band the Rolling Stones, and was their uncontested leader in the early/mid 60's?
If you said Mick Jagger----WRONGGGGGGG!
Brian Jones (No not the Monkey--that was Davey)-a multi-instrumental musician- would be the right answer---which if you are a Baby Boomer Rock and Roller, you knew.
Brian was a musical genius whose alcohol and drug abuse turned the band against him, and on June 9, 1969, was kicked out. Three weeks later, he partied at his house with some friends, and enjoyed large amounts of alcohol and other illicit substances and decided to go for a midnight swim. His friends pulled him out when he appeared unconscious; his girlfriend felt a pulse. He died in the ambulance on the way to the hospital. Coroners labeled the drowning "Death by Misadventure"- thus going down in history as one of the most creative descriptions of a drowning caused by drugs and alcohol.
In Summary, let’s revisit a scene from Friends-
Rachel: "Guess what, guess what, guess what!!??"
Chandler: "The fifth dentist caved and now they ALL recommend Trident?"
Ummm, not exactly-
1. If you haven't had your annual checkup, get one.
2. Ask about a treadmill or event monitor -it may prevent fainting in the water.
3. Do not use a sauna or Jacuzzi alone, especially if you are over 50 or have a history of fainting.
As Chandler Bing would say: “Could the advice BE any more obvious?
Gregg DeNicola MD
CEO, Caduceus Medical Group & PDQ Urgent Care & More
Self-book your annual check-up, and/or request a consult with your primary care provider to review your options for either a treadmill test or event monitor. You can also request directly by live chat from our website, through your patient portal, or call our dedicated appointment line at 844-807-8558.
Gregg DeNicola MD
Caduceus Medical Group
PDQ Urgent Care & More