Medical Chronicle

A final medical appraisal

Photo sent from the boat Bastide Otio, on December 3rd, 2016 - Photo Kito de PavantPhoto envoyée depuis le bateau Bastide Otio le 3 Décembre 2016 - Photo Kito de PavantObjet : le calme avant la tempetebonjour la terreoh, j'ai bien dormi cette nuit..

Tiredness has many causes, but it is the length of the race that is so hard to bear. If you look at your balance for example. On a boat you are pummeled by the waves all the time, you have to struggle to avoid falling over or to remain standing up and this puts pressure on your nervous system and requires a lot of hard work from your muscles. This fight goes on day and night, except in the rare periods of calm. Then, there is the constant noise, dangerous and exhausting manoeuvres, the daily worries, stress, the lack of sleep. And also being alone.

Yet, in previous races, you have been through all the blood tests to make sure everything is in order and there is nothing to explain the tiredness. Nothing has been found of significance even analysing the blood of sailors, who have spent longer at sea. So it must be down to the high level of activity over several months. When you see that the daily requirement in energy is twice that of normal life, you understand how intense these efforts really are. In spite of the extra calories, many have lost weight. This is often due to the withering of the muscles in the legs. Ocean racing usually requires you to remain on your knees or sitting down, instead of standing up or walking. In the post Vendée Globe recovery period, it is not just rest that is required, as these leg muscles need to be built up again by doing gym exercises, walking and cycling.

Mentally, it is vital to get back in the habit of a good night’s sleep. But after weeks of short naps, this can take several weeks of insomnia and tiredness. Relaxation techniques can help at this point. In general, depending on the individual cases, getting over the Vendée Globe and getting back to some sort of normality can take months rather than weeks.

In this eighth edition, there were no serious accidents. It had more in common with the previous race with minor affections, which could be controlled. This year, we did see a number of bruises over the body. Fractured ribs knitted themselves back together. Injuries, in particular concerning the hands, were dealt with at the finish. The skin, softened by the salt water, had become fragile and less resistant to external aggression. The epidermis thickens with chaps, swelling, nails coming off. It is hard to treat these skin infections in the damp salt conditions and that is particularly the case for places that get rubbed around the wrists for example. In bad weather, the sea water gets in and evaporates with the heat of the body. The salt crystals remain and act like emery paper each time you move. The epidermis peels off allowing bacteria to thrive.

There were some injuries to the knees, ankles and elbows, which were treated with the appropriate treatment. Dental problems were quickly resolved with the medical kit on board. Other pathologies affected the respiratory and digestive systems. There were muscle and tendon pains due to the lack of warming up, and pains in the joints, in particular in the shoulders and the lumbar region.

There were also some complaints linked to swelling around the knees and elbows around the joints. The bursa is the area around the joint which allows the skin and tendon to move around the bone. Bursitis is when there is a swelling here, which results in pain, particularly when the joint is moved or pressure is applied. When sailing in such races, this inflammation is linked to the repeated minor injuries, such as the elbow movements required at the winch or helm. Antibiotics are often recommended to avoid any infection developing.

At the start, it is worrying to see the inside of some of these boats, which look totally empty, meaning you can get thrown around. There have not been any major problems linked to this danger. Even a minimum of ease of working can vastly improve life on board and offer safety down below. Some of the troubles were not mentioned by the skippers over the phone. That is their right, of course. The doctor will always treat these matters in confidence in any case.

Seeing younger competitors win is now clearly part of the game, even if you need a certain maturity to compete. Several elements need to be considered. The foilers are highly demanding boats. Without the correct level of preparation a long way before the start to offer endurance and resistance, it is impossible to keep up the pace set by the frontrunners. With age, the ability to maintain such efforts over such a long period of time is reduced and it is important that everyone knows their limits and takes care of themselves to avoid collapsing before the finish. The average age for this edition was in fact the oldest - 44.7. In 2012, the average was 43.1 and in 1989 just 38.6. The competitors are growing progressively older, but as the boats become more demanding, this process may well be stopped.

The close result between the two frontrunners and the duels we saw at other levels throughout the fleet saw people pushing harder and harder. Psychologically, it is not easy to relax, when your nearest rival is just a couple dozen miles away. Nevertheless, the sailors needed to remain vigilant during these battles, as sometimes pushing themselves too hard can have the opposite effect from what they were looking for and it can also be dangerous. In spite of the exclusion zone around Antarctica and the improved safety means, this race remains one where anything can happen with occasionally extreme situations, like the ones experienced by Kito de Pavant and Thomas Ruyant. That is something that must not be forgotten.

In reply to the inevitable question on the podium – “Will you be back in 2020?” It may be too soon to reply, but everyone knows how this race fascinates. There are so many things to discover and to talk about in the solitude of the Southern Ocean. We’ll be there to see them, listen to them, understand them and love them. Looking beyond the performance, these sailors of the extreme share with us their adventure in this hostile and unknown world, where man has no place. Today they are all back, whether they have completed the race or not. They have left the Southern Ocean behind them and their memories will stick with us until the harbour explodes with delight again in Les Sables d’Olonne at the start of the next Vendée Globe.


Dr Jean-Yves CHAUVE

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