Highlights
- French freediving champion Thibault Guignés recounts his experience with hypokalemia in two freediving competitions
- Hypokalemia is a result of inadequate potassium levels in the body
- It is considered an imbalance of electrolytes due to a disturbance of potassium
- Increased excretion of potassium is a common mechanism of hypokalemia
- It is often associated with cardiac disease, renal failure, malnutrition and shock
Reading Time: 15 minutes
Who is Thibault Guignés?
Thibault Guignés is a French freediving record holder with many dives exceeding 100 meters (330 feet). His personal best is 117 meters (384 feet) in the Free Immersion (FIM) discipline and 110 meters (361 feet) in the bi-finning (CWT-B) discipline.
This is a human being that pulls down a line to 100 meters (328 feet), hangs there for 1 minute, before pulling up again to the surface. Yes, all on one breath. His total time underwater on one breath? 4:15 minutes.
Let me simply break that down for people that don’t believe this. Thibault usually takes 3:05 minutes to 3:20 minutes to do a 100 meter Free Immersion (FIM) dive. He adds on a 1-minute hang at depth, which to most people would feel like an uncomfortable eternity, before coming back up. A FIM dive in freediving is pulling down a line with a bottom weight set at a specified depth.
Here’s Thibault setting the French National Record in Free Immersion back in May 2019.
A quick discussion on freediving accidents
Freediving is an addictive sport. This addiction is often translated in the desire to dive deeper, often at the detriment of our physical and psychological preparation. Accidents happen. Just as in any other sport. We have to recognize accidents when they occur and openly discuss them. This way we can grow and learn from each other’s experiences, both negative and positive. By discussing accidents, rather than hiding them, we can make freediving a safer and more accessible sport for everyone.
“I have always believed in sharing the setbacks as well as the successes.”
Michael Board, British record holder.
Thibault’s experience and willingness to share was inspired by a potential decompression sickness (DCS) accident that occurred to Michael Board just last year. As Michael said in his post, “I have always believed in sharing the setbacks as well as the successes.” If top level athletes and professionals continue to share both their successes and setbacks, freediving as a competitive sport will continue to evolve. Hopefully, it will evolve from the realm of the arcane and impossible to an accessible sport for everyone.
Thibault’s experience with hypokalemia
In Kalamata, Greece
Let’s back-track to Kalamata in 2019. Thibault was training CTW-B for about three weeks at a depth of 110 meters (361 feet). This depth, in an environment with a high-quality safety team, was comfortable for Thibault. However, after 10 days of training Thibault noticed he was having symptoms of polyuria.
Polyuria occurs when the body urinates more than usual and passes excessive or abnormally large amounts when you urinate. This can lead to severe dehydration and lead to kidney (renal) failure is left untreated.
Thibault noticed he was urinating up to 10 times per day. Having invested time and money to attend two top freediving competitions in Greece and Cyprus, Thibault under-estimated the importance of his symptoms. He attributed the excessive urination to diet and to an intensive training program. However, since the symptoms were developing, he made an appointment with a specialist upon his return to the Philippines from Europe.
Over-Training Syndrome (OTS) is common among many top athletes in high performance sports. It can have physical and psychological setbacks to an athlete’s performance, recovery and health.
He decided to take three days rest, before attempting a 100 meter CWT-B during the first day at the competition in Kalamata, Greece. He recounts the dive felt good, however being slightly hypoxic at the surface, he had a small blackout after his surface protocol. Red card. He attributed this to competition stress and having just heard the devastating news of Sayuri Kinoshita’s death the night before.
Following five days of rest, Thibault attempted the same dive to 100 meters in CWT-B. After a minor blackout with no other complications, five days of rest is a conservative move. The second dive once again felt easy, however Thibault lost consciousnesses at around 12m depth. Within 10 seconds he is awake without the need of rescue breaths. His oxygen saturation returned to normal and he had no other issues. After discussing the situation with colleagues, medical staff and other professionals, Thibault recounts attributing the accident to over-training.
In Cyprus for the second competition
At this point Thibault decides to take 10 days rest. Once arrived in Cyprus for the second competition, he decides to do an easy fun dive to 60 meters with a short hang. He feels really good during and after the 60 meter dive, and announces a 100 meter FIM dive for the competition. A 100 meter depth dive in FIM discipline is very comfortable and easy for him. He approached this dive very confidently and relaxed.
It’s important to recognize that for Thibault, a 100 meter (328 feet) FIM dive is well withing is ‘zone of comfort’. Having dove to this depth over 150 times in his life, this was a dive where he was physically and psychologically prepared for.
The dive went very well. The way down Thibault felt great and so on the way back up from 100 meters. However, at 25 meters from the surface he felt off. The deep safety for the dive, Savvas, also noticed something was wrong. Savvas decided to intuitively grab Thibault and assist him to the surface. Thibault doubts he would have been able to return to the surface on his own efforts.
After several unsuccessful attempts at rescue breaths, Thibault is evacuated by boat. His laryngospasm is so strong, tracheal intubation also not an option. His pulse is difficult to find, and so the rescue team focuses their efforts on chest compressions. He is also experiencing seizures at this point. 3:15 minutes after he surface, Thibault wakes up. Breathing pure oxygen, Thibault has to focus on the task at hand and force himself to stay awake. He recalls the encouragements of the safety team to keep him awake and focused on breathing.
Once at the port and in the ambulance, Thibault starts to feel better. Still breathing oxygen, he is evacuated to the hospital. By then he only feels tired. Barely a lung squeeze (pulmonary edema), but with no blood or pinkish foam, nor detected with x-rays. Only a slight “crackling” in the lungs is detected with the stethoscope, which alleviated within hours.
The results at the hospital and from subsequent tests show:
- Not a diabetic
- He did not have any urinary tract infections (UTI)
- Prostate or kidneys (renal) were not affected
- Nothing abnormal with blood tests (RBCs, minerals, etc.)
The only thing detected was a severe potassium deficiency known as hypokalemia. Thibault has since worked with the AIDA International Medical Committee to continue investigating this incident. At the time of this article, no definite conclusion has been established and research is on-going.
Thibault’s thoughts on hypokalemia
After many discussions with physicians and specialists, Thibault has drawn some tentative conclusions.
Firstly, hypokalemia can spiral out of control through one of its symptons: polyuria. Polyuria is excessive urinating, which in itself will increase the excretion of potassium. The excretion of potassium is further exacerbated in the water because of immersion diuresis.
As hypokalemia develops furthers, it can cause cardiac arrhythmias. Coupled with a prolonged breath-hold, arrhythmias could explain the blackouts and seizures. It may also help to explain the difficulty the rescue team had at finding Thibault’s pulse at the surface.
As for the cause of potassium deficiency? Thibault is still unsure. He recounts a change in diet as a potential factor, but he’s also conscious of having eaten foods with high potassium sources. He started an anti-oxidant supplementation of grape seed extract, and this, he thinks, might be worth looking into.
Thibaults advice
Thibault suggests, especially to top performing deep athletes, to never under-estimate minor changes in your physical or psychological well-being. Even if something seems insignificant at first, it’s well-worth identifying potential issues early. At this level of athleticism, minor changes in physical or psychological well-being can have grave consequences.
Thibault is now currently back to health and is actively training again. Keep up with his travels, stories and upcoming competitions.
References and acknowledgements
Firstly, a big thank you to France Apnée for being the first to record this incredible and valuable story in the freediving community. Our goal for this article is to translate this story with Mr. Guignés’ permission so the English-speakers can benefit from it as well.
Secondly, I congratulate Thibault for having shared this incredible experience so others may learn from it as well. Often we hide or silence freediving accidents because of shame and stigma. But injuries such as lung and trachea squeezes happen in our sport. We often feel a sentiment of shame and guilt when they do: we went too deep too quick. Instead, we should discuss them openly for everyone’s benefit.
