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Many surfers suffer from Asthma and if well controlled there are no immediate issues, though a good understanding of your illness is very important to avoid major trouble during sessions. Cold air, exercise, inhalation of water may set of wheezing and difficulties breathing (medical jargon bronchospasm), which may lead to severe distress and has lead to fatal drowning incidents among surfers. When seeing your doctor it is important to explain you are frequent in an ocean environment, this will aid to create an appropriate Asthma Management plan tailored to your Surf Life Style. Currently I am suffering from a flare of Asthma, what should I do? Surf Travel & Asthma Please let us know if you have more questions or want to share your experiences with Asthma & Surfing, we love to hear from you. Answered by, Dion van de Schoot, MD The Advanced Surf Life Support™ (ASLS™) course is the first and most advanced course of its kind now running for almost a decade. The ASLS format has been custom-made to prepare and train health professionals in acute and surfing medicine, to learn and master basic aquatic life saving and rescue techniques, and wilderness medicine at remote surf locations. The ASLS course is appropriate for licensed medical professionals (MD, PhD, OD, PA, NP, RN, Paramedic, EMT, etc.) who have interest in surfing and water activities. Medical professionals in training can take the ASLS depending on their stage of training. Our graduates include surfing enthusiasts, ship doctors and expedition physicians, physiotherapists of national teams, medical personal from pro surf events, big wave surfers and other water sport professionals, among others. In addition to challenging yourself and learning something new, earning CME credits and an Advanced Surf Life Support certification, will provide you with skills, tools and knowledge to handle medical care in beach and surf settings where help may not be readily available. And it is also a lot of fun! The Advanced Surf Life Support™ Course features a wide array of topics with drowning and hypothermia, rescuing techniques, theory about waves, tides & rips, outdoor scene safety and patient assessment, diagnosis and treatment of wounds, marine envenomation, and musculoskeletal injuries among others. The participants get practical training by experienced surfing doctors, wilderness medics, drowning specialists and professional surf lifeguarding instructors. You will receive an ASLS certification after your participation in and completion of the FULL course, which includes successful passing of the written and practical exams. Participation in the course mandatory includes water fitness (see “Fitness to bring”) and showing confidence in the ocean and waves, both of which will be continuously assessed throughout the course to ensure your personal safety and make sure you meet the course’s criteria. The ASLS certification lasts for 4 years from the completion of your course. For more specific details on the course’s certificate and passing criteria please read the “Terms and Conditions” on the registration pages. After four years a in order to keep your certification you have the choice of either (1) retake the ASLS course, (2) be an active and instructing member of the ASLS team or (3) take one of our refresher courses. Please note, that the later are not taking place on a regular basis so far. If you have a request, please let us know. The ASLS™ course programme takes account of our mutual passions: medicine and surfing! While we sure can not control the swell and weather conditions itself, the schedule leaves enough time for a daily surf-session. Or two. No! The ASLS™ course is NOT teaching you how to surf, it is about surfing medicine! You sure will learn some things for your surfing, but we do not give no dedicated surfing lessons. Also, when applying for the ASLS course you should bring some surf experience. This does not mean you should be a super surf crack, however bloody beginners barely able to standup on a surfboard sure will be overwhelmed by the course’s water exposure. Yes & No. – We do provide surfboards for the course’s life saving training, scenarios etc. But we do NOT provide surfboards for surf sessions before/after the course day. However you can rent equipment locally, with one of our many local contacts offering you good rental rates. We expect anyone taking the ASLS™ course already should have been around in the water for a while. Anyone surfing, kiteboarding, windsurfing, or alike should have her or his own wetsuit anyway. Please bring it along. Not at all. On which board you use to ride on the water is secondary. However, to attend the ASLS™ course you must feel comfortable in the ocean and waves, with and without board. During you course you will do quite some swim and ocean rescue training, including rip currents and in breaking waves. You don’t need to be on swimming competition level, but feeling comfortable in waves is a must! Participation in the course mandatory includes water fitness (see “Fitness to bring”) and showing confidence in the ocean and waves, both of which will be continuously assessed throughout the course to ensure your personal safety and make sure you meet the course’s criteria. For the exact physical requirements please see the course’s Terms & Conditions. Not at all. On which board you use to ride on the water is secondary. However, to attend the ASLS™ course you must feel comfortable in the ocean and waves, with and without board. During you course you will do quite some swim and ocean rescue training, including rip currents and in breaking waves. You don’t need to be on swimming competition level, but feeling comfortable in waves is a must! Participation in the course mandatory includes water fitness (see “Fitness to bring”) and showing confidence in the ocean and waves, both of which will be continuously assessed throughout the course to ensure your personal safety and make sure you meet the course’s criteria. For the exact physical requirements please see the course’s Terms & Conditions. There are two major aspects on this question: mental and physical preparation. In order to get ready for the ASLS™ course all registrants will receive a preparation manual prior to the course in sufficient time, so you have all the things at hand gain all the knowledge to fully enjoy the course. As for your physical preparation and water fitness level please see the next question. The surf rescue training will be incredibly fun but also physically quite demanding. So, you need to be in shape before the start of the course. The fitter you are, the more fun you will have while learning the rescue skills and saving people in the scenarios. You must be able to meet the following criteria to attend the course: Participation in the course mandatory includes sufficient water fitness (see above) and showing confidence in the ocean and waves, both of which will be continuously assessed throughout the course to ensure your personal safety and make sure you meet the course’s criteria. For the exact physical requirements please see the course’s Terms & Conditions. If there are any questions, please do not hesitate to contact us: asls@surfingmed.com If you can already answer all the above points with ‘Yes’, you are already in a great shape and physically ready for the course. If not, don’t worry: there is still plenty of time to get in shape. ASLS alumni or seasoned Surfing Medicine professionals are encouraged to apply. We would love to explain you the pathway in person. One thing said in advance: it is a very rewarding, sometimes challenging but ALWAYS fun and satisfying job! We love what we do and we are sure you will, too. If you have a great facility and passion for Surfing Medicine we invite you to think about hosting a licensed course. Please get in contact with us and we will let you know all the details: ASLS@surfingmed.com Yes, of course there is a course programme providing day-to-day information. With plenty of activities in the water and on the beach we do need swell for several exercises but also we do not want do endanger anyone by massive waves or rips. With a course like the ASLS™ we do have to adopt the timetable to these external conditions. For this reason the course schedule is not yet available for download, however it will be handed to all registered participants in sufficient time. You can come and leave whenever you want, just be aware that to get the ASLS certificate you will need to attend the full course, and pass the written and practical exams, which will be held on the last course day. In other words, anyone being absent during the course will NOT get the full course certificate. Instead you will receive a printed “Proof of Attendance”, still eligible to apply for educational points. In order to receive the Advanced Surfing Medicine Life Support course certificate participants need to fulfill ALL the criteria as stated in the course’s Terms & Conditions. In order to receive the Advanced Surfing Medicine Life Support course certificate participants must pass the written and practical exams, which will be held on the last course day. Also, for the full certificate you must attend the full course. Additionally make sure to meet our required level of water fitness, among other criteria stated in the course’s Terms & Conditions. Anyone NOT meeting the criteria above will receive a printed “Proof of Attendance” instead of the certificate, still eligible to apply for educational points. Yes. Friday though, has a full schedule and is as such part of the course. Furthermore, on Friday of the course the written and practical exams will be held. We advise you to plan you travel times to arrive at the course location before the first course event and to leave without stress at earliest on Friday evening. Ideally you leave Saturday or Sunday, so you’ll have the chance to celebrate your successful completion of the course at our legendary closing party. Please note that anyone being absent during the course will NOT get the full course certificate. Instead you will receive a “Proof of Attendance”, still eligible to apply for educational points. In order to receive the Advanced Surfing Medicine Life Support course certificate participants need to fulfil ALL the criteria as stated in the course’s Terms & Conditions. Since we all know the pitfalls of working in the medical business, we sure understand anyone getting into the situation of cancellation. Of course anyone can cancel her/his reservation at any time. As we usually already have some people on the waiting list, your place being assigned to someone else will make her/him happy. In that case that your place will be inherited by someone on the waiting list, as soon as she/he paid we will refund you 100% of the course fee. However, if your course place can not be assigned to someone after your cancellation, you might not be eligible to a full refund. Please read our easy to understand refund policy can be found in the ASLS course’s Terms & Conditions. While we would love to get to know your wife/family, the course program will be quite packed. From the past year’s we have learned that ASLS™ course + surf + family might get pretty ‘intense’. Also, the available space on the venue & locations is perfectly fitted to the participants + instructors + ASLS™ team leaving few to none space for extra guests. However, if you still wish to bring your beloved ones along, we sure could arrange something. Let us know. Call or write us. asls@surfingmed.com Yes, you heard absolutely right. After a week of hard training, lectures and the exams, we all deserve some more surf time together and a closing celebration. As this party will be on the evening after the exams, please arrange your flights accordingly so we all have your big smile around on the closing night. On Saturday, the first course day you will have sufficient day to arrive, do the on-site registration, get the keys to your lovely apartments, etc. Just make sure to arrive before 15:00 on Saturday. In the evening there will be a welcome dinner for all participants, the course team, the instructors to get together and with first easy-to-digest presentations. Risk assessment before going into the water Risk assessment while in the water Emergency plan for an accident during the session Exposure to UV radiation is the main cause of the most common forms of skin cancer. Surfers can be ‘sun smart’ by simply taking some precautions to protect their skin: Answered by Alex Kelleher, MD Anyone can develop a skin cancer and this risk increases with time and cumulative exposure. However, some people are more likely to do so than others and these include those who have: *Note: Without the use of sunscreen Answered by Alex Kelleher, MD The commonest cause of skin cancer is exposure to UV radiation, e.g. from sunlight or sunbeds. Hence, protecting yourself from UV radiation exposure can drastically reduce your chance of getting skin cancer. Read the next question on how to stay safe. Answered by Alex Kelleher, MD Firstly, you should protect your skin with clothing, i.e. wear a hat that covers your face, neck, and ears, a pair of UV protective sunglasses for when you’re back on shore, and a UV protective rash vest and boardshorts. Answered by Alex Kelleher, MD Apply plenty of broad-spectrum, water-resistant, SPF 30 or higher sunscreen to exposed/uncovered skin 15 to 30 minutes before going out into the sun, and reapply frequently throughout the day and straight after coming out of the water and drying off with a towel. Remember, sunscreens should not be used as an alternative to clothing and/or shade, rather they offer additional protection. No sunscreen will provide 100% protection. Answered by Alex Kelleher, MD The Sun Protection Factor (SPF) is commonly thought of as how much longer skin covered with sunscreen takes to burn compared with unprotected skin. Let’s say you would typically start to burn after 10 minutes in the sun, then using a SPF 15 rated sunscreen, would imply that you can safely remain in the sun for 10 min x 15 = 150 minutes before burning. Or with an SPF 50 rated sunscreen, you can safely remain in the sun for 50 times as long as compared to no sunscreen. If you’d do the math, that would be 10 min x 50, which would result in 500 minutes. Just be aware that sunscreen wears off during surfing, sweating and due to other activities. So the 50x times only can be assumed if you re-apply your sunscreen regularly. Another way of thinking about SPF, rather than as time extended in the sun, is in dose/exposure-related terms. If you spend a certain time in the sun, wearing sunscreen with a given SPF would reduce the UV dose to 1/SPF of that which you would experience by spending the same time in the sun but without sunscreen – e.g. applying an SPF30 sunscreen results in a UV exposure of one-thirtieth of that which you would have received had you not worn sunscreen. Of course, one caveat applies, this assumes perfect application, which is rarely achieved. Most people in real life apply less sunscreen than the amount required, and they typically apply it less uniformly leaving patches of skin without adequate protection. As a rule-of-thumb, the protection actually achieved is only about one-third to one-half of the labelled SPF! Answered by Alex Kelleher, MD Sure, from a sun protection perspective that’s ideal. Remember, it’s best to stay in the shade at peak UV radiation exposure times, typically between 11am and 3pm when it is sunny in Northern hemisphere locations. Make sure you step out of the sun before your skin has a chance to redden or burn. Answered by Alex Kelleher, MD Often the first thing noticeable on a bottle of sunscreen is the SPF rating on the front. If you turn over to the back label you can usually find the Star rating, typically ranging from one-to-five stars, as shown below. The higher the number of stars, the more balanced protection offered, i.e. blockade of UVA and UVB radiation. The star rating represents the ratio of UVA-to-UVB protection afforded. You may sometimes see an encircled UVA logo (refer below) on the label, this indicates that the product has been approved by the EU. In practice, it is an equivalent way of saying that the product provides good balanced protection against both UVA and UVB. Answered by Alex Kelleher, MD Some researchers have raised concerns that, despite being an unquestionably important tool in reducing the risk of skin cancer development, the formulation of sunscreen may need to be improved to contain safer ingredients. In 2019 the US Food and Drug Administration (FDA) – one of the two main global regulators of sunscreen ingredients along with the European Commission – removed 14 of the 16 chemicals found in sunscreens from its’ GRASE (generally accepted as safe and effective) category. Answered by Alex Kelleher, MD There are two types of UV filters employed in sunscreens. Inorganic UV filters, like titanium dioxide and zinc oxide, are broadly considered safe. Organic sunscreen filters such as oxybenzone and octinoxate have become controversial due to environmental concerns. In 2018, the Environmental Working Group (EWG) reported that two‐thirds of the commercially available sunscreens in the US contained chemicals, namely predominantly organic filters, that were deemed to be harmful to the environment. The deleterious environmental effects of these filters relate to their impacts on coral reefs, as well as their prevalence in the water supplies and in aquatic wildlife. Furthermore, organic filters have been reported to have negative hormonal effects in animal models. There effects in humans continue to be examined. For those concerned about the environmental impact of organic UV filters, zinc oxide and titanium oxide containing sunscreens could be used. Note: Zinc oxide and titanium oxide are most often used in combination to provide broad-spectrum UV protection. Answered by Alex Kelleher, MD SMI General A1 No, all our merchandise can only be purchase online or one-off events hosted by SMI. We will process orders as soon as we can, we are an organisation run by volunteers. We will do our best to process our orders as fast as we can. Please contact us at shop@surfingmed.com if you experience any delays or have questions regarding your purchase. We ship worldwide! Costs for shipping are Netherlands – Belgium – Luxembourg € 6,25 Europe € 15,25 Rest of the world € 23,00 Please email shop@surfingmed.com to request a quote for your shipping location. We can be reach by emailing us at shop@surfingmed.com Please check this link below on our refund policy. We only accept PayPal at this point of time. Please contact shop@surfingmed.com to arrange alternative methods. You will be charged in EUR (Euro, €). Please email shop@surfingmed.com immediately and reference your order number. Please check our refund policy. Delivery time will depend on your location. All items will be shipped from the Netherlands, delivery time will depend on the distance from the Netherlands. Please note that our shop is run by volunteers so delivery times may vary. On average Netherlands – Belgium – Luxembourg One week Europe Two weeks Rest of the world Three-four weeks The answer is three (3) times a clear NO! Let’s clarify three huge misconceptions: Learn how you can avoid it or slow it down in the Q&As below. Answered by M. von Grote, MD and M. Goettinger, MD Surfer’s Ear is a condition that develops slowly, usually over decades. If not stoped or slowed down can lead to severe problems like hearing loss or reoccurring ear infections. Or it can be just annoying by trapping more water in your ear canals more often. Surfer’s Ear is a narrowing of your ear canal (“auditory canal”) caused by bone growth of you skull. This extra bone growth, also called exostosis (or “bony exostosis”) is caused when your ear canal is exposed to cold water. Even more than just cold water, in combination with wind creating a chill factor, this can really speed up bone growth. Cold water & wind → cold ear canal → bone growth → narrowing of the ear canal → Surfer’s Ear The problem is that once your bone has grown, it doesn’t shrink anymore when your ears get warm again. Surfer’s ear won’t ever disappear — but you can slow it down, or avoid it in the first place. It is called Surfer’s Ear, because it is common among surfers. As surfers we are frequently exposed to water, wind and (depending on where and when you surf) cold conditions. Yes, also swimmers, triathletes, windsurfers or kiters can get it. So, cold, water and wind, that’s it? Answered by M. von Grote, MD and M. Goettinger, MD It is called Surfer’s Ear, because it is common among surfers. As surfers we are frequently exposed to water, wind and (depending on where and when you surf) cold conditions. Yes, also swimmers, triathletes, windsurfers or kiters can get it. Not to be confused with Swimmer’s Ear, or Otitis externa, which is an inflammation of the ear canal. However, having Surfer’s Ear make your more likely to catch such an Otitis externa, which often presents with ear pain, swelling of the ear canal, and occasionally decreased hearing. Answered by M. von Grote, MD and M. Goettinger, MD You can’t. We get your thought: if cold causes it, then warmth will make it go away. Sadly that is not the case. Once your bone has grown, it doesn’t shrink anymore when your ears get warm again. Think of it how your other bones grow — you start of as a small child, over the time bone grows but it will never shrink again. (Unless you break it, impacts it or because of diseases like osteoporosis occurring mostly in elderly people.) Surfer’s ear won’t ever disappear — but you can slow it down, or avoid it in the first place. So, there is this ONE way to make Surfer’s Ear go away: surgery. If your bone growth in the ear canal becomes severe, the only way to have it removed is by surgery. There are currently two major techniques, one where the extra bones get drilled, the other one got chiseled out. While chiselling sound more brutal, it turned out to be the more precise technique leading to better results. So, yeah, surgery can make it go away, but that is definitely not the most pleasant way. And while surgery buys you time, it doesn’t mean your bone will never grow back when exposed to cold water afterwards. In short: Surgery is the last option! Hence our strong recommendation to avoid Surfer’s Ear as good and as early as possible. Answered by M. von Grote, MD and M. Goettinger, MD Not quite. How bad it gets varies from person to person as your genes also have a role in this. Some people seem to be more prone to develop Surfer’s Ear than others, even if the had the same amount of time off “water + wind + cold” exposure. Thank your parents if you are a slow grower. 😉 Answered by M. von Grote, MD and M. Goettinger, MD You have some of those symptoms and wonder if you got Surfer’s Ear? Read on to find out how you can find out. Answered by M. von Grote, MD and M. Goettinger, MD First of all: Relax! Surfer’s Ear is not dangerous. It is not a disease, it is a condition. In other words: an anatomical special feature. But it might cost you a few surf sessions in the future. And this is what we are concerned about as your ‘Surf Docs’ and this is why Surfing Medicine International is working on this project. Protect yourself Depending on how severe your Surfer’s Ear is and how old you are you should consider wearing ear plugs and/or a hood. If you keep surfing in cold water the bone will keep growing. And if you surf in dirty water you will get infections way easier then surfers without Surfer’s Ear. So, get surgery and be done with it once and for all? Nope, sorry. Surgery is no easy solution since once the bone has been drilled or chipped away it will grow back if you don’t protect your ears in the water. Ear Plugs We do not sell any. So we have no interest in talking you into wearing them. Except for the fact that they seem to do a great job: Many surfers choose not to wear them. Because no matter which brand you buy: You have to remember to bring them, put them in, take them out, not loose them, clean them every once in a while. It is a pain. And with many of them your hearing is impaired. People feel disconnected from their environment and many surfers say it affects their equilibrium. For the good ones that feature a membrane and promise less hearing impairment you have to pay around 60 Dollars, check out Doc’s Proplugs / Surfears or EQ Ear Plugs for good quality. Loosing them is pretty annoying. For cheap ones that will keep the water out just as good but the sound as go to Home Depot or a drugstore. Neoprene Hood Why nobody wears them unless it is freezing? Probably because of the Kook-Look. Yes, even Julian Wilson doesn’t seem that pretty anymore with a hood on. People might drop in on you. From a medical point of view we think they protect you better against Surfer’s Ear than ear plugs because they keep the whole head warm. Let’s see if the data we are collecting supports this theory. A famous hood wearing surfer is Dr. Renneker from Ocean Beach California. He usually wears two hoods (a thin short one and a normal one with a neck part) and is probably the only surfer who spent over 40 Years surfing cold water and does not have Surfer’s Ear! Other things that work Care Ear plugs and hoods are not your thing? There is still something you can do. Just like some people have drier skin than others and use lotion to take care of it, every person’s ear canal hat a different anatomy and you should look after it. Glycerol/Alcohol (aka ‘Swimmer’s ear drops’) Most common is the mixture with glycerol and ethanol. It fits well into the natural environment of your ear canal, especially the PH level. Depending on the country you can get the drops in drugstores, supermarkets and pharmacies. Some pharmacists can even mix them themselves. You can put a couple of drops in your ears after every surf especially when the water is dirty. They might not delay the growth of the bone but they will certainly avoid infections and blockage of your ear canal. If you do not like them (some people say they sting) talk to your pharmacist. There are other options. Hydrogen peroxide/ agua oxigenada/ H202 This solution is easy to buy all over the world. And it is not bad to clean your ears either. However, it is more aggressive than the drops mentioned above. Most important is that you never use a mixture with more than 3% H2O2 and if your ear canal is sensitive it is better to use other drops and to dry your ear gently (for example with a blow-dryer). So if your ear is fully blocked or you surf really dirty water once a month this is a great option. If you need to use drops several times a week use the drops above. Blow-dryer You have water stuck in your ear and you can not get it out? This is not only irritating. Bacteria love it when it is moist, the odds to get an ear infection increase. Take a blow-dryer to get rid of the water in your ear canal. It is a simple and effective solution, you will feel the difference. Just don’t hold it too close to your ear and don’t take an extra hot one. Answered by M. von Grote, MD and M. Goettinger, MD Just like many ‘therapies’ out there, some are better than others. Few even can worsen the healing, like toothpaste on burns (Nope, don’t do that) or pee on jellyfish stings (Nope, don’t do that either). Also for Surfer’s Ear there as some Urban Myths, proven to either be ineffective or even causing more harm than doing good. Here some examples we advise you NOT to do: Answered by M. von Grote, MD and M. Goettinger, MD
Asthma & Surfing
Can I go surfing when suffering from Asthma?
Benefits for Individuals
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F.A.Q. - ASLS Course
Risk Assessment in Surfing
Skin Protection and UV
SMI General
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Surfer's Ear
In short:
Not quite. How bad it gets varies from person to person as your genes also have a role in this. So, sometimes people seem to be more prone to develop Surfer’s Ear than others, even if the had the same water+wind+cold exposure. Thank your parents. 😉
(Without Surgery)
When your ear canal gets narrower due to the bone growth (exostosis), it is harder to get the water out that has gotten in your ears during surfing. Hence, experiencing water stuck in your ears after surfing can be a first sign of developing Surfer’s Ear. (There are other reasons for stuck water too, so don’t freak out if you got water in your ears. Just get them checked.)
With water being stuck in your ears more frequently and for longer, your ears get worse at drying. This “more humid climate” in your ear canal increases your risk of catching acute ear infections.Also, if the water you surf in is polluted, dirt, chemicals and germs can get stuck in your ear with the water. In healthy ears this nasty stuff gets out quickly again after the surf. If you have surfer’s ear, the nasty pollutants can work its magic for longer, causing increasingly frequent ear infections.
So, by now you know Surfer’s Ear is caused by bone growth in your ear canal. In other words the canal where the sound gets in get narrower and narrower until at some point you will notice a hearing loss. Usually this occurs at a very, very late stage of Surfer’s Ear. Or the other way round: if you start working about Surfer’s Ear when you start hearing less, your only option left is probably surgery.
With the current knowledge about Surfer’s Ear these are the advantages and disadvantages of earplugs and a hood:
We met quite a few surfers who put vinegar in their ears to clean them. This is ok, you will not destroy your eardrum doing it once. But honestly, your ears deserve better. So some of the drop recommended above are better.
Alcohol is another effective fluid against germs but not the best care for your eardrum. It is a sensitive region and even if there are not enough vessels in your ear canal to get you drunk pure alcohol is too aggressive for this part of your body.
Olive oil is a cure for everything? Not quite. Due to Surfer’s Ear your ear canal is very tight. It will be harder to get the olive oil out of there than the sea water. We are not saying it harms you. It might even have a good effect if you put some drops of oil in your ear before the surf since a fatty surface rejects water. But good luck getting it back out. Olive oil can be put to one very good use (besides in the kitchen): to get insects out of your ear. Sometimes small insects get trapped in the canal. If you pour olive oil in your ear canal they will drown and slide right out.
Just a clear ‘No’!. It won’t help in Surfer’s Ear, nor in Swimmer’s Ear. “But if it doesn’t harm…?” Well, that’s exactly the point. Just forget about it.