Rapid Fire

Pre-Screen to Intervene: A Proactive Approach to Firefighter Health and Survival

Battalion Chief Bob Keys Season 1 Episode 8

Understand how preventative measures and regular monitoring can help reduce occupational health concerns like cancer and cardiovascular disease with Todd LeDuc, Chief Strategy Officer of LifeScan Wellness Centers, and Rob Brown, Physicians Assistant and founder of the New York Firefighters Heart & Lung Institute, who are helping firefighters gain access to regular health check-ups and spread awareness about early detection. 



WHAT YOU CAN EXPECT TO LEARN:

  • Why You Should Schedule Regular Monitoring of Your Health
  • How to Take Precaution Even When You're Asymptomatic 
  • Why It's Important for Doctors to Translate Science to Firefighter Speak 
  • The Importance of an Annual Preventative Exam
  • How COVID-19 Can Have an Impact on Your Cardiovascular Health
  • How to Access Preventative Monitoring Resources



ABOUT OUR GUESTS:

Todd J. LeDuc, MS, CFO, FIFirE, retired after nearly 30 years as an Assistant Fire Chief of Broward County, Florida, an internationally accredited career metro department. He serves as a Chief Strategy Officer for LifeScan Wellness Centers, a national provider of comprehensive physicals and early detection exams. For over a decade, he has served as a member of the International Association of Fire Chief’s Safety, Health & Survival Section and is currently the Secretary of that section. LeDuc is also the editor of Surviving the Fire Service (Fire Engineering Books) and serves on numerous advisory boards and publications.  

Rob Brown began his fire service career in 1992 with the Glenwood Fire Department in Long Island, NY. He currently serves as a Lieutenant with the New York City Fire Department and has been an active member since 1996. FDNY Lieutenant Rob Brown, who is also a Physicians Assistant, and the founder of the New York Firefighters Heart & Lung Institute, has also previously written for Firehouse Magazine, WNYF Magazine, and continues to speak about firefighter health & safety issues on a national level.  

ABOUT THE HOST:

Battalion Chief Keys
completed a total of 31 years of service, beginning as a firefighter for a high volume station in the Bronx. As a Captain and Lieutenant, he served various municipalities including Midtown Manhattan, until settling into East New York Brooklyn, where he became Battalion Chief. Within his new role he took charge of Research and Development where he learned how new innovations are tested and introduced to the fire service.

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Bob Keys, Retired FDNY Battalion Chief: [00:00:00] Hello, and welcome to Rapid Fire, a podcast hosted by fire-Dex, dedicated to sharing best practices and lessons learned in hopes of making firefighting a little bit safer. I'm your host, Bob keys, Retired Battalion Chief from FDN Y 

We're fortunate to be joined today by Todd LeDuc, Retired Assistant Fire Chief of Broward County, Florida. Todd now works as the Chief Strategy Officer for LifeScan Wellness Centers. We're also fortunate to have active Fire Lieutenant Rob Brown, who works at FDNY and Squad 41 in the Bronx. Rob is also the founder of New York firefighters, Heart and Lung. And Rob is also a Physician's Assistant. How are you gentlemen doing today?

Todd? 

Todd LeDuc, Chief Strategy Officer for LifeScan Wellness Centers: [00:00:38] Doing great. Thanks Bob  for having us on excited to have a great conversation today and talk about some, serious issues confronting the fire service. 

Bob Keys, Retired FDNY Battalion Chief: [00:00:48] Great. Thank you. Rob, how's your day going? 

Rob Brown, FDNY Lieutenant: [00:00:50] Yeah, all good over here in New York you know, things are getting better with the pandemic. Things are moving forward. Things are opening up, so people are happier and especially me and most of my family members. So it's all good here in New York. 

Bob Keys, Retired FDNY Battalion Chief: [00:01:03] Great. Great to hear. Yeah. Did have many thoughts and plans on getting back to New York more often than prior to COVID, but life has changed for all of us. And hopefully we'll get through this all together and stay healthy. Thank you guys both for your time today. Really appreciate what you do and what you're doing for the fire service. 

So  today, we're going to discuss firefighter health  and regular monitoring. And this is so very important now more than ever before. Before we get started, I'd like to ask each of our participants to take a minute or less to tell everyone an interesting fact or an event in their career. Chief LeDuc?

Todd LeDuc, Chief Strategy Officer for LifeScan Wellness Centers: [00:01:40] Sure, absolutely.  It's actually how I started my career and that my passion for getting into the service I had the opportunity when I was in my high school years of having an incident where my grandmother collapsed while I was on the phone with her and we live not too far away. we made a mad dash over there and she was unresponsive on the floor and the turned out she was in a pulmonary edema, congestive heart failure. And I watched the magic of the emergency medical services system, the first responders, the fire system, and at the time paramedics, so were hospital-based paramedics or resuscitate her.

So it made a lasting impression on me. And I was in high school at the time. I started with EMT training and after that Paramedic training and Fire Academy and led to 34 years of service. So I always remember that moment in a really made an impression on myself and defined my desire to serve the community.

Bob Keys, Retired FDNY Battalion Chief: [00:02:40] That's, that's a great story. And so similar, I hear so many firefighters get that call of feeling to be able to serve others and help out totally a rewarding career that you've had. 

Rob won't tell us something interesting about your career?

Rob Brown, FDNY Lieutenant: [00:02:55] Yeah. I've been blessed to work in many great places in the FDNY and you know I'm just finishing up my 25th year now.

 Every place I've been I've had special events, but most recently I would say just like we were speaking yesterday is  I got a phone call last Thursday and the company that I work in Squad 41 is part of the Special Operations Command in the FDN Y and we respond to all types of incidents, whether it's drowning in the water building collapse, hazmat major fire technical rescue, we handle all of that from 80th Street up in Manhattan and about half of the Bronx. 

And we, we responded back in September during the pandemic to a fire on 150 Eighth Street, up in Washington Heights, where with the members were encountered heavy fire conditions with multiple, multiple people trapped on reports of a family of nine, still trapped in an apartment above the fire and we were able to get in very quick.

 And My members were able to work in two different teams. And we were able to rescue along with the Latter 23 and a Ladder 34 and a couple other units on scene over 11 people that were trapped in this fire. And two of those rescues were made via roof rope, lifesaving rope, without an anchor on the roof, meaning that the, you know, the. The weight of the firefighter going over on a rope life-saving rope to pick somebody up, that's trapped at a window, ready to jump out. They usually when there's heavy fire like this it stalls the inside team from getting into those apartments. So those people have no way out except the fire escape or the jump. And there were seven stories up. 

So the members of a 34 and 23 had decided they were going to start a roof up rescue. I sent two of my guys up to the roof to assist with them in the process of them doing the roof rope rescue, the woman who was handing a baby out of the window, when the baby was handed off to the firefighter and they started lowering them to the ground.

The woman tried to jump out of the window and got hung up on the the child gates. And one of the members was alerted to this and they ended up to my team members strapped in and hooked in and went over the rope Firefighter Castro and firefighter Ingwersen and again, they, you know, firefighter Ingwersen who lowered the member, usually the operations done while you're anchored, but they didn't have substantial object and they had absolutely no time to, you know, be aware of it to time to save. And they  were able to get him over on the rope and it was just an amazing operation. And last Thursday, the department called us up and said that we would get in the highest metal, the 911 Elsasser medal for rescuing all these people and helping at this fire which to me in 25 years is the pinnacle when you have a great team work team operation, and it's recognized by your peers, it's really an amazing accomplishment that I'm so proud of the guys that I work with now, and it's nice to get recognized for what, you know, you're willing to do every day, each and every day, the guys that are out there, out in the field, taking in all the runs, putting their selves on the line.  Those people all deserves to be recognized, but when your team gets to be, you know standing up in the podium to honor all of the sacrifice of all the firefighters at work every day, it's pretty cool.

So it's probably the pinnacle of my career. And I know you have a very similar story, Chief. 

Bob Keys, Retired FDNY Battalion Chief: [00:06:06] Yeah. That's funny that we chat about this the other day. The Elsasser medal for people who don't know  is only awarded to one company each year. And it's the company that had the most outstanding unit citation or unit recognition.  To get a unit citation. You have to go above and beyond what's normally expected of you and make a huge difference in the outcome of people's lives  or a fire. And to be honored like that is amazing. It was also the pinnacle of my career.

Back in 1993, when I was a Lieutenant in Ladder 24, we had a very challenging fire operating on the floor, above a fire in a Manhattan hotel, a non fireproof building. And and the flashover occurred in some members from Engine 23 were trapped. And and guys from  Ladder 24, my team were able to get in and rescue them and get them out. And along with lots of other great heroic actions, they did that, but we too were awarded the Alsager for 1993 and it was a great experience standing on the steps of city hall with my whole family there and our whole team. A great honor and congratulations to you and the guys from Squad 41. I remember reading about that job sounded like all hell broke loose, and you guys made a big difference. So congratulations, Rob. 

Rob Brown, FDNY Lieutenant: [00:07:12] Thank you. Thank you. 

Bob Keys, Retired FDNY Battalion Chief: [00:07:15] So guys, I'd like to now get to the very important topic of today's podcast. As we all know, fire departments across the country have been doing a better job of educating the members about the statistics that show firefighters are way more likely to contract cancer than non firefighters.

We have seen much more protective bunker gear and particularly the new particulate blocking hoods that are keeping the carcinogens off the firefighters face and neck. We're washing our PPE more often and working towards cleaner cabs for our apparatus. We're staying on air throughout overhaul with initiatives like Boston's Take No Smoke Program. What there is much more that we can do.

Our two guests today are doing amazing work and helping firefighters get regular health checkups and diagnosed early, making a huge difference in the outcomes of what could otherwise have been a fatal illness. 

Bob Keys, Retired FDNY Battalion Chief:  [00:08:06] Todd, can you please share with our listeners what LifeScan Wellness is all about and their philosophy?

Sure. I'm happy to do that.  As you guys were both talking about your tremendous careers in service at FDNY, my hats off to both of you and the entire department for all you do. I couldn't help, but remember  I've got a little FDNY in my blood, I actually did my part field internship with, I guess that was a New York City EMS back in the day. So spent some time responding to calls in the city. And I have the utmost respect for the department in some glad to be joining you guys today. 

As you mentioned, I am the Chief Strategy Officer for LifeScan Wellness Centers. So LifeScan started 23 years ago serving a unique need within, at the time Florida was early detection and medical surveillance for both firefighters and law enforcement officers. And, and since that time we've evolved into now twenty-five States seeing close to 50,000 first responders a year.  We actually have a handful of bricks and mortar clinics for some of our larger departments that we service. And the majority of what we do is we come on site with a three-person clinical team which consists of a Nurse Practitioner, an Exercise Physiologist, and a Ultrasound Technician.

Prior to us getting there, we coordinate blood draws. So we will have labs when we see the first responder. And then we, we engage each first responder with a three hour comprehensive physical that includes the NFPA 1582, a head to toe physical exam done by the Nurse Practitioner incorporates NFPA 1583 fitness assessment. And that's done by the Exercise Physiologist. And then somewhat unique to us. We also have for 23 years incorporated ultrasound imaging, so work in addition to the physical exam and the 1583 assessment which includes a 12 lead stress test. We also use ultrasound imaging to look at some of the vasculature of the left ventricle, ventricular function, the aorta, the abdominal organs, and then in men we do a ultrasound of the testicles and in women external pelvic cavity.

So we exclusively for the most part only see first responders. So our 20 some odd clinical teams that we have throughout the country are very up to speed on the evolving research within first responders and in the NFPA standards and guidelines that guide our care for the first responders.

For me, I got to say, it's, been Just terrific. It's been so rewarding to spend 30 years in Broward as a Assistant Chief, and then be able to now work for an organization that almost not a day goes by that I don't hear it by a phone call or an email that we found an early detection of a, whether it be a cancer or early cardiac issue that we're able to diagnose firefighter occupational threats to health early and be able to intervene and treat them early, which leads to better outcomes. And, you know, for me, and I know for both of you, it's all about, you know, making sure that our first responders are able to through their career serve safely and serve healthy and then enjoy a long retirement for the fruits of their labor. It's been really a tremendous experience for me to continue to give back to the fire service in that capacity.

Bob Keys, Retired FDNY Battalion Chief: [00:11:48] Thank you for what you do and thank you for explaining that. Truly is no greater honor than to protect those that serve and exactly what you guys are doing. 

Rob, can you explain to our listeners is New York firefighters, heart and lungs, similar to LifeScan or is it different and how so?

Rob Brown, FDNY Lieutenant: [00:12:02] Well, we're just in a fixed medical facility in New York. And know I mostly see New York City firefighters or first responders. But over the years we've been asked to help out with a family member or a friend or a neighbor or something, and, you know, anybody that needs access to care, we always try and do whatever we can to help them out.

But predominantly, yeah, the mission is to you know, prevent line of duty deaths and that's what we've been working on. And you know, I'm in my 20th year now as a PA graduated in about three months before September 11th. And this program started out just by chance with helping a senior guy in my firehouse that was a little bit older than me. I was like 24, I guess, at the time. And he was probably 47 and you know, he was having some chest pain or whatever. I said, listen, I work in an office. We do these stress tests. Why don't you just come in and have a stress test? I mean, every fireman should have a stress test. Anyway, you should just do it. And I came in and we found some heart disease and no men. The rest is history. You know, from there we've we've probably saved At least over 150 guys that in my estimation, you know, maybe 30% of those would have been a line of duty death which is about 50 guys were able to keep off the wall of honor down at headquarters for the FDNY and then as it's evolved over the years, we've been doing a lot of cancer screenings.

The number one cancer I'm finding right now Is a thyroid cancer and I think we need to rethink you know, how we train our members to get dressed for, for different runs and how we utilize the hood and, you know an area of protection that we need, but we only need it during certain operations.

And I think we not only can to your mission of trying to get better gear for guys, that's one of the areas that's probably the biggest problem set that we're going to see in the next 10 to 15 years is, you know, the explosion of thyroid cancer for firefighters. But yeah, so we've had a lot of impact.

You know, we've helped, we've helped wives of firemen that fed cancer. We felt wives that have had a heart disease.

You know, it's come to the point where I see a guy at  The Rock or a training Academy or at headquarters, or just out of the fire or anything and they usually say, Hey, you know, I'm sorry. I'm I know I'm supposed to see ya I forgot to make my appointment or whatever it is. And I see. That, Hey, listen we see the two things. One's we had the see ya before, there's a problem, or we'll see you have that has a problem, but most likely we're going to see you. I prefer to see it before the problem so we can find that early and fix it. 

 

But, it’s hard to penetrate a community that has to feel invisible in order to do their job right. And that is the truth behind it, right? That is the secret sauce. I call it the invisibility complex, you know? I meet them when they are healthy, usually. And then, you know, on the, on the extreme ends, I walk them through, you know, a surgery to remove a section of the colon because they have a tumor in there and, you know, coordinating with the surgeon and, you know, I become the quarterback of the case for them.

 

So I get to you know, learn but I also get to talk to firefighters a lot. And if you thought kids had excuses at school for not turning in the homework I had a guy like two weeks ago that. That I saw three years ago and he came into the office and now I examine them and it would come in and I have, there's a couple things I'm looking back, I'm going well, you know how, you know, the colonoscopy, I don't have the report was that, Oh yeah, I didn't go for that.

 

What about this? And he goes, he goes, well, let me, he pulls out his wallet and he's got one of those big old wallets. Right. And in the section where you keep your money, he pulls out three prescriptions that I wrote for a colonoscopy, a thyroid scan and blood work. And he goes, you think these are still good?

 

I was like, are you kidding me? You, you telling me you had those scripts in every day. You got to go in there a couple of times, a day to get money out, to pay for things. And you saw those scripts in there for three years and you never went to get them done. He goes, yeah, I know. I, you know, I don't know.

 

What do you want me to tell you? No, but so, you know, we're a different animal. We're a different breed. And it's, and it's, you know, hard for us to admit that something could potentially be vulnerable in our body. And they, unfortunately, in the past, we've buried our hands in the sand and that was the way we dealt with it.

 

But I think guys are getting smarter and, you know, the fire services getting smarter about how to talk about it and educate about it. And I think you know, we ha we, you know, we, it, it it's, it. The message has to resonate the right way, but the message has to resonate the way that the firefighter can hear it. 

 

Bob Keys, Retired FDNY Battalion Chief: [00:16:08] and trust it.

And the very fact that both of your businesses are booming is proof that the message is getting out. 

 

Todd LeDuc, Chief Strategy Officer for LifeScan Wellness Centers: [00:16:16] Yes, that is, that's a good thing.

Rob Brown, FDNY Lieutenant: [00:16:17] Ya know, at the end of the day, that's how you're going to make the difference. Not, not in building collapsed, you know, structural integrity, all that super important at the end of the day, we owe it to firefighters.

It's a moral obligation that we have as a society to take care of. Those people expect to work in environments that are deadly not only to themselves at the moment, but because of what they're going to be exposed to. And I think the more that we, get that message up through the chain of command in the legislature, on the federal level, the easier it will be for the locals to be able to, you know, go and access money to, you know, start these programs and, and, and keep them going because that's something that the employer, the citizens, right? Because we all work for the government. They, we we all went to those and IO to the next generation of firefighters to make the job just a little bit better than when I found it. And that's, you know what, I hope that, you know, we're trying to accomplish here.

And I think that's the mission statement of what Todd's trying to do as well is you know the access to care educating the members in making sure that they're not putting themselves in greater risk. And the greatest risk of firefighters is, not the fire ground, it's, it's the contaminants on the fire ground and we're learning more and more each day about that and not only how it affects, the body and developing cancer more rapidly than it would in somebody else that doesn't have that exposure, moderate, chronic exposure or extreme exposure with events like 911 or the Deutsche bank.

Or you could pick different areas where there've been hazmat fires all over the country that you know, these members need to be monitored. They need to be cared for and when we're asking people to put themselves in harm's way, we have a responsibility, the public has responsibility and the departments have a responsibility to take care of them and to make sure that they're, they're being monitored and there, and we're doing everything that we can to find it early so that the next person that. Jumps in that seat and is willing to put their life on the line and their family's lives on the line will understand that the departments are looking out for them and that the people care about them. And that if God forbid something was to happen to that member, that their family is going to be taken care of for the rest of their lives.

And if we don't keep that up and if we don't do that, and if we don't understand that that's the big risk of today, then I think we're doing a disservice to the fire service in the future. And the public is going to lose because if you don't take care of the firefighters, that guy's not going to push himself to the point so that he can get to that back bedroom and save your kid, that's trapped in there.

And I think that that's important for people to understand that. And you don't have to look too far away then back to Katrina where, you know, that that state has not a lot of protections for those workers  and they, they lost a lot of firefighters that said you know, I'm going to go with my family to Texas and relocate and, you know, and you didn't see that in New York, after 911.

New York has great protections. And it's one of the things that New York City fire department does is, you know, they do a good job at taking care of the members. They've been , first and foremost getting the medicals up and running. Although we're having a little tough time with that right now because of the pandemic.

It puts a little more weight on my shoulders because guys come to see me for the regular physical because they don't have access to the medicals and the department now.

Bob Keys, Retired FDNY Battalion Chief: [00:16:46] Very good information there. 

I've heard it said by somebody smarter than me, that with modern building materials and the things that are being stored inside homes that structure fires are more hazmat than hazmat runs are and we don't take nearly the same precautions to protect ourselves at a structure fire than we do at hazmat zones. So the education piece is ongoing and needs to continue and the message that you're sending out there and both of you guys are sending out there is so valuable needs to be picked up and heard. 

Todd, do you have any similar stories? That would prove interesting for firefighter who's contemplating coming in for an examination, somebody who an asymptomatic, but goes for the exam anyway and has a revelation?

Todd LeDuc, Chief Strategy Officer for LifeScan Wellness Centers: [00:17:28] Yeah, absolutely. You know, we, as I mentioned and as Rob said, I mean, the goal on this is early detection, right? Because by the time symptoms often are, are present. There's already been a progression of the disease process, whether that's, we're talking about cancer or cardiovascular disease.

I could go on literally all day just with examples, but the one that sticks in my mind is a 43 year-old Special Ops Captain on a large Metro department, and this captain had gone through the year prior so I had the complete three hour exam with the NFPA 1582 physical, the NFPA 1583 fitness assessment, the stress testing, all the ultrasound imaging, and the lab work, everything was picture perfect. Just really had a very clean exam and he went back on shift in just this past year came in a year had passed and it was that department time for the department physical and he completely felt fine. Came, in again 43 years old, in the course of his exam this year we were able to identify a mass within the bladder on ultrasound imaging and it was suspicious in the record follow up with in this case urology.

So this firefighter, I don't want to say what department, but they reached out to one of the top urologists in the region and that urologist was not seeing new patients, but was keen enough that when he heard a 43 year old firefighters. So obviously he knew that firefighters have higher rates of certain types of cancer was asymptomatic, but had a mass on bladder imaging. He said, you know what?  I'll see you. 9:00 AM the following morning. So he was able to get in quickly And he tells the story, the urologist said, I don't even need to do really any further testing, just looking at that imaging looking at the mass, the irregularity it's cancer. And he went on to have a great outcome. He had a course of treatment that was was really successful because we caught those things so early, and that's the goal early detection, but, you know, what's stuck in my mind, Bob. And, and I'm sure Rob sees this in his practice. You know, the urologist said I've been practicing for three decades and you're the first asymptomatic presentation or of a bladder cancer that I've seen in my practice. And it's because it was picked up on the imaging. And I'm sure Rob will tell you in the cardiac side, you know, like liking cancer if we find a pre-cancer or a stage one, so the cancer is isolated to the primary site of origin, as in this case, the bladder survival five-year survival on the cancer furnace is in the high nineties to close to a hundred percent in almost every type of cancer. But, you know, once symptoms are present in that cancer has spread outside the primary site of origin, whether that's through the lymph nodes or the blood system, or other organs, those survival rates really, you know, start dropping dramatically.

So, the goal for all of us  is to find these things at the earliest stage. So in this case, this captain, you know, he had his treatment and he's back to work. He's on the job healthy cancer-free and we'll keep a closer eye on him every year with his department physical his oncologist will keep a close eye on him, but he's going to go on and have a healthy, successful career and hopefully enjoy a long, long retirement.

Bob Keys, Retired FDNY Battalion Chief: [00:21:11] What a great story. 

Rob Brown, FDNY Lieutenant: [00:21:12] Strong work, strong work. 

, I'm sure you see this. I mean  it's the part that makes it so rewarding. When you, get either a family member that says, thank you, or, you know, a brother or sister firefighter that says, listen, I'm alive today because of early detection.

Todd LeDuc, Chief Strategy Officer for LifeScan Wellness Centers: [00:21:28] We've grown from just really the entire state of Florida to now being in multiple States. Seeing close to 50,000 and so those stories are just so impactful.

Rob Brown, FDNY Lieutenant: [00:21:39] It's sort of pile up. 

Yeah, they do. That's how we're gonna make it a safer service. It's all about making sure folks go home at the end of the shift and we keep them safe and keep them healthy. And so they can get their time in and retire and enjoy time with family. 

Bob Keys, Retired FDNY Battalion Chief: [00:21:53] Amen. I agree with that a hundred percent

Rob Brown, FDNY Lieutenant: [00:21:55] We need smart, aggressive firefighters on and off the fire ground. 

 

(INSERT IMPENTREBLE SECTION)

 

Bob Keys, Retired FDNY Battalion Chief: [00:22:00] Rob, you mentioned an interesting quote to me yesterday when we spoke, you said that much of your day, you translate science into fireman speak.

I can, I can appreciate that very much. I struggle even pronouncing some of the names of the medications I take. I don't have a science background. Can you expand on what you do and how you help firefighters understand and get the proper treatment they need?

Rob Brown, FDNY Lieutenant: [00:22:25] Yeah, well, it's probably my favorite word in the whole world and I wish I could take credit for it knowledge translation. I learned it at a congressional fire service dinner I got to meet a psychologist that worked for the Chief of the St. Louis Fire Department through Dr. Dennis O'Neil. And we talked for about five minutes and within that five minutes, he. mentioned the term knowledge translation, and it stuck in my head for all these years probably I don't know might've been 15, 12, 15 years ago when had said it. And I said, that's the million dollar thing is that translating information to what people can understand is, is why I exist.

 And I'm not smart. I'm a fireman, right? Just like we said the other day we're not the brightest with the bravest. Right? 

And thank God, we're not because if we were really smart, we probably wouldn't do what we have to do to save lives. Right? Who would be running into a burning building? You know, so at the end of the day we're happy that we're brave. But we need firefighters to be smart and they need to be smart aggressive.  Every firefighter wants to be smart, but every firefighter also wants the other firefighters to think that they're aggressive too. So the problem is, is if you're aggressive all the time, you can make mistakes and most of the times when we have major problems on the fire ground is that we get ahead of ourselves or in skiing terms, we're, we're over the tips of our skis  and that's because  we're not being smart aggressive, and smart aggressive is, you know, putting yourself in the right place at the right time so that you can affect the rescue and save a life.

And not every day, you're going to be the bride and not every day, you going to be that person, but there are things that you need to do off the fire ground to make sure that you can put yourself in the best spot there is to be able to make that rescue when it might be your time.

And part of that is training, part of that is understanding risk, part of that is talking to firefighters have been there and done that before and part of it is checking the equipment on the truck, just as simple as checking the saw. Right? And if I told you when we look back at the last hundred line of duty deaths at about 40% of line of duty deaths were because the roof firefighter put the saw on backwards. What would you do?

You know, I think most firefighters that are out there would, would make sure every time that they had that roof before their tour started, that they would check that saw and they would make sure that blade was on right because there's no way that they would let that saw and they're position fail the other members on that fire ground because this is the biggest problem on the fire department. And there's no way that when it's your turn in the queue that you're going to let you're failing to make sure that the saw is going to work properly when it's needed to do that. And most of us would say that well, the saw isn't the most important piece of equipment on the fire ground and the saw isn't the leading cause of death in the fire service for line of duty active deaths,  it's heart disease, and it's making sure that your pump is working properly so that when you go on the fire ground and you're going to operate the saw that you're not going to fail and your body's not going to fail.

That's really the message that we need to get out there is that the firefighter and the fire officer, they're the most important piece of equipment on the fire ground. And we need to make sure when we're asking people to put themselves in harm's way and run up 15 flights of stairs to put out a fire or save somebody that the most important piece of equipment, which has that firefighter is ready to go and fit the duty and they're not going to drop dead from the leading cause of death on the fire ground, which is heart attacks. It sounds simple, but we're still struggling to get that that number pushed down.

 Although it's been better. But in the FDNY 2001, one of the things that people forget is that prior to 911 that year we lost 10 firefighters, seven firefighters from heart disease, heart attacks, and the line of duty that year.

Since 2002 we were able to drop that number through the fire department, starting the medical program, the private public partnerships that they have with organizations like mine, dealing with the unions and making sure that, you know, people are, you know, it's not an adversarial process, right?

The medical for most firefighters, the biggest fear firefighters have is getting pulled off the line. So if that's the case, then you make sure that the medicals aren't going to be something that is going to be a penalizing to the firefighter or that threat of getting pulled off line is not there so that, you know, they can make sure that they have nothing life-threatening going on.

Right? So if you're gonna pull a guy applying for blood pressure, well, if the guy goes and gets medicine and he's on the right medicine, his blood pressure is normal. He goes for his medical. He's going to be okay. And he's going to pass his medical and be full duty. But we need to get that message out there. We need to make sure departments understand that that's a real there's a, there's a real tension or real a wall between medical offices, right? The occupational medical office  and the firefighters in the field and bridging that gap and breaking down that wall is something that needs to be done so that we can make sure more firefighters go home to their families.

Bob Keys, Retired FDNY Battalion Chief: [00:27:27] It brings to mind the co-operative relationship that took place in the last eight years in Boston, where the city, the union, and the Fire Chief all came together to make a difference to change the culture and the Take No Smoke Program. I talked about a few minutes ago.

You're a hundred percent right. In order to make a difference in firefighters lives. It needs to be non-punitive. It needs to be everybody working together for the same goal is to keep those firefighters healthy, keep them alive while working together and not punishing them.

 Todd, you shared with me recently that many fire departments around the country signed up to have LifeScan evaluate all of their firefighters on an annual basis. If have a firefighters listening to this podcast and wants his department to look into this kind of annual exam, what should they do? 

Todd LeDuc, Chief Strategy Officer for LifeScan Wellness Centers: [00:28:11] Absolutely. that's a great point and I know FDNY is blessed to have the resources like Rob and my department that I retired from is blessed to have the resources.

But a lot of departments are still looking at how do they do this and how can they bring NFPA physicals with the way we do it by coming onsite and really being turnkey in the easiest way to get that information is just to visit our website, www.lifescanwellness.com I think about it this way it's probably not a fire department in the country that wouldn't think of not maintaining their apparatus.

Right? And have a fleet preventative maintenance program and we really need to think about that same kind of mentality with our, with our members, with our firefighters, because within the course of even a year cancer can grow so much cardiovascular issues, hypertension, can take a  tremendous toll on the body and put that member at elevated risk for sudden death, line of duty deaths.

So if you're interested in more information, I'd love to have that dialogue with you. We have departments coming on in both on the law enforcement side and on the public safety fire side. So it's a total approach to just taking care of our first responders.

Bob Keys, Retired FDNY Battalion Chief: [00:29:31] Rob. I worked with your dad when he was a Battalion Chief in the Fourth Floor Battalion in Brooklyn. I was brand new Battalion Chief and he was very helpful to me. I remember him introducing you to me at a time. You were on the promotion list to Lieutenant.

I just assumed that you would follow your dad's footsteps, become a chief officer as well, but your path and your career seems to me, way more satisfying. You have made a difference in hundreds of firefighters lives, if not more, can you tell us how and why you founded New York Firefighters Heart and Lung.

Rob Brown, FDNY Lieutenant: [00:30:02] Well, I first graduated PA school in July of 2001 and I started doing plastic surgery. So I would work my two night tours and I'd go to the office in between and I'd come into the firehouse around four 30, five o'clock and sitting around and have coffee and everybody would sit around and they'd say, what did you do today?

Hey Joe, what did you do? I was at Billy's house. I was fixing his plumbing and he was a plumber and a there's a roofer there. It said, Hey, Joe, what'd you. I was over at Dave's house. I was helping him fix his roof and they go, what were you doing today, Brown? I said, well, I did two nose jobs an eye lift and a, and a chin tuck, like what? And I said, Oh yeah, no, I, I do plastic surgery on the side. 

So long story endless I started the Heart and Lung based upon you know, just the need that was there. We were, we were killing firefighters. We were killing firefighters when bunker gear came on scene it was putting a tremendous strain on each and every firefighter. 

There was a life safety conference and then big push was, "how do we push down line of duty deaths?"   I said all's you got to do is do a 50% reduction. If you start looking at firefighters and early screening them to make sure that they don't have heart disease and we can identify the firefighters that at the most highest risk for it. it's not that hard. But you have to incentivize them to do that, whether it's through health incentive bonuses, or some sort of release time to go get testing or whatever it might be. That's how you're going to drive down that number and the public private partnership, which, I can take a little credit for, but the department really takes the credit is setting up the medical investing in, you know, one of the better medicals that's out there.

But places like LifeScan, and in New York we have you know, the Heart and Lung where we do those advanced screenings for them where they might not be able to get it  for the department.

 I have, patients that from Columbia, I got patients retired fireman that live in Ireland, Florida, South Carolina, California, all over the place that come in once a year to get checked out because, you know they're willing to fly or drive up to two hours. Some of these guys have come in because, you know, they understand that I know what they do, and I know what they're at risk for, and I'm not gonna give them a roundabout answer. I'm going to unfortunately tell them what's going on, you know, and I'll be real straight up with them. But that ability to do that drove down the line of duty. That's by over 60% from heart disease in the FDNY, when you look at the decade prior to 911 and the decade after 911, and you could look the same decade 2010 to 2020, the reduction stayed the same. 

It's a remarkable, remarkable thing. It can be done, right? What's that song, you know, if you can make it in New York, you can make it anywhere. Well, if we can do firefighter health and safety in New York, and we can drive down line of duty deaths in New York City fire department, then you can do it anywhere in the United States of America, right? 

Bob Keys, Retired FDNY Battalion Chief: [00:32:59] Absolutely. A hundred percent agree with that statement. And congratulations to you and my hats off to you for the amazing accomplishments that you've made in a very challenging environment, I know that firsthand.

Rob Brown, FDNY Lieutenant: [00:33:10] Just one more thing it might be important to note I'm sure Todd's group is aware of this is that,  COVID-19 is a real problem in the fire service. And the effects of COVID-19 on the heart, on the vasculature are extraordinary. And any firefighter that has contracted COVID-19 and had some symptoms from it should have an echocardiogram to make sure that there's no damage. 

It can inflame the heart, it can weaken the heart, causing a myopathy that a normal heart functions at like 50- 60% in that range there ,it can make it drop down to 20 to 30%, which can, potentially kill somebody and we've seen it in New York. I've had some patients that had it and had him admitted to the hospital and you know, caused a lot of damage. It's very, very bad for inflammation. 

It's basically in the fire service, if I was acquainted to a fire service term they're sending a third alarm to a kitchen fire, or a food on the stove in New York.

 You know what I'm saying in that regard, but it just searches into an area and attacks weaknesses in your body. It can accelerate disease processes, and it's very important for us to identify those firefighters and make sure that they're you know, at least getting a simple screening, like an echocardiogram and an EKG to make sure that they have no lingering effects from that. 

And that's why it's good for a firefighter in his early in his career to get a baseline so that if he does have an incident or we have incidents like this, we can go back and look and see where the damage was. Right? 

So, I don't know if the guy had the damage because he's 45 years old and he had an event or from COVID, but at 35 he came in and we had an echocardiogram to compare to. We could see if he had damage that is lasting, or if it's something that's going to bounce back. And so it makes it much easier for us to do our job at keeping him safe by the guys getting that first visit that we can use as a baseline

Bob Keys, Retired FDNY Battalion Chief: [00:35:05] Really valuable information. Thanks, Rob. Good to get that out. So people understand the difference. I have heard that, that something very similar is going on in the NCAA, but anybody who It has had COVID before they start a program whether it's a football team or any other Scholastic activity, they need to go for that echocardiogram first and they have held some people out because of a under-performance in their heart. 

So Todd, you recently shared with me that you went to the Texas Fire Chiefs Conference, I think the whole fire service across the country is dying to get together and and be social. The conferences I've gone to in the past probably the most rewarding part other than listening to the speakers is, is getting together with colleagues from across the country that you haven't seen in awhile finding out how they're doing.

Can you share with our audience, the feeling of the firefighters you met with in Texas who have been fighting through this? I think you're the first one. I know who's gone to a trade show in the past year. And think folks would like to know that there is light at the end of the tunnel we are going to get together again.

Todd LeDuc, Chief Strategy Officer for LifeScan Wellness Centers: [00:36:00] Absolutely.  You're spot on it was first trade show in 13 months for myself and LifeScan was there of course as an exhibitor and we were actually thrilled to be able to support the Texas Fire Chiefs. But  I think the general consensus was just as you said, Bob was relief to be able to to get back to some sense of normalcy. Most of the folks had been vaccinated not only you know, involved in, in distributing vaccinations throughout the community, but had been able to get their own vaccines within the department. There was still some social distancing throughout, so the setup was maybe looked a little different than what we would remember pre COVID, but it was a good example that, you know, we can hear round the bend shortly and get back to some sense of getting together, sharing best practices, fellowship, and networking, I know. Being on the board of directors of the International Fire Chiefs Safety, Health, and Survival Section, we've made the decision to move forward with Fire Rescue at the national which will be the end of July, that'll be in Charlotte.

 The footprint may be it's going to look a little bit different. We'll have to take some precautions, a lot of hand sanitizing stations or a little bit spread out between exhibits and seating arrangements.

I think the Texas chiefs showed that it can be done and can be done safely, might just look a little bit different.

But I think the feeling from everyone was just a great sense of after a year of a lockdown that  we're able to get back and ensure what we like to do as far as fighters is you know, get together and have fellowship and share stories and great, great being able to get out. And I'm thrilled that we're, we're seeing light at the end of the tunnel. 

Bob Keys, Retired FDNY Battalion Chief: [00:37:45] Thanks for the optimism. I, for one, I'm dying to get out and see some of my friends I haven't seen in a year and a half or so.

Guys, thank you so much for sharing all of your knowledge. Thank you for your dedication to protecting firefighters. Thank you for getting this message out and continuing to make a difference  in our society, our culture look forward to meeting with you guys in person in the future

To our listeners if you enjoyed listening to the podcast today there's many others, please log on to fire decks.com and search for rapid fire. The name of our podcast and send us messages, let us know what you think. Let us know what you'd like to hear. And we look forward to getting messages out, to make a difference, to make firefighters a little bit safer.

Rob and Todd, thank you guys both very much. Have a great weekend. Take care. 

Todd LeDuc, Chief Strategy Officer for LifeScan Wellness Centers: [00:38:30] You as well. Thanks for having us on stay safe. 

Good luck Todd.  Take care. Bye Bob.