Heat

OK. I am getting up on my soapbox now.

Heat Hurts and Heat Kills... Heat Hurts and Heat Kills... And I am going to say it again. Heat Hurts and Heat Kills.

Why do I mention this? Because every day I work outside in the heat working EMS, I see people who:

1. Don't drink enough fluids
2. Don't drink enough fluids
3. Don't drink enough fluids

And I see them with heat cramps, heat exhaustion, and heat stroke. I treat them at baseball games, football games, races, triathlons, walking on the street (twice, as a bystander).

Dehydration can affect ANYONE. Once you become dehydrated, you become very vulnerable to the effects of heat. Heat cramps first. This is where you feel cramping in your muscles, and you may become nauseous due to stomach cramping. This is INTENSE, and painful. Treatment: more fluids, cooling, and working out the cramps. You'd think that would convince people to drink more fluids. Nope.

Once you pass through heat cramps, next is heat exhaustion. It feels like exhaustion. And more nausea, vomiting, fainting, and maybe a low grade fever (a degree or two high). The cause is the same. Dehydration. Treatment is fluids (sometimes intravenous, due to nausea and vomiting), quick cooling, and maybe a trip to the E.R.

Don't treat that, and you can move on to heat stroke. Red skin, hot skin, not sweating. Temperatures can go to 106 degrees or higher. Highest I have seen was 107 in someone. We checked his temp twice, and on ourselves, because we didn't believe it when we saw his temp was that high at first.

He didn't make it. Temps over 105 can cause significant brain damage, as your brain literally begins to cook and cells die. Oh, and other cells in your body, like heart muscle, liver, and kidneys. Treatment is rapid cooling, including ice packs EVERYWHERE (even the groin and around the neck), intravenous fluid therapy, supportive care such as ventilation (breathing for someone who isn't breathing on their own - or not enough). Guaranteed trip to the hospital for heat stroke. And a stay there for a while, too. If you survive. Heat stroke is LIFE THREATENING, folks. People die from heat stroke every time there is a heat wave. And maybe without the heat wave.

Some medications and conditions increase your risk of heat injury. Know what you take, and how it makes you react to heat. Keep a list of your meds on you. I've even treated someone for heat stroke in 67 degree temps. Really. She was vulnerable to heat due to a medication she took, and she ran in a triathlon. Oh. She was also dehyrated.

Why do I say this? Because it is preventable. Absolutely preventable. And yet, I see people with heat injuries just about every day I work in extreme heat.

• If you aren't acclimated to heat, start to become acclimated. It doesn't happen instantly.
• Drink plenty of fluids, well ahead of the heat. Like days ahead of time.
• Drink plenty of fluids while in the heat.
• Drink plenty of fluids after heat exposure.
• Gatorade/Powerade/Deluge by itself is not good. Alternate with water, folks. Really.
• Keep drinking fluids. Hey, don't get dehydrated in the first place.

OK, now that I have said this, how much should you drink? 8-10 8oz glasses per day is what you should drink daily (unless your doctor tells you otherwise). On hot days? Try 15-20 8oz glasses. Thats about a gallon of fluid. Yesterday, I drank approximately 2.5 GALLONS of fluid. But I know my body, and what it requires when I am working in 105 degree temps. I am moving around, sometimes bolting around on runs instantly (Yeah, even at my weight... I can run pretty fast!). I don't drink that instantly. It is in small amounts all day long.

Off the soapbox now.

BTW, yes, I have been a victim of heat cramps and heat exhaustion. Last year, even taking care of myself, I sweated more than I could take in. Why did I develop symptoms? Simple. I didn't start out well-hydrated. I felt like crap. My head hurt, I was nauseous, my muscles ached (even days later, they hurt), my pulse raced, and my temp was 102. I was tempted to ask a medic friend of mine to come over and start an I.V. on me. I hate needles. So I kept sipping fluids all night long.

And as I said, I have seen people die from heat stroke. Which is why I take heat seriously. I hope you do, too.