Heat Exhaustion: Recognize the signs!

It doesn't matter how strong of an athlete you are and how long you have been training in your particular sport.  Heat exhaustion can hit us all!  There are a number of reasons a person can become victim to heat exhaustion and as endurance athletes who train in Arizona heat it is important for us know the signs.  Here is an example of an athlete experiencing heat exhaustion and then a refresher on the signs, risks, and treatments.

It has been extremely hot here in the Valley the last couple of weeks and I needed to get a 3 hour ride in.  I arranged a 4:30am start with some fellow riders hoping to beat the major heat although even at 4:30 it was still 87 degrees outside.  We headed off into the dark and went on our usual 45 mile route.  Right around mile 30 I started to notice my friend David, a normally very strong rider struggling a little bit.  He was breathing heavy and looked tired so I asked if he was ok and he said that the heat was bothering him but he was hydrating and taking in fuel.  We carried on and came to another stop about 5 miles from the last and this time as he rode up I noticed his skin color was almost grey and looked clammy.  I immediately got nervous and told him he did not look good and we needed him to maybe go wait in the shade somewhere until we could get back or find him a ride.  He agreed that he was probably not going to make the entire ride but he wanted to get a little closer to end of the route so we could go back and get him.  As we continued riding I mentioned to my friend Bridgit that I was really concerned about David and she expressed the same concern.  I decided to call his wife and see if she could come and get him.  I realized that his wife was out an a shorter ride at the time and then called my friend Bev a fellow rider and someone I know I can count on in an emergency situation.  I explained to her what was going on and she told me very sternly you need to get him off of his bike and into the shade NOW!  I followed her direction and he listened obediently and Bev and Jim were on there way to come and get him.  Phew.  Thankfully David is home now recovering and is going to be ok.  But let me tell you watching something like that escalate to quickly really gave me a scare.  Why did that happen to him?  He is a great athlete who knows how to hydrate and fuel.  We left early in the morning and though it was hot he has certainly rode in hotter conditions and there was even an overcast this morning. 
That is what made me want to write this blog.

Here is the reasons this could happen to you or anyone regardless of there athletic ability...
1. In David's case he had rode 7 days in a row in AZ heat and had not replenished his body enough after his rides and through out the rest of the day.  We forget that we need to hydrate and fuel not just during our workouts but also for hours after.
2. Heat Exhaustion can occur when your body is not regulating it's core temperature correctly.  Ways that this can happen are.

• Dehydration, which reduces your body's ability to sweat and maintain a normal temperature
• Alcohol use, which can affect your body's ability to regulate your temperature
• Overdressing, particularly in clothes that don't allow sweat to evaporate easily  

Risk factors: (MAYO Clinic)

• Young age or old age. Infants and children younger than 4 and adults older than 65 are at higher risk of heat exhaustion. The body's ability to regulate its temperature isn't fully developed in the young and may be reduced by illness, medications or other factors in older adults.
• Certain drugs. Medications that affect your body's ability to stay hydrated and respond appropriately to heat include some used to treat high blood pressure and heart problems (beta blockers, diuretics), reduce allergy symptoms (antihistamines), calm you (tranquilizers), or reduce psychiatric symptoms such as delusions (antipsychotics). Additionally, some illegal drugs, such as cocaine and amphetamines, can increase your core temperature.
• Obesity. Carrying excess weight can affect your body's ability to regulate its temperature and cause your body to retain more heat.
• Sudden temperature changes. If you're not used to the heat, you're more susceptible to heat-related illnesses, such as heat exhaustion. Traveling to a warm climate from a cold one or living in an area that's experienced an early heat wave can put you at risk of a heat-related illness because your body hasn't had a chance to get used to the higher temperatures.
• A high heat index. The heat index is a single temperature value that considers how both the outdoor temperature and humidity make you feel. When the humidity is high, your sweat can't evaporate as easily and your body has more difficulty cooling itself, making you prone to heat exhaustion and heatstroke. When the heat index is 91 F (33 C) or higher, you should take precautions to keep cool.

What are the signs or symptoms of heat exhaustion?  (From the MAYO clinic)

• Cool, moist skin with goose bumps when in the heat
• Heavy sweating
• Faintness
• Dizziness
• Fatigue
• Weak, rapid pulse
• Low blood pressure upon standing
• Muscle cramps
• Nausea
• Headache

Treatments for heat exhaustion are... (Mayo Clinic)

• Rest in a cool place. Getting into an air-conditioned building is best, but at the very least, find a shady spot or sit in front of a fan. Rest on your back with your legs elevated higher than your heart level.
• Drink cool fluids. Stick to water or sports drinks. Don't drink any alcoholic beverages, which can contribute to dehydration.
• Try cooling measures. If possible, take a cool shower, soak in a cool bath or put towels soaked in cool water on your skin.
• Loosen clothing. Remove any unnecessary clothing and make sure your clothes are lightweight and nonbinding.

If you don't begin to feel better within one hour of using these treatment measures, seek prompt medical attention. You may be given intravenous (IV) fluids to help you rehydrate. Immersing yourself in cold water, misting your skin, placing yourself in front of fans, or using cold or ice packs and cooling blankets are some of the techniques that may be used to bring down your body temperature.