Heat Stroke

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Canyonram
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City, State: Payson, AZ

Heat Stroke

Post by Canyonram » Aug 11 2012 5:40 am

New summary article on Heat Stroke in 'Current Sports Medicine Reports.' Here's the abstract:

"When athletes, warfighters, and laborers perform intense exercise in the
heat, the risk of exertional heat stroke (EHS) is ever present. The recent
data regarding the fatalities due to EHS within the confines of organized
American sport are not promising: during the past 35 years, the highest
number of deaths in a 5-year period occurred from 2005 to 2009. This
reminds us that, regardless of the advancements of knowledge in the
area of EHS prevention, recognition, and treatment, knowledge has not
been translated into practice. This article addresses important issues
related to EHS cause and care. We focus on the predisposing factors,
errors in care, physiology of cold water immersion, and return-to-play or
duty considerations."

http://journals.lww.com/acsm-csmr/Fullt ... 120716xL12

You can also select the PDF version (easier to read).

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kingsnake
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Re: Heat Stroke

Post by kingsnake » Aug 11 2012 9:22 am

It blows my mind football is not a winter sport here. Starting camp in July is asking to kill people, no matter how much water they drink ...
http://prestonm.com : Everyone's enjoyment of the outdoors is different and should be equally honored.

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Al_HikesAZ
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Re: Heat Stroke

Post by Al_HikesAZ » Aug 11 2012 10:41 am

kingsnake wrote:It blows my mind football is not a winter sport here. Starting camp in July is asking to kill people, no matter how much water they drink ...
The AZ Cardinals are up in Flagstaff. The Sundevils always went to Camp Tontozona and ran Kush Mountain. I don't know recent statistics for AZ high school football, but back in the day (BITD) we didn't have very many deaths in AZ from football heat. Our workouts were at dawn and dusk. AIA kept us out of full pads until just before the season started. The problem really seems to be in places where they have high heat and high humidity. BITD, The AZ coaches shoved salt pills down our throats all the time and usually recognized the symptoms and got us to the hospital before we died. Almost worse than dying was being the poor schlub dryheaving on the sidelines. Glad it never happened to me. My problem was always those "dizzy drills" where you put your head on the baseball bat and spin around for a minute or two and then try to sprint back to the coach.
Anybody can make a hike harder. The real skill comes in making the hike easier.
Not if we can help it UNCLE JACK. http://www.sleepingdogtv.com/reel/Uncle-Jack.aspx Not if we can help it.

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Canyonram
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Re: Heat Stroke

Post by Canyonram » Aug 11 2012 11:32 am

Believe you are correct on the combination of high humdity + high heat. The body cools via evaporation of sweat off the skin and when the humidity is high, less 'room' in the atmosphere to accept the moisture from the body. People in the mid-west complain that it feels like they just stepped out of the shower and can't dry off. There have been sports/football related deaths in the mid-west. The Cards (when they were in St. Louis) lost a TE and the Vikings lost an OL while out on the training field in August.

My old football coach thought he was getting us tough---he'd refuse us water during practice---with kids dropping all over the practice field. Luckily sports medicine has caught up with that nonsense and now fluids and electrolyte replacements are required with coaches forcing kids to drink up with free access at any time to fluids.

Those coming to AZ from a high heat + high humidity are often fooled that they are not losing a lot of body fluids because the dry air wisks away the sweat. The clue of being soaking wet with sweat isn't there and since I'm relatively dry I must not be losing fluids. I've had the reverse experience when hiking back in the mid-west after a long absence ---the soaking sweat can make you feel as if you're suffocating.

The NPS used to advise on salt tablets---I'd chomp down a few before a hike and then end up gagging up seawater---until I just elimniated the salt tablets. Now the current advice is 'salty snacks' plus hydration with the body/kidneys balancing out the sodium loss and water. Hyponatremia is being recognized as more frequent a cause of illness on the corridor trails in Grand Canyon---the BA has water stations and hikers try to stay hydrated but end up ingesting way too much water and end up throwing their sodium out of whack. A hiker may be ill not because they are dehyrated but because they have lost sodiun and/or chugged too much water with no electrolyte replacement. NPS ER are now checking for both dehydration and hyponatremia when they respond to a hiker in distress. A lot of people new to desert hiking think that their illness is because they haven't drank enough water---so they drink more---kicking deeper into hyponatremia. http://www.gcrg.org/bqr/14-1/hypo.html

The article included some updated info: (1) sleep deprivation can increase the chance for heat stroke---how many of us are up in the wee hours to make that drive to be at the trailhead by dawn? (2) Medical treatment used to be given a 'golden hour' to treat heat stroke---the article indicates it is a golden 'half-hour' (3) Full body immersion in cold water ----so get in the Bright Angel creek!

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kevinweitzel75
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Re: Heat Stroke

Post by kevinweitzel75 » Aug 11 2012 5:24 pm

Working as an A/C tech, I'm on a roof or in an attic most of the day (10-15hrs). I usually drink 4 32oz gatorades or powerades and a gallon of water a day. I have never used salt tabs cause I have heard that they're not that good for you. Plenty of those and I think a person should be hydrated just fine. ;)
"Two roads diverged in a wood, and I,
I took the road less traveled by,
And that has made all the difference."
Robert Frost

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Canyonram
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Re: Heat Stroke

Post by Canyonram » Aug 12 2012 1:50 pm

KW75---Salt tablets used to be an OSHA recommendation and one followed by the NPS in their hiking literature. Outdoor supply stores would sell the tablets in little vials. Awful to swallow a tablet then burn a salty hole in your stomach and gag up seawater.

Going through 4-32 oz Gatorades would likely get me ill from the sugar overload. When Gatorade was tested, they arrived at a 6% sugar content---for your ingestion you are getting about 7 oz of sugar. Do you take your meals at fast food---plenty more sugar there plus the Big Gulp at the convenience store on the drive between job locations. I'd have the Sugar Blues at the end of the day if I hit my adrenal glands with that much sugar. Have you tried any of the 'home' receipes for electrolyte replacement that leave out the sugar or else replace it with a zero carb flavoring? (Plenty of receipes on the Net.) Much cheaper to mix your own. To get the electrolytes requires only a pinch of Morton's Lite Salt (contains both sodium and potassium). Some claim that you are missing out on the magnesium and calcium in some of the sports drink with the do-it-yourself concoctions. I avoid sugar as much as possible and find that my endurance is much greater when I go low carb-high protein. The sugar gets me on a yo-yo ride of high burst of energy and then a crash-and-burn feeling of exhaustion---until I chug down some more sugary drink. OK for a short day hike but rough on an extended hike. A handful of salted peanuts or sunflower seeds and/or jerky plus water during hiking breaks works great for me---no sugar burnout and no fortune spent buying the Gatorade. Most of the dehydrated meals that I use contain mucho sodium as a preservative and flavor enhancer so I get dosed with sodium while eating the main meal. An apple or orange provides the sweet desert but provides dietary fiber as well.

Gookinade (spelling) is made with glucose as well as fructose. I believe the company has changed the name to Vitalite. The glucose goes straight into the blood stream---talk about a sugar high. It is a favorite of prison inmates---they'll fast for a few days and then chug a quart of Gookinade and get a free trip out of jail. I carry a pouch in my emergency kit in the event I really need to push it on a hike.

We are all an experiment of one when it comes to our physiology and how we respond to hiking in our AZ climate.

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big_load
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Re: Heat Stroke

Post by big_load » Aug 12 2012 6:37 pm

Canyonram wrote:I believe the company has changed the name to Vitalite.
Yes, that's still my favorite late-in-the-day boost.

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kevinweitzel75
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Re: Heat Stroke

Post by kevinweitzel75 » Aug 12 2012 9:17 pm

@Canyonram
A friend of mine gave me a link for making your own Gatorade minus the sugar. Will try it out after I finish moving (everything is packed). As for food, I try to avoid fast food places. I usually make my own lunch, roastbeef sandwich on whole wheat with some granola bars. Believe it or not, I used to drink nohing but diet coke. As of July 4, I haven't touched a soda. I' m slowly quitting my bad habits one at a time and sugar is definitely one that's going to be hard. Coffee and smoking are the roughest ones.
On the trails, I drink mostly water, but will have some sort of electrolytes with me for longer breaks or lunch. But coffee is a must for backpacking trips. Sometimes I bring my flask with a nice Canadian whiskey or carry up a can of good beer to enjoy before bed.
"Two roads diverged in a wood, and I,
I took the road less traveled by,
And that has made all the difference."
Robert Frost

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fotogirl53
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Re: Heat Stroke

Post by fotogirl53 » Aug 12 2012 10:22 pm

Congrats, Kevin, on breaking your Diet Coke addition! You give me hope--I'm a DC addict, too. Maybe we should start a support group. Seriously, you are taking on some serious bad habits. I applaud your choices to get healthier. :worthy:
Allergic to cities.

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Tough_Boots
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Re: Heat Stroke

Post by Tough_Boots » Aug 12 2012 10:43 pm

kevinweitzel75 wrote:Coffee and smoking are the roughest ones.
I finally quite smoking about 5 1/2 months ago and haven't had a cigarette since. Quitting coffee? NEVER!!! :D

The hard part about quitting smoking was watching my metabolism instantly tank. I worked really hard to lose a lot of weight and then when I quit, I could feel an immediate difference in my metabolism. Its frustrating when you're trying to do something healthy and the side effect seems so negative at first. I'd recommend introducing running or something cardio into your routine-- it'll help level out your metabolism and make you hate smoking more.

Also, another trick to quitting smoking is understanding the truth about nicotine. Its actually not a very addictive chemical. You break the chemical addiction within the first few days. The whole "evil nicotine" thing is just a way to demonize an industry that's really no worse than soda or any processed foods. Your brain is wired with smoking as part of your routine and that's what you really have to break. Drive to work a different route or find something else to do with the time you would usually take a cigarette break. Do dishes immediately after dinner instead of after your post-meal smoke. Stuff like that helps. :)
"there is no love where there is no bramble."
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tibber
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Re: Heat Stroke

Post by tibber » Aug 13 2012 7:20 am

Tough_Boots wrote:
I finally quite smoking about 5 1/2 months ago
:y: : app :

As to the weight, with all of your hiking, that should help. The other ideas you speak about are good ones as well. Soon you won't even think about cigarettes.

As to the coffee or soda, that's a tough one to be sure. Here I'm thinking moderation is the key.
For me, sometimes it's just as much about the journey as the destination.
Oh, and once in awhile, don't forget to look back at the trail you've traveled.

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BobP
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Re: Heat Stroke

Post by BobP » Aug 13 2012 7:32 am

Pickle juice is my before and after drink when I'm exercising in extreme heat. It works for me....its an acquired taste though :)
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kingsnake
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Re: Heat Stroke

Post by kingsnake » Aug 13 2012 7:43 am

I used to drink 6-10 Diet Cokes a day, until I went on soda methadone: Diet Dew. :D
http://prestonm.com : Everyone's enjoyment of the outdoors is different and should be equally honored.

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outdoor_lover
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Re: Heat Stroke

Post by outdoor_lover » Aug 13 2012 11:00 am

i've tried some of those "non-sugar" electrolyte drinks, it's like drinking lightly carbonated Sea Water. :yuck: I find that if I don't drink something that tastes good, as well as water, I won't drink enough. I'm not a fan of just plain water, especially if it's no longer cold. I usually take at least one gatorade, sometimes two, while hiking. When I was working constantly outside in construction in the summer, I had a "split" cooler. One half was filled with powdered Gatorade mix and the other was ice water, most of which ended up over my head.... :D
Life is not a journey to the grave with the intention of arriving safely in a pretty & well preserved body, but rather to skid in broadside, totally worn out & proclaiming, "Wow What a Ride!"

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chulavista
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Re: Heat Stroke

Post by chulavista » Aug 13 2012 11:21 am

I personally refuse to drink Gatorade. I liked it, but a few years back I ended up in a job where I was working outside, physically strenuous stuff, mid-summer. I was warned from the get-go, stay hydrated. Drink Gatorade, or something like that (Poweraid), etc to keep electrolytes in balance, etc. OK, cool. But I found it really upset my stomach, too high in acid, etc. Then one day I accidentally left a styrofoam cup half full of it on my desk. The next day, the stuff had eaten through the side of the cup and ruined the desk top. No wonder it hurt my stomach! And this stuff is supposed to be good for you??? That's also when I discovered just how much sugar is in it. I'm not convinced the health benefits outweigh the detriments, but I'm no expert by any stretch of the imagination.

I don't drink soda, quit that habit a LONG time ago, thank goodness. I also never took up smoking, I was too big a coward. I tried it, and couldn't get past the inhale part. But there is one vice I need to curb, and that's good old beer. Hubby and I have started the habit of working our silly pumpkins off after work in our back yard, then sitting down as the sun is setting and having a beer...or two....or three.... it's getting to be way too many. We do drink light beer, but that's not a good excuse!

My hydration choice is simply water. Now when I start hiking harder, longer, and it becomes more physically demanding, like most of you here, I know I will need more. We'll cross that bridge when we get there!

Kate
You will never succeed if you don't try.
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chulavista
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Re: Heat Stroke

Post by chulavista » Aug 13 2012 11:22 am

kingsnake wrote:I used to drink 6-10 Diet Cokes a day, until I went on soda methadone: Diet Dew. :D
On the REALLY rare occasion I do decide I want a soda, I also like Diet Dew! I've probably had one this year so far??? HA!
You will never succeed if you don't try.
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The_Eagle
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Re: Heat Stroke

Post by The_Eagle » Aug 13 2012 11:53 am

chulavista wrote:having a beer...or two....or three.... it's getting to be way too many.
1, 2, or 3 is too Many? Oh Crap.....
There is a very fine line between "hobby" and "mental illness."
Dave Barry

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Al_HikesAZ
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Re: Heat Stroke

Post by Al_HikesAZ » Aug 13 2012 12:08 pm

My Current choices in electrolyte replacements :M2C:
1) Charles at Arizona Hiking Shack introduced me to Elete Electrolytes. ( 2018-08-28 dead link removed ) Very pure (no carbs). Near perfect osmolality. Osmolality is the condition that causes the "sludge" in your stomach when the electrolyte does not quickly pass from the stomach to the intestines and into the bloodstream where it is needed. elete is very concentrated so works great for backpacking. One drop to one oz of water.
Makes the water taste a little "dusty". They have come out with Citrilyte but I haven't tried it yet. Can be added to hydration bladders without damaging or mucking up the bladder. When you compare what you pay for it for the electrolyte it is actually cheaper than the comparable amount of Gatorade where you are buying all of the extra stuff, packaging and marketing.

2) Thorne's Purelyte. You need to buy this from a Doctor who sells nutraceuticals. My Doctor is a triathelete and recommended this (and sells it to patients) Uses processed citrus rind to add a little flavor to an otherwise pure electrolyte.( 2018-08-28 dead link removed ) As I said before, when you compare what you pay for it for the electrolyte it is actually cheaper than the comparable amount of Gatorade where you are buying all of the extra stuff, packaging and marketing.

3) My Doctor - the triathlete - mentioned a new electolyte that he is testing - but I don't know the name or if it is even on the market.

I used to use Accelerade, but it left a funny taste in my mouth after a couple of hours of use. I also used to use Pedialyte - which is used for electrolyte replacement in sick children.
Anybody can make a hike harder. The real skill comes in making the hike easier.
Not if we can help it UNCLE JACK. http://www.sleepingdogtv.com/reel/Uncle-Jack.aspx Not if we can help it.

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chulavista
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Re: Heat Stroke

Post by chulavista » Aug 13 2012 12:24 pm

coanbru wrote:
chulavista wrote:having a beer...or two....or three.... it's getting to be way too many.
1, 2, or 3 is too Many? Oh Crap.....

:sl: It probably wouldn't be if we would stop there..... :guilty:
You will never succeed if you don't try.
http://www.kathysieloff.com

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Sredfield
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Re: Heat Stroke

Post by Sredfield » Aug 13 2012 2:04 pm

@Al_HikesAZ Do you know if REI carries it? Hiking Shack is a jaunt for me.
Shawn
The bear went over the mountain to see what he could see.

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