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Craig W.
(xnomanx) - F - M
The Hype of Dehydration and Heatstroke on 04/08/2013 15:03:36 MDT Print View

From The Science of Sport, one of my favorite sites.
http://www.sportsscientists.com/2013/01/dangerous-exercise-hype-of-dehydration.html

Interesting read, especially in the context of backpacking, which would typically be categorized as not strenuous (sorry, as hard as I know it can feel to some, it's not the same as racing a time trial or other high intensity pursuits).

The article raises the issue of underlying causes as well as personal perception; being made very uncomfortable by thirst or heat while simultaneously being in no actual physical danger.

It also makes me wonder about how effectively we have all been marketed to be drink and supplement companies.

I've always thought that overly complex hydration and nutrition strategies during average backpacking pursuits seemed a little silly in the face of athletes that can knock down 4:45 miles for 26 straight, lose 5kg of bodyweight in the process, not take a single sip or bite, and recover just fine.

BJ Clark
(bj.clark) - MLife

Locale: Colorado
Waterlogged on 04/08/2013 16:26:34 MDT Print View

Waterlogged: The Serious Problem of Overhydration in Endurance Sports
Timothy Noakes

The above is a pretty detailed look at the issue of hyponatremia or over hydration. While dehydration can be an issue, a lot of what we were taught as coaches and athletes may not be particularly accurate. It's a long book and extremely detailed, but Noakes is one of the premier exercise physiologists in the running community. Needless to say, the Gatorade sports science guys are not happy with his research.

Edited by bj.clark on 04/08/2013 16:27:11 MDT.

Roger Caffin
(rcaffin) - BPL Staff - MLife

Locale: Wollemi & Kosciusko NPs, Europe
Re: Waterlogged on 04/08/2013 17:29:04 MDT Print View

> Needless to say, the Gatorade sports science guys are not happy with his research.

There are NO 'Gatorade sports science guys'. None. Contradiction in terms.
They are mainly marketing spin doctors with funny hats on.

Cheers

BJ Clark
(bj.clark) - MLife

Locale: Colorado
Re: Re: Waterlogged on 04/08/2013 17:33:17 MDT Print View

Roger,
I stand corrected and humbly so! And I agree.
BJ

Doug I.
(idester) - MLife

Locale: MidAtlantic
Re: Re: Waterlogged on 04/08/2013 17:58:46 MDT Print View

"There are NO 'Gatorade sports science guys'. None"

That's a bit harsh. Perhaps not now, but it was developed by researchers.

Edited by idester on 04/08/2013 18:51:54 MDT.

Ken Thompson
(kthompson) - MLife
Re: Waterlogged on 04/08/2013 18:12:20 MDT Print View

Go Gators!

I still like the lemon lime.

Though is has certainly changed since it first came out.

Heatstroke sucks. I don't recommend it.

Thanks for the link.

jerry adams
(retiredjerry) - MLife

Locale: Oregon and Washington
Re: Re: Waterlogged on 04/08/2013 18:16:13 MDT Print View

They had me drink Gatorade the night before colonoscopy

I do not like Gatorade

spelt !
(spelt) - F

Locale: Midwest
Re: Re: Re: Waterlogged on 04/08/2013 18:47:40 MDT Print View

Me neither, Jerry.

Todd Taylor
(texasbb) - F

Locale: Pacific Northwest
Re: Re: Re: Waterlogged on 04/08/2013 19:17:37 MDT Print View

"They had me drink Gatorade the night before colonoscopy

I do not like Gatorade"

Not anymore, I guess! :-)

On the other hand, I'd have given my eye teeth for Gatorade instead of the evil potion they made me drink.

Tom Kirchner
(ouzel) - MLife

Locale: Pacific Northwest/Sierra
Re: Re: Re: Re: Waterlogged on 04/08/2013 19:23:16 MDT Print View

"On the other hand, I'd have given my eye teeth for Gatorade instead of the evil potion they made me drink."

That they produce the same result makes one wonder about Gatorade. ;0)

Franco Darioli
(Franco) - M

Locale: Melbourne
The Hype of Dehydration and Heatstroke on 04/09/2013 00:29:06 MDT Print View

I still see the idea that hikers need to continually sip from their water bladder a bit odd but if it makes them happy....

Nelson Sherry
(nsherry61)

Locale: Mid-Willamette Valley
Re: The Hype of Dehydration and Heatstroke on 04/09/2013 11:53:59 MDT Print View

Okay, I can't resist this one. . .
1) Marathon runners don't run marathons without drinking anything. They just don't drink nearly as much as they sweat out.
2) The linked article is about incorrectly attributing sudden death in sporting events to dehydration or heat stroke, not any suggestion that rehydration drinks are less than claimed.
3) I agree with the general direction of this thread that we, as a culture, are over excited about hydration and food chemistry in lower intensity, non-competitive sports.
4) For low intensity exercise in warm weather, gatorade provides people with a nice sugar drink that includes some electrolytes. Both sugar and electrolytes are helpful in keeping one going during exercise on a hot day. What's wrong with that.

Of course, from the standpoint of elite endurance performance, Gatorade is lousy because it isn't the best balance electrolyte mix and it is too concentrated, sugar based, carbohydrates that tends to bloat the stomach, slow digestion and cause vomiting. However, diluted Gatorade actually works pretty well for re-hydration, although there is plenty of better product out there. My favorite re-hydration strategy for lower intensity exercise, like backpacking, is to drink water and eat a balanced diet of various snacks that have some salt in them. Admittedly, during hot weather, some salts added to my water or taken as tablets can be helpful.

HK Newman
(hknewman) - MLife

Locale: Western US
Re: The Hype of Dehydration and Heatstroke on 04/09/2013 12:47:18 MDT Print View

In my experience, a continuous stream of dehydration, heat cramp, heat exhaustion, and heatstroke victims probably keeps the preventative tips in the first aid books (civilian and military). Even "ultra-fit" can succumb since they are used to toughing it out (remember that competitive runner who died in the Grand Canyon a couple years back?).

Handling medical evacs was one of my deployment assignments so during the summer train-up one afternoon, I had a string of Medevac choppers waiting to pick up heat injuries (all ages) out of the field for these problems - they were from another southern state no less, so acclimation only goes so far. A couple of the older ones were never the same health-wise and didn't deploy. In warm to hot weather, dehydration is nothing to mess with (of course, sometimes you just get caught short on water).

ed: gram

Edited by hknewman on 04/09/2013 12:52:51 MDT.

Bob Gross
(--B.G.--) - F

Locale: Silicon Valley
Re: Re: The Hype of Dehydration and Heatstroke on 04/09/2013 13:18:36 MDT Print View

"However, diluted Gatorade actually works pretty well for re-hydration, although there is plenty of better product out there."

For decades now I have used diluted Gatorade on warm backpacking days. Sometimes it is 50% strength and sometimes only 33% strength. The powder probably is not the very best product on the market, but it is cheap, effective, and readily available. I tend toward a potassium deficiency, so Gatorade takes care of that. Alternatively, I could carry along a bushel basket of tomatoes or something. I think I will stick with the Gatorade powder.

--B.G.--

Larry De La Briandais
(Hitech) - F

Locale: SF Bay Area
Heat stroke on 04/09/2013 16:25:39 MDT Print View

Having been very near heat stroke myself (not while hiking) it is nasty business that I don't want to repeat. I will error on the side of drinking to much.

I have also seen a young lady on the verge of heat stroke at the top of Nevada Falls in Yosemite. She had stopped sweating and couldn't lift her head without sever dizziness. She had drank only one liter of water on the climb from the valley to half dome and back. I think it is 17 miles round trip and she was 12 miles or so into it. While I can't say that she would have died from it had she not drank (I filtered water for her group) she easily could have from the fall had she attempted to continue. I don't think she would have recovered before dark without intervention.

While hiking the "secondary problems" can become a deadly problem. And if you can push though the initial symptoms, once you near heat stroke you don't feel bad anymore. The confusion alone is dangerous.

All that said, yeah, staying hydrated is over hyped. You don't need to have clear urine. I hate hydration bladders, a simple water bottle works great for me.

Edited by Hitech on 04/09/2013 16:40:06 MDT.

just Justin Whitson
(ArcturusBear)
Re: Re: Re: The Hype of Dehydration and Heatstroke on 04/09/2013 16:38:14 MDT Print View

Bah humbug on Gatorade, i like Coconut water with a bit of salt, or Lemon powder mixed with water and a bit of salt and sucanat.

Paul McLaughlin
(paul) - MLife
Re: The Hype of Dehydration and Heatstroke on 04/09/2013 19:52:04 MDT Print View

Comparing elite marathon runners to backpackers is not of much use. Those guys take about 2 1/4 hours to finish. Yes, they are doing something more intense, but it's very different. My general rule of thumb is that no matter how hard I'm working, if it's 2 hours I can drink before and after and all is fine.

A much better comparison is a full days work on a hot day on a construction site. I've done a lot of that. 8 hours in the heat swinging a hammer and hauling lumber around. And I've watched guys who were not drinking enough get very close to collapse. When you see a guy turning gray and getting wobbly, it makes an impression. So I drink plenty. And It's pretty clear that I'm not drinking too much, since on a hot day I'll drink 5 or 6 liters and still only pee maybe once. Of course, everyone is different. I sweat quite a bit when I'm active, so I need to drink quite a bit to replace that. You have to know your body to know what works for you in various different conditions.

A typical backpacking trip is not as intense as that for me, since it's not often 100 degrees in the mountains. So I would be drinking less than that when I'm hiking - although for the first couple days at altitude I'll drink a little more, as it helps with acclimatization.

The easy indicator is what my urologist told me after I had a kidney stone - you should be peeing every 2-3 hours during the day. If you need to go more often than that, you're drinking more than you need. If you go 6 hours without taking a leak, you ought to drink more.

Craig W.
(xnomanx) - F - M
Re: Re: The Hype of Dehydration and Heatstroke on 04/09/2013 20:15:10 MDT Print View

I'm not sure how many people commenting here actually read the article which got me thinking about this, but here are a few points I found interesting. I see no reason why the underlying ideas behind them couldn't also apply to backpacking, though perhaps on a different time scale.
_____________________________________________________

"Similarly, there is no link between fluid loss and heatstroke. Human beings can safely lose big volumes of fluid without their body temperature shooting through the roof. Typically, in a marathon on a reasonably warm day, we lose about 2 to 3 L of fluid over many hours. Faster runners lose more - Haile Gebrselassie is reported to have finished his Berlin World Record 5kg lighter than at the start."

"Heatstroke is a viable candidate for the tragic deaths that sometimes happen, but it's a grossly overstated risk and those who diagnose any athlete's collapse or medical condition on a hot day as 'heatstroke' are also taking a lazy and possibly very wrong option. The reality is that heatstroke is a pretty complex phenomenon, and is likely to involve some kind of pathology. Once again, I'd draw attention to the difference between the perception of being hot and actually getting to the kind of dangerous temperatures that characterize heatstroke. We're not talking about feeling hot, uncomfortable and slowing down or stopping here."

"...But recreational athletes don't produce enough heat to develop heatstroke through normal muscle activity. Therefore, we look at alternative theories - either these individuals are failing to lose heat, or they produced excessive heat from unnatural means." (I personally wonder how much obesity and/or poor cardio are at work here creating "unnatural means").

"... So the key points from those case studies - there are 18 documented cases, I've only discussed three - is that the athletes who suffer REAL heatstroke most often are not exercising very hard, they're not in impossibly hot conditions, and they show 'abnormal' heat gain even after they've finished exercise, sitting out of the heat (in a bucket of ice, in one case). Clearly, there's something else going on, and heatstroke does not happen just because we run hard on a hot day."

Todd Taylor
(texasbb) - F

Locale: Pacific Northwest
Re: Re: The Hype of Dehydration and Heatstroke on 04/09/2013 20:24:19 MDT Print View

Good comments, Paul. I think very few of the things one learns from running marathons apply to hiking. I always tell backpacking beginners:

It's a trek, not a marathon.

That has implications well beyond hydration. Nutrition, for example: forget those silly gel packs--you need real food to hike 10 hrs/day for a week. And playing through the pain: you can't go home and take a week to recover--you've got to get up in the morning and go again, and the next morning, and the next. If you hit the wall, you don't get to fall out and hitch-hike to the finish line; you must get to a campable spot tonight.

All those things imply sustainable effort and steady intake of food and water. Trickle the calories and water in. Snack often to keep electrolytes up. Etc.

Craig W.
(xnomanx) - F - M
Re: Re: Re: The Hype of Dehydration and Heatstroke on 04/09/2013 20:34:23 MDT Print View

"...forget those silly gel packs--you need real food to hike 10 hrs/day for a week."

Explain that to Greg "Malto" Gressel.

_______________________

I think most people in this thread are mistaking heat exhaustion for heat stroke.
Yes, heat exhaustion brings you to a quick halt and makes you feel like you are going to collapse and die...except you don't die or have to be hospitalized. Not the case with heat stroke.

Edited by xnomanx on 04/09/2013 20:35:34 MDT.

Bob Gross
(--B.G.--) - F

Locale: Silicon Valley
Re: Re: Re: Re: The Hype of Dehydration and Heatstroke on 04/09/2013 20:50:16 MDT Print View

I saw the difference first-hand when I was in Army training during the summer at Fort Polk, Louisiana (read: hot and humid). They picked a warm day for us to do our 15-mile road march. One guy collapsed around nine miles out. They dragged him off the road and into the shade, then rubbed his skin with cool water while they got him to drink more fluids. He was conscious, so they hauled him back to base. That was heat exhaustion. The second guy was too stubborn to quit, so he was going until about 12 miles out where he collapsed. They dragged him off the road and into the shade, but he was unconscious. His skin was hot and dry, so they were not able to revive him. Once he got to the hospital, he was revived, but he had some brain damage. That was heat stroke. Not good.

I think our goal here is to drink more fluids and maybe electrolytes so that we never collapse in the first place.

Too many hikers will try to cross the desert without carrying enough water (weight). You have to have the experience to know what works and what doesn't work.

--B.G.--

Craig W.
(xnomanx) - F - M
Re: Re: Re: Re: Re: The Hype of Dehydration and Heatstroke on 04/09/2013 21:07:21 MDT Print View

"I think our goal here is to drink more fluids and maybe electrolytes so that we never collapse in the first place."

But that's the crux of it.

The entire premise of the article I linked is that heat stroke (and death from it) and dehydration do not necessarily correlate. Too many examples of people dying of "heat stroke" too early in an event or race to have been dehydrated. Nobody critically dehydrates in less than 5K, yet people die from "heat stroke" in the beginning miles of events on a regular basis.
In addition, there are plenty of cases of death and illness attributed to "heat stroke" that occur when it's not particularly hot and the victim was not exerting themselves very hard, thus leading to the question of how many of these supposed "heat stroke/dehydration" cases are actually due to some other issue.

This article is not arguing that heat stroke and dehydration do not exist; it's saying they are too loosely used to describe medical emergencies people are having that could have entirely different causes.

Dan Durston
(dandydan) - M

Locale: Cascadia
Dehydration & Heat stroke on 04/10/2013 13:20:10 MDT Print View

Great thread going here. This is something I've been meaning to get a better understanding of.

Perhaps someone can offer some insight/diagnosis on my situation last August. I planned a 1 night 60 miler that consisted of 15 miles one evening and then 45 miles the next day. The second day I hit the trail at 6am feeling good. It was a warm day and I was on a quick pace, so I sweating decently. I was trying to drink water, but I was probably falling behind. Then I got to an uphill forest fire burn area that offered little shade, which left me exposed to the mid day heat (full sun, 80 F) at the same time I ran out of water (poorly planned). This section was about 5 miles and I couldn't find my hat before the trip, so I felt like I was withering in the sun. I started to get a headache, which isn't that abnormal for me. I was sweating quite a bit - I remember marvelling at all the white sweat stains on my shirt and pack.

Anyways, in the late afternoon the headache remained and I started getting nauseous but forced down some water. All had been eating that day was energy bars and a tiny bit of jerky. I realized I was probably low on electrolytes so I finished the salty jerky, but it wasn't much. Even though the day cooled after dinner I still felt really hot and I was getting muscle cramps. My hands would clench and I couldn't release them - first time that had happened to me. By 5pm I really felt like crap: headache, nausea, overheating. I pushed on for a couple more hours and called it an early night (8pm) after ~35 miles. In camp I tried to sip water but I puked it up. The evening had cooled off but I was hot, so I laid naked in my tent with my heart racing. That was the weirdest part - my heart was probably up around 120 and it wouldn't slow down. I realized I could keep water down if I just had a wee bit and waited 20 minutes, so I worked on hydrating that way. I figured the biggest problem was maybe electrolytes, so I opened a foil pouch of tuna and drank only the salty brine (way too nauseous for food). I laid there barely sipping water from 8pm to probably 2am with my heart rate up for the first ~3-4 hours. The next morning I got up around 7am. I didn't feel so great, but I wanted to finish that last 10 miles before the heat of day.

So is this standard dehydration/low electrolytes? Or something else? For me the weirdest part was laying there while my heart was cruising along and refusing to come down. I heard that when you're low on water, heart rate can elevate to pump blood to help with cooling the body, so perhaps it was dehydration plus some overheating?

Edited by dandydan on 04/10/2013 14:21:10 MDT.

jeffrey armbruster
(book) - M

Locale: Northern California
"The Hype of Dehydration and Heatstroke" on 04/10/2013 14:01:22 MDT Print View

Dan: this past winter I went nordic skiing pretty hard for three days. Highish altitude, cold dry air and a stove in my cabin at night. On the fourth night I woke up at 1:30 with my heart racing and erratic. It didn't stop. I ended up in the ER and was cardioverted--electric shock to the heart, not fun--at which time I reverted to normal rhythm. Docs called it idiopathic, which means they don't know what caused it, but the best bet was dehydration. Very very scary.

So I just bought a steripen and will carry it along with a collapsible nalgene in my GG belly pack. This is to make it as easy as possible to drink water during the day during my hikes.

You don't want this to happen for a ton of reasons, but one more is that now there's a higher likelihood of recurrence. Also, apparently this sort of racing/atrial fibrillation (did you have that?)often onsets at night while you're sleeping.

It never occurred to me that I was overdoing things; in fact I felt great for the three days of skiing. But I live at sea level and ski at 7,000 feet. Age is catching up to me. Now I have to watch things.

Scary, no? I bet that you'll remember this and not do that hike again.

Craig W.
(xnomanx) - F - M
Re: "The Hype of Dehydration and Heatstroke" on 04/10/2013 14:14:17 MDT Print View

Both scary stories.
Jeffery, your experience is sort of what the article is talking about. The author raises the idea that many people are actually having some sort of cardiac event during exercise. Since the cause of the cardiac event is hard to pinpoint and could have to do with some existing pathology, a lazy answer is that it must have been due to dehydration or heatstroke, which both can present many of the same symptoms as a heart issue.
But if your bodyweight wasn't compared before and after the event and no actual tests on your fluids were done, how would anyone know that dehydration had anything to do with it beyond simple speculation?
Same goes for heatstroke; unless your core temperature is being monitored, most serious cardiac issues would present the same symptoms that heat stroke would.

But hey, I'm no doctor, (was a former working EMT with wilderness first aid training)
but I find it an interesting topic.

Sort of scary, because there have been many studies in recent years on endurance athletes and sudden cardiac issues or lasting damage supposedly done through endurance sports.

Dan Durston
(dandydan) - M

Locale: Cascadia
Cardiac on 04/10/2013 14:19:01 MDT Print View

Scary stuff indeed. My heart was fast but not erratic - so steady but alarmingly high while I laid there for hours. My guess was 120 BPM whereas I normally measure 55-65 at rest.

Edited by dandydan on 04/10/2013 14:22:45 MDT.

Bob Gross
(--B.G.--) - F

Locale: Silicon Valley
Re: "The Hype of Dehydration and Heatstroke" on 04/10/2013 14:30:54 MDT Print View

Many years ago I was leading a peak climb on skis. The group got up to the midway camping point during the first day, and the plan was to bag the summit early on the second day. That first evening we were sitting around eating dinner, and then we retired early to sleep before the 4 a.m. wakeup call. Late that night one of the crew came over to my tent to wake me up. His tentmate was having some sort of stress and could not sleep. I checked the guy out, and he had a fast pulse. His respiration was not shallow and rapid (which might point to hyperventilation), but in fact it was deep and rapid, and he had plenty of oxygen. There was not a great deal that I could do for him, so I gave him one pill, had him drink some water, and then try to sleep. That worked. At 4 a.m., the rest of us got up to prepare for the summit, and this guy decided to stay in camp, even though he felt better. We all left the mountain by the afternoon of the second day.

What was the pill? A salt tablet, perhaps as a placebo.

What was the ailment? Hard to say. Maybe an anxiety attack. Maybe dehydration. Maybe low electrolytes.

--B.G.--

Paul McLaughlin
(paul) - MLife
Re: Dehydration & Heat stroke on 04/10/2013 16:54:04 MDT Print View

Dan, I can't diagnose what happened to you, but I can safely say that if I had done what you did while eating and drinking as you describe I would have felt like crap at best. Saltier food and more water would be my recipe for a better result - it's what I have done in the past in similar situations. Walking across the Grand Canyon in a day in midsummer, I drank all the water I could get(around 3 or 4 gallons) and ate a lot of salty peanuts. That worked out well. My feet were trashed by the end, but no ill effects from the extreme heat (110 at the river) and low humidity.

Roger Caffin
(rcaffin) - BPL Staff - MLife

Locale: Wollemi & Kosciusko NPs, Europe
Re: Dehydration & Heat stroke on 04/10/2013 17:00:47 MDT Print View

Hi Dan

> some insight/diagnosis on my situation last August.
I am NOT a medico, but ...

To me that sounds a bit like a combination of heat stress (not heat stroke) and a viral infection. I suspect that without the virus you might not have been affected at all.

Cheers

Nick Gatel
(ngatel) - MLife

Locale: Southern California
Re: The Hype of Dehydration and Heatstroke on 04/10/2013 17:08:07 MDT Print View

A highly trained endurance athlete is a lot different than us mere mortal backpackers.

I agree that we focus too much on drinking water and to never, never feel the least bit thirsty.

Each individual is much, much different. A while back Craig and I did an all day hike through the desert. I consumed probably 1/2 the water he did and probably was less thirsty. At the time Craig was doing a lot of long distance running training and I am about 30 years older than him. My body just works differently, not to mention I am more attuned to water needs since I hike in deserts a lot. In addition Craig is bigger than me with lot more muscle. Neither of us were in any kind of danger or was water a problem, just want to point out that each body is different.

I normally stop to drink about once an hour, and sometimes longer between stops... even when it is hot. But I have a lot of experience hiking were water is a precious commodity and am acclimated to the conditions -- if there is such a thing a acclimation.

The other thing to consider is the ambient temperature. Anyone running a 5K in 90F temps is going to have a different experience than running it at 100F.

I remember Colin Fletcher posting a table showing how long a person could last with different amounts of water. At 120F during the day and only walking at night, the average person will die in 1 day with no water, 2 days with a quart of water. If they sat in the shade at 120F and did nothing to exert themselves, the average person will die in 2 days. Move the ambient temperature down to 70F and death occurs in 10 days for no movement and 7.5 days if hiking at night.

Almost every year people die from "heat stroke" where I live when it gets hot. Most of these die on day hikes on strenuous trails. Of course we don't know about any pre-existing conditions or their physical condition. There have been several Marines from the 29 Palms Marine base, where they do desert training, who have had to be rescued on the Skyline Trail here, when they have hiked less than 7 miles and ran out of water and became too ill to continue.

I guess the bottom line is that we need to know what the hell we are doing when hiking. Articles like this a good, but we need to be prepared.

jeffrey armbruster
(book) - M

Locale: Northern California
"The Hype of Dehydration and Heatstroke" on 04/10/2013 19:07:17 MDT Print View

Elevated heart rates will often revert to normal rhythm on their own. You really want this to happen. But think this through: someone like Dan, obviously young and fit, crashed his body to a point where his heart went crazy for many hours. This is a warning sign. If it happens to you, and your normal rhythm returns, you might want to take it easy for a couple of days.

Look, Dan's "one night sixty miler" without a hat in high temperatures and not enough water: that's extreme. This would be extreme--in my estimation-- even with the hat and water etc. I mean, I couldn't do it. Sometimes everything works right and you get away with pushing the envelope. But if you watch (or play) enough basketball, for example, you realize that the human body has peaks and valleys. Performance varies. Everyone on this forum has bonked for no apparent reason, etc. And you can't always predict things beforehand.

Sometimes mental determination overrides the body's needs and messages.

I used to think that I couldn't exert myself too hard; it was always healthy to push the limits. I'm backing off on that philosophy. But then I'm becoming an old guy.

p.s. they did instantly put me on fluids in the e.r. and say that I was dehydrated.

Edited by book on 04/10/2013 20:18:13 MDT.

Larry De La Briandais
(Hitech) - F

Locale: SF Bay Area
the link on 04/10/2013 21:18:40 MDT Print View

I always thought that the link was when you became dehydrated enough to stop sweating your temperature began to rise. If it got high enough then you could suffer heat stroke. Anyone know? And anyone know what heat stroke actually is?

Bob Gross
(--B.G.--) - F

Locale: Silicon Valley
Re: the link on 04/10/2013 21:35:47 MDT Print View

Generally there is a maximum body temperature, maybe 106 F, and that is where irreversible brain damage occurs. Maybe it will be a little. Maybe a lot.

--B.G.--

Michael Ray
(topshot) - MLife

Locale: Midwest
Re: The Hype of Dehydration and Heatstroke on 04/10/2013 21:53:35 MDT Print View

I wish the author explained more of what they found in the runner that kept gaining heat in the ice bath.

Fascinating subject since my son and I will be doing Grand Canyon and a little Death valley this summer. I don't recall noticing my sweating in dry desert heat though I suspect it's just because it evaporates so fast and the air temp negates the evaporative cooling effect. That was decades ago so maybe I don't recall correctly. I do remember having the windows down while driving felt like standing in front of a furnace duct. :)

Ian B.
(IDBLOOM) - MLife

Locale: PNW
Dunno on 04/10/2013 22:01:22 MDT Print View

Dan,

Without being there to take your vitals over a period of time, and BP checks supine and standing, all I can offer is pure speculation.... And I'm not a Dr.

My first guess is hypovolemic shock exacerbated by hyponatremia/kalemia.

Second guess is SVT.

Third guess, all of the above.

Gregory Allen
(Gallen1119) - M

Locale: Golden, CO
Re: Re: the link, "Waterlogged" on 04/10/2013 22:01:23 MDT Print View

I'm reading Noakes book now and it is slow going with lots of detail and references. It is a VERY well documented and referenced book. I think the key is drinking when thirsty and not forcing water, or a "sports drink", past that point. It is very clear that ultra endurance athletes are much different than us mere mortal BPL-ers, but how much different I don't know...maybe not as much as we think. We do respond in a similar fashion to water loss, but the human body is well equipped to handle that water loss, elevated HR, and even some moderate elevated body core temperature and recover without untoward effects. Metabolic rate, or level of exertion, seems to be the key and not what has been hammered into our heads about hydration, electrolytes, etc over the last 30-40 years, is the key. The body will adjust itself with a fairly wide margin of safety. Even ER docs have been duped my the pseudoscience propagated by the market gurus on the payrolls of the sports drink and supplement companies. Pushing too far past what our bodies tell us is dangerous, but maybe not as dangerous as what we have been led to believe marketing and industry. Moderation, and doing what your body tells you, is key. Slow down when it tells you to slow down, and drink when it tells you rhat you are thirsty. Keeping it fueled with balanced nutrition is far more critical that some "cocktail" of electrolytes or excessive water.

Lynn Tramper
(retropump) - F

Locale: The Antipodes of La Coruna
Re: The Hype of Dehydration and Heatstroke on 04/10/2013 22:19:28 MDT Print View

Though I don't doubt the hype of heatstroke caused by dehydration, for me, even mild dehydration can cause a migraine. I am not alone in this. So I drink regularly, before I am actually thirsty, to prevent migraines. My migraine-free comfort has improved immeasurably since I have been using a hydration bladder instead of waiting until I stop to access a stream or bottle on my pack. We are all different!

just Justin Whitson
(ArcturusBear)
To Dan on 04/10/2013 23:26:15 MDT Print View

Dan, i'm not a doctor, nor professionally trained anything medical, but i have had a long time interest and research in diet, natural health, etc. because i was forced to treat myself due to a mysterious childhood condition. Necessity is the mother of invention, AND applied knowledge.

It sounds like possibly one contributing factor was you were consuming too much protein on too hot of days. The combination of energy bars, jerky, and tuna equals a lot of protein (depending on the energy bars, some seem to have a lot and others not so much). Protein requires a lot of water to digest, hence it can speed up and/or exacerbate dehydration.

Not only that, because it tends to be harder to digest in general, it generally raises your metabolism making you feel hotter, hence you will sweat more, internal temps may more easily become critical, etc. Plenty of trained, knowledgeable people have advised to limit your protein while very active on hot days and stick more to carbs. Save the proteins for when it's cooled down and you're more inactive.

Anyways, there may be more contributing factors than that which helped to create a perfect storm of body imbalance.

Dan Durston
(dandydan) - M

Locale: Cascadia
Protein on 04/11/2013 06:54:14 MDT Print View

I didn't actually eat the tuna - I just drank the liquid brine to get some salts into me. My jerky was pretty minimal too - not more than 2oz. I'm not sure how much protein was in the energy bars.

Rob E
(eatSleepFish)

Locale: Canada
Re Protein on 04/11/2013 07:53:17 MDT Print View

Dan,

I'm no doctor, nutritionist, or anything like that, just my own experience with endurance sports, but here is my take: I would suspect a combination of dehydration, electrolyte imbalance, and not enough calories getting digested properly (note, not eaten, but digested and absorbed). I've had almost identical symptoms quite a few times in the past. The last time I experienced it was a few years ago training in the heat for an ironman distance triathlon. For me the trigger is some dehydration, plus the wrong combination of foods, then trying to push through it basically shutting my body down eventually: bad headache, nausea, overheating, waves of chills, cold sweats, elevated heart rate, inability to sleep.

To cover that distance in those conditions, the speed, trail time required with the heat, you have strayed from the hiking to an intensity that would be an endurance sport. Hang around the finish line at any all-day endurance event and you'll see a lot of similar symptoms to what you describe. At higher intensities, a little bit of dehydration, or the wrong combination of foods shuts down their digestive system, they can keep eating, but things aren't getting digested, glycogen stores get burned up, blood sugar drops, dehydration kicks in and the results can be nasty.

Endurance sport forums have many posts from people who are very physically fit and well trained, but are wondering what the heck happened to them when they pushed themselves further/farther/faster in tough conditions and they basically shut down. The lesson on those forums is that muscular endurance and fitness is only one aspect of the training, and that nutrition is critically important and is an aspect of endurance sports that must be trained and dialed in as well. Basically everyone has to experiment in exerting themselves all day in tough conditions and find the right combination of foods and fluids that works for them. I know this forum can think of gatorade, gels and other sports nutrition as simply marketing hype, but in tough conditions at higher intensities, the stuff really works well, at least for me, but it took over a year to fully dial in my nutrition plan to find the combination products, intake rates and timing that really worked for me.

I will say though, pretty impressive mileage in tough conditions to gut it out like that.

Edited by eatSleepFish on 04/11/2013 07:55:30 MDT.

Larry De La Briandais
(Hitech) - F

Locale: SF Bay Area
headache on 04/11/2013 08:39:15 MDT Print View

I always get a headache when I get dehydrated. It took me a long time to realize that was the cause as I "blamed" it on everything else first.

John S.
(jshann) - F
Re: Dehydration & Heat stroke on 04/11/2013 08:54:05 MDT Print View

Dan Durston had heat cramps that phased into classic heat exhaustion in my opinion, brought on by everything ; ) (environmental exposure, dehydration, electrolyte imbalance).

Edited by jshann on 04/11/2013 08:58:53 MDT.

just Justin Whitson
(ArcturusBear)
Re: Protein on 04/11/2013 09:59:00 MDT Print View

My bad, i assumed after you drank the tuna brine, you then ate it at some point during that difficult period and yes 2 oz of jerky isn't much all in all. In any case, to simplify it, i agree with what John Shannon wrote, as i suspect there were multiple factors. Keep the protein thing in mind though for the future, though that may not have been a big factor in this particular case. I have largely stopped eating any foods higher in protein while being very active on warmer or hot days, and i've noticed a bit of a difference in how much water i will need, how much i sweat, how hot i feel, etc. Btw, Cody Lundin is one of the people who talks about this in one of his books, and as he is a desert survivalist par excellence, he should know what he is talking about.

Conversely, i do the opposite when it's very cold and/or i'm less active on cooler days. I will eat more protein and fat, and definitely notice a difference in being warmer and more comfortable then. I saw some idiot on a reality, comedic t.v. show once, decide to eat only meats for a period, and he ended up being tired all the time, got the "meat sweats" bigtime and generally ran hotter than usual.

Dan Durston
(dandydan) - M

Locale: Cascadia
Dehydration & Heat stroke on 04/11/2013 10:58:09 MDT Print View

Thanks for the thoughts guys. Since then I've been paying more attention to electrolytes (i.e. adding some powder to my water). That also makes the water taste better which helps with hydration.
sweat

Edited by dandydan on 04/11/2013 10:58:59 MDT.

Nick Gatel
(ngatel) - MLife

Locale: Southern California
Re: Dehydration & Heat stroke on 04/11/2013 11:06:43 MDT Print View

Dan,

The white residue is very familiar. In my mind our food should contain most of what we need. For me, eating a few Pringles during the day does the trick. I really don't care for sports drinks -- plus if you fill all your water bottles with sport drinks, how do you wash your hands after pooping; don't ask how I know to ask this question :)

Electrolyte replacement is a different animal for those engaged in extreme sports.

Sarah Kirkconnell
(sarbar) - F

Locale: In the shadow of Mt. Rainier
Re: Migraines on 04/11/2013 14:20:55 MDT Print View

Lynn,

I too get migraines from dehydration. Walking while having auras blows so I have learned the painful lesson to stay ahead.

As for the whole heat stroke topic...well all I can say is one of my past hiking partners lost his wife to a combination of it. It came on quick. Anytime other issues crop up - having vomiting or diarrhea for example, while hiking in heat/exposed, heat stroke can easily grab a foot hold. And it can be fatal quickly. It isn't something to take lightly IMO.

Tom Kirchner
(ouzel) - MLife

Locale: Pacific Northwest/Sierra
Re: Re: Dehydration & Heat stroke on 04/11/2013 17:18:07 MDT Print View

"plus if you fill all your water bottles with sport drinks, how do you wash your hands after pooping;"

Purell.

@Dan Wise move, deciding to add electrolytes to your water. Don't let anyone convince you otherwise at the levels you are exercising. That picture of your pack strap says it all. Been there done that, and I'm here to tell you electrolytes have changed my life. It doesn't have to be a fancy sports drink or ripoff Nuun tablets, a 1/4 teaspoon of Mortons Lite salt/liter of H2O will suffice. It provides ~280 mg of Na and ~350 mg of K, which are the two electrolytes most easily depleted. You may want to cut your water with something like Crystal Lite if you don't care for the taste of slightly salty water. A small canister of Mortons Lite costs something like $2.50 and will last at least a year, probably more, depending on how much hiking you do and the conditions you are hiking in.

Bob Gross
(--B.G.--) - F

Locale: Silicon Valley
Re: Re: Re: Dehydration & Heat stroke on 04/11/2013 17:40:19 MDT Print View

"It provides ~280 mg of Na and ~350 mg of K, which are the two electrolytes most easily depleted."

I wish they would sneak a little magnesium in there.

--B.G.--

Jason Elsworth
(jephoto) - M

Locale: New Zealand
The Hype of Dehydration and Heatstroke on 04/11/2013 17:41:14 MDT Print View

Born into a Catalan family, Jornet [Kilian] grew up in the Spanish Pyrenees at 6,500 feet, and his gifts are literally in his blood. “When you are born and bred at altitude, you tend to have a higher blood volume and red-cell count for oxygen-carrying capacity,” which translates to better endurance, says Stacy Sims, a researcher at Stanford who holds a doctorate in exercise physiology and nutrition science. Years of daily running and skiing up mountains have further bolstered this advantage. This helps explain why Jornet sweats so little. During exercise, the bodies of very fit people quickly act to disperse heat by, among other things, vasodilation — expanding blood vessels at the skin’s surface where the air can cool the body. A body that sweats less loses less precious liquid from its circulatory system, a major factor in fatigue.
In moderate temperatures, Jornet says, he can run easily for eight hours without drinking water.

From -http://www.nytimes.com/2013/03/24/magazine/creating-the-all-terrain-human.html?pagewanted=all&_r=0

I add salt to my water and have to be very careful to stay hydrated due to a health issue.

Edited by jephoto on 04/11/2013 20:22:25 MDT.

Nick Gatel
(ngatel) - MLife

Locale: Southern California
Re: Re: Re: Dehydration & Heat stroke on 04/11/2013 17:50:04 MDT Print View

"Purell"

Hmm... is it a good idea to kill the good germs with alcohol? Might it get rid of the germs that protect us? Does soap and water do a better job of cleaning?

Inquiring minds want to know.

Bob Gross
(--B.G.--) - F

Locale: Silicon Valley
Re: The Hype of Dehydration and Heatstroke on 04/11/2013 17:54:37 MDT Print View

"I add salt to my water and have to be very careful to stay dehydrated due to a health issue."

Jason, why do you want to stay dehydrated? That doesn't sound very healthy.

--B.G.--

Tom Kirchner
(ouzel) - MLife

Locale: Pacific Northwest/Sierra
Re: Re: Re: Re: Dehydration & Heat stroke on 04/11/2013 18:11:59 MDT Print View

"Hmm... is it a good idea to kill the good germs with alcohol? Might it get rid of the germs that protect us? Does soap and water do a better job of cleaning?"

On a small area for a few days at a time, I suspect it is not an issue. I still have all my fingers and all my skin on same in good condition. ;)

Soap and water do a better job of physically removing material, including the good bacteria, but alcohol sure does a number on bacteria, at least IME. I would think this makes for a good argument for using alcohol in areas where water is at a premium and should be conserved for drinking, especially if you have to carry your entire supply. That said, I certainly wouldn't recommend it for year in/year out use. My 2 cents

Craig W.
(xnomanx) - F - M
Salt, lemon, and water. on 04/11/2013 18:28:32 MDT Print View

I've been drinking a daily concoction of ~1/4 teaspoon sea salt, 20 oz. of water, and a lemon, lime, or orange wedge squeezed into it immediately when I wake up.

I'm usually up at 4:45 AM to surf before work and a few months ago I realized that consuming nothing but coffee until after my session wasn't doing me any favors for performance, recovery, or energy later in the day. So I started this drink, combined with a bowl of steel cut oats with a good handful of blueberries in it (sometimes with a big glob of plain Greek yogurt as well), and it has made a HUGE difference in how I've felt over the last two months. I don't drink my coffee (only a cup) until after I've had my drink and breakfast. I've never been much of a breakfast person until now.

Will probably take this same routine backpacking from now on.

Tom, you're dead on about salt and water. No need to get fancy with things. Added benefit, it's very economical.

Tom Kirchner
(ouzel) - MLife

Locale: Pacific Northwest/Sierra
Re: Re: Re: Re: Dehydration & Heat stroke on 04/11/2013 19:24:26 MDT Print View

"I wish they would sneak a little magnesium in there."

According to what I have read, it doesn't get depleted as fast. I just make sure to take a magnesium tablet at either end of the day, along with calcium. If you would rather take it in "on the fly", just pick up an OTC magnesium supplement and take one, or more according to your need, during the day. They are easiest to find in a 250 mg dose, IME.

Steven Paris
(saparisor) - M

Locale: Pacific Northwest
The Hype of Dehydration and Heatstroke on 04/11/2013 19:59:52 MDT Print View

A great snack to have on hand during a hike: Trader Joe's Plantain Chips

http://www.fatsecret.com/calories-nutrition/trader-joes/roasted-plantain-chips

Note: I only link to this site b/c it came up on a google search for the nutrition label; I'm not a regular on "fatsecret.com", honest.

Jason Elsworth
(jephoto) - M

Locale: New Zealand
The Hype of Dehydration and Heatstroke on 04/11/2013 20:23:42 MDT Print View

Jason, why do you want to stay dehydrated?

Typo corrected - must be dehydrated today.

Tom Kirchner
(ouzel) - MLife

Locale: Pacific Northwest/Sierra
Re: Re: Re: Re: Dehydration & Heat stroke @ Nick on 04/12/2013 19:24:47 MDT Print View

"Inquiring minds want to know."

Always a good policy. I did a little inquiring on both our behalfs and came up with an interesting report from the Berkeley Wellness Center on just this subject:

http://www.berkeleywellness.com/self-care/preventive-care/article/6-tips-smart-handwashing

The gist of the article is that washing the hands with soap and water is still regarded as the most effective way of sanitizing one's hands. Alcohol based gels are effective at killing bacteria and viruses, but not bacterial spores, and less so if the hands are dirty. Alcohol can also irritate tender hands, although I have not experienced this problem so far. They also specifically recommend washing with soap and water after pooping. So, if you can spare the water it would seem that is the way to go. Still, I have been using alcohol based sanitizer for years with no apparent ill effects. Go figure. Anyway, I thought it would be good to mention this as a follow up to our dialogue.

William Segraves
(sbill9000) - F - M
Re: Re: Re: Re: Re: Dehydration & Heat stroke @ Nick on 04/12/2013 20:30:03 MDT Print View

Wrt alcohol vs hand-washing, it's worth pointing out that alcohol-based hand sanitizers seem to be particularly ineffective against norovirus, something you *really* don't wanna get when you're out in the middle of the wilderness.

Bill S.

Tom Kirchner
(ouzel) - MLife

Locale: Pacific Northwest/Sierra
Re: Re: Re: Re: Re: Re: Dehydration & Heat stroke @ Nick on 04/12/2013 21:14:42 MDT Print View

"it's worth pointing out that alcohol-based hand sanitizers seem to be particularly ineffective against norovirus, something you *really* don't wanna get when you're out in the middle of the wilderness."

I doubt this would be an issue for most backpackers.

According to the link below, the sources of norovirus are: "Produce, shellfish, ready-to-eat foods touched by infected food workers (salads, sandwiches, ice, cookies, fruit), or any other foods contaminated with vomit or feces from an infected person."

http://www.foodsafety.gov/poisoning/causes/bacteriaviruses/norovirus/

That said, hand washing is still considered by most medical authorities to be the most effective way to eliminate pathogens on your hands.

Nick Gatel
(ngatel) - MLife

Locale: Southern California
Re: Re: Re: Re: Re: Re: Re: Dehydration & Heat stroke @ Nick on 04/12/2013 22:13:34 MDT Print View

Of course the comment was "tongue -in-cheek."

But we have become such a risk adverse society. I see hand sanitizer available to the public for free in so many places these days -- supermarkets, department stores, etc. This has got to be a bad idea. Soon we won't have an immune system.

When I was a kid we were always dirty from playing outside. My mother made us wash our hands before meals and we took a bath once a week. We never got sick.

A good friend of mine grew up in rural India. He told me the local water sources usually had greenish water. He never got sick. I am sure some health expert here will point out the dangers and provide case studies to disprove all of this. I think we are all a bunch of sissys ;)

just Justin Whitson
(ArcturusBear)
Re: Re: Re: Re: Re: Re: Re: Re: Dehydration & Heat stroke @ Nick on 04/12/2013 22:35:03 MDT Print View

The Dos Equis Man of men, "You ask, how do i wash my hands? Well, i will tell chtoo, i pee on them."


A real man, and next in line after Nick G., the most interesting man in the world.

Tom Kirchner
(ouzel) - MLife

Locale: Pacific Northwest/Sierra
Re: Re: Re: Re: Re: Re: Re: Re: Dehydration & Heat stroke @ Nick on 04/13/2013 20:41:01 MDT Print View

"Of course the comment was "tongue -in-cheek."

:)

"But we have become such a risk adverse society.

+1

"I see hand sanitizer available to the public for free in so many places these days -- supermarkets, department stores, etc. This has got to be a bad idea. Soon we won't have an immune system."

Americans have never been known for moderation. If a limited amount of something is good, then more must be better. :( That said, I do believe there are public situations where using hand sanitizer makes sense, physicians offices and hospitals for instance, particularly during flu season, as they are concentrators of sick people by definition. I believe the same applies to the back country. but CYOH is the operative phrase here, just like HYOH.

+1 to supermarkets, department stores, etc.

That said, I doubt very much that using hand sanitizer has any more of a lasting impact on one's immune system than washing the hands. Both effectively remove pathogens from the affected area, which will soon be repopulated from adjacent skin areas in the course of the hundreds of touching motions that occur every day, scratching, rubbing, etc.

"When I was a kid we were always dirty from playing outside. My mother made us wash our hands before meals and we took a bath once a week. We never got sick."

I grew up under the same conditions, and heartily concur. Numerous conversations I have had with docs I know socially reinforce my opinion on this one. The real problems with our immune systems start early on, beginning with the increasing frequency of cesarean births, which deprive the newborn of its first exposure to immune system stimulants.

"A good friend of mine grew up in rural India. He told me the local water sources usually had greenish water. He never got sick."

This one is a bit more complicated than that. My wife was born in what is now Bangladesh and spent the first 12 years of her life in what is now West Bengal, under similar conditions. She survived, as did your friend, but millions of other Indian kids didn't and don't. It is a harsh environment and many do not make the cut. Those who do have very strong immune systems indeed, a phenomenon I have discussed with medical professionals on site in Iraq, Iran, and Afghanistan. An interesting related aspect of this involves Indians who emigrate to the West and spend years here, then go back to India and get sick just like a lot of Western tourists do, because their immune systems are no longer primed to resist the local pathogens. It a battle that requires constant stimulation to keep up resistance, a lot like having to get booster shots for typhoid, tetanus, etc. I always "self inoculate" when visiting India by eating lots of yogurt. It is not a cure all, but it jump starts the process of adjusting to the local flora by stimulating my immune system and introducing some local allies into my gut.


"I am sure some health expert here will point out the dangers and provide case studies to disprove all of this. I think we are all a bunch of sissys ;)"

+1 to both statements. :)