29 Comments

Given how Michael Mosley died recently, someone intelligent, fit and healthy - this is a timely reminder, and explanation, about how easily things can escalate out of control.

…now I’m off to drink a glass of water!

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Growing up in the Arizona heat (I remember a day at 119 F) and now in the middle of yet another NYC heat wave, I have often wondered how close I was to a heat stroke. It was fascinating to read the levels of change our bodies go through as we try our best to survive. Thank you are all the excellent information - in, of course, your perfectly unique voice. Only you could tell me I was dying and I’d still smile…!

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Tshirts, but with printed instructions that appear based on your body temperature. Just trying to get ahead of that climate change thing.

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I really enjoyed your heat illness article. I work in occupational safety and health and this time of year I spend a lot of time creating training materials so that workers do not suffer any of the stages of heat-related illness and I really like how you explained it with the timeline. You've given me some new ideas for possibly getting through to them. Thank you!

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This was a really interesting article, Mike. I had no idea you should actually eat salty foods (along with lots of water, of course) when you are getting close to a heat stroke. The article is also timely because it helps to explain why so many people participating in the hajj right now in Saudi Arabia are dying in the 50 degree heat.

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At 50c no-one should be doing anything but sitting in a darkened room hugging an AC.

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That's absolutely true. But the hajj only takes place at one time during the year and people literally pay thousands of dollars--often far in advance--to attend it. So they don't have the luxury to postpone if the weather doesn't cooperate. It's all such a tragedy.

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I'm sure you're right, which makes it an interesting exercise in the psychological power of loss aversion, since I would happily pay thousands of dollars not to die.

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As you recommended, I bought the book. Then, took a look at the Threadable thingie. I eagerly await your further instructions and signal to start.

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Mike, good to see you. I always feel somewhat smarter after your post. Maybe someday you could do something on epidemiology. I have a moderate interest in it, & I was subject to diagnosis for a UTI Thursday. I did 1 paper on epidemiology when in university that was nigh - on SPOTLESS ! Not to brag..... much.

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I got full heat stroke when I was 16 at an outdoor concert. There was just no water anywhere and I got thirstier and thirstier. Eventually I bought a pint of cider just to tip it away and drink water from the one standing pipe on site. But it was too later by then. Blur came onstage, and I said to my brother (who was 14 at the time): I’m just going to take myself to the medical tent to see if I can get some water. They were really nice and gave me a chair, but then I remember slooowly sinking sideways to the ground. I came to in an ambulance with several people absolutely panicking around me; and then again in a makeshift festival hospital with my Dad there. That’s honestly all I know about it. I felt terrible for about a week.

My brother, however, loves to tell the story of how an announcement came over the tannoy saying that there were trying to identify a girl who couldn’t remember her name but had three identical twin brothers, and could they step forward? Somehow, despite only having the one brother, he worked out it was me.

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Yikes! This is truly gruesome. It reminds me of when my toddler got a high temperature. He was too hot to touch, almost, and looked like he'd been boiled. With no doctor near, no transportation, and no idea what else to do, I laid him in the tub and ran a couple of inches of cold water into it. I splashed the water onto the parts of him that weren't submerged. In no time, the water was quite warm. I did it again, and managed to get his fever down. When I was able to get him to a doctor, I learned he had scarlet fever.

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My daughter would get a temp of 105 if she got an ear infection! The doc at the time said to get the fever down quickly to put her in a tepid bath (tepid rather than cold so as not to shock her system into trying to warm itself up or something?). The tepid water sure felt cold to her, though. Screamed bloody murder. But it helped!

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The water I used was probably closer to tepid than cold. But as you pointed out, it was relatively cold. He cried while I was doing it but it worked.

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I've has some very close shaves with heat stroke. The first marathon I ran was NY. It snowed the day before the run and thus forewarned I wore a Helly Hansen thermal top for the run itself. The temperature got up into the 70s. As my temp climbed I toyed with running it half naked, but couldn't face either throwing away my shirt or running on with my moobs flapping about (all Englishmen would prefer death to embarrassment). At first I sweated heavily. Then the sweating stopped and a salt crust formed on my shirt. My body increasingly began to say "stop ... you idiot". My thinking became muddier but some part of my brain pushed me from water station to water station until I had enough fluid in me to start sweating again.

It was good training because when I later did the Milan marathon it was 30C. I'd wanted a PB and welcomed the sunshine, but as the heat intensified, I had the experience just to back off the pace entirely and concentrate on finding whatever shade there was around the route. The last couple of km involved picking my way round prone bodies of runners being tended to by ambulance crews.

It is a weird aspect of humanity that one part of brain can generate the will to keep us doing something lethal whilst the rest of it is screaming warnings until it fails altogether.

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So, putting this together with your equally morbid (and fun) article on freezing to death, which would you take, Mike?

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Coming from Australia, I travelled to the uk last year. It’s hard to explain to Australians the heat you experience in the uk, it might not get as hot as in Australia (generally speaking), but the length of days (at the most we get 13 hours of day light) means the heat seems to linger and peak much later in the day. My take in it is the hot weather in the uk is much more depleting (not helped by in many places we stayed windows that don’t fully open and lack of fans). At home on the east coast even the hottest day cools by 8 pm. Good luck to you all in the coming weeks, drink up!

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The heat index here today is 107° and I am notoriously bad at remembering to drink enough fluids. As it happens, I find boiled egg whites to be borderline repulsive, so thank you for that wonderfully motivating analogy. 😬

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Geez. I had my first ever (that I can recall) bout of heat exhaustion a couple summers ago, when I was at an amusement park with my husband and son. I thought I was drinking enough water but it wasn’t cutting it. I felt overly hot, my face was flushed, and I was beginning to feel sick. I had my hubby pay six bucks for a Powerade and sat myself down in the shade for a while. Perked back up after about thirty minutes.

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"It could well be that the only thing between you and a coma right now is half a tube of Pringles."

The things I do for survival...

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Well that's a cheery read while I've got a Covid-related fever!

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