written by: David Altreuter
The thermometer was finally removed and the nurse adjusted my shorts hastily before four assistants reached into the ice-water-filled kiddie pool, grabbed me, and pulled me out onto my feet. Discomfort from a few badly placed ice cubes made walking difficult, as did the dizzying drainage of blood from my head. Assisted heavily, I made it to a recovery cot and lay back down. The excitement that had surrounded me for the past 12 minutes was gone and I was left alone with my thoughts. What had gone wrong? What had just happened?
As I lay on the cot my thoughts were less than organized. I considered the ‘what if’ possibilities of the moment. What if there hadn’t been a watchful medical staff at the finish line? What if my body had gone critical a mile earlier?  With fear I briefly swore off racing altogether, it could not be worth this risk. As I calmed down I tried to understand why I had gotten heat stroke and why I hadn’t realized the serious nature of my worsening condition as I ran.
- I had overheated during a 7-mile road race and had crossed the finish line with a core body temperature of 107.1°F. Body temperatures of 106°F and higher are associated with seizures, brain damage, and death.
- I may have owed my survival to the medical personnel who recognized my condition as I crossed the finish line, intercepted me, and immediately treated me. It had taken over 10 minutes of complete immersion in an ice bath to reduce my temperature to a feverish 102.
The truth is, I don’t know what happened that day to make me so dangerously hot. It was in the low 80s and humid when we ran, but I’d successfully competed in harder and longer races at higher temperatures and more oppressive humidity in the past. I was very well hydrated before the race. I had consumed water at every aid station and had accepted small cups of water from local kids between mile marks. I had run through sprinklers at least twice during the course. I had run on the shaded side of the road wherever it was available. My pace was about the same as similar efforts in the past and was steady up to the last mile. I hadn’t felt particularly bad until the last few hundred feet. For whatever reason, my body’s temperature regulation attempts had failed. I might not know what I would have done differently that day, but I can be more alert to the dangers of heat stroke and can encourage others to be vigilant and informed as well.
The medical staff at the race had noticed me at the finish line because of my ashen color. Recognizing the signs of heat exhaustion and heat stroke may allow you to identify friends and fellow athletes before the become critical and to prevent or treat similar events. The signs and treatment actions are listed below:
Heat Exhaustion – SERIOUS condition
Heat Stroke – EMERGENCY condition
There is heavy sweating, weakness, dizziness, perhaps fainting or vomiting. The skin is pale, cold, and clammy. Temperature is normal or below.
Have the person lie down in a cool place and sponge the body with cold water. Loosen or remove clothing to aid cooling. If the person is not vomiting, offer a cool liquid to drink (no alcohol). The person may feel better quickly, but should take it easy. If the person is elderly or cannot keep the liquid down, he or she should be taken to a hospital.
I was lucky. I continued to race through the season. Just seven days later I would be fine during a hot half-ironman race in which I placed second in my division. These events can happen to anyone, so be careful and be informed.
The victim feels very feverish but stops sweating; temperature soars (perhaps to 104ºF or higher), pulses pound. The person is confused or becomes unconscious. The skin is first flushed, then ashen or purple. This is a medical emergency!
Call 911 or an ambulance immediately. Bring down the victim's body temperature as quickly as possible. Put the person in a tub of cold water or sponge the body with cold water or alcohol. If possible, rub the patient's arms and legs with ice cubes. People with heat stroke usually need to be hospitalized.