Death by 100 Degrees

  • In retrospect, the warning signs seem painfully obvious. The Minnesota Vikings started their training camp last Monday on what was one of the hottest days of the year in Mankato, Minn. All-Pro tackle Korey Stringer was overcome during the morning session and had to be carted from the field. The next day turned out to be even hotter and more humid. Some of Stringer's teammates reportedly teased him about a newspaper photo that caught him doubled over with exhaustion the day before. "I'll show them!" the 335-lb. offensive lineman must have figured. He turned in what was by all accounts a stellar performance, although he vomited three times. Then Stringer collapsed; he was able to walk off the field into an air-conditioned trailer. He then had trouble breathing, and was rushed to the hospital.

    When Stringer arrived shortly before noon on Tuesday, he had a temperature of more than 108[degrees]F. Emergency-room personnel hooked him up to an I.V. and began cooling him with buckets of icy water. Doctors and nurses labored all afternoon and into the evening to keep his organs from failing, but Stringer's heart couldn't take the stress. He died 14 hours after entering the ER without ever regaining consciousness.

    I don't want to add to the unspeakable grief of Stringer's family and friends. But his death should be a lesson for the rest of us, a tragic reminder of how dangerous the combination of high heat and stifling humidity can be. Of course, most troubles with overheating don't progress quite so far. Often you get nothing more than a heat rash, muscle cramps or headache. Things can get very serious very fast, however, depending on your underlying physical condition, how dehydrated you've become and whether or not you have had time to acclimate to a surge in temperature. Still, the most devastating conditions--like the heatstroke that killed Stringer--can usually be avoided, if you know what to look for.

    The body's first line of defense is to shunt blood away from the torso and out to the skin. The brain sends signals to the blood vessels, commanding them to expand in size and increase the amount of blood being pumped by the heart. Then, working much like a car's radiator, the body cools itself off by warming the air around it.

    Next come the sweat glands, which release enormous quantities of water through the skin. It's not the sweating per se that cools the body but the evaporation that draws heat from the skin and lowers its temperature.

    But once air temperature reaches into the 90s, your body has trouble dissipating any heat. And if the air is already full of moisture, as it is on a day with high humidity, it's hard for sweat to evaporate from your skin. With no place else for the heat to go, the temperature inside your body begins to rise dangerously.

    Mild cases of heat exhaustion--a serious but not necessarily life-threatening condition--should respond rather quickly to a few simple measures. Try cooling off by heading for the nearest air conditioner. Apply damp towels all over the body, especially places like the wrist and temples, where blood vessels are nearest the skin. Drink plenty of liquids to help replace all those lost body fluids. Water is generally the best option. Alcohol, tea and colas, which act as diuretics, can actually increase fluid loss.

    Heatstroke occurs when the body's internal temperature-control system gets overwhelmed. Signs that this may be happening include confusion, disorientation and hallucinations. Sometimes (but not always) the body becomes so dehydrated that it will stop sweating altogether. If that happens, you've got a real medical emergency that requires immediate professional attention.

    The best defense is to avoid overheating in the first place. Remember, it usually takes a week or two to adjust to any major jump in temperature. Try to avoid exercising in the hottest part of the day. Wear loose-fitting clothing that allows air to circulate around your body. And be sure to drink plenty of liquids.

    The elderly and the young are especially vulnerable to heat stress. So are folks who are overweight or suffer from heart disease. Whatever you do, don't ignore the signs of heat stress in yourself or those around you. When the thermometer's rising, everyone's at risk.

    See Dr. Ian on NBC's Today show; e-mail ianmedical@aol.com