L OCAL LIVING


District


13 DC


93°


Temperature at which the skin on a human body begins absorbing heat


104°


A core body temperature above this indicates a potentially fatal medical emergency


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heat, sometimes after a sedentary summer, Casa says. Outdoor runners and others are more susceptible during races, when, like youngsters trying to secure a spot on a team, they ignore the signals their bodies are sending, he says. Now that we have endured the hottest


Precautions you can take


Number of U.S. deaths from exertional heatstroke between 2005 and 2009


The only way to address heat-related illness before it happens is to adopt simple but critical precautions for exercising in hot weather, according to Douglas Casa, chief operating officer of the Korey Stringer Institute, and other experts. Here they are:


Exercise sensibly


Defending yourself against heatstroke the misfits


IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII LENNY BERNSTEIN


It has been nearly nine years, but I still vividly remember the day Korey Stringer died. A mammoth offensive lineman for the Minnesota Vikings, Stringer collapsed at training camp, where, according to some reports, the heat index had reached 110. He died later that day of complications of heatstroke. When he was taken to the hospital, the 335-pound Pro Bowler had a body temperature of 108 degrees. If the 27-year-old star could die under


the watchful eye of the Vikings, which had invested millions of dollars in him, and the NFL, which controls the sport closely, it was impossible not to wonder how much risk the heat posed for the typical weekend athlete. In fact, according to the institute founded in Stringer’s name, the number of deaths from exertional heatstroke, while still tiny, is on the rise. There were 18 between 2005 and 2009, up from 11 in the previous five-year period and 13 in the five years before that. There had not been more than nine in any previous period over the past 35 years. “Almost all are kids,” says Douglas Casa,


chief operating officer of the Korey Stringer Institute, which opened in April at the University of Connecticut as part of an agreement between Stringer’s widow, Kelci, and the NFL. Kelci Stringer’s lawsuits against the league, the Vikings and medical personnel were settled or thrown out without admissions of culpability on their part. She still has one pending against Riddell, which manufactured the helmet and shoulder pads her husband was wearing. Most often, the deaths occur on football


fields, during preseason conditioning camps and practices, when teens or young men are pushing themselves in the


June on record and are moving into the traditionally sweltering summer months, Casa and other experts warn that we should take precautions against exertional heatstroke and other heat-related illnesses: heat exhaustion, heat syncope and heat cramps. Even severe heatstroke is “100 percent


survivable if someone goes in a cold-water immersion within 10 minutes of collapse,” Casa says. The water must be stirred frequently. Relatives of a heatstroke victim are often traumatized again when they discover that with “a $100 kiddie pool and ice and water . . . my child . . . or spouse could still be alive,” Casa says. Another way to quickly cool a heatstroke victim is to wrap him in wet towels and replenish them often.


Quickly recognizing symptoms and responding is critical. Heatstroke is


The single most important rule is to back off the intensity of workouts in severe heat, especially if you start to feel symptoms of heat-related illness or anything else unusual, Casa says. Don’t try for personal records; respect the conditions, he says. “If you’re running, back off to a jog. If you’re


characterized by a core body temperature greater than 104 degrees, increased heart rate, abnormally low blood pressure, sweating, hyperventilation, disorientation and confusion, dizziness, irrational behavior, irritability, headache, inability to walk, loss of balance or muscle function, vomiting, diarrhea, collapse, seizure and coma. Heat exhaustion can have some of the same signs, but a major difference is that the body temperature (obtained rectally) is below 104 degrees. Victims also can suffer from fatigue, weakness, heavy sweating, dehydration, sodium loss, fainting, dizziness, irritability, headache, hyperventilation, nausea, vomiting and decreased urine output, blood pressure and muscle coordination. But half of all heatstrokes occur without warning. As a teenager, Casa was running one of the best races of his high school career when he collapsed. He says he felt nothing that could have alerted him to the impending crisis. Last summer, Edwin “Dek” Miller, a


16-year-old at Northwest High School in Germantown, collapsed during preseason football drills on a relatively mild 81-degree day and died in the hospital early the next morning. A preliminary autopsy indicated heatstroke, though the final report was inconclusive, said Alston Nah, the teen’s uncle.


“Dek was quiet, and he would run through a wall for the coaches,” Nah says. “In fact, the story one of his teammates told at the vigil for him was that he appeared lethargic that day, and every race he would come in last.” The coaches penalized Miller’s group by making them run more, he said. “On the last one before he collapsed,


Dek ran from the rear and came in first, ensuring that his team, his guys, wouldn’t have to run anymore.”


bernsteinl@washpost.com MORE ONLINE 2000 PHOTO BY TOM OLMSCHEID/ASSOCIATED PRESS


Minnesota Vikings lineman Korey Stringer died of complications of heatstroke during training camp in 2001.


to identify and treat the most common conditions, go to the Web site of the Korey Stringer Institute, ksi.uconn.edu, and click on “important info.”


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For more information about heat-related illnesses and ways


jogging, slow down to a walk. If you’re gardening, get out of the sun and get into the shade,” Casa says.


Acclimate


Your body adjusts to the heat over time. That’s why throwing teens into two-a-day practices at the start of training can have disastrous results. In 2003, the NCAA ordered a five-day acclimatization period for football practices, but there is no national standard for high schools. States and school districts handle the matter in different ways. Last year, the National Athletic Trainers Association recommended gradually increasing the amount of practice time and equipment used over 14 days.


NFL medical staffs closely monitor players and their weight during hot weather in training camp. They also emphasize the importance of hydration and the dangers of taking banned substances such as ephedra, according to Greg Aiello, the league’s spokesman. Individuals should not schedule tough workouts until they have become accustomed to the conditions.


Hydrate


Thankfully, the days when coaches and drill sergeants toughened young men by refusing them water while they exercised are mostly gone. Now we know you must remain adequately hydrated to exercise efficiently and prevent illness. With every 1 percent loss in body weight due to dehydration, the body’s temperature rises a half-degree, Casa says. And don’t forget salt or other electrolytes. If you sweat heavily, you can reduce the level of salt in your body enough to cause problems. Gatorade and other sports drinks may replace only part of what you need if you’re exercising for several hours in the heat. Certain medications and illnesses such as the flu also may affect this calculation, Casa says.


Adjust to conditions


The heat and humidity can combine to make it difficult for your body to cool itself, Casa says. When the temperature is above 93 or 94 degrees, your skin is actually absorbing heat. Be proactive when temperatures rise, Casa


says. “Prevent problems in the first place. Go out earlier, go out later, run on a trail instead of blacktop, don’t run that day,” he says. “Bring a CamelBak [water carrier]. Go to a fitness center where it’s air-conditioned.”


—L.B.


K THE WASHINGTON POST • THURSDAY, JULY 1, 2010


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