7 Tips for Avoiding Heat Exhaustion on Vacation

It's the first day of summer. And while most of you are preparing for the season's fun and sun, I want to give you a head's up about the very real dangers of heat exhaustion.

In Tiananmen Square before the fall

When it comes to this topic, I am quite the expert. I have ended up in the hospital for heat exhaustion and dehydration four times (after the first time you are felled by heat exhaustion, you are a more likely candidate for encore performances)  Details here. The most recent incident happened in Beijing. It occurred on Day 3 in China. Day 1 included a fourteen-hour flight from the US of A. Day 2 included a climb up the Great Wall. All resulting in Day 3, which included a visit to the pavement-laden Forbidden City in the smog and 90 degree heat, followed by a trip to the ER for an IV.


Even if you are not traveling to exotic climes, the fact is, summer is the time when heat exhaustion is most likely to strike. If you fly to your vacation destination, you are starting off your trip dehydrated. Add in the fact that you are likely out in the sun day after day, for hours at a time. It's the perfect recipe for a heat attack. Heat exhaustion can hit anyone of any age and any level of fitness (see LeBron James). It can hit at the beach, on the pitch, or on city streets. Here is some advice (vetted by doctors) on avoiding heat exhaustion.

1. HYDRATE, HYDRATE, HYDRATE. You can never have too much water before you go out in the heat and while out in the sun.  As you hydrate, it's smart to alternate between water and beverages loaded with electrolytes.

2. Take it easy within 24 hours of landing after a long-distance flight.

3. Carry electrolytes with you if are prone to heat exhaustion.  I recommend REI electrolyte tablets, which are among the few without artificial ingredients.

4. Along with your water bottle, carry energy bars, dried fruit or something similar.

5. Wear a hat and sunscreen.

6. Get out of the heat and rest. Once you start feeling the effects of heat exhaustion, you may be too far gone...and an IV may be your only solution, so to speak. But if you feel on the cusp, immediately stop activity, head toward shade and try to cool your body off with ice or cold water.

7. What do you drink once heat exhaustion kicks in? Interestingly, the Chinese doctor who treated me said drinking water straight is one of the worst things you can do. He suggested that once heat exhaustion sets in, water intake further dilutes salt and potassium levels. This condition is called hypontremia. If this is your issue, there is a need to drink liquids containing electrolytes instead of straight water. At the same time, avoid carbonated beverages or anything with caffeine.

Crazy Travel

It seems we live in an age of specialization. The jack of all trades and mistress of many is increasingly undervalued. To wit, even though I have covered travel for 25 years (I started very young) and I know a lot about a lot (if I do say so myself), it's not enough. Seems expertise isn't valued unless billed very specifically--family travel expert; tennis travel ace; hotel industry hot shot; nude travel maven, etc. I have frequently covered all of the above (although I suppose it is somewhat oxymoronic to "cover" nude travel), and likely have far more knowledge than many of the so-called experts with blogs devoted to a particular proposition. Nonetheless, my expertise is left under-appreciated.

Finally recognizing that you can't fight City Hall (despite the best efforts of Occupy Wall Street),  I decided the beginning of the new year was a fine time to establish a singular specialty. Not so easy, my friend, as  much of the travel world is plucked over. But then, after a spate of visions about phenomena like Stendhal's Syndrome, Paris Syndrome and Jerusalem Syndrome, something clicked.  "Why," I said to myself (not that I really talk to myself...okay, I do), "maybe I'll become an expert in travel and mental health." After all, people frequently say I'm crazy. Plus, is it delusional to explore why sojourners so often succumb to the artistic beauty of Florence with hallucinations and quivers? Or why American and Scandinavian pilgrims (usually Protestant, according to the research) turn into raving lunatics in Jerusalem? Or why Japanese people are especially prone to depression in Paris? I will explore all of these issues in later columns, mes amis.

But let's start at the very beginning, with a phenomenon known to travelers since time immemorial. Said phenomenon--Travel Stress Syndrome.  To intelligently discuss, let me refer to a "Travel Mental Health Checklist-Travel Stress" developed by the International Association for Medical Assistance to Travellers (it's based in Britain, hence the "ll").  Parenthetically, but without parentheses, IAMAT also provides a travel checklist for psychosis, but I realize it would be crazy to start with that.

So, here was go. As we all know, travel is always stressful to some extent. Even the most experienced traveler gets annoyed at the airport; is flummoxed by foreign fare; and becomes rattled by reversals in routine. And certainly, no one is insulated from culture shock (or culture schlock, as the case may be for travelers heading to Disney World or shopping areas around any major tourist attraction).

According to IAMAT, travel often exacerbates mental health problems. And even those with no prior experience with mental illness could develop panic attacks, anxiety, et al, due to travel stress. In order to circumvent such mental ills, IAMAT offers the following suggestions:

1. Before you leave, assess your travel plans and change them if needed to minimize your stress levels.
    Dr. Laura's interpretation (no, not that Dr. Laura)   Leave yourself plenty of time to get to the airport; don't overschedule your days; and don't try to see too much in too short of a time.
2. If your expectations are not met, find non-confrontational solutions to improve the situation.
    Dr. Laura's interpretation: Don't yell at the airline agent o the front desk clerk; cast aspersions at your neighbor on the aeroplane; or pick a fight with your tour guide.
3. Take the time to enjoy the people, new sights, sounds, smells and experiences when in country. Be present and try to live in the moment. Know your mental and physical limits.
    Dr. Laura says, "Amen, IAMAT."

IAMAT also offers suggestions on dealing with more specific issues, ranging from culture shock to the aforementioned psychosis. We shall check in with some of those issues in upcoming posts.