7 Things to Know about Heat Exhaustion

Looking perky before the fall

After a long day of summer sightseeing, have you ever felt headache-y, queasy or nauseous? Have you experienced the shakes or has your face gone pale? You may have had heat exhaustion without even knowing it. And it's important to know it, because once you have an episode of heat exhaustion, you are more susceptible to it in the future.

Now, I am not a doctor, nor do I play one on TV. But believe you me, I know from heat exhaustion. I've ended up in the hospital with it four times. The first was after a three-hour singles match in the mid-day California sun. The second was after I had flown to California non-stop and played tennis (doubles, this time) later in the afternoon. That incident was clearly caused by the triple whammy of dehydration from the plane, the sun, and exercise. Incident #3 was after my first and only attempt at Bikram Yoga (I highly DO NOT recommend this form of yoga--it's actually the antithesis of yoga, IMHO). And finally, there was the infamous incident in China, which took place, not after a round of exercise, but in the middle of a day of sightseeing in Beijing. That's another one that resulted in an IV in the ER. I highly DO NOT recommend the ER in China.

The face of heat exhaustion

One month later, I am still sorting out dozens of receipts written in Chinese, trying to decipher what's what in order to send my claim to the Travel Guard insurance company. So that you can avoid similar travails--both heat stroke on your travels and the accompanying paperwork, a bit of advice is in order. Again, I am not a doctor, but I've learned some excellent tips from the four who have treated me for the condition.

1. HYDRATE, HYDRATE, HYDRATE. You can never have too much water before you go out in the heat and while you are out. Better yet, as you hydrate, alternate between water and sports drinks loaded with electrolytes.

2. Take it easy within 24 hours of landing after a long-distance flight. Aside from the above-mentioned combo of coast-to-coast flying and tennis, I believe the incident in Beijing may have developed from the following set of activities:
    Day 1: 14-hour flight to Beijing
    Day 2: Climbing to the top of the Great Wall in heat and humidity
    Day 3: Four hours at the (shaded) Summer Palace, followed by an afternoon of sightseeing in Tiannamen
              Square and the Forbidden City. Temperature was in the high 80s, not taking into account the heat    
              from the pavement and the air quality.
While I had taken care to get plenty of sleep and what I thought was plenty of water (although probably rationing unconsciously due to the yen to avoid using squat toilets still so prevalent in China), BOOM! Down I went in the Forbidden City.

3. Carry electrolytes with you if are prone to heat exhaustion. I had Emergen-C packed in my suitcase, but it wasn't with me in the Forbidden City. A friend had salt pills packed, but again, she didn't have them in her purse. Both would have been perfect for dissolving in a bottle of water.

4. 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 will be your only solution, so to speak. But if you feel on the cusp, immediately stop your activity and stay cool. This is what I tried to do in the Bikram class 30 minutes in....but the instructor wouldn't let me leave the room, the heat index of which was probably upwards of 130. After 30 more minutes in this extreme sauna, I forced my way out (as the instructor chased after me calling me a coward--nice).  Had I left the  room when I initially felt ill, I would have been okay with liquid, rest, and shade. But the extra heat did me in, even though I was laying on my mat during that time. On to the ER.

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 levels. This condition is called hypontremia. If this is your issue, there is a need to drink liquids containing electrolytes instead of straight water. No other ER doctor had  ever mentioned that to me.  Interestingly, though, in checking a number of legitimate medical websites, 100% recommend water, although agreeing that electrolyte-spiked liquid is better yet. These same sites put a total kibosh on drinking carbonated beverages or anything with caffeine.

Best bet--before leaving on a hot trip, ask your doctor for his/her advice and get travel insurance, just in case. As for me, I'm staying out of the heat.