Heat stroke a serious threat in exercise

FITNESS CLINIC

May 31, 1994|By Gabe Mirkin, M.D. | Gabe Mirkin, M.D.,United Feature Syndicate

The most common time for people to die of heat stroke is in late spring or early summer, when the weather suddenly turns warm. It takes a week of exercising in the heat for your body to acclimate to it. If you try to exercise intensely before your body adjusts to hot weather, you can suffer a heat stroke, which is a sudden uncontrolled rise in body temperature that can cause you to pass out.

Your body will give you plenty of warning signs before a heat stroke happens. First, your muscles will feel like a hot poker is pressing against them. Then, the air that you breathe will feel like it's coming from a furnace, and no matter how hard and fast you breathe, you will not be able to get enough air.

When this happens, stop exercising and get out of the heat. If you continue to exercise, your body temperature will rise further. Your head will start to hurt, you'll hear a ringing in your ears, you'll feel dizzy, you may see spots in your eyes, and then you will fall on the ground, unconscious.

When a person passes out from heat stroke, his brain is being cooked just like the colorless part of an egg which turns white when it hits the griddle. Get medical help immediately. The person could possibly be having a heart attack. If it's heat stroke, the victim should be carried into the shade, placed on his back with his head back and his feet up, and cooled by any means possible. Pour liquid on him. It doesn't matter whether it's from a hose or a glass. It could be water, cola, milk or whatever you have.

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Q: What's the safest and most effective program to make yourself fit?

A: Competitive athletes know that you should not train at the same level of intensity every day. To improve in sports, take a hard workout one day that causes your muscles to feel sore on the next. Then take easy workouts until your muscles feel fresh again. If you try to exercise vigorously while your muscles are still sore, you are likely to injure yourself.

Each sport places its major stress on specific muscle groups. If you run fast on one day, your lower leg muscles will usually be sore on the next, so you shouldn't run fast on them. But you could pull on a rowing machine, which would spare your leg muscles and stress your upper body. You also need days of rest to let your body recover from hard physical training, so the best exercise program involves alternating two sports, one that stresses your lower body with one that stresses your upper body; taking one or two days a week off; and exercising intensely once a week in each sport.

An ideal program would be to run on Monday, Wednesday and Friday and pull on a rowing machine on Tuesday and Thursday. Row hard on Tuesday and easy on Thursday. Run slowly on Monday and Wednesday and very fast on Friday. Then take off Saturday and Sunday. You can apply these principles to any combination of sports.

Q: I'm considering estrogen replacement to help prevent osteoporosis. Which is more effective, pills or patches?

A: When estrogen is taken by mouth, it passes from the intestines directly into the liver. There it causes the liver to make potentially harmful proteins that cause clots, but also healthful HDL lipoproteins that prevent heart attacks. Women who are at increased risk for heart attacks should take estrogen pills, while those at increased risk for clots should not take pills.

Estrogen skin patches are preferred over pills for women who smoke cigarettes, have migraine headaches, high blood levels of a fat called triglycerides, liver disease, fibrocystic disease of the breast, or a history of forming clots. The patches are applied to the skin twice a week, and women who have not had a hysterectomy usually need to take progesterone pills also.

Gynecologists rarely recommend estrogen injections and implanted estrogen pellets because they are far more expensive than the other routes of administration and may be harmful.

Dr. Mirkin is a practicing physician in Silver Spring specializing in sports medicine and nutrition.

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