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Cycling Wed: It’s really dangerous out there…Be careful

You make promises to yourself, right?

I made a big one when starting this blog. It was a promise not to post Pollyanna-ish health advice. People can read about the importance of wearing sunscreen and getting basic vaccines anywhere–and everywhere.

But tonight is different. I’m taking the risk. (Give me a chance; I’ll do my best to spice up the basics.)

This is serious:

This kind of heat really does threaten those who fail to master the obvious.

Are heat warnings overblown?

No. If I had a dollar for every heat-related heart illness that I’ve seen over the years, I’d have half that retina MacBook paid for. Seriously, one of the body’s most tightly regulated systems is temperature control. We are heat-dissipating machines. That’s because organs begin to shut down at high temperatures. Blood thickens, adrenaline spikes and blood pressure drops. Inflammation runs amok. We are all vulnerable.

I’ve seen the strongest of cycling cyborgs reduced to babbling and shriveled patients.

We told DB that it was an 80-mile road race in 95-degree heat. No early attacks, we will ride together. DB is an ER doctor. He attacked at the gun. After a group nature break, his gap rose to 15 minutes. On the final climb, aptly named the Furnace, our mate was traversing the road and speaking in an unknown language. When we finished the race, DB was busy schooling the paramedics on the latest study of volume expansion. They nearly dropped him out the back.

DB’s brush with heat stroke is an extreme example. Even mild dehydration and heat exposure can play havoc with susceptible patients. Now I’m talking to middle-agers with (or without) AF. The stressful effects of heat-illness–electrolyte depletion and high adrenaline levels–can act as pokers of the nests of cells that drive or initiate AF. You don’t want to poke these cells. Remember: the thing about first arrhythmia episodes is that the day before you were fine. The day after, you are in the club. Dang it.

Okay, let’s do a list–the diet pill for bloggers.

Here are ten Mandrola rules for dealing with the heat:

  1. Vote for an environment-minded progressive. That’s just a joke. I’m laughing out loud. Give me a break; I’m about to give you basic health advice. Boring scares me. I don’t do politics, mostly because none of it matters.
  2. Hydrate immediately upon awakening. A number of years ago, I had to drink 30 ounces of water in the early morning before a kidney ultrasound. The sensations were amazing. I bopped around that entire day. Starting the day on ‘full’ can make a huge difference in dealing with the heat.
  3. Drink an entire bottle of water BEFORE the run or ride. Even when it’s not hot, exercising in a fully hydrated state improves performance. A side effect: the need to negotiate an early nature break.
  4. Limit caffeine intake on hot days. I harbor little doubt that caffeine improves performance–in certain individuals–during short bursts of exercise done in moderate weather. I cannot imagine starting a cyclocross race without drinking a stiff Americano. But on hot days, the diuretic effect of caffeine wreaks havoc with heat regulation and electrolyte depletion. I don’t have studies; I just know this.
  5. Talk to yourself during a hot ride/run. Keep telling yourself to drink fluids. For guys like me, with imaginary friends, talking to yourself comes naturally. You may need to practice.
  6. Colored water can help on long rides/runs on hot days. I’m partial to orange and purple sport’s drinks. Of course, the best color drink needs to be individualized. Don’t ask me which proprietary formula best replenishes muscles. Just pick a good color. I say this with caution: The fizzy carmel-colored stuff in a red can also works for me.
  7. Avoid Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Under normal circumstances, regular use of NSAIDs is risky. One of the greatest risks of these drugs is kidney failure–the dialysis kind. Taking NSAIDs in a volume-depleted state increases the risk of this catastrophe. Let me repeat: Do not take NSAIDs while dehydrated.
  8. Don’t push through sickness. When fighting a viral infection—I say viral, because no one exercises through serious bacterial infections—you need to let your heart and body rest. By definition, infection means you are inflamed. Don’t risk pouring in more inflammation. Never add inflammation. That’s a severe health rule!
  9. Exercise in the morning. The advantage here is that you may learn to go bed early.
  10. Be alert for signs of heat-illness in yourself or your buddies. It’s pretty obvious. Being cold on a hot day is a really bad sign. Babbling is a less specific indicator.

Feel free to add in any personal nuggets of wisdom for dealing with the heat.

And be careful out there.


8 replies on “Cycling Wed: It’s really dangerous out there…Be careful”

Great post John- i tell my athletes (Rugby Ubion) that there are three reasons for not training with a systemic viral infection: 1. You’ll pass on your bugs to everyone else at the club; 2. The quality of your training will be crap anyway, and; 3. You night get a myocardial infection which could leave you needing a heart transplant. The last one tends to hit home.

I’d hate to cycle in those humidity levels- i had a quick look at the Perth (Western Australia) mean 3pm humidity levels and they don’t ever hit 50% during the hot months.

Tim Noakes in his book, The Lore of Running, talks about consuming flat, carmel coloured liquids for in-competion hydration during the Comrades Marathan in Durban.

Great post! I can tell you that the vast majority of my Dad’s Paroxysmal Afib events have been in hot weather. Makes perfect sense.

I myself have POTS, so I’m VERY cognizant of my volume status. AC for me 🙂

I didn’t know about the 30oz of water first thing in the AM, I will have to try that, thanks for the tip Doc!

While, I’m thinking about it: re sports drinks. I’ve read and been told over the years that Gatorade actually contains to much sugar and to dilute it 50/50 with water, in order for the electrolytes to be properly absorbed. Any truth to this?

I’ve noticed when I don’t dilute it, it makes me feel rather bloated and nauseated as well.

I actually prefer what used to be called Gookinaid, can’t recall offhand what they changed the name to.

Great advice, didn’t realize the caffeine effect in the heat as well as the use of NSAIDs. Will have to share this info with others as it heats up on the East Coast again. You mention colored water – what about Gatorade?

I tried #2 above, hydrating upon awakening today and I’d say I feel subjectively ‘better’.

Thanks for the tip Doc!

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