Heat Exhaustion
The human body is a complicated metabolic engine. We eat food, our digestive system processes it, and we “burn it” in the course of our daily activity. The by-products of our metabolism include heat, water, carbon dioxide, and various “waste” chemicals. We have a complicated “thermostat” that regulates our body temperature, and it does a remarkable job of maintaining us at about 98.6 degrees F. When we exercise or enter a warm environment, our thermoregulatory mechanism springs into action, cooling us and keeping us safe and healthy. If we push ourselves to extremes, we can overwhelm this mechanism, and that is when heat related disorders appear.

Let’s say you’re in Abaco and you’ve rented a boat. It’s a gorgeous, bright, hot, sunny day, not much wind. You run Tilloo Cut, head out to maybe 75 feet, and cut your motor so you can drift over the reefs and catch some of those nice groupers that frequent the area. As soon as you stop moving you realize it is hot; so does your body. In an effort to keep you cool, the blood vessels in your skin dilate (become wider) to allow greater blood flow which will transfer some of the heat from your core to the surface where it can be dissipated by your skin. You will also begin to sweat; some heat is transferred to sweat, and further heat dissipation occurs as it exits your body. As sweat evaporates, even more heat is consumed and diverted away from your core. You get thirsty and drink some cold water, which consumes heat as well as provides more fluid that you can then sweat away. You breathe out hot water vapor; your body realizes that fluids are precious, and your kidneys make less urine. Maybe you’ll put on a large hat, or maybe you’ll stay under the boat’s Bimini top. Usually these actions will keep your temperature normal; you’ll have a nice day, and maybe bring home a few fish for dinner.

But it doesn’t always work this way. If the wind isn’t blowing, a thin jacket of very warm air will envelop your skin, preventing heat dissipation. If it is very humid, evaporation will be impeded. You may have forgotten to bring adequate fluids, or your crew may have consumed more than you anticipated, and you don’t rehydrate adequately. Lastly, you may have brought a case of Kaliks to use for “fluid replacement.” Unfortunately, the alcohol in beer is a potent diuretic, and it can fool your body into thinking it is fluid overloaded. You start to frequently urinate, you get more thirsty, you drink more beer, you lose more fluid, you drink more beer, and…….

You start to get a little confused. You think of something you want to do, and you quickly forget to do it. You wander around the boat, you’re restless, irritable, you get a headache, you’re nauseated, you’re even more irritable,  you have terrible leg cramps,  you’re tired, you want to lay down, there’s nowhere to go, you want to drink but you’re getting sick, you finally vomit, you’re head hurts, you’re dizzy, you get weak, you’re head’s pounding, people talk to you and you sort of hear them, it’s really hot, and………….

You are now very ill. You’ve entered the Heat Exhaustion Zone. You’re body temp is 103 and climbing, you can’t think, you’re in and out of consciousness. If you’re lucky, someone will take care of you before you have a seizure or your kidneys fail and your cardiovascular system collapses. What a way to end your Abaco vacation!

It doesn’t have to be like this; in fact, it seldom is. Most of us are perceptive enough to realize that “something isn’t right” when we begin to slide into The Zone, and we take corrective action. If we are informed, we’ve anticipated the heat and have prepared for its effects. As is true with so many of these types of problems, an ounce of prevention is worth a pound of cure. Let’s consider how to avoid heat exhaustion:

Take plenty of fluids on your trip. Water is cheap and works very well. Electrolyte solutions such as Gator Ade contain sodium, potassium, chloride, and other minerals that are lost in sweat.  Electrolyte solutions are also absorbed from your stomach and small intestine more quickly that water. Soft drinks work to some extent, they provide sugar and electrolytes. Beer (and mixed drinks) will get you into trouble as we have shown; don’t use alcoholic beverages for fluid replacement! If you’re drinking beer and you’re in a hot situation, alternate beer with water or an electrolyte solution.

Keep the air moving! If the wind stops blowing and it gets really hot, crank up the boat and move. Grab a cup and pour a little water on your back or head, and do it frequently. If you feel like you are slipping away, get in the water, and stay there until you feel better. Get out of the sun. I have watched people we are fishing with go from “normal” to confused and irritable in a matter of a few minutes. When I recognize this, and it can be subtle, I stop the boat and get them in the water. Occasionally, people in the early phases of heat exhaustion will get a little belligerent. Say whatever it takes to calm them down, but get them in the water. I have on a few occasions pointed to a “pretend” fish in the water and literally pushed or dragged a crewman into the water. Let me tell you, they are furious at first, and then they become aware that they “weren’t quite right” and will become cooperative. I tell Bunny that if I walk around the cockpit in a circle three times without doing anything meaningful on a hot day she is to stop the boat and dump a bucket of water on my head; it’s happened twice in the last few years. The scary thing is that you don’t realize it is happening.

Watch your crew. Kids, elderly, and debilitated people are much more vulnerable to heat. Take care of them before they get into trouble. If a crewman passes out and you can’t rouse them, if they develop difficulty breathing, if they get confused to the point where they can’t make sense,  realize that this is a medical emergency. Cool them off now and plan to get them emergency treatment.

Maximize your vacation fun and minimize trouble. Anticipate the heat and the sun, keep everyone in your party cool and healthy, treat heat exhaustion early! Hydrate with water and electrolyte solutions, save the heavy partying for nighttime at the Tipsy Seagull.