By Dr. Terence Chu, a pediatrician at the Children’s Hospital of Orange County, now Rady Children’s Health
Contributing Columnist
Shortly before my son went to college, he attended an all-day basketball camp.
Things got heated.
After playing hoops all day in a humid, sweat-soaked gymnasium, his calves throbbed with pain and the color of his urine was brown.
He ended up being fine.
But he probably had early signs of rhabdomyolysis, a potentially serious condition where damaged skeletal muscle breaks down, releasing harmful substances into the bloodstream that can lead to kidney damage and other complications.
Intense physical activity, especially in heat, can lead to issues beyond dehydration. This is something to keep in mind, especially during these sizzling summer days. Staying properly hydrated is critical for staying safe and healthy in the heat.
Don’t play catch-up
Parents need to be proactive in making sure their kids are drinking even when they’re not thirsty.
When you drink after you’re thirsty, you’re playing catch-up.
Kids, teenagers and adults should be drinking before, during and after a sporting event or activity. Kids should have free access to water as much as possible and take frequent breaks. Although it depends on the heat and humidity, you should drink at least every 20 minutes.
Plain water is fine for an hour of activity. Anything longer, I recommend a sugar electrolyte solution like Pedialyte or Gatorade.
The goal is to keep the urine clear or the color of light lemonade; if the color is darker, that means you’re not hydrated enough.
Serious stuff
Heat illness is among the top four causes of death in high school athletes.
Mild dehydration is subtle, but once you are moderately dehydrated, it’s more obvious. Your urine is darker (more concentrated), and you will feel fatigued and lethargic if you remain in this stage.
Heat exhaustion occurs when the body cannot cool itself effectively. Your affected child may have a temperature between 100.4 and 104 degrees. In addition to feeling fatigued, they might experience mild confusion, headache, dizziness, chills and nausea. They might be lightheaded (due to low blood pressure), but they will still be lucid.
If your child is experiencing heat exhaustion, get them to drink cold water, get them undressed as much as possible, and put ice around their neck, armpits and groin area. Get them in a shady or air-conditioned area if you can. Putting water on them and fanning them will also help cool them down.
Heat stroke is present when a person’s core temperature exceeds 104 degrees and there is an alteration in mental status. It is a medical emergency that requires IV fluids and monitoring. Signs of heat stroke include confusion, a lack of sweating, skin that is hot and dry to the touch, a rapid pulse and rapid breathing. A person with heat stroke is at risk for a seizure, unconsciousness and death.
Drink up
Again, drink before you’re thirsty when working out or playing sports. It’s a simple concept, but one that, if ignored, could lead to an emergency.
Also, be aware when you go to a hot climate that you’re not used to. Acclimate to the environment gradually to improve exercise capacity in the heat.
If you are trying a new activity or if you’re not in the best shape, remember that a lack of conditioning increases the risk of dehydration and heat exhaustion – or worse.
Dr. Terence Chu is a pediatrician at the Children’s Hospital of Orange County, now Rady Children’s Health, who has worked at Southern Orange County Pediatric Associates for nearly 25 years, practicing in south Orange County and now mostly in Irvine.
