Several years ago, in his early stages of training for the New York Marathon, my father decided to run the “Steeple Chase” with his brother. This event, unique to Lincoln Massachusetts, is a 6.7-mile endeavor through Lincoln’s conservation lands from one church steeple to another. The night before, my parents attended a party where my father consumed 2-3 standard alcoholic beverages. Despite warm temperatures the next day, he felt well, and had a strong start to the race. He pushed himself to kept pace with several of Lincoln’s elite runners and left my uncle behind. At mile 5.5, my uncle found my father running erratically adjacent to the trail, before collapsing. Shortly after, a paramedic was on the scene checking my father’s vital signs. When he pricked my father’s finger to check for hypoglycemia, my father responded with a punch. Fortunately, the paramedic was not injured and once additional first-responders arrived, they restrained my father and brought him to the emergency room. There, his temperature was 107o F. He was treated with intravenous fluids and an ice bath for severe heat stroke. Eventually, his delirium resolved and he found himself in a hospital bed. He made a full recovery and ran his best marathon in New York City the following year.
There were several factors at play that led to the events that day and the answers can be found in lessons learned in Exercise Physiology. To develop heat stroke, my father’s normal thermoregulation must have been impaired. One of the most important forms of cooling during exercise is sweating, and since sweating can be limited by dehydration, I suspect that my father was dehydrated. One hormone secreted by the pituitary gland is antidiuretic hormone (ADH). This helps to increase individuals’ reabsorption of water in the kidneys, which ultimately saves water for other bodily functions such as sweating. Alcohol inhibits ADH release and leads to water loss. The half-life of ADH is short, so once ADH is no longer present, the kidneys cannot conserve water and repeated trips to the bathroom are required. This phenomenon has been described as “breaking the seal.”
Another factor that may have contributed to the heat stroke was my fathers’ determination to beat his brother and keep up with the elite runners. This effort impaired his judgment and he was not able to gage his own symptoms.
In summary, the alcohol consumed the night before and my father’s competitive nature, led to water loss from the kidneys so that he was dehydrated before he began the race. This caused his thermoregulation to fail. Ultimately, he overheated and suffered from heat stroke. This entire endeavor could have been prevented if he did not drink alcohol the night before. It also helps to explain why alcohol should be avoided by athletes.
Epstein, Murray. Alcohol’s impact on kidney function. Alcohol Health and Research World. 1997. https://pubs.niaaa.nih.gov/publications/arh21-1/84.pdf accessed January 26, 2017
Hoenig, Stephen. Personal Communication. 25 Jan. 2017
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