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Staying Healthy on the Road Medical info, e.g. malaria, vaccinations, travel medical tips, medical insurance, where to find a doctor.
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It's going to be a long 300km...
Bolivian Amazon



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  #31  
Old 11 Aug 2013
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with 23 years in the Army medical services, heatstroke, heat exhaustion and dehydration are things I know a bit about and have seen many many times. I have worked in temperatures upto 65degrees for short periods and 45 degrees for sustained periods.

I have seen a soldier collapse from dehydration and heat exhaustion in the snow. He was wearing too much clothing whilst undertaking strenuous activity and wasn't drinking enough because of the cold - he didn't feel thirsty.

You can become dangerously overheated in a lot less than 40 minutes.

Drink little and often. small sips regularly. You should not feel thirsty. If you do you are already dangerously overheated and will struggle to make up the deficit. You are drinking to stay alive, not because you are thirsty.

be careful how you cool down. wet rags on areas where the areties come close to the surface help. namely in the groins, around the neck and under the armpits. Also wet the head. DO NOT throw cold water over some one or soak their clothes with water. You will cause the skin to chill, this causes the peripheral circulation to shut down and the body core to super heat.

Paracetamol and ibuprofen can help the body reduce it's temperatures.

If someone collapses from heat exhaustion/heat stroke they must seek medical advice. they will need blood tests to monitor their vital organ functions. The test should be repeated after 3-4 days. Death is from multiple organ failure. This can have a delayed onset after the person appears to have recovered.

damage to your pituitary gland means if you have had heat strok once you are more likely to have it again.

watch your pee!! The old adage was pee clear twice a day. However, early on in Iraq the army ran into problems with guys knackering their renal(kidney) function trying to achieve this. You will not pee clear in hot conditions. You should aim to pee straw coloured AT LEAST twice a day, preferably more.

If you have diarrhoea and vomiting for other reasons (i.e. food poisoning) seek cool conditions and do not exert yourself, you are at significantly higher risk as you are already dehydrated. even if you are vomiting, continue to take small sips of water. some will be absorbed even if you vom it back up.

watch each other, and monitor each others water intake and toileting habits! If you think someone hasn't had a pee today, ask them!

we had bottled water with electrolytes added, diorolyte is ok, but tastes horrible I think. Energy drinks are pretty much as good, but of course more bulky to carry than a few sachets of Dioroylite added to water bought as you go.

Don't drink caffeine containing drinks or alcohol. They will dehydrate you more. Also, because they increase urine output, they give a false idea as to your true state of hydration. They make you pee clearer than you would otherwise because of the additional diuresis so you may think you are ok when you aren't.

Working hard in those conditions could easily require a water intake of 10 litres a day, maybe more. It sounds like these guys weren't carrying enough with them.

Sorry, long post, but hopefully useful
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  #32  
Old 11 Aug 2013
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Extremely useful, rest assured.

Thanks a lot for taking the time to write such a detailed post. I'm sure we all learnt something we didn't know about this crucial issue. Really appreciated.

Esteban
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  #33  
Old 12 Aug 2013
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Thanks Moggy good stuff
only part I didn't understand or would disagree on would be
Quote:
be careful how you cool down. wet rags on areas where the arteries come close to the surface help. namely in the groins, around the neck and under the armpits. Also wet the head. DO NOT throw cold water over some one or soak their clothes with water. You will cause the skin to chill, this causes the peripheral circulation to shut down and the body core to super heat.
What I heard is that ice water or water below 15 degrees shouldn't be used as it can impede peripheral blood circulation. 15-18 is optimal, the more the better.

Not being a biker I am less exposed in my 4x4 (but no AC or fridge).
Being in Algeria and Mali in May was a new experience to me.
I've spent years in the tropics but here we had 40-50 daytime and not below 28 at night. There was no respite, and limited water supply.
When your drinking water is too warm to drink and the nearest shower is days away it gets interesting.
Usually I get by just with soaking my beret - helps a lot!
Now I had to soak my shirt too and let it evaporate. Thankfully it was windy every day.
Strangely, I felt really great all the time.
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  #34  
Old 13 Aug 2013
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Quote:
Originally Posted by priffe View Post
Usually I get by just with soaking my beret - helps a lot!
Now I had to soak my shirt too and let it evaporate. Thankfully it was windy every day.
Strangely, I felt really great all the time.
Definitely!
When travelling in veeery hot weather by car with no AC, my wife and I carry our "sissy summer kit": we spray water all over us and move our Spanish "abanico". It cools you down inmediately, feeling great relief from the heat. In our experience, it works much better if all items are pink...



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  #35  
Old 14 Aug 2013
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Quote:
Originally Posted by priffe View Post
Thanks Moggy good stuff
only part I didn't understand or would disagree on would be

What I heard is that ice water or water below 15 degrees shouldn't be used as it can impede peripheral blood circulation. 15-18 is optimal, the more the better.

Not being a biker I am less exposed in my 4x4 (but no AC or fridge).
Being in Algeria and Mali in May was a new experience to me.
I've spent years in the tropics but here we had 40-50 daytime and not below 28 at night. There was no respite, and limited water supply.
When your drinking water is too warm to drink and the nearest shower is days away it gets interesting.
Usually I get by just with soaking my beret - helps a lot!
Now I had to soak my shirt too and let it evaporate. Thankfully it was windy every day.
Strangely, I felt really great all the time.
I would advise against soaking with water at all. More than once I've seen soldiers who have been soaked in water from peoples water bottles, so reasonably warm. On one occasion he went unconscious and started to fit (end of career by the way), almost certainly as a result. On all occasions the soldiers concerned were more poorly than they probably would have otherwise been (compared to others at similar times on the same exercise and in similar weather conditions)

We used to be issued sweat rags. It's a lightweight fabric square, basically a large hanky, that you wrap loosely round your neck and keep wet. Also stops your collar rubbing
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  #36  
Old 24 Nov 2015
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Recurring news item

Quote:
Originally Posted by Walkabout View Post
Bump.

Because:-
1. It's that time of year, again (comes around every year, strangely).

2. Some folks never learn, so reminders are valuable. Others never knew.

3. It is pretty hot across most of Europe, not even considering other bits of the northern hemisphere - it's your turn next, in the south, by the way.

4. The news in the UK has this subject as a topic at present.



This thread should be a sticky???? (maybe in the health/safety on the road forum).
Still not a sticky.

Since this thread was started there has been a case of hyperthermia that occured during the making of a documentary TV programme (for the Brits, channel 4's "Walking the Nile").
The events leading up to the event, including the final hours of the life of the deceased, were broadcast as part of the first of the four episodes.

The Adventure Blog: Journalist Dies While Walking The Nile With Levison Wood

As an aside, after the broadcast an amount of shock and horror was expressed from some quarters at being exposed to death on documentary TV, rather than via the more usual, everyday, news outlets.
But, perhaps some people, even just one or two, learnt a thing or two from that extra publicity?
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  #37  
Old 25 Nov 2015
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Quote:
Originally Posted by moggy 1968 View Post
I would advise against soaking with water at all.
I should perhaps add that soaking will only work well if there is a wind, as when you are in/on a moving vehicle.
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  #38  
Old 26 Nov 2015
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Water On Raghead

I used to do a fair bit of weekend walking in the Omani Jebels.Even in the winter temps could be over 36Deg and usually 28-32Deg. Used to start at 5-6am and finish by 10-11am when it was to hot to safely do more.I always wore an arab Shamag(raghead) around my head and found that when I started to get really hot a good dousing with water on the head to keep the 'rag' wet really helped. I also always carried an electrolyte drink as well as water.

Once or twice I overdid the exertion and was very debilitated - not recommended!

Recommend the raghead for outdoor use in these kinds of places. People may think you look like a poser but - do they really know?
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  #39  
Old 26 Nov 2015
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Originally Posted by tony johnston View Post
I used to do a fair bit of weekend walking in the Omani Jebels.Even in the winter temps could be over 36Deg and usually 28-32Deg. Used to start at 5-6am and finish by 10-11am when it was to hot to safely do more.I always wore an arab Shamag(raghead) around my head and found that when I started to get really hot a good dousing with water on the head to keep the 'rag' wet really helped. I also always carried an electrolyte drink as well as water.

Once or twice I overdid the exertion and was very debilitated - not recommended!
Coincidentally, I intended to mention the ubiquitous shemag in this other thread, and then forgot to do so in my general enthusiasm for silk scarves.
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  #40  
Old 6 Oct 2017
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Quote:
Originally Posted by Chris Scott View Post

• the less expensive 'preventative' tablets like High5 Zero or Nuun tablets, or 'isotonic' tubs of powder like Gatorade sold for sports activities. Tabs about 60p/litre.
Thank you for the recommendation. Was in the desert last month near Mhamid, and boy was it hot. I managed to get tubes of them for £2.50 each from wiggle. Bargain. However, I put them in the bike luggage and they turned to powder, the ones stored in my rucksak didn't! Cautionary words, although I could still use the powder, what was left of the tablets didn't want to come out. They did when I smashed them with a tyre lever. :-)
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  #41  
Old 6 Oct 2017
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Have had the same prob but powder is powder - easier to snort ;-)
Got 3 tubes to last me this week: warm and getting warmer.
Don't normally come here this early.
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  #42  
Old 6 Oct 2017
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Just as another anecdote about the heat:
We recently had a blow out on the very hot Tarmac in Sudan, cruising in our 4x4.

Changing the tyre, getting tools out etc probably took ca. 45 minutes, though we weren't clock watching.

We had to get out again after 5 minutes with the spare tyre to replace the valve: too long waiting to get used.

But, that day, our 2nd in Sudan after the cool mountain temperatures of Ethiopia: we each drank 4.5 litres of water and pee'd TWICE... that's ridiculous!!
I wonder if we were already dehydrated leaving Ethiopia and hadn't noticed.

More importantly here probably is that we are in an aircon 4x4 with little physical activity required, except for that midday tyre.

You can think up the sums yourselves for when you're out in the dunes having a (beached) whale of a time....

keep your fluid and mineral levels up!!! It's terrible to read of such incidents of bikers dying so quickly.

Hearts out to the friend and families.
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  #43  
Old 10 Oct 2017
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Quote:
Originally Posted by wickychicky View Post
Just as another anecdote about the heat:
We recently had a blow out on the very hot Tarmac in Sudan, cruising in our 4x4.

Changing the tyre, getting tools out etc probably took ca. 45 minutes, though we weren't clock watching.

We had to get out again after 5 minutes with the spare tyre to replace the valve: too long waiting to get used.

But, that day, our 2nd in Sudan after the cool mountain temperatures of Ethiopia: we each drank 4.5 litres of water and pee'd TWICE... that's ridiculous!!
I wonder if we were already dehydrated leaving Ethiopia and hadn't noticed.

More importantly here probably is that we are in an aircon 4x4 with little physical activity required, except for that midday tyre.

You can think up the sums yourselves for when you're out in the dunes having a (beached) whale of a time....

keep your fluid and mineral levels up!!! It's terrible to read of such incidents of bikers dying so quickly.

Hearts out to the friend and families.
Pretty hot here in Nouackchott too. Got stuck in gridlock traffic after coming into the city yesterday, well above 40C. Had already been on the bike for 4 hours and expecting to park at hotel, in 30 mins and it took 2.5 more hours. Had to get off the bike at one point and lie on kerb in shade to avoid passing out. Locals offered cold water which I poured on my head and body armour, to get back my senses. Was over 30 mins before I could ride again. Makes you realise how dangerous it could be in this heat stuck in the desert.

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  #44  
Old 2 Dec 2017
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Above 40C you won't notice if your sweating or not because it evaporates so quickly.
Piss straw colour twice a day, minimum.
Caffeine drinks such as coffee or cola will make your pee clearer so may give a false impression of how dry you are
Don't wait to drink until your thirsty, by then you are already well into a fluid deficit. Drink regularly, your not drinking because your thirsty, your drinking to stay alive.
These guys didn't dehydrate and get heat stroke in 40 minutes, they were already into the advanced stages when their friend went for help. This will have been developing for sometime.Look for the early signs such as headache, lack of concentration and irritability.
Be aware that if you've had a close call with heatstroke, your still at risk of going into organ failure for several days, so stay somewhere you can get help if you need it.
when your working hard, digging out etc, strip down to loose light clothing, then put your stuff back on when you need it. It's a fag but you need to try and stay cool.
If your getting a bit desperate, piss on a rag and wrap it around your neck and/or pack it in your groin to aid cooling (if you can piss!!)
Don't start on a deficit (because you've been out on the lash the night before for example)
Drink plenty when you can, i.e when your at a water source, so you have a good positive balance on board when you start. Once away from the source, don't drink large volumes at once as you'll just piss it back out again, little and often.


That's my advice off the top of my head born of 23 years as an Army medic, and seeing plenty of full blown heatstrokes
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