DEAR DR. DONOHUE: This will be my first year as an assistant football coach at the high-school level. The head coach has given me the task of preparing for heat-related injuries. It stays hot here way into October. I’d appreciate any tips you can give me. — G.O.
ANSWER: The best prevention for heat injuries is calling off practice on hot, humid days. What exactly is a hot, humid day? If your school has a wet-bulb globe thermometer, on days when it registers 82 or higher, either call off practice or limit the work done. This reading incorporates heat and humidity.
It takes two weeks for the body to acclimatize to heat. In the first few days, drills should not be demanding. Once acclimatized, the body sweats earlier and the sodium content of sweat lessens. Encourage players to stay hydrated. They should drink 16 to 20 ounces of water or a sports drink two hours before and again half an hour before practice. Players should continue to drink 8 ounces every 20 minutes. Sports drinks provide sodium.
Heat cramps are the first sign of trouble. Muscles of the arms, legs or abdomen cramp. Cramping players should be taken out of practice, sit in a cool, shaded place and drink sodium-containing fluids. Heat fainting is a more serious sign of heat trouble. Such a player should be taken to an air-conditioned room, hydrated and carefully watched. This player ought not to practice the following day.
Heat exhaustion is the next and is a quite serious sign of heat injury. The player sweats heavily, might be nauseated, breathes rapidly and has a fast pulse and low blood pressure. He’s apt to be confused. The player is dehydrated and sodium-depleted. He must be quickly taken to an air-conditioned room, have his clothes removed and his legs elevated. Cold fluids containing sodium are essential. If he’s not responding to this treatment shortly, he ought to be taken to a hospital emergency department.
Heatstroke is the most serious heat injury. All the signs mentioned above are present, but the skin can be dry. The player is groggy or unresponsive. He needs to be taken to an emergency room by ambulance. Clothes are removed. During transport, ice-water-soaked towels are placed under his arms, in his groin and around his neck. Immersion in an ice-water bath will be accomplished at the hospital.
DEAR DR. DONOHUE: What can you tell me about hypothyroidism? Does taking iodine help? I hear that taking thyroid hormone is a lifetime commitment. — C.N.
ANSWER: Hypothyroidism is a thyroid gland that’s putting out way too little thyroid hormone. All body processes slow. People become weak and are exhausted. They’re cold when others are pleasantly warm. They gain weight without overeating. Their skin dries. The face becomes puffy. The heart beats slowly.
Worldwide, iodine deficiency is the main cause of a sluggish thyroid gland. It is not in North America. Here, the main cause is an attack on the gland by the immune system.
The appropriate treatment is supplying the hormone in pill form. It usually is a lifelong treatment, but it’s not an onerous one. It’s taking only one pill a day.