Hurricane Irma sidelined student athletes from game play and practice. But some school teams are about to re-start practice about a week after the storm passed through South Florida. Like with any break from regular activity, muscles, tendons and bodily systems may be jeopardized if return-to-play is not handled cautiously.

This health concern prompted the Florida High School Athletic Association to issue a warning to school athletic directors and sport coaches.

“Due to recent events and school closures because of Hurricane Irma, fall sport coaches and school administrator should be aware their players may have become deconditioned and de-acclimated during this time,” said the bulletin issued today. “Some athletes may have had (or still have) inappropriate nutrition during this challenging time. Therefore, in preparation for the next game and/or practices, it is recommended that modifications be made in order to safely return athletes back during our continued warm weather.”

The modifications suggested include shorter practices with less equipment and frequent hydration breaks. In addition, the warning urged athletic directors and coaches to closely monitor student athletes during practices “for any signs of fatigue, dehydration or heat illness.”

Dehydration Among Top Reasons for Post-Hurricane Emergencies

Student athletes aren’t the only ones who need to be careful during the days after a major storm. In addition to cuts and lacerations from clearing debris, a surge of people who are dehydrated are being treated at emergency departments. And with outdoor readings at about 90 degrees, combined with high humidity, the temperature feels more like 100-plus degrees outside. Conditions are ripe for a high number of heat-related illnesses to continue.

“Many people get caught up in the aftermath of hurricane clean up and are not used to the type of strenuous activity required, putting them at risk of dehydration and heat stroke,” said Gabriel Solti-Grasz, M.D., an internal medicine physician with  Baptist Health Primary Care.

Widespread power outages mean no air conditioning, and that’s another factor that can lead to heat-related illnesses.

Signs and Symptoms of Dehydration

South Floridians need to be aware of the area’s heat index, dangerous temperatures and related illnesses, such as dehydration, heat exhaustion and heat stroke. Here are some key signs to keep in mind:

• Thirst– As soon as you feel thirsty, know that dehydration is underway.
• Reduced urination – If you don’t have to urinate while in the heat, you need to drink more fluids.
• Headache – Once your head starts to hurt, you’re likely entering the next phase of heat-related illness – heat exhaustion.

With any of these signs, or a general sense of not feeling well while in the heat or during exertion, Dr. Solti-Grasz advises to seek relief by going into an air-conditioned or shaded environment to cool the body down. He also recommends drinking water or a sports drink slowly to replenish lost fluids, while preventing nausea or vomiting.

Heat Exhaustion

Heat exhaustion, Dr. Solti-Grasz says, is the middle category of heat-related illness and can quickly turn into heat stroke, if not treated.

Symptoms of Heat Exhaustion

• Headache– As a heat-related illness progresses, a headache may become more severe.
• Dizziness or lightheadedness – Shakiness and a feeling of instability or weakness often accompanies heat exhaustion.
• Nausea or vomiting – The body prepares for systemic shut down by purging contents in the stomach, including liquids, which can lead to a faster deterioration of health through further dehydration.
• Reduced urination – As your body tries to regulate your temperature, it begins to shut down organs, like your kidneys. This can lead to acute kidney injury, Dr. Solti-Grasz warns.
• Fainting – This is the body’s way of taking over to protect vital organs against loss of fluids.

With symptoms of heat exhaustion, Dr. Solti-Grasz advises seeking medical attention right away, including calling 911, so fluids can be given through an IV as soon as possible. He does not recommend drinking liquids at this stage, as fluids may enter the lungs through the trachea, or airway.

Heat Stroke

As heat illness progresses, heat stroke can occur. With heat stroke, Dr. Solti-Grasz says, the body tries to lower its internal temperature by systematically shutting down organs to protect the heart and brain.

Signs of Heat Stroke

• Low blood pressure– The body limits blood flow from extremities and redirects it to vital organs.
• Perspiration stops – When you stop sweating, your body has begun to shut down certain systems and functions to preserve life.
• Cold or clammy skin – As blood is redirected to vital organs, the skin becomes cooler.
• Shock – All of the above symptoms, Dr. Solti-Grasz says, signal shock, a life-threatening condition that occurs when the body enters survival mode.

“Heat stroke is a grave condition,” he said. “Often people use this term interchangeably with heat exhaustion, but heat stroke can be fatal, so it’s important to focus on preventing dehydration first to avoid the progression to heat stroke.”  

How to Stay Hydrated

Dr. Solti-Grasz says preventing dehydration is key to warding off heat-related illness.

“People often don’t drink water or liquids until they begin to feel thirsty,” he said. “But thirst is an indication that the process of dehydration has begun.”

Dr. Solti-Grasz recommends drinking water before going out in the heat and continuing to drink water regularly for the duration of time spent outside. If working or exercising in the heat, he recommends drinking a sports drink with electrolytes to replenish nutrients, such as salt and potassium. These, he says, are lost quickly during exertion in high temperatures or high humidity. Electrolytes help your body function properly, including regulating heart rate and maintaining a healthy body temperature.

He also points out that dehydration, and the subsequent progression to heat stroke, can occur when it’s not necessarily hot, if you’re not replenishing fluids regularly.

“When you start to feel symptoms, it’s too late for prevention, you must switch to replenishment and recovery,” he said.

How Much Water Do You Need?

Most healthy people can stay properly hydrated simply by following their thirst levels. But how much water to drink each day varies according a person’s weight, overall health and whether they spend a lot of time outdoors in a warm climate. Of course, working extensively outdoors, prolonged physical activity or exercising to stay healthy and maintain a proper weight requires additional fluid intake to prevent dehydration.

Natalie Castro, chief wellness dietitian for Corporate Wellness at Baptist Health South Florida, advises people to keep stock of water intake by monitoring changes in the number of times they have to go to the bathroom, and even the color of their urine, if necessary.

“If it’s (the urine) a pale yellow, that indicates a good hydration level,” she says. “If it has a very dark color, then that indicates dehydration.”

Despite conventional beliefs, there is no hard rule for most people to drink eight glasses of water a day, but the most important factor for those who are overweight or have other health issues is to diminish the amount of sugary drinks, sodas or alcohol consumed in favor of water.

And when it comes to the “8 by 8” rule (drinking eight glasses of water over an eight-hour day), Ms. Castro says you can use it as a goal to help you adopt healthier nutritional habits.

“How much do you need? It can be a little less than eight cups a day, or a little more,” she says. “But you should be listening to your body to determine how much water you should be having or how thirsty you are.”