Maine news, sports, weather from Portland Press Herald / Maine Sunday Telegram, Portland, Maine

July 29, 2012

Surviving the race

Real-life lessons and research guide treatment of overheated runners at the Beach to Beacon and Boston Marathon.

By Glenn Jordan gjordan@mainetoday.com
Staff Writer

After 14 years of volunteering in the medical tent at TD Bank Beach to Beacon 10K Road Race, Mylan Cohen figured a visit to this year's Boston Marathon was in order.

It was more than half a century after his grandfather was the official physician for the Boston Marathon, and Cohen -- a cardiologist from Cape Elizabeth -- planned to go to Boston to observe. Instead, the marathon's medical director put Cohen to work as head of the heat deck, an add-on to the main medical tent.

And he was plenty busy when scores of runners suffered from heat exhaustion on that unseasonable, scorching day this April. Because of what Cohen and his colleagues had learned in the Beach to Beacon tent about the importance of ice-bath immersion and rectal thermometers, lives were saved.

"Oh, without a doubt," said Chris Troyanos, the medical coordinator at both Boston (run on Patriots Day in April) and Beach to Beacon (run the first weekend in August), who is also director of sports medicine at Laselle College in Newton, Mass. The Boston Marathon "is not traditionally a hot-weather race, so we're not as experienced (with heat) as the medical team at the Beach to Beacon race."

Cohen, who moved into his Cape Elizabeth home on the very day of the inaugural Beach to Beacon in 1998, will be at his 15th race on Saturday and any runner who hits the roads should know that the medical staff is prepared for emergency situations.

RUNNERS GET OVERHEATED

Runners can collapse for a variety of reasons. It might be cardiac arrest. It could be heatstroke. At longer races, drinking too much water -- resulting in low sodium levels in the blood -- can lead to problems.

Two runners have died at the Boston Marathon, one in 1996 from a cardiac event and another in 2002 from hyponatremia, or low blood sodium.

The Beach to Beacon has never had a casualty -- and chances of a fatal event are significantly diminished with a 6.2-mile race compared to the 26.2-mile marathon distance -- but the medical volunteers regularly deal with overheated runners. One even became combative enough to throw a punch at a caregiver while in an ambulance.

"That's just the effect of heat on the brain," said Dr. Michael Baumann, chief of emergency medicine at Maine Medical Center and medical director, along with Cohen, at Beach to Beacon. "Some of the people are 107 (degrees). When the brain gets that hot, they are not really that aware and they're quite agitated."

The brain isn't the only vulnerable organ. The liver and kidneys are also stressed by heat. Troyanos said he's heard of athletes who weren't cooled quickly enough "who are still on dialysis and will be for the rest of their lives."

One of the leading experts on the topic of exercise-related heat stroke is Dr. Douglas Casa, chief operating officer of the Korey Stringer Institute at the University of Connecticut. Stringer, you may remember, is the professional football player who died of heatstroke 11 years ago during the Minnesota Vikings' preseason training camp.

The institute that bears his name is dedicated to research, education and advocacy about the prevention of sudden death in sports, with a particular emphasis on exertional heatstroke.

"The key to heatstroke is getting their temperature under 104 as fast as humanly possible," Casa said by phone from Storrs, Conn. "If you can do that within 30 minutes of collapse -- and we've tracked over 2,000 cases of heatstroke in the military and in athletics in a variety of scenarios and venues -- we found it has been 100-percent survivable and with no long-term complications."

(Continued on page 2)

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