flushing as symptom of heat stroke?

[frostfire]

I was rucking yesterday (70% humidity, 85degrees, sunny, flat terrain, sandy gravel track, 45lbs backpack, no LBE, steel-toe leather boots, jeans). After the first mile or two, I felt my face flushing like when you're smitten and blushed or when you o....you know. I did four miles total but the symptoms repeated a few more times near the end. I don't think I pushed myself too hard as I tried to ensure I was at a sustainable* pace for 12 miles.

Are these flushings the same symptoms as flushed skin in heat exhaustion/stroke?
(I assumed it was not because immediately afterwards and after a few sips of water, I could still skate 3 miles around the park, which after rucking it felt like flying)

*note:
I was trying to do what TR advised on attaining a 13min pace without running. The first mile, I walked, trying to do long strides and the arm swings. It was 14:48. Dissappointing. I ran (shuffle) the second mile and it was 13:08. I do realize that although I've shuffle-run the entire four miles before (don't laugh, indoor track, A/C) in 54min, running the entire 12 miles is not advisable. The last two miles, I both walked and shuffle-ran. 4 miles, 58:18, no rest/stop, which was bad. I also noticed that the shuffle-run took a tolll on the shoe sole. The heels're chipped pretty bad and I don't think it would have lasted with 12 miles.

[wook]

The below is not intended to replace your primary physician's evaluation for your concerns and is only an opinion. You should consult a medical professional for any medical concerns.

Heat stress is a continuum with heat cramps being on one side and heat stroke on the other. Heat stroke is the most severe form of heat injury with alteration in mentation being a key feature of this ailment. It is unlikely that the flushing you were experiencing is secondary to Heat stroke.

The flushing you're describing can be attributed to several different factors, but the most likely are either a physiologic compensatory response to heat, or early heat exhaustion. While doing this type of physical activity it is very important to stay hydrated.

The Wet Globe Temperature Index has been used to identify hydration requirements for individuals participating in activities in warm environments. A description of this Index can be found at Wet Globe Index (http://www.vetsofsafety.org/Articles/IH%20for%20the%20CSP%206%20WBGT%20Heat%20Stress%20 Index.pdf) .

Below are some descriptors for the Wet Globe Temperature Index....

Heat Category 1 78-81.9° Fahrenheit
Drink at least ½ quart of water per hour
Continuous activity allowed

Heat Category 2 82-84.9 ° Fahrenheit
Drink at least ½ quart of water per hour
40 minutes of work/20 minutes of rest (civilian)
50 minutes of work/10 minutes of rest (military)

Heat Category 3 85-87.9 ° Fahrenheit
Drink at least 1 quart of water per hour
30 minutes of work/30 minutes of rest (civilian)
45 minutes of work/15 minutes of rest (military)

Heat Category 4 88-89.9 ° Fahrenheit
Drink at 1.5 quarts of water per hour
20 minutes of work/40 minutes of rest (civilian)
30 minutes of work/30 minutes of rest (military)

Heat Category 5 >90 ° Fahrenheit
Drinnk more than 2 quarts of water per hour
10 minutes of work/50 minutes of rest (civilian)
20 minutes of work/40 minutes of rest (military)

Wearing body armor or MOPP gear raises all heat conditions to Category 5

When deploying, always assume 4 gallons water/per person/per day (for logistics purposes).



Wook

[The Reaper]

Are you taking any vitamins or supplements?

TR

[frostfire]

Heat stress is a continuum with heat cramps being on one side and heat stroke on the other. Heat stroke is the most severe form of heat injury with alteration in mentation being a key feature of this ailment. It is unlikely that the flushing you were experiencing is secondary to Heat stroke.

The flushing you're describing can be attributed to several different factors, but the most likely are either a physiologic compensatory response to heat, or early heat exhaustion. While doing this type of physical activity it is very important to stay hydrated.

The Wet Globe Temperature Index has been used to identify hydration requirements for individuals participating in activities in warm environments. A description of this Index can be found at Wet Globe Index (http://www.vetsofsafety.org/Articles/IH%20for%20the%20CSP%206%20WBGT%20Heat%20Stress%20 Index.pdf) .

Below are some descriptors for the Wet Globe Temperature Index....

Heat Category 1 78-81.9° Fahrenheit
Drink at least ½ quart of water per hour
Continuous activity allowed

Heat Category 2 82-84.9 ° Fahrenheit
Drink at least ½ quart of water per hour
40 minutes of work/20 minutes of rest (civilian)
50 minutes of work/10 minutes of rest (military)

Heat Category 3 85-87.9 ° Fahrenheit
Drink at least 1 quart of water per hour
30 minutes of work/30 minutes of rest (civilian)
45 minutes of work/15 minutes of rest (military)

Heat Category 4 88-89.9 ° Fahrenheit
Drink at 1.5 quarts of water per hour
20 minutes of work/40 minutes of rest (civilian)
30 minutes of work/30 minutes of rest (military)

Heat Category 5 >90 ° Fahrenheit
Drinnk more than 2 quarts of water per hour
10 minutes of work/50 minutes of rest (civilian)
20 minutes of work/40 minutes of rest (military)

Wearing body armor or MOPP gear raises all heat conditions to Category 5

When deploying, always assume 4 gallons water/per person/per day (for logistics purposes).

Wook

Thank you for the info, wook. Now I remembered going through that chart while preparing presentation on dehydration for the JROTC. I really don't think high intensity exercise regiment or rucking can follow the 30 minutes of work/30 minutes of rest (civilian) or 45 minutes of work/15 minutes of rest (military)
guidelines. Nevertheless, I'll pay more attention to hydration next time.

Forgot to include that I only slept 3-4 hours before the exercise, but that should not be closely related to the symptoms. I also already did heat acclimatization by running few times around the same gravel/sand track and calisthenics over several weeks.


Are you taking any vitamins or supplements?

TR

Reaper Sir,

yes I am.

Why I was not considering their effects before I don't know. I take glucosamine-chondroitin complex and the generic version of Centrum complete multivitamin every night. More than 15 hours should have past between taking the vitamins and the rucking.

I also drink what I consider low dose of protein supplement. I'd mix 6-7 raw eggs, low-fat ice cream, ice chips, and 70g protein powder to be consumed over 3 days. Yes, the powder does contain creatine. Perhaps even low quantity is still counterindicative.

I'll cease taking the protein powder, and give it a go again. Next time, I'll drink sips of water or gatorade intermittenly during rucking as opposed to afterwards

[Red Flag 1]

Was anyone with you to perhaps "take a look" at you? Were you "beet red"?

Were you sweating?

Did you have access to fluids? Did you hydrate during your ruck?

Were you rucking in direct sunlight?

As an RN, what have you found in your own research into this?

I guess the short answer to your question is yes.

RF 1

posted during your reply @ 1417

[frostfire]

Was anyone with you to perhaps "take a look" at you? Were you "beet red"?
Were you sweating?
Did you have access to fluids? Did you hydrate during your ruck?
Were you rucking in direct sunlight?
As an RN, what have you found in your own research into this?
I guess the short answer to your questiion is yes.
RF 1
posted during your reply @ 1417
Red Flag 1,

No, I was by myself. I did not even think of asking people "how do I look" :D

I was sweating profusely, at first. My mouth was not dry though. Vision was also still clear. Not dizzy or nauseous. Tired, yes.

Yes, there's a water fountain by the track. No, I did not hydrate during ruck

Yes, it was sunny

I found how to examine flushed skin in people on the heat-related illness continuum. I did not find how the person should feel the flushing, though.

Thank you for the questions/checklists!

Anyway, did another go today. 78°F, 64%, cloudy, BDU, 45lbs + water, no protein shakes, only breakfast of chocolate cake and lunch of ramen and boiled chicken breast, maxed out PU and SU before going. I did have a water mixed with juice in the backpack....but stupid as stupid does and I could not access it while rucking and since I did not want to waste time, I did not drink the entire time. No flushing symptoms this time, only several adrenaline rush as I was using audio "drugs" ie. Rammstein, Hans Zimmer, and Two Steps from Hell. Yes, they won't be available during the actual test unless I can sing 'em in my head or something.

57:12, 4 miles. Long stride and trot every 200 yards or so. I still felt great so I kept going, and hauled ass for the last 100 yards. 84:57, 6 miles. Still good to go and only minor hot spot on one left toe. No other pain, fatigue, nothing. 1 mile from the car to the gravel track. At this point 14:19 is my sustainable pace. Still got a lot of work to do.