It’s been several days since my last post. There is a good reason for that. As my readers know, I am installing a pool in the backyard. It’s almost done, and I decided that this was the best time to install the landscape sprinklers. I rented a gas powered trencher and spent a day pushing that thing around the yard as it dug a few hundred feet of foot-deep trenching.
I thought the trencher would make the job easy, and it didn’t. It made the job easier and faster, but it was still a chore trying to maneuver that thing all over the yard. It was hot, and by hot, I mean 95f with dew points around 70f. That’s a heat index of about 102f. I drank four quart sized bottles of Gatoraid during the six hours I was working. When it was time to return the trencher, my wife came with me and we went to dinner afterwards.
At dinner, I began losing my words. It started when I tried to say “skin in the game” and what came out was entirely different. Then I couldn’t really hold a train of thought long enough to continue our conversation. When we tried to leave, I was walking like I was drunk. My wife drove us home. When I got home, I was feeling confused, my pulse was 125, and temperature was 101.9f. I asked her to take me to the ED.
When we got there, the staff thought the same thing that I did- they put me under the sepsis protocol. Another oddity was that my right ankle was swollen to twice its normal size and extremely painful. My vital signs were odd:
Pulse 120, respirations 28, Oxygen Saturation 98%, BP 145/110, temp 99.8f
They also tested my heart, did a CT scan of my brain, and a bunch of other tests. The results that were abnormal was my D-dimer, which was critically high at 1.02, as well as my creatinine levels and liver enzymes were elevated. It looked like my kidneys and liver were being damaged somehow.
For those who don’t know, d-dimer is a protein that is found in the blood of someone after the breakdown of widespread blood clots. Elevated D-dimer levels suggest increased fibrinolysis, which can be a sign of either clotting or bleeding. Now they got really concerned that I had blood clots, which can cause swelling legs, strokes, heart attacks, and other problems. The decision was made to admit me at that point. I went back to CT for an angio scan.
All of the tests of my heart, brain, and other systems came back normal. That d-dimer still bothered everyone. Finally, the hospitalist came to see me the next morning with what we all agreed was the answer. The combination of fluid loss due to my large amount of sweating, as well as the elevated core temperature from strenuous outdoors work cause a severe case of heat stroke, which activates your body’s clotting mechanisms, causing widespread micro blood clots.
Studies have shown a correlation between elevated D-dimer levels and the severity of heatstroke, as well as with the development of complications like AKI (acute kidney injury). In patients with exertional heatstroke, high D-dimer levels are associated with an increased risk of acute kidney injury. This in turn causes hyperinflammation (hence, the swollen ankle).
The danger here is that I was on the verge of developing disseminated intravascular coagulation (DIC) and multiorgan failure, which would have killed me. I didn’t even feel bad while I was working, and I thought that drinking large amounts of fluids would keep me from being dehydrated. I was wrong. I lost 12 pounds in that six hour period when I was working. When you consider that I drank about 12 pounds of Gatoraid, that means I lost about 12 liters of sweat in those six hours. Sweating out 24 pounds of fluid in an afternoon is potentially deadly. I am fortunate to be alive.
In short, I had an extremely severe case of heat stroke, and it damned near killed me. I wound up being in the hospital for several days. It was stupid of me not to recognize the signs and symptoms, especially as a nurse, a paramedic, and as someone who has lived in the Florida heat nearly his entire life. I was supposed to work today. I called off. I still feel a bit weak and under the weather, and my ankle still hurts.
39 Comments
JimmyPx · May 20, 2025 at 8:56 am
DM, I’m glad you are OK.
It is one of the hardest things in the World for a man to admit that he is too old to do a big job like that and it’s better to hire someone to do it.
My father almost killed himself with heat stroke when he was in his 50s.
Also when in the heat like that, put a packet of the electrolyte mix in the Gatorade, that helps alot.
Billybob · May 20, 2025 at 9:11 am
Wow!
Where does that leave the rest of us that don’t know as much about the body as you?
Glad you are ok, and that help was there when you needed it.
I read the other day about how the formula of Gatorade has changed, is it still a good choice?
Jen · May 20, 2025 at 1:01 pm
Damn I’m glad you’re ok! I had no idea heat stroke could head that direction. Please take care of yourself.
Robert · May 20, 2025 at 10:09 am
I am glad you are back.
Take care of yourself.
Stealth Spaniel · May 20, 2025 at 10:27 am
Might I suggest Liquid IV? Liquid I.V. generally has significantly less sugar than Gatorade. This makes it a better choice for individuals who are diabetic or trying to reduce their sugar intake. It also has a higher electrolyte content with more sodium and potassium. Either way, take care of yourself-especially those kidneys. The problem with Florida is the heat AND HUMIDITY. That drains even more out of you. The pool can wait til it is cooler to dig.
Divemedic · May 20, 2025 at 1:18 pm
It was actually Gatoraid zero. No sugar.
hank · May 20, 2025 at 10:31 am
OUCH! Holy moley! Glad you’re ok. A lesson not only for you, but all who read your account. Thanks for sharing. Here’s to a quick recovery.
Troy Parker · May 21, 2025 at 9:09 pm
Get well brother I’m praying for you love you I’m here for you if you need me
nick flandrey · May 20, 2025 at 10:35 am
Glad you survived it. I had a serious heat injury some years back and it took years to fully recover. You will likely be extra susceptible to heat and heat injury for a couple of years now.
I found a couple of things to be really helpful.
If it’s not too humid, and air flow is available (ie, I’m outside) this cooling vest really works. It’s easily rechargeable by soaking it in water. Doesn’t have to be cold water, although that feels good… https://www.techniche-intl.com/our-technology/evaporative-cooling/
It’s available in a lot of places.
If I’m in an attic, or the humidity is too high, I wear this vest, with active cooling.
https://www.ergodyne.com/chill-its-6260-lightweight-phase-change-cooling-vest-rechargeable-pcm-packs
I keep it in my freezer, ready to go.
It is absolutely worth the money to not die.
Stay frosty.
nick
Cederq · May 20, 2025 at 10:45 am
The old saw, Physician, heal thyself… should be amended, Physician, realize you are an old man. We know better and our ego says, no you don’t, I can work like a rented mule when I was 18. A new word and mantra, pace yourself and slow. Glad the outcome was favorable. What is the prognosis on the liver and kidneys?
Divemedic · May 20, 2025 at 2:29 pm
The liver and kidneys will recover, as will my other blood values. It will likely take a couple of weeks.
Joe Parrette · May 20, 2025 at 10:56 am
Glad you are ok. it is best to leave the gatorade at the store. best to use water with some salt.
Not sure what warm weather is because I am here in southern Maine where we are still in the 40’s with day highs in the 50’s. hopefully i can plant my garden soon.
I lived in NC and would run and mountain bike like a mad man. After that i got a doctor and mentioned what i would do, but had to stop at 105. He did not like that and said temps that high with that much physical activity has killed many people. I was young and in great physical condition. I would not attemp anything like that now. I would do what Jimmy said and hire someone.
Slow Joe Crow · May 20, 2025 at 10:59 am
That sounds scary, glad you emerged OK. The humidity in the Southeast is killer. I remember a bike ride in Virginia where I went through a 3 quart Camebak each way, plus a quart or so at the end of the ride. Here in the high desert we don’t have the humidity but we have lots of heat so we’re careful to stay hydrated and carry extra water
Noway2 · May 20, 2025 at 12:22 pm
I am glad you are OK and got emergency treatment quickly.
I have been told by multiple people that once you suffer from a heat stroke, you become much more susceptible and don’t handle heat as well anymore, so be careful going forward. There is also no shame in hiring jobs out.
Bob · May 20, 2025 at 12:50 pm
Same thing happened to me several years ago. Driving home after work I passed out at a red light. Heatstroke & I drank so much Gatorade that day it poisoned me . That stuff is not good for you. Water is best.
TRX · May 20, 2025 at 1:19 pm
“Heat stroke”, like “kidney stone”, is something that sounds vaguely amusing until you get personal experience with it.
In my case, I woke up on the ground with bugs crawling up my nose after pushing the lawnmower too long in 110F weather.
Took me a while to figure out how I got there, but I don’t think I was as bad off as you were since I recovered in half an hour or so.
Big Country Expat · May 20, 2025 at 1:29 pm
Oh Damn Bro (seems like a echo in here right?) I’m glad they figured it out. Better to be on this side of the dirt than the other. Take it slow and easy man. Get better
Dr. Coyote · May 20, 2025 at 2:33 pm
Glad you’re OK, and everything turned out OK-ish and improving. Here’s to life in Florida!
Irish · May 20, 2025 at 4:03 pm
Glad you’re ok DM and will be on the mend!!
Henry · May 20, 2025 at 4:11 pm
Thank goodness you had the presence of mind to realize it was serious and to have your wife get you to the hospital. Best wishes for a quick recovery and no long term damage.
Ben C · May 20, 2025 at 6:05 pm
Glad you’re alive and hope you keep getting more healthy! Do you know the mechanism behind losing you words? Was that clot & damage related or just the massive stress on the body from all the extra inflammation and dehydration?
Last time I got heat stroke was 20 years ago, and it sucked but I didn’t do as good of a job of it as you did!
Steiner · May 20, 2025 at 7:01 pm
We need all hands and you chose wisely with zero Gatorade.
Unless there is some date that it has to be done go slow and take lots of breaks with water.
My second stroke featured gibberish coming out when I tried to talk and my right arm seized up.
I now talk way too fast and hardly anyone can understand it but I’ll keep on.
It was due to high blood pressure the stroke at Christmas 2024.
Tom762 · May 20, 2025 at 7:07 pm
Gonna say something about Gatorade, it is not longer as good for dehydration as it once MAY have been. Here in SoAZ, lots of high heat experience. 1 bottle,maybe 2. Good old H2O and light but nutritious breakfast and lunch.
The real trick is to stay out of the sun! Early am and late afternoon is best. Hat and long sleeves. And start hydrated, start the night before with water. Honestly, when I drink more than one Gatorade I feel sick. The sugar free stuff seems to be the worst for some reason, but any of it in excess ruins my guts. Salty snacks like nuts or pretzels will recharge your sodium, and a light teaspoon of baking soda in a quart of water will be refreshing and help also.
Very glad you are OK. Heat stroke can be a stone bitch. I have carried ice with me and filled my hat with a handful when working on 110+ degree days. You can also take a handkerchief or bandana and tie ice to your wrists. That really works fast, just a tad cumbersome.
As noted previously, heat stroke will be more likely in the future! Please be careful!
Divemedic · May 20, 2025 at 7:20 pm
It’s a bit different here. When we go to Vegas, staying out of the sun makes even 105f temperatures tolerable. The humidity is what gets you here.
old geezer · May 21, 2025 at 10:34 am
i’m not really sure why this came to mind after reading your story, but it did.
Stay Well
Desiderata
Go placidly amid the noise and the haste, and remember what peace there may be in silence. As far as possible, without surrender, be on good terms with all persons.
Speak your truth quietly and clearly; and listen to others, even to the dull and the ignorant; they too have their story.
Avoid loud and aggressive persons; they are vexatious to the spirit. If you compare yourself with others, you may become vain or bitter, for always there will be greater and lesser persons than yourself.
Enjoy your achievements as well as your plans. Keep interested in your own career, however humble; it is a real possession in the changing fortunes of time.
Exercise caution in your business affairs, for the world is full of trickery. But let this not blind you to what virtue there is; many persons strive for high ideals, and everywhere life is full of heroism.
Be yourself. Especially do not feign affection. Neither be cynical about love; for in the face of all aridity and disenchantment, it is as perennial as the grass.
Take kindly the counsel of the years, gracefully surrendering the things of youth.
Nurture strength of spirit to shield you in sudden misfortune. But do not distress yourself with dark imaginings. Many fears are born of fatigue and loneliness.
Beyond a wholesome discipline, be gentle with yourself. You are a child of the universe no less than the trees and the stars; you have a right to be here.
And whether or not it is clear to you, no doubt the universe is unfolding as it should. Therefore be at peace with God, whatever you conceive Him to be. And whatever your labors and aspirations, in the noisy confusion of life, keep peace in your soul. With all its sham, drudgery and broken dreams, it is still a beautiful world. Be cheerful. Strive to be happy.
Bad Dancer · May 20, 2025 at 7:45 pm
Glad you’re still with us. Do I need to get doc to follow you around with his silver bullet and heat casualty card?
Do you got a big floppy sun hat? Do we need to get you a big floppy sun hat?
Divemedic · May 21, 2025 at 12:31 pm
Am i old enough yet for a big floppy sun hat?
God, I hope not.
Hightecrebel · May 22, 2025 at 5:34 am
At this point I don’t think it’s a question of if you’re old enough, it’s a question of if you’re stubborn enough to be outside working in the heat long enough for the big floppy hat (and with the humidity, maybe go with the solar powered fans one)
Chris in Nanuet · May 22, 2025 at 7:09 pm
I’m interested in what the docs proscribed while you were admitted to assist in healing. Take care DM.
SP RN · May 20, 2025 at 8:05 pm
When there were no posts for a few days, I figured you were tied up at the hospital. I’m sorry to read I was correct, but not the way I thought. Rest and be well DM.
SP RN
Aesop · May 21, 2025 at 2:37 am
Glad you got sorted out. When I heard your recorded temp., my first thought was “But what was the tailpipe temp??
As someone who once ended up sitting in a kiddy pool ice bath at Quantico one June morning (94° F. and 98% humidity that morning) until my core temp dropped from 103.9 back to 98, and guzzling 6L of water in about 20 minutes, I had a pretty good idea where this was headed.
Kind of a case where if you’d already had your pool, you would’ve been fine with some rapid whole-body cooling.
And also, it’s bitch getting older, because we don’t bounce back as quick.
Pro tip: when Gatorade starts tasting good, you’re already fairly dehydrated.
Glad things didn’t go any further south for you than they did. One of those drugstore $20 pulse oximeters is a help, because you can spot a problem early once your pulse rate starts shooting upwards beyond 100 – provided you spot-check yourself occasionally.
I hope you didn’t have go to the ED you work at. No sense flagging yourself with your co-workers. 😉
Divemedic · May 21, 2025 at 12:31 pm
That’s exactly where I was. The only trouble it caused was my wife seeing how many young female nurses stopped by to check on me, and how friendly they were to me.
Aesop · May 23, 2025 at 7:40 am
So, flirting with death twice in one day??
At least you can plead heat stroke for the second one.
TCK · May 21, 2025 at 3:13 am
Allow me to add my echo to the chorus offering thanks that you’re alright (mostly) and recovering.
TLF · May 21, 2025 at 3:15 am
That’s an amazing amount of water loss through sweating. I need to be careful myself, because I do similar things in the summer (in north GA, the 95/70 combo usually does not hit until July). We also need to be conscious of our aging–I’m about the same age as you, and I have to be focused on decreased abilities. I’m not 30 anymore…
Boneman · May 21, 2025 at 5:23 am
When I read the first couple of sentences in the post, living here in N. Ft. Myers and in “The Soup” right here with you I thought… Oh shit… this is not a good idea…. I’ve lost 6lbs cutting the grass in that kind of weather… but had the advantage of being able to fall in to the pool during the activity.
Glad you are OK. I see there is a plethora of replies… I’ll get to those but I’m sure it’s all well wishers such as myself.
Scary how that can creep up on you for sure. You did all the right things it seems like… but damn… and that it was quite a bit of time after the fact that it caught up with you.
Makes you wonnder how those guys working outdoors… and particulary up on roofs do it.
Glad to hear you are OK.
Don’t do that again. Ever. And yes, that admonshment can be filed under “Things said with tongue fully emplanted in cheek and to be filed in a folder labeled “NO SHIT CAPTAIN OBVIOUS””
Be well sir… and enjoy that pool
Jim · May 21, 2025 at 6:19 am
My brother lived in Port Orange, and was a landscaper. He suddenly started having the same occurrences you’ve described. He’d get checked out by the doctors, who had no idea. He’d go back to work and a few weeks later have it happen again. Hospitalizations, plural, and the docs couldn’t figure it out. Less than a year later, he died. At home, alone, we guess peacefully. I wish my brother had YOUR doctors. Please take care of yourself. I miss my brother.
Vlad the non-Impaler · May 21, 2025 at 12:39 pm
As a firefighter/medic, I was still playing golf in 114° AZ weather. Back when I was 43 I used to drink 3 liters of salted water, drink 2 liters of Gatorade and still didn’t pee until 1700…which looked like strong tea.
On humid days it was a string of calls going from job site to job site plugging in NS IVs and extricating guys off of rooftops that were fixing AC units.
After retiring I ditched the Gatorade and added more salted water and no f-ing way am I playing when it’s anywhere near 105°.
Mark J · May 26, 2025 at 10:04 am
Had similar experience a few years ago during COVID, I was still recovering a few months after having that crud, woke up feeling shaky and cold sweats, tried to eat something mild and it came right back up. After the vomiting I felt a little better and decided I was good to head to work.
Soon as I got there, the boss took one look at me, told me hell no I was going to the ER instead. They got me on the LifePak monitor, BP was around 130/95 IIRC, tachycardic with some PVCs, and ETCO2 of 11. Boss stuck a 16 g IV lock in my arm (hurt like a mo-fo), then they hauled me over to the ER. Turned out I had got dehydrated from being sick, plus the (dry) heat didn’t help matters. After giving me 4 mg zofran ODT and a liter of IV saline, they discharged me out and I followed up later with my PCP.
Am glad to hear you’re going to be on the mend, watch yourself out there.
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