Tuesday, May 24, 2011

Stubborn or Stupid?

So... today it was in the low 80's here in Massachusetts. It had reached 77 degrees by the time I left work this afternoon. I left two hours early because I had an appointment with the doctor to start a new steroid treatment, attempting to beat my anhidrosis into submission. (For information on anhidrosis, what it is and what it can do to me, see my entry titled "No Sweat, No Problem... Not Really!") The fact that it needs to be beaten into submission indicates to those of you who are paying attention that it is still in full swing. I can't sweat a drop.
Just for fun, I'll describe what it feels like to very slowly go into heatstroke, like I did today.

  • First, I start to feel hot. Extremely hot, like I am laying out in the sun at the beach, even when I am in the shade or inside. Have you ever been standing in the sun and you can feel that your hair is hot? Not reached up and touched it, but felt through your scalp that your hair is hotter than the rest of you? I get that feeling, though I have no hair, since I am heating up from the inside out and heat rises. Lots of heat is trying to get out through my head, and the skin gets hot enough that I can feel it, just like you feeling that you have hot hair.
  • Next, I notice that my heart rate is high. Much higher than would be normal for me while exerting myself as much as I am at the time. I know my at rest heart rate is 50 beats per minute. When I start to overheat I've taken my pulse at rest and found it to be upwards of 120 beats per minute.
  • Now I begin panting. Like a dog. I'm not out of breath, I can stop panting and breathe normally if I think about it, but if I think about something else I start panting again. My body is trying to do a little heat exchange through ventilation.
  • At about this point I notice I'm turning pink. It looks like a sunburn, but if I lift my shorts-leg, or raise my shirt a little, I can see that the pinkness extends into places where the sun cannot reach. There are no potential tan lines from this reddening, since it's not a reaction to the sun. That increased heart rate I was talking about? My heart is pushing all the blood it can to the surface, like a whole body blush. It's trying to cool my blood before re-circulating it through my body. Good luck.
  • Quite soon after the reddening, my hands start to feel funny. Swollen. They are swollen. Blood is flooding my extremities as my heart continues to try to cool me down. 
  • Sometimes coinciding with the hand swelling, sometimes coming slightly later, is the numbness. I start to lose feeling in my face, like the skin is going to sleep. Eventually the feeling in my hands becomes compromised as well. I'm not sure if this is a result of the amount of blood that is pumping into my head and hands or if it is my brain warning me. Maybe it's a part of my brain shutting down, or being effected by my rising core temperature. I don't know.
  • Shortly after the numbness sets in I start to lose my fine motor skills. It takes me a few tries to pick up a letter. I look a little like a drunk as I stab the key at the keyhole three times before getting it in. My balance is a little off, and I know my reaction time is slowed. This is probably not the best time for me to be behind the wheel. 
  • At some point during all this, serious exhaustion sets in. It most likely has a little to do with my heart running at 120+ bpm, sustained for hours. 
  • The loss of motor skills grows until I have a hard time speaking without slurring my words, and balance becomes a bit of a problem for me. Unless I cool down, this will progress until I fall down. If I fall down in the sun, or someplace else hot where I won't bleed off heat very well, it will be a Very Bad Thing.
Today, with a high of 77 degrees while I was on the clock, and knowing I was leaving early to go to the doctor's, I decided to forgo wetting my shirt down to cool off and tried to control it simply through use of the fan in my mail truck. Most of the people working with me to try to cure my anhidrosis have never actually seen it in action. Since I know that without wetting my shirt it takes me hours to cool down, even when inside an air-conditioned building, I just wanted the fan to slow the heating process down enough that I could finish my work and get to the doc's.
By the time I got back to the office I had reached the "loss of fine motor skills" portion of my day. I was exhausted, and since my heat was almost all internal I continued to heat up for a short time even though I was now in an air-conditioned building. Now, this may seem a little off-color, but to show how bad it got, I'll describe my trip to the bathroom.
Standing in front of a urinal did not seem to be an option. I was wobbly, and my balance was off. I didn't want to have to be cleaning the walls or anything. So I went in a stall and had a seat. I did what I had to do, and then tried to get up. It seems that there is a little bit of balance involved in rising from a seated position, and I just didn't have it. There are also some muscles involved, and mine just didn't want to work anymore. After a couple of failed attempts, I took hold of the toilet paper dispenser and used it to heave myself to my feet. Luckily, it did not just come off the stall wall.
Now, my shorts were still down, and that was not an option for leaving the bathroom. My leg muscles being pretty much on strike seemed to remove the option of squatting, and my balance was pretty crappy, so I wasn't sure exactly what to do. Eventually I just leaned forward and rested my forehead on the door and stretched my arms down to get a grip. I got everything most of the way up, then let go with one hand to use my old friend, the toilet paper dispenser, to get myself standing upright again, where I finished the job. It took me a while to get the belt buckled, but that was okay.
It took me four tries to get a grip on the small knob for the sliding bolt that was locking the stall door. That set me to laughing. Eventually I was able to get out of the stall, and subsequently, the bathroom. I went to my route and had a seat on my stool for a while before trying anything else.

Doesn't this sound like fun? In the 70's and lower 80's I can usually avoid all the worst symptoms by wetting my shirt down occasionally. Today I didn't do that intentionally, trying to get to the doctor's office while still showing symptoms of heatstroke while perfectly hydrated. This was the result. I know all these symptoms and stages quite well by now, and I was monitoring myself out on the road as well as I was able. I was feeling horrible, and yes, it was dangerous. But I would like my doctor to actually see what she's dealing with sometime.
It was a horrible day, but I'm stubborn. Or stupid. Sometimes I'm really not sure which....

Talk to you later!

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