Expert: Todd Bublitz, RCEP - 5/7/2005

Question
Hi, thanks for volunteering. I know this may not be your specific area, but I thought you might have a thought to share. My question concerns cooling the skin and body in hot weather during exersise.

My son hasn't had a seisure in almost 2 years and we beleive he may outgrow the Mild Seisure Disorder that he has. He has only had a total of 5 ever, so he is the Neurologist's healthiest patient...thankfully!

My question is about the side effect of his medication and living with it. He takes Topamax, which has obviously been great. The only problem is this medication doesn't allow him to sweat properly and he over heats. We live in Florida. Today, once again, he was out playing (he's 13) and some kids at a party went on a hike. He ate watermelon before leaving. He brought water with him. He drank when he got back. Still he started to feel bad. When I picked him up at the party, he said his hands wouldn't close up all the way- we never got to THAT point before. Anyway, I give him Gatorade and pop him in the shower. At camp he hopped in the pool. Today I took him to a neighbors pool and he submerged. All of these work- submerged works very fast.

But is there a way to do something before he heads out? When I used to be a welder we would take salt tablets on a hot day. Is that something my son could do? I would appreciate any ideas on cooling down, but mostly I'm looking for suggestions on avoiding the over heating. We have to address this with the PE teacher every year- I wish there was something more comforting for me and him besides drinking water and Gatorade.

Thanks for any advice,
Lisa

Answer
Lisa,

You say his "medication doesn't allow him to sweat properly and he overheats."  If he is not sweating properly, there is no reason to give him extra liquids.  Extra liquids are needed to replace all the fluids lost during excess sweating.  Also, never give or take salt tablets.  The details of why this is bad is a bit complicated, so please, just trust me.  No salt tablets.

Sweating is the body's main mechanism for cooling itself in hot weather.  If you cannot sweat properly, you are at an increased risk for heat stroke (inability to cool the body)- which is serious.  You could try "artificial sweat" and use a spray bottle to moisten the skin, but this may have to be applied every few minutes.  Drinking normal amounts of cold liquid can help cool the body a little, but it is a poor replacement for a good sweating mechanism.  It may be that your son will just have to take it easy in hot weather.  

I see no easy answer.  Sweating in hot weather is essential.  I don't think it would be safe to engage in strenuous activity in hot weather without a properly functioning sweat mechanism.

I suggest you discuss this with your doctor, or a knowledgeable sports medicine doctor, it you have not already.  I would also suggest that your son keep his activities at a lower level and stop all activities if he starts to feel poorly.  If this occurs he should seek active cooling (water bath, fan, A/C) immediately.  Heat stroke can be life threatening.

Best of luck.

Todd

Please go to this link to read more about Heat Stroke:
http://www.umm.edu/non_trauma/dehyrat.htm