On the Mend
Joseph DiVincenzo
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This past week, tens of thousands of runners competed in the Boston Marathon — one of the most grueling and intense marathons of all time.
Hot weather coupled with steep hills and more than 26 miles is a recipe for serious health problems — or even death.
As the story goes, the city of Marathon was under siege from an invading army. To manage reinforcements, the commanding general sent the fleet's fastest runner 26 miles back to the city to deliver an important message. Upon his arrival, the runner did indeed deliver the message, but died shortly thereafter.
It would seem strange given the history of Marathon that anyone in today's society would engage in such a dangerous activity. But running and completing a marathon affords a sense of accomplishment unrivaled by other athletic feats.
Today, we have medical tents filled with highly trained staff, plentiful supplies and quick access to the best hospitals in the world. But despite the advanced training routines, good nutrition and all the advantages of modern medicine, the marathon always yields wounded soldiers.
This year, several thousand people dropped out of the race mid-way because of the heat. Of those capable of finishing, nearly 2,000 more needed some degree of advanced medical care to prevent progression of serious race-related issues.
The two main medical tents, A and B, operated at maximum capacity from noon until eight o'clock at night. Hundreds of volunteers worked tirelessly to remedy some of the problems you'll read about below. If you're still keen on running a marathon after reading what happened to several thousand people this past Monday, your courage is admirable— and we'll be in the tent again next year if you need us.
Hypothermia is a problem regularly encountered on marathon courses. Runners cool off too quickly, lowering their core temperature to levels so low, disorientation and organ damage can occur. Blankets and plastic wraps along with supervised walking usually do the trick just fine, but you'll feel chilly for a while.
Hyperthermia is more rare, but occurred several thousand times this past week. When the core temperature rises, cell and organ function could become irregular or stop altogether. At 106 degrees Fahrenhiet, your DNA coil starts to unravel.
So if you're temperature is up, you'll be getting ice bags and cold towels. If it's high enough, you'll be dunked in a makeshift bathtub filled with water and ice for a minimum of 10 minutes. Let's just say you'll never complain about cold showers anymore.
Hyponatremia, otherwise known as low-salt or a severe electrolyte imbalance, could result in cardiac arrest if left untreated. A sodium-saturated IV bag certainly will help, but a standard dose of three chicken bullion cubes in a cup of warm water more often than not eliminates the problem. Chicken soup to the rescue again.
Cramps can be caused by fluid imbalance or by extreme muscular fatigue. In either case, they're responsible for more shrieks and screams than anything else in the medical tent.
Aggressive massage, passive weight bearing by a physical therapist and fluid all help, as does a short period of rest. But be careful — if you're resting longer than 10 minutes, the cramps could come back with a fury and stay for a long time.
Gloucester resident Joe DiVincenzo is a physical therapist and clinical specialist in manual therapy. He writes "On the Mend" weekly. Questions may be submitted to Joe by email: joedivincenzo@comcast.net.
