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LIFE 101
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Never mind the part about the extreme temperatures that are becoming the new normal. Ok, do mind, but go back to doing that in a few minutes. Right now, worry about something else, so that you can keep yourself safe: What is so dangerous about heat stroke, and how does one die of it?
Very long story very short: your gut bacteria kill you. While this statement is correct, it hides within itself many levels of interesting physiology that open doors to understanding how you function and, therefore, what you can do for yourself. So let's unpack, in progressive installments, that simple statement: "your gut bacteria kill you". - Overheating causes your gut to become leaky, which leads to your gut bacteria killing you. The reason why your gut microbiome is USUALLY your friend is that your gut, which is technically the OUTSIDE of your body (fun topology fact - just put your hand on the metaphorical wall of your lips and follow it all the way to your anus and you'll see), is SEALED from your insides by a cellular barrier called the gut-brain barrier. This is akin to the blood-brain barrier that keeps your brain as a safe environment from the rest of the goings-on in your blood. Blood, it turns out, is TOXIC to your cells - but that's another story. Point is, all is well while your gut bacteria remain in your gut, which is at the same time right there and very, very far away from your blood. But letting them in is a potential death sentence, because... - Overheating causes your gut to become leaky, which lets in gut bacteria that make your body kill itself. The important part here is realizing that it is NOT the gut bacteria themselves that destroy you, once they get into your bloodstream. They are not killer machines, like little soldiers with spears that break you down - not compared to the vastness of your body. BUT bacteria produce substances (lipopolysaccharides and the like) that your BODY reacts to with an immune response. A bit of bacteria that slowly grow into more and more bacteria causes a bit of immune response that grows into a bigger and bigger response, and that gives you and your body time to adjust, sense the problem, and seek medical help. But the sudden increase in body temperature opens the floodgates of intestinal bacterial hell, and the all-at-once invasion of your bloodstream by your till-then-friendly gut bacteria causes sepsis once they are in the wrong place - inside your blood - and a massive immune response that causes cardiovascular disarray and leads to a sudden drop in blood pressure. The whole thing is a process, not an event, called heat stroke, which deserves a different name because now you're not just overheated; you are crashing, suddenly toppling over away from that delicate dynamic equilibrium that is life. - Overheating causes your gut to become leaky, which lets in gut bacteria that lead to sepsis which kills you by stopping oxygen from getting to your cells. Ultimately, there are only two ways of dying: asphyxiation or disintegration. In other words, either your cells can't breath anymore (a process called "cellular respiration", or cellular "breathing", which is different from the kind of mechanical breathing that your diaphragm subjects your lungs to), or your cells are physically annihilated (cut, crushed, burned, blown to smithereens - plenty of ways of doing this). In the case of sepsis, the drop in blood pressure caused by catastrophic loss of arterial tonus drains the blood our of your heart, which now both lacks the energy to pump and what to pump, so cardiac failure ensues, which is just the last straw on what was already happening with the drop in blood pressure: a sudden, massive drop in oxygen supply to the cells that compose your body. And so you die of cellular asphyxiation - because the oxygen molecule is the final sink that moves the flow of energy from food to your cells. That was the energy that kept your body delicately balanced away from entropic equilibrium, in that beautiful, improbable , ethereal state that is life. Take that energy away, and it all crashes down - just like turning off the muscles of the tightrope dancer. It takes moving for life to stay in place. So there you have it: death by heat stroke is death by sepsis caused by your own gut bacteria. Sure, in the process your blood-brain barrier also breaks down, which also contributes to mental disarray - as if the overheating wasn't enough. Severe dehydration, which usually comes along with the overheating process, also means that the blood thickens, which makes moving blood more difficult and doesn't help matters. What can you do? That's the most important part. The only sure way to not die of heat stroke is to not overheat in the first place. The following is NOT me giving medical advice, but a scientist walking you over what YOU can CHOOSE to do on your own: - Keep yourself in the shade (AC is even better if you can). The temperature difference is significant and every little bit helps. - Don't even think of exercising in the heat. Exercising means producing even MORE heat from the INSIDE. Need I say that's adding insult to injury? - Drink fluids and salts (pure water is better than no water, but gatorade is your best friend, formulated specifically to replenish the salts that you also lose by sweating) (no I don't make any money from this). - If you start feeling unwell, seek help immediately. If the process of heat stroke already started, you soon won't be able to do much for yourself anymore, so make sure to enlist somebody else to care for you while you still can. - Until then, do what you can to keep your body cool: get under a cold shower, fill the bathtub and stay in there, or at the very least splash water on yourself, put a damp towel around your neck. Your gut bacteria are your friends, but only as long as they stay where they belong. |
Sources:
Ashcroft F (2002) Life at the extremes: The science of Survival. University of California Press.*
Kamler K (2004) Surviving the extremes: A doctor's journey to the limits of human endurance. St Martin's Press.*
Lim CL (2018) Heat sepsis precedes heat toxicity in the pathophysiology of heat stroke - a new paradigm on an ancient disease. Antioxidants 7, 149.
*Links to Amazon provided for your ease. I don't make a cent from your clicks.
Kamler K (2004) Surviving the extremes: A doctor's journey to the limits of human endurance. St Martin's Press.*
Lim CL (2018) Heat sepsis precedes heat toxicity in the pathophysiology of heat stroke - a new paradigm on an ancient disease. Antioxidants 7, 149.
*Links to Amazon provided for your ease. I don't make a cent from your clicks.