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Thursday, July 28, 2011

Bad Medicine-The Leadville IV


If you are running The Leadville 100 Race, you can now "pre-order" your recovery IV Fluid for a mere 75.00 folks.  An additional bag is 100.00
Here is the link to the web site: https://leadville100.10ksportmed.com/Page/Details/2


So you have finished your epic 100 mile race.You are tired, and dehydrated. You look forward to that IV fluid that you pre-ordered several weeks ago. Wow, recovery will go so much faster!

But what  happens if you finish the race-congrats-!  Go for your recovery fluid, which you ordered, because you assumed 4 weeks ago you would be a bit dehydrated-and you really are NOT dehydrated?

What  happens if you are the opposite: hyponatremic?  This is a medical condition where the runner has consumed too much water.  The sodium chloride level in the body is now too diluted. This causes the cells to swell with too much water. Although most cells can handle this swelling, brain cells cannot, because the skull bones confine them. Brain swelling causes most of the symptoms of hyponatremia.

This is becoming more of a problem as marathons get more popular. Slower marathon runners, who can take 6 hours or longer to complete a marathon, dutifully drink as instructed at water stations.  An older report from WebMD:

Marathon Runners Drink Too Much

Study: Dangerous Salt Loss Linked to Drinking Too Many Fluids
By Daniel J. DeNoon
WebMD Health News
April 13, 2005 -- One in three marathon runners drinks more fluids than she or he needs, a study of Boston Marathon runners shows.

In the 2002 Boston Marathon, one female runner died because her body lost too much salt, a condition known as hyponatremia. Many of her race mates risked the same fate, find Christopher S.D. Almond, MD, MPH, and colleagues.

Almond's team got blood samples and other data from 488 women and men who ran the 2002 Boston Marathon. They found that 13% of the runners had low sodium levels. And three of the 488 runners analyzed had critically low sodium levels -- putting them at very high risk of headache, confusion, seizures, and death.
Since 15,000 people ran the race, this means that nearly 1,900 of the runners had too-low sodium levels at the end of the race. And some 90 runners, Almond and colleagues estimate, had critically low sodium levels. The main cause of low sodium levels: drinking too many fluids during the race, diluting the body's salt.
"These observations suggest that hyponatremia -- and particularly severe hyponatremia -- may be a greater problem than previously recognized," Almond and colleagues report in the April 14 issue of The New England Journal of Medicine.

I won't even go into the legality of this. I'm assuming there is a Medical Director of this race.

I have never (and knock on wood) needed medical treatment after a race, but I am "assuming" someone takes responsibility, when, in a race or post-race, a decision is made that someone needs a bag of IV Fluid. I am not a physician, nor a paramedic, so I don't know how that all plays out, who makes the decision of the administration of fluids.  This may be a protocol approved by the Emergency Department at the hospital that the EMT's can use their own judgement in a 'emergency run' situation.

But who is taking responsibility when Susie Finisher shows up at the IV Tent, ready for her IV,  and it's not medically appropriate and/or necessary?

If you are a health care professional, I have a question for you: Could you or would you hook up someone to an IV after a race, just because they requested it?

Update: The web page has now been removed from their website. Glad I grabbed a screen shot of it!!

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