NUTRITION
Too much of a good thing Julie Flynn (Evan Barr’s mother) This article has been written with Evan’s consent.
Orienteers rarely experience life-threatening conditions related to their sport. This is a story about such an event. As usual with these incidents, it followed a series of unfortunate circumstances, this time at the Christmas 5-Days. The condition is hyponatremia, and it happened because of heavy sweating and an attempt to recover from dehydration by drinking too much water.
Hyponatremia: deficiency of sodium in the blood. It can be fatal if the salt levels in the blood are too low. Sodium, potassium and chlorine are vital for every muscle cell contraction and every nerve cell transmission in our bodies. These salts are lost through our sweat and urine. THE Christmas 5-Days promised to be an enjoyable opportunity for bush orienteering in some great terrain and time to relax with friends at Buckenderra. After having spent Christmas with relatives in Canberra, we drove (in two cars) to the first event site just south of Cooma. En route we bought our supplies, including sports drinks to help with hydration, knowing that we’d get pretty hot running on the first evening. The first unfortunate circumstance was that the shopping, including these drinks was in the parents’ car. It was a hot day and, typically for the 5-Days, the first event was run in the late afternoon. Water on the courses ran out quickly, so that those of us who ran later and didn’t carry water, missed out. Thirsty runners had emptied the containers of water at the finish well before many of us arrived back. The second unfortunate circumstance was that Evan didn’t run with water, had none on his course and had none at the finish after his 7km run in the heat. Soon after returning to the finish area following our run, Neil and I (his parents) headed off to Buckenderra, to set up our tent for the next four days in a good shady position (third unfortunate circumstance). We expected Evan and his sister Ilka to follow along soon afterwards. The kids didn’t get to Buckenderra until after dark; they’d got themselves lost relying on the ambiguous copied map from the program (fourth unfortunate circumstance). Some hours had passed since the orienteering event, and Evan was feeling very dehydrated, with headache and nausea. He tried to slowly re-hydrate but couldn’t eat dinner. Ilka offered to lend him her hydration pack for the event the next morning, and Evan agreed that he’d probably run with it. He wasn’t up to pitching his tent that night so, feeling sorry for him, a couple of us did it for him. Next morning he wasn’t 100%, but decided to run anyway. Evan had been training consistently for 3 months, so he could run 8 THE AUSTRALIAN ORIENTEER MARCH 2006
competitively, and dropping the second day would have been very disappointing. I had a late enough start to watch Evan finish, and noticed no hydration pack on his back. Speaking to him about it later he said he decided he didn’t need it due to the cooler weather in the morning. This was the next unfortunate circumstance. Later he reported that he hadn’t noticed water at any of the control sites, and there wasn’t any at the control indicated on the clue sheet. It was actually at a different control site to the one marked on the clue sheet, but he hadn’t noticed it. At the finish he headed straight for the water containers. He drank several cups of water after finishing. Evan felt worse as the afternoon progressed, and recognising his headache as a sign of dehydration, drank as much as he could over a few hours. He drank mostly water, but included one sports drink and a couple of sweet carbonated drinks. His body reacted by vomiting, and he did his best to replace the lost fluids, as he was feeling worse. He and Ilka have estimated that he probably drank about 5 or 6 litres over the day. Just before 4pm, Evan had a seizure, while sitting in the park in Cooma. Ilka and his friends called an ambulance, and put Evan in the recovery position. Ilka accompanied him to the Cooma hospital. It was very fortunate that this fit happened in town rather than at the campsite, and that there were people around who cared for him. Thanks go to Jim Russell and Daniel the Swede.
He was in the emergency department hooked up to sophisticated machines. The beeping became very familiar through the night. Every time it faltered, we woke up. Evan spent the next 12 hours very agitated, disoriented and not conscious of anything except that he was very sick. He doesn’t remember anything except feeling very sick and being unable to see. The medical staff at Cooma were alarmed when they discovered fluid in his lungs and rang for advice from a specialist in Canberra. At this stage, Evan was breathing pure oxygen from a mask, as his blood oxygen levels had dropped, and was hooked up to a saline intravenous drip. Blood tests were ordered, and an ECG and a chest X-ray carried out. A catheter was inserted so that his urine could be measured. He was still vomiting regularly. It was very scary to watch our son going through all this. After a couple of hours, Evan was airlifted to the Canberra Hospital where medical staff with experience of this condition could take care of him. Neil, Ilka and I followed by car, arriving close to midnight. He was in the emergency department, hooked up to the sophisticated machines that measure blood oxygen, pulse, blood pressure, and respiration rate. The beeping of this machine became very familiar through the night. Every time it faltered, we woke up. Evan regained full consciousness at nearly 4.30am and wanted to know what had happened and why he was in hospital. He was shocked to find himself connected to so many tubes (particularly the catheter). A blood test that morning revealed that his blood salts were back within the normal range, and he was allowed to leave. On the following day, Evan was able to get an appointment with a sports physician in Canberra. His case was interesting enough for the doctor to fit him in before leaving town for the New Year long weekend. Evan expected a check-up and advice on appropriate hydration for orienteering. He didn’t get much advice, but had another blood test, expecting the results 5 days later. The pathologist who looked at Evan’s blood test was alarmed by the very high levels of Creatine Kinase, an enzyme that indicates muscle damage. He tried to contact the now absent referring doctor. When that failed, he made some further calls that eventually lead to the