AWEEK PRIOR to writing this article, a few of my friends and I decided to attend the 33rd Annual Laughlin River Run, located just on the other side of the Colorado River
border of California in Laughlin, Nevada, about 300 miles from
my home. For those of you who have never been to the “River,”
although the event is held in late April, Laughlin is in the desert
(about 100 miles south of Las Vegas), and it is usually very hot—
120° in the shade hot. Yet the Colorado River is still ice cold, so
it feels very refreshing to spend a day in and out of the water.
Imagining we could avoid the worst of the heat by getting an
early start, especially as we were riding air-cooled Harleys, we
got together at 6:00 AM and were on the road by 6: 30. Of my
two leather jackets, I took the lighter one, anticipating it would
be soaked in sweat before we arrived.
We literally shared the road with hundreds of riders, each bike
fancier than the rest. In contrast to my full-face helmet, most of
the riders wore traditional Harley skull caps, lots of them used
“ape hanger” bars, and very few even wore jackets.
The weathermen had been promising rain for three days in a
row (it rarely rains in the Southwest), but when we left, the skies
were clear. However, not even one hour into our five-hour ride, I
was shivering to the point that I got worried about being able to
ride safely; my entire body head to toe was involuntarily shaking,
and I could not control myself. Being from Chicago, I’m not a
stranger to the cold, and in fact, I prefer it over extreme heat. But
since my friends seemed to be doing okay, I decided to tough it
out and not be such a wimp—which was not the correct decision.
Because my Road Glide was a recent purchase, I hadn’t yet
ridden it on any long trips. Its stock fairing is low profile, thus it
looks cool, but as I’m tall, I really feel the wind. And although
I’d considered getting a larger windshield, when preparing for
the trip, it totally slipped my mind.
Not only was the day much colder than expected, when we
were about10 minutes from our destination, it started to rain. We
counted ourselves fortunate to have gotten an early start; thousands
of riders were still on the road, and we watched them riding in,
cold and drenched, for several hours after we arrived.
Hypothermia is a medical emergency that occurs when our
body loses heat faster than it can produce heat, causing dangerously low body temperature.
In mild hypothermia, there is shivering, mental confusion,
dizziness, hunger, nausea, faster breathing, trouble speaking,
lack of coordination, fatigue and increased heart rate.
In moderate hypothermia, we can actually lose the awareness
that we are in trouble. Shivering stops and as confusion increases,
we become clumsy and lack coordination, slurring our speech or
mumbling incoherently. We make poor decisions, like trying to
remove warm clothes. We become very drowsy and have very
low energy, a weak pulse and slow, shallow breathing.
In severe hypothermia there may be a paradoxical undressing, where a person begins removing their clothing, as well as
increased risk of heart stoppage.
Not only can we get hypothermia from exposure to cold, but
alcohol, drug use, low blood sugar, anorexia, certain medical
conditions, many medications, and advanced age, among others,
can all contribute to lower body temperatures.
Alcohol consumption increases the risk of hypothermia by its
action as a vasodilator. Because it increases blood flow to the skin
and the extremities, it makes a person feel warm while actually
increasing heat loss. Between 33% to 73% of hypothermia cases
are complicated by the effects of alcohol. (Rosen’s Emergency
Medicine: Concepts and Clinical Practice, 7th edition.)
Heat is primarily generated in muscle tissue, including the
heart and the liver, and it is lost through the skin (90%) and the
lungs (10%). Heat production may be increased from two- to
four-fold through muscle contractions (both phyical exercise and
shivering). (Crit Care Clin 15 ( 2):235-49.) And of course, the rate
of heat loss on a motorcycle increases the faster we ride at any
cold temperature due to wind chill.
Our clothing is critical to maintaining our body temperatures in
extreme conditions. I own a rain jacket and pants that fit in a convenient little bag and did not bring them. Synthetic and wool fabrics
are superior to cotton as they provide better insulation when wet or
dry. Also, some synthetic fabrics will wick moisture away from the
skin. Clothing should be loose-fitting because tight clothing reduces
circulation. Covering the head is important, but several studies I’ve
read say it’s no different than any other part of the body losing heat.
What do we do if we suspect hypothermia in ourselves or
others? The UK National Health Service advises the lay public
against putting a person in a hot bath, massaging their arms and
legs, using a heating pad, or giving them alcohol. These measures
can cause blood to be directed to the skin, causing a drop in blood
pressure to vital organs, potentially resulting in death. (“Treating
Hypothermia” NHS. Archived from original on Sept. 14, 2014.)
For mild hypothermia, make sure the person’s clothes are dry,
or remove the wet clothes and replace them with dry, and move
them to a warm dry environment. One can use a heating blanket,
or hot water bottles positioned at both the armpits and groin.
For moderate hypothermia, a person should go to the emergency
room to receive warm intravenous fluid and irrigation of body
cavities like chest and abdomen with warmed fluids. I could go on,
but you get the point, call 911 immediately to save someone’s life.
Warm, sweet liquids can be given to an alert person who can
swallow. Always monitor the person’s breathing; shallow breaths
are not acceptable and require immediate professional help.
If you plan to ride in the cold, since you may not live in the
warm South, there are charts you can look at that show the wind
chill effect at any temperature and any speed. For example, if it
is 45° F outside and you ride at 65 mph, the charts indicate your
face will feel like it’s 32° or even less. But keep in mind that
many charts don’t agree on methodology.
On the way home from our four-day trip, with lots of great
rides every day, there was a wind advisory going through the last
section of desert—another weather-related test of our riding skills.
Overall, the trip was epic, but next time, you can bet I’ll be
●●Dr. John Alevizos is Board Certified in Family Practice and specializes in Anti-Aging Medicine. He has offices in Irvine, CA, has been
in private practice for 21 years, owns three motorcycles and did his
internship and residency at USC in Los Angeles.