Thread: Gatorade
View Single Post
Old 03-01-2005, 10:15 AM   #9 (permalink)
laconic1
Junkie
 
oops, the runner was drinking large amounts of Gatorade, but that wasn't what caused her to die

http://www.restonrunners.org/special...cero_death.htm

Quote:
Boston Globe Article on Tragic Death of Cynthia Lucero
in the 2002 Boston Marathon
by Stephen Smith

Cynthia Lucero, who in the week before the April marathon completed her doctoral dissertation on how marathons help runners grieve, died from a condition known as hyponatremic encephalopathy, which happens when the brain becomes swollen because of a critical imbalance of sodium. She was only the second runner to die in the 106-year history of the race.

''This is a relatively rare catastrophic complication,'' said Dr. Ronenn Roubenoff, associate professor of medicine and nutrition and director of human studies at the Jean Mayer USDA Human Nutrition Research Center at Tufts University. ''It really is a tragedy because it's such a preventable thing.''

For the neighborhood jogger taking to the baking pavement in the August heat, the death of Lucero provides a graphic illustration of the dangers of drinking too much water or even sports drinks. Runners have long known the importance of replenishing fluids, but they may not know that it is also vital to maintain a balance in sodium levels to keep cells healthy. If runners drink too much fluid, they can dangerously dilute their blood sodium levels.

That condition is called hyponatremia. Although people seldom die from hyponatremic encephalopathy, health-threatening sodium deficiencies are more common among athletes than doctors once believed. Roubenoff cites one study, for example, that tracked 18,000 marathoners and found that among those seeking medical care after the race, 9 percent suffered from the condition. Deaths are sufficiently rare that specialists can recount them individually.

Until recently, hyponatremia was a little-known, even less-understood medical condition. But researchers, including Dr. Arthur J. Siegel of McLean Hospital, are learning more about hyponatremia, known more commonly as water intoxication.

Siegel is deeply familiar with Lucero's case, having obtained with her parents' permission a blood sample drawn at Brigham and Women's Hospital, where the runner was taken after she collapsed. He and other scientists are hopeful that, in death, Lucero will yield medical evidence that can prevent other runners from the fate that befell her.

''We want as Cynthia's legacy a better understanding of this problem so that we can work out strategies to make it less likely that these cases will happen in the future,'' said Siegel, director of internal medicine at McLean.

The 2002 Boston race was Lucero's second marathon. The previous one was two years earlier in San Diego, a race she completed in about 41/2 hours. She was running the Boston Marathon to raise money for the Massachusetts chapter of the Leukemia and Lymphoma Society.

On that April Monday, friends tracked her progress. They said that Lucero, wearing bib number 15,611, drank large amounts of Gatorade and looked well as she loped through the bottom of Heartbreak Hill in Newton, about six miles from the finish.

But with Cleveland Circle in sight, Lucero began to falter, those friends recalled. One of them hopped into the race next to her and Lucero told the friend that she felt dehydrated and rubber-legged. Lucero tumbled to the pavement. When she reached Brigham and Women's, she was comatose.

Lucero's parents, who'd traveled from Ecuador to mark the completion of her dissertation, had been waiting at the finish line.

The precise causes of the syndrome that killed Lucero remain somewhat mysterious, and dispute persists among researchers over whether the predominant triggering mechanism is related to too much fluid or extreme dehydration. Increasingly, though, scientists believe that the problem transcends a simple equation of too much or too little water.

They believe it's vastly more complex. Siegel and other researchers theorize that marathoners, triathletes, and other athletes who engage in extreme sporting competition often deplete the fuel that powers the body's cells. When this happens, a hormone called arginine vasopressin gets released. Part of its function is to tell the kidneys to hold on to fluids.

That, in turn, precipitates an imbalance in sodium levels in the blood. But as salt drops in the blood, it does not do so in cells. The body, in its constant pursuit of equilibrium, attempts to force salt out of cells by flooding them. That causes swelling. Muscles can endure such swelling because they can bulge outward. The brain, though, cannot.

''The brain lives in a box - the skull - and it doesn't have anywhere to go when this swelling starts,'' Roubenoff said.

Lucero's death showed that even runners who drink sodium-laden sports drinks remain at risk of the condition, which Siegel cites as evidence that the syndrome is more complicated than simply taking in too much fluid. That is why he and people who organize races are working on ways to improve measures of runners' health, including weighing them before and after races to make sure they haven't lost too much fluid or, conversely, consumed too much.

''We are moving toward understanding this problem,'' Siegel said, ''and if we can make some headway, maybe we can prevent more losses like Cynthia's.''

Stephen Smith can be reached at stsmith@globe.com.

This story ran on page A1 of the Boston Globe on 8/13/2002.
laconic1 is offline  
 

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360