Physical Activity and Dehydration
My Firsthand Experience

By Skip Holmes

Endurance athletes and active people participate in many sports and recreational activities. During the summer months and even in some winter environments it is possible to experience dehydration symptoms.

The symptoms of dehydration are numerous. They can include dizziness, fatigue, lightheadedness, extreme thirst, dry mouth, headaches and muscle cramps. Athletes and those who simply overexert themselves can find that they can experience these issues. If you or someone else experiences severe symptoms, such as extreme dizziness, confusion, fainting, rapid breathing, or no urine output, seek emergency medical attention immediately. This is a dangerous health concern.

Those of us who engage in endurance sports often find that fluid replacement is one of the biggest challenges. Replacing fluids (water) is only a part of the equation for maintaining adequate hydration. During prolonged periods of high intensity exercise the body secretes sweat which is comprised of water as well as a number of important minerals for regulation of body processes needed to support exercise. 

The role of electrolytes in maintaining heart rhythm is well documented in health and medical literature. These minerals are potassium, sodium, magnesium, and calcium. Many sports drinks contain various amounts of these important and necessary minerals. However, what each athlete requires is somewhat unique to themselves.

As a lifelong endurance athlete who has competed in cross country ski marathons, cycling races and long-distance rides, as well as winter mountaineering, I have personally experienced dehydration symptoms in both summer and winter conditions. On several occasions I was able to recognize the symptoms and take appropriate steps to supplement my fluid intake and recovery.

However, a recent experience was very different and the outcome was not what I expected. While on a spring vacation and riding my road bike in the mountains of North Carolina, I experienced a case of dehydration that was unexpected. The weather was warm, mid 80s but not humid. I rode three days in a row and apparently did not sufficiently increase my fluid intake. On day four, I felt very fatigued and started to drink larger amounts of sports fluids to raise my electrolyte levels. My resting heart rate was normally 50 beats per minute, for a 78-year-old male who has been an endurance athlete, that is normal. My HR was now 38 bpm and was so fatigued that I felt uncomfortable to drive.

I sought out a local urgent care facility and they took a blood sample and sent me for an electrocardiogram to check my heart. The test results showed that my electrolyte levels were normal, but my EKG data showed what is called bradycardia. It’s a slow heart rate, and in my case, a low level of electrical signal between the upper and lower chambers of my heart. My blood pressure was also low. I was told to rest and see my physician when I got home.

Upon returning, I went to a Capital Region cardiology office that took walk ins. They immediately took another EKG as well as my pulse rate, which was 33 bpm, and then told me that they had just called the hospital ER and that they would be waiting for me to be admitted, so that I would receive a pacemaker THAT DAY. The lower chamber of my heart was no longer receiving electrical signals from the upper chamber. That was a moment I could not even begin to comprehend.

During the wait in the ER, I experienced two episodes where my heart rate went to ZERO. Fortunately, I managed to regain my pulse on my own without use of a defibrillator. I received a pacemaker that afternoon and began to experience a normal heart rhythm with a new resting heart rate of 60 bpm. The medical staff told me that the only reason I survived was due to having a heart that was strong enough to withstand the loss of electrical signal to one part of my heart.

The lesson learned for me was that even though I thought I was dehydrated there was an underlying problem that mimicked an electrolyte loss. Electrolytes are necessary for the heart to send electrical signals to each chamber of the heart. Just prior to being on vacation, I had a complete physical including an EKG. My physician looked at my previous year’s EKG and the new one, then said it was just like the previous one. He told me to enjoy my vacation, so I rode for three days in the mountains and had great rides, with no sense that something was amiss.

As we enjoy summer in the Northeast, with many outings and events, it’s crucial to remember to increase fluid intake along with necessary electrolytes. Extra salt on a meal, a salty snack or salt tablets are useful as well. The climate here in the Northeast is changing with more extreme temperature days, along with the wildfire smoke we now experience.

Ensuring that you are in good physical health for whatever event you may participate in is also important. In my case, I thought that I had done all the right things only to find out that there was something unexpected. 

Hydration, nutrition, and conditioning are all important elements for all of us no matter what our age is. Getting an annual physical is important to detect changes that we may be unaware of. Doing all of these items is critical and yet the unexpected can still occur. 

Three months after the pacemaker implant, I am fully recovered. Back riding my bike, paddling and hiking in the Capital Region and Adirondacks. Take care of yourselves and enjoy the great outdoors!

Skip Holmes (serottaskip@gmail.com) of Delmar provides sustainable building training programs for the Urban Green Council of NYC. He is a member of Mohawk Hudson Cycling Club and Capital Bicycle Racing Club. He can be found road and gravel bike riding, canoeing, hiking, and cross country skiing.