'I Almost Died of Heatstroke at 52—This Is the First Symptom I Wish I'd Paid Attention To'
The heat rises in the summer—but we probably don't have to tell you that. While the longer days and warmer weather can mean fun in the sun, it can also bring on risks for heat-related deaths. The Environmental Protection Agency reports that heat-related deaths reached new heights in 2021 and 2022, the two hottest years on record before 2023 and 2024.
Heatstroke is one risk that—as the name implies—comes with rising temperatures.
The CDC cautions that infants, people ages 65 and older and those with underlying conditions have higher risks of health issues in extreme heat. One avid runner, husband, and father fit none of those bills in 2013 when he nearly died from heatstroke doing something he loved: running in the Falmouth Road Race.
The race started in 1973 and is an annual Cape Cod tradition. Richard Dodakian has run it many times. "It's a seven-mile long run, and it's the third Sunday in August every year, so it's hot," Dodakian tells Parade.
Since previous participants had had heat-related issues, the race had a medical tent at the finish line that included providers from the Korey Stringer Institute, which was founded in honor of the late Korey Stringer, a football player who died of heatstroke at 27.
Dodakian had no idea he'd need life-saving care or that his competitive spirit was putting his health at risk. He was 52, had no underlying conditions and had done the Falmouth Road Race every year for the previous decade.
"I've been athletic my entire life—always active and doing something," Dodakian says. "I didn't expect it."
He shares what he learned after having a heatstroke at 52 and what life is like for him today.
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The No. 1 Thing One Man Wishes He Knew Before Having a Heatstroke
Honestly? Heatstroke came out of the blue. However, Dodakian wishes he understood that drinking plenty of water is important—even if he didn't feel thirsty, even if it was mid-race and added a few seconds onto his time.
"For me, the big one was probably hydration," he says.
Dodakian's wife is a nurse practitioner and constantly reminds him to hydrate. However, after a few years of running the Falmouth, Dodakian realized something. "Even if you stop and drink fast, it still costs you 10 to 15 seconds for every water stop," he explains.
So, Dodakian sped past the water stops, and his times improved. In 2013, he took the same approach. He drank water before the race but not during it.
The One Symptom Dodakian Wishes He Had Paid Attention To
Dodakian has a fast-paced career and colleagues that span multiple time zones, so he's used to handling a lot at a time, but he wishes he had noticed how tired he was both before and during the race.
"I had been dealing with a lot of people and business partners in Asia," Dodakian says. "At that time, I was really busy. The timezone difference in Asia is about 12 hours for us...there was definitely a lack of sleep on my path that accumulated over time."
The day before the race, he attended his niece's wedding. He didn't have anything to drink that night (or the week leading up to the race—a habit he started to put himself in the best chance to succeed). However, he got home at 1 a.m. and was up at 5 a.m. to shower and head to the race.
This experience tracks with a small study that suggests that sleep restriction could decrease vigilance and increase risk in the heat.
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Right Place, Right Time
Dodakian has many fond memories of the Falmouth Road Race. However, he has "zero memory" of the final mile of the 2013 race. Dr. Robert Huggins, Ph.D., LAT, KSI's president of research and athlete performance and safety, still remembers Dodakian's finish.
"When Richard arrived at the medical tent, he was confused, unsteady on his feet and stumbling as he walked," Dr. Huggins says. "He was also sweating profusely, had a vacant stare and slurred his speech. I knew right away it was exertional heatstroke, which is also called EHS."
Dr. Huggins and the team took his rectal temperature, which he explains is the sole valid measure of core body temperature in the field.
"After confirming he was suffering EHS with a temp over 105 and the observed mental status dysfunction, my team and I immediately immersed him in an ice water tub and cooled him down," Dr. Huggins explains.
That's where Dodakian came to and asked if he would survive. The doctors told him they were doing the best they could, but he would need to go to the hospital.
"Richard experienced overshoot hypothermia, which caused his temp to go to below 96," Dr. Huggins says (overshoot hypothermia is a serious type of hypothermia that happens when you're overheated). "He wasn't regulating temp well, so we transported him to Falmouth Hospital to ensure nothing else was happening."
Dodakian received IV fluids and was cleared to go home that afternoon, though he understandably didn't feel well.
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What to Know About Heatstrokes
While receiving treatment, Dodakian learned he had heatstroke. And, when he says that he wouldn't be here today without the Korey Stringer Institute, he isn't speaking in platitudes.
"EHS is a medical emergency," Dr. Huggins says. "The body temperature is greater than 104, and there is mental status dysfunction. EHS must be treated within 30 minutes of collapse to increase chances of survival."
Heat exhaustion can also be dangerous but is distinct from exertional heatstroke.
"Heat exhaustion is about fluid losses and fatigue or exhaustion with the inability to continue to perform activity," Dr. Huggins says. "The body temperature is less than 104."
Since time is of the essence, understanding signs is critical for saving your life or that of a loved one. "The body temperature greater than 104 with mental status changes such as disorientation, confusion, vomiting, nausea, dizziness, anger, irritability and sometimes loss of consciousness, usually coupled with stumbling, staggering and often collapse," Dr. Huggins says.
People of all ages can suffer heatstroke. Dr. Huggins says people with higher risks include people who are:
Performing intense activity in the heat
Not acclimated to the heat
Unfit or untrained
Wearing protective layers or equipment
Taking medications known to increase metabolic heat production
Dehydrated
Lineman in football
Living with an underlying illness
Dr. Huggins says that if you suspect a loved one is having a heatstroke:
Immediately remove them from the heat
Call 911
Cool them down using ice-cold water in a tub, by rotating ice towels over the entire surface of the body or placing them in a cold shower
Get someone to confirm EHS
Let EMS know that they have EHS
Ask that EMS continue to cool and transport after they are below 103
To reduce your heatstroke risk, Dr. Huggins advises that you:
Get or remain fit and acclimate to the heat or work
Stay hydrated and consume electrolytes
Plan ahead and know the temperature and humidity, ideally the Wet Bulb Globe Temperature (WBGT), which measures heat stress in direct sunlight
Take breaks. "A great place to start is 20 minutes of rest for every 60 minutes of activity," Huggins says.
Recover in cool conditions
What Dodakian's Life Is Like Today
While heatstroke can cause long-term damage, Dodakian says he's one of the "lucky ones." He quickly returned to playing basketball and still runs and participates in the Falmouth Road Race. He's signed up this year. You might see him—not just at the start and finish lines but also at the water tents. These days, he grabs cups of water from two to three of the tents (there are about five on the course), he says.
"I'd be crazy if I didn't stop," Dodakian says. "I drink a cup of water and dump another on my head."
Dodakian hopes others learn from his story. "It's hard to talk to competitive people, but you can at least put the thought in the back of their mind," he explains. "If something feels a little funny, maybe you pull the throttle back, drink water or put some on your head. I don't want anyone to experience what happened to me."
The silver lining? Dodakian gained a "brother for life" in Dr. Huggins, who is proud of his former patient for literally living and learning.
"People like Richard must continue to tell his story because EHS is not well known by the public," Dr. Huggins says. "Most have never seen an EHS and don't know the signs and symptoms."
Next up: The #1 Sign You Aren’t Drinking Enough Water—and How To Tell if You're *Overhydrated*
Sources
Climate Change Indicators: Heat-Related Deaths. Environmental Protection Agency.
2023 was the world’s warmest year on record, by far. NOAA.
Extreme heat and your health. CDC.
Richard Dodakian, runner who survived heatstroke
Effects of partial sleep restriction and subsequent daytime napping on prolonged exertional heat strain. Occupational and Environmental Medicine.
Dr. Robert Huggins, Ph.D., LAT, the Korey Stringer Institute president of research and athlete performance and safety.