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CHAPEL HILL -- Last August, Atlas Fraley, 17, started drinking half a dozen bottles each of Gatorade and water a day after he collapsed following football practice.
A year later, the Chapel Hill High School lineman is dead, and dehydration is one of the possible causes.
Fraley's coach and others close to him initially thought Fraley, who was expected to play major college football, died Tuesday from an asthma attack. The medical examiner's office is investigating that, among other possible causes. "We have to sort it out," Deputy Chief Medical Examiner Tom Clark said Wednesday evening.
Dr. Selene Parekh, an orthopedic surgeon at UNC-Chapel Hill, said the issue of dehydration crops up often during summer training.
"It plagued the NFL a decade ago," Parekh said, referring to instances of professional football players getting sick during summer practices. "I think it's a matter, especially with football players, of being jocks, or tough. I don't know if they think it's a sign of weakness getting water. It's hard to know where the breakdown is happening."
But, Parekh said, both coaches and athletes should be vigilant for the signs of dehydration, which occur in degrees of intensity.
EARLY SIGNS OF DEHYDRATION INCLUDE: thirst; loss of appetite; dry skin; flushed, red skin; fatigue, weakness, dry mouth and headache.
IF DEHYDRATION PERSISTS, IT CAN LEAD TO: increased heart rate, increased respiration, decreased sweating, extreme fatigue, muscle cramps and core body temperature increase.
IN ITS LATER STAGES, DEHYDRATION CAUSES: muscle spasms, vomiting, vision changes, mental status changes, confusion and seizures.
HOW TO AVOID DEHYDRATION
The American College of Sports Medicine makes the following recommendations for athletes training in heat:
-Drink to match fluid Loss. Appropriate fluid intake -- before, during and after exercise -- is important to help regulate body temperature and replace fluids lost in sweat. Dr. Selene Parekh, at UNC-CH, suggests taking in a liter of fluid, preferably water, each hour.
-Drink early and often. Don't wait until you're thirsty and then gulp gallons. Drinking over a set period of time is more effective for complete rehydration as rapid replacement of fluid stimulates increased urine production, reducing body water retention.
-Consume salty foods and beverages. Foods and beverages with sodium help promote fluid retention and stimulate fluid intake.
Fraley's father, David, who played quarterback at Winston-Salem State University in the 1970s, said his son had been following his hydration regimen since nightly practices began Aug. 1.
Tuesday was the first day the teenager could not drink several bottles of fluid before practice, because Chapel Hill had a morning scrimmage in Apex. Before that, practices had run from 6 to 8:30 at night. The team left Chapel Hill High at 6:30 a.m.
"He didn't have the chance to do his regular routine with Gatorade and water, Gatorade and water," his father said.
Tuesday's high temperature at Raleigh-Durham International Airport was 89 degrees, normal for this time of year, said National Weather Service meteorologist Mike Strickler. The humidity was very low for August, and the heat index never rose out of the mid-80s, he said.
Tuesday had been projected to be a "code yellow" air quality day, Strickler said, meaning "unusually sensitive people should consider limiting prolonged outdoor exertion." Strickler didn't have air quality measurements.
Fraley complained of a headache during the game against Middle Creek High School. The coaches took him out until he felt better. The headache returned, and they took him out for good.
Fraley drove himself home that afternoon, and his parents found him unresponsive, face down on their living room floor, after they arrived home about 6 p.m.
Many of Fraley's teammates were at an evening scrimmage between Carrboro and East Chapel Hill High School on the East Chapel Hill campus when they learned of his death. Many had expected to see him there as they scouted their future opponents.
Cell phones started vibrating all over Wildcat Stadium about 6:20 p.m. Grief overcame several Chapel Hill players. One, sobbing, was led away by an adult.
Skepticism about asthma
David Fraley does not think asthma killed his son.
"His doctor said that his asthma was fine," he said. "That had been under control. It had gotten better each year that he played football."
People with asthma can safely play sports if they take medication regularly and have their pulmonary function checked, said Michelle Hernandez, an investigator at the Center for Environmental Medicine, Asthma and Lung Biology at UNC-Chapel Hill. People with asthma should also carry a "rescue inhaler" that quickly increases air flow to the lungs in case of an emergency.
"It's tricky, but if you have the medication to reduce the inflammation and their lung function is as good as a normal person, [you can] let them be active," she said. "But make sure you have your rescue medication."
Gridiron in the blood
Football runs in the Fraley family. His mother, Melinda, coaches the Chapel Hill High cheerleading squad. His cousin Dovonte Edwards starred at Chapel Hill High and N.C. State and now plays defensive back for the Detroit Lions in the NFL. Fraley loved to draw pictures of Edwards, his father said.
Scouts projected the 6-foot, 2-inch, 250-pound Fraley would play at the NCAA Division I level, according to ESPN.com. He drew interest from N.C. State, Wake Forest, Georgia Tech, Louisville and Hampton University.
His father said he really wanted to go to Virginia Tech to become an engineer. "That was his dream, to be able to go there, whether he played football or not," said David Fraley of his only child. "He was just a great son. We loved him dearly. He's going to be truly missed."
In addition to playing football and AAU basketball, Fraley helped with statistics and training on the school's basketball and track teams. "He just loved being around his teammates," his father said.
A Facebook group called "R.I.P. Atlas" was created in Fraley's memory. "No one who knew Atlas can say that they couldn't see the potential he had," wrote the group's creator.
A fellow player remembered Fraley as a great teammate, someone who kept the team in good spirits.
"He always looked for the fun side of life," said rising senior Justin Giersbrook, a fullback. "He was just a funny guy. ... It's going to be tough without him."
Giersbrook said he hadn't noticed anything wrong with Fraley at the scrimmage Tuesday.
"He was a young man who was a class act, very well liked," said Chapel Hill High athletic director Ron Hayes. "Something like this reminds everyone that sports aren't always what's important. Family is more important."
A funeral is scheduled for 4 p.m. Saturday at Chapel Hill Bible Church on Sage Road.
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