The United States Open tennis tournament in New York City in 2018 was called ``the wettest,`` even without much rain. Journalists had fun depicting the ``wetness`` as coming from ``inside out,`` as tennis players ``drowned in seas of themselves`` or ``rained on their own parade.`` This was because many players were soaked from head to toe in their own sweat. The Open was hot and humid from its start on August 27. Ambient temperatures topped 95 degrees and humidity hovered near 50%. Seven of the first 11 days were played under special rules for extreme heat. On day 2, the eventual champion Novak Djokovic and his opponent Marton Fucsovics sat in ice baths for 10 min between their third and fourth sets, while five men quit their matches, citing heat exhaustion or cramping. In the quarterfinals, John Isner went through 11 shirts and lost up to 10 pounds in a four-set loss, while John Millman, in another loss, changed his entire wardrobe V shirt, shorts, socks, and shoes V as early as midway in the second set, when he was dripping so much sweat that the tennis court became dangerously slippery. So the Open in 2018 was not all fun and games. It was survival of the fittest in the heat. And with climate change on us, we can expect more of the same in the near future. My focus, however, is not on climate change, but on pearls and pitfalls in preventing and treating heat cramping.
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