How could something like this happen to someone as physically fit as John?

Let me break this down.

From last week’s episode, we saw John was building fire and seen repeatedly blowing on it when he felt dizzy.

He lay down, fell asleep, but was easily arousable. His tribemates then noticed that his breathing quickened.

The medical team was alerted about this immediately and we arrived at the scene approximately 5 minutes after being alerted.

There was no loss of consciousness, no vomiting, but he complained of stiffening of his muscles, his inability to move them and difficulty opening his eyes.

John was alert, conversant although hyperventilating when we arrived and remained that way during transit to the nearest hospital.

He was beginning to show signs of movement on both lower and upper extremities when we were on the speedboat. His breathing became normal.

We were considering that John was having a hyperventilation syndrome, and was possibly hypokalemic, which meant that his potassium levels were below normal.

This was what the Thai doctors have also seen after their examination and laboratory tests.

What is hyperventilation syndrome? Dr. Katherine Vinculado-Rosado, an Internal Medicine specialist at the MegaClinic, explains.

“Hyperventilation causes release of C02 from the body placing us in a state of acute respiratory alkalosis, or an increase in blood pH.

During this time, the potassium is redistributed temporarily so we are actually in a temporary state of hypokalemia.

Also, this state of respiratory alkalosis temporarily shifts ionized calcium to the intracellular space placing the body in a relative state of hypocalcemia (low calcium levels), like tetanic or tetanus.

When this happens, there will be a tingling sensation around the eyes and extremities.

There might also be muscle rigidity, twitchings, and lockjaw which is very temporary.

Once breathing is restored, the whole thing shifts back to normal spontaneously. ”

How can something like this happen to John and not the other castaways?

According to eMedicine, the underlying mechanism by which some patients develop hyperventilation is unknown, but there are many theories.

A population clearly exists in whom certain stressors provoke an exaggerated respiratory response.

John was admitted overnight and was found out to have mildly decreased potassium. He was given potassium that night. It was corrected by early morning so he was discharged.

However, John was warned that this could happen again. Bananas may sustain him but may not prevent him from having hyperventilation syndrome or hypokalemia again during the course of the game.

With this warning, John decided to return to the game. And so he came back.