Doc’s Corner

How to Cope with Sumer Heat

We in the Conejo Valley are blessed with some of the best weather anywhere in the world. In fact many of us get so spoiled that when the temperature rises into the 90’s and above for a few days, we struggle to cope with the heat. Perhaps it would be prudent to review some of what heat can do to our body.

Sweating

It’s our natural cooling system. Our body pushes sweat out onto the surface of the skin. As the air absorbs it (evaporation), it draws heat away and cools us down. This works better in drier climates where humidity is low, such as our local area. Generally sweating is a good, protective response. You might get very tired and sometimes seriously ill if it doesn’t work quickly enough.

Heat Exhaustion

It happens in extreme heat when the body can’t get cool enough. Severe sustained sweating results in a loss of too much water and salt. You may get pale and clammy, and your “core” temperature can climb to over 100 degrees. Often one feels tired, weak, lightheaded, and nauseated, and have a headache. It is important to get to a cool shaded area, lie down, and drink something with salt and sugar. Sip water if that’s all you have. If you are at a party, cool down in a pool or get into the water at the beach but before, NOT after, exhaustion sets in. If you ignore it, it could lead to heatstroke, which then becomes an emergency. 

Heatstroke

This is heat at its most dangerous. You can no longer control your “core” body temperature, which can go above 104 degrees. The skin gets warm and dry. Confusion and possibly agitation may set in with a fast thready pulse, nausea, and a headache. Call 911 right away. Left untreated, it may cause seizures, coma, shock, kidney failure and can be life-threatening. Get to a cool area, sip something (if you can), and pack ice under your arms and between your legs until medical help arrives.

Dehydration

Drink water frequently to maintain adequate hydration. When it’s very hot, you can sweat away a lot of fluid, along with essential minerals like sodium and potassium. You may be thirsty and pee less than usual, and your mouth and tongue might feel dry. You could even feel dizzy, lightheaded, and confused and proceed into heat exhaustion. Head for a cool place and drink something balanced with salt and sugar (such as an oral rehydration solution). Serious cases need emergency care, including fluids you get through an IV.

Heat Rash

It happens more to some than others, often in hot humid weather, when you sweat so much that your sweat glands get blocked. When your pores can’t get rid of it, you can break out in tiny red bumps. It’s more likely at your armpits, groin, neck, elbows, and under the breasts. You can help prevent it and treat it if you wear light, loose, absorbent clothing like cotton or some of the newer “dry-fit” athletic clothing designed to wick moisture. Try to stay as cool and dry as possible.

Sunburn

Bare skin burns if it’s in the sun too long unprotected. Some have much more sensitivity than others and some medications enhance skin sun sensitivity. The skin may get reddish, itchy, painful, and warm to the touch. If serious, you could have blisters, headache, fever, and nausea. Get out of the sun as soon as possible. Drink plenty of water, and don’t pop any blisters. A cold, damp cloth and aloe vera lotions may help soothe the pain. Better yet, prevent sunburn with clothes, hats, and broad-spectrum sunscreen of at least 30 SPF, reapplied appropriately.

Fainting

It’s more likely when you’re new to a hot place, so take care to stay well hydrated. Heat can dehydrate you and make it harder for your brain to get enough blood. That may make you dizzy and pass out. It might be worse if you stand for a long time or get up suddenly. Adapting to a hotter place can take up to 2 weeks. If you feel faint or light headed, lie down and raise your legs above your head. Go to a cool area and drink fluids as soon as possible.

Heat Edema

Heat can cause your fingers, toes, or ankles to swell and make your skin feel tight. It’s not serious and usually goes away when you cool down and elevate your legs. If the swelling does not completely resolve or recurs after you are no longer hot, seek medical evaluation.

Higher Heart Rate

When you get hot, your heart may beat faster. It does that in order to pump more blood to your skin, where it can release some of that extra heat. Also as dehydration sets in due to fluid lost in sweat and leaks out into tissue spaces (referred to as “3rd spacing”) can result in other parts of your body may not get enough blood. This could make you feel tired and sluggish, especially if you’re trying to do hard physical or mental work.

Lower Blood Pressure

When you’re hot, you sweat. That makes you lose fluids and electrolytes. Together, these things might drop your blood pressure, sometimes enough to make you dizzy or even pass out. It could be even worse if your heart doesn’t pump normally and isn’t able to adjust to the greater demand.

Confusion

You may find it harder to concentrate and do hard tasks as things heat up. It’s usually nothing to worry about, and you can fix it with a rest in a cool place and something to drink. But if you’re already sick from the heat and you become seriously confused about where you are or what you’re doing, it could be a sign of heat exhaustion or proceed into heatstroke, which needs immediate medical care. 

Should You Exercise in the Heat?

You might be fine exercising when it’s 85 degrees and the humidity is low, if you maintain adequate fluids and take sun precautions. But if the humidity hits 80%, it’s like it’s really 97 degrees. (That’s the “effective temperature,” which you can check online.) Even if you’re healthy, that makes you more likely to get heat exhaustion. Wear loose clothing, drink plenty of water, and know the signs of heat-related illness. Or just take your workout indoors or where ever it is cooler.

Precautions

When a heat wave hits: 

Drink lots of water, even if you’re not thirsty.
Avoid caffeine and alcohol, which dehydrate you.
Eat lighter meals, more often.
Wear lightweight, light-colored clothing.
Check on loved ones who live alone or don’t have air conditioning.
Stay inside or take sun precautions as much as possible and avoid vigorous exercise.
Never leave a child or pet alone in a car, even if it’s not that hot outside.

Extreme Heat

It can be life-threatening, and heat exhaustion and heatstroke aren’t the only reasons. Heat can also trigger heart issues, and even worsen breathing problems, as it boosts air pollution. The city and local health department may have online information about where to find resources such as public pools, air-conditioned spaces, medical assistance, and other help during a heat wave.

Above adopted from Sabrina Felson, MD, Web MD 2018.

Paul R. Block, MD., FCAP, FCCP


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