The Heat Is On—How To Stay Well In Hot Weather

September 1, 2014 - “Summer time and the living is easy” is the famous song line from the Gershwin opera Porgy and Bess. This summer in southwest Florida has been “easy living”—but also hot and humid. Heat and sun, combined with high humidity and little or no wind, can change us from comfortable to over-heated very quickly … if we are not careful.

According to estimates, the number of people in our nation who die each summer from heat-related problems ranges from 175 to 1250. It is important to know the causes of these tragedies in order to avoid them, or get immediate treatment if not.

The Centers for Disease Control and Prevention, in Atlanta, warns that those at greatest risk for heat-related illness include infants and children up to four years of age, as well as people 65 years of age and older, those who are considerably overweight, and patients who are ill or on certain medications.

People suffer from heat-related illness when the body’s intrinsic control system cannot cool itself. Normally, we perspire which cools the body by having moisture evaporate from its surface. Sweating is usually an efficient process which can keep up with heat from the environment. But under very adverse conditions, a person’s body temperature rises above normal, causing first sluggishness, confusion, dizziness, nausea, headache and then progresses to a rapid pulse, abnormal blood pressure and unconsciousness. If left untreated, organ failure ensues followed, ultimately, by death.

Most heat-related injuries can be prevented by good hydration, and by avoiding too-heavy clothing, excess exercise in too hot an environment, poor conditioning, lack of adaptation, sleep deprivation, alcohol use, saunas, poor living conditions, and lack of air-conditioning. People with chronic illnesses and those who use certain medications are also at risk

Dehydration is most common and easily avoided by drinking non-alcoholic fluid before getting overheated or starting to exercise. If you become thirsty, you are already behind on water consumption. Drinking small amounts about every twenty minutes, if vigorously exercising, is prudent. During summer training sessions for athletic teams, hydration can be monitored with practice weigh-ins and weigh-outs. A 2-3% drop in weight signals the need for more hydration. Salt tablets used to be popular but are not necessary. Sports drinks are sometimes too concentrated and can easily be diluted with plain water.

Heat-related injuries include heat stroke and heat exhaustion. Heat stroke is much more serious and can be fatal if not treated quickly. Heat exhaustion is more common, though not as serious; it can, however, progress to heat stroke if not treated.

Heat stroke is divided into two categories related to cause. Classic heat stroke affects mostly elderly, chronically ill, those who do not exercise, and patients on some specific medications. During heat waves in areas without enough air conditioned refuges this first type of heat stroke can be common. The second type of heat stroke occurs mostly in younger individuals who are strenuously exercising or working in hot environments and not getting enough fluids, rest, or shade.

The take home message is to stay cool, enjoy the rest of our summer weather, and “live easy”—with plenty of fluid intake, shade, air-conditioning and good common sense.


 
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Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.