Lower Your Risk

In Summer Sense Volume 1, we talked about the different mechanisms the body uses to lose excess heat, the environmental conditions that can cause them to not work, and the resulting heat-related illnesses that can arise. In Summer Sense Volume 2, we discussed some of the conditions and medications that can make one prone to develop a heat-related illness.

In this edition, we will look at ways that people who are more prone to develop a heat-related illness can protect themselves. These people fall into groups defined by age, certain medical conditions, lifestyle activities and medication use.

The elderly

For younger people, we might say, “Listen to your body,” but that same advice doesn’t hold for the elderly. Seniors do not have as strong a thirst mechanism as do other age groups, nor do they sense heat as well. In hot, steamy weather the elderly should take special precautions.

• Stay indoors with the AC on, or at least with fans running and the windows open. Remember, a fan doesn’t cool the air – it moves it, which aids in sweat evaporation and blowing away body heat.
• Drink plenty of fluids (water, juice, etc.) regularly instead of waiting to feel thirsty, as it may not come! Avoid caffeinated drinks as they can actually cause more fluid loss than gain. Certain medications can exacerbate this phenomenon.
• Close the shades on the sunny side of their apartment or house.
• To avoid additional heat generation, use the microwave instead of the stove.
• Ask family, friends, or neighbors to check in with you during heat waves.

Outdoor workers

Those who work outdoors in very hot weather should be aware of the symptoms (fatigue, dizziness, nausea, etc.) of a heat-related illness. Common-sense practices include:

• Drinking plenty of liquids (they do not have to be freezing cold or even cool).
• Drinking small amounts of liquids frequently – try one cup every 20 minutes when engaging in moderate activity in moderately hot conditions. Note that drinking too much water can also be harmful. Balance is the key. There are no exact guidelines for rehydration, but the limit, in most circumstances, is usually 12 quarts in 24 hours. Normally, the kidneys can process approximately one quart of water per hour.
• Eating small meals with more frequent snacks.
• Avoiding caffeinated drinks (such as cola soda and energy drinks).
• Checking your urine. Clear to lightly colored urine indicates good hydration. Darker, more concentrated urine indicates that not enough fluids are being ingested.
• Avoiding old-fashioned salt pills, which used to be a mainstay of many first aid kits. They were erroneously thought to decrease sweating, but could increase sodium levels in the blood to dangerously high levels.
• Taking frequent rest breaks in an air-conditioned area if possible.

Athletes and the fitness minded

Anyone exercising in extreme heat should have a healthy respect for hot, humid conditions.

• Wear loose-fitting clothing, pace yourself and hydrate well.
• Work out in the early morning or late afternoon (remember to use insect repellent if mosquitos or gnats are a problem).
• Avoid mid-day work outs – they are likely to result in a counter-productive disruption to your workout schedule!
• If muscle cramps develop, stop, hydrate and cease further activity!

For the rest of us

Many people may share qualities or conditions with the above mentioned groups and can draw advice accordingly. Use common sense, listen to your body and employ the guidelines mentioned here relevant to your situation.

Keep in mind how we shed excess body heat

• Evaporation of sweat is the main summertime heat reducing mechanism and is helped by drinking plenty of liquids, wearing loose-fitting clothes, and getting good air flow
• Convection is when moving air carries away body heat – keep that fan handy.
• Radiation of body heat is greatly enhanced by being in a cool place – seek shade and AC as needed.
• Conduction is the direct transfer of body heat to a cooler surface – so jump in that swimming pool, pond or shower if you can or even sit on a cool surface (your grandmother was wrong about sitting on cool surfaces causing health problems!).

We New Englanders can be grateful for seasonal variety. So heat waves will pass. While we are in them, we can take measures outlined in this blog to get through the hot weather — rather than letting it get to us!

Remember, Truesdale Health is here to help you with your medical needs!

Henry R. Vaillancourt MD MPH FAAFP, a Truesdale Health member, specializing in Public Health.