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Some Like It Hot - But Enough's Enough
Like many Seabrookers I was at the starting line of the fourth of July fun run and dog walk. The thing that struck me, and I think everyone else, was just how hot and humid it already was at 7:30 am. Come to think of it, this has been an unusually hot summer already at Seabrook with some of our hottest days still ahead. When we add exercise to our heat we invite the discussion of heat stress and the several physical disabilities that heat can cause.
We all know that the body has a wonderful way of regulating our temperatures, in fact, if the thermometer is much away from 98.6 degrees F, we know something is wrong. Our cardiovascular system and sweat glands keep us remarkably normal even when it is hot and humid - the kind of lowcountry days my father (in the days before air-conditioning had arrived in Charleston) used to call "three shirt days*." However, if the heat from the environment and heat generated by exercise or physical activity exceed our capacity to eliminate the heat by vasodilation, increased cardiac output and sweating, then heat accumulates in the body and we can suffer a progression of increasingly menacing heat illnesses. These illnesses range from simple heat fatigue (which is benign if treated) to heatstroke (which can have a mortality as high as 15%).
Who is susceptible to heat illness? Anyone who is out in hot (over 85 degrees) and humid weather performing vigorous exercise especially in the sun is potentially susceptible if not prudent. Other factors which will make one particularly susceptible to heat illness are older age, heart disease, other chronic diseases, extreme exercise, sunburn, obesity, sleep deprivation, alcoholism, and several drugs. Patients taking beta-blockers, tricyclic antidepressants, aspirin and diuretics all predispose to heat disorders.
What goes wrong is the cardiovascular system cannot maintain the elevated cardiac output because body fluids are lost to sweating and to internal swelling, then the blood vessels in the skin collapse and finally the body is unable to sweat. As a result heat cannot be dissipated and it will build up within the body ultimately causing a variety of symptoms which are abnormal and if not recognized and treated can lead to serious medical consequences. Symptoms are a weak, but rapid pulse, rapid breathing, no sweating and mental signs of headache, confusion, clumsiness, disturbed gait, dizziness and in very severe cases unconsciousness. If a rectal temperature were taken it would be elevated. If the temperature is over 105 degrees the patient meets the criteria for heatstroke. Lesser temperature elevations and symptoms are categorized as heat exhaustion or heat illness.
Seabrookers, especially us older ones, want and need to prevent heat illnesses and there are a number of things (see table) we can do to make sure we avoid heat stress. Most of the things are well known and make common sense. The most important preventive measure is to stay hydrated with fluids which contain some carbohydrates and salt. The drink Gatoraid is a good one to have when you know you are going to be out and about in our hot humid island weather. Regular gatoraid can be diluted to taste or to avoid too much salt intake if you are on a restricted salt diet. It is not good to hydrate with alcohol since that is a vasodilator and diuretic which could deplete blood volume and coffee and tea are also diuretics. Plain water in excess can lead to dilution of important electrolytes.
If any of the symptoms listed above occur in yourself or someone you are with and you measure or sense a very high temperature immediate first aid should be administered. It is important to get into an air conditioned room if possible. If not cooling can be commenced by removing most clothing, spraying with a mist of tepid water while fanning, immersing in cool water (if subject is conscious). If the subject is alert enough fluids should be taken by mouth and the legs should be elevated at about 15 degrees. Medical attention should be obtained either by transport to a doctor or hospital. If the subject is unconscious 911 should be called immediately.
We live on Seabrook and we are active - that is the secret to healthy aging. However, when the temperature is high, the humidity even higher, and the sun is out - plan the vigorous activity for the cooler parts of the day and only after taking preventive measures. Enjoy the summer!
Survival Tips for Seabrook Heat and Humidity 1. Drink plenty of fluids, carbohydrate-electrolyte (Gatorade or like)
2. Wear light colored clothing that wicks perspiration (cotton)
3. Do not do strenuous exercise in the hottest part of the day in full sun
4. Get acclimated - increase exercise gradually each day in the heat
5. Avoid sunburn
6. Enjoy the air conditioning - that's why it was invented
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* Three shirt day: dry one in the morning, afternoon and evening Other Online Resources Include:
Extreme Heat (Centers for Disease Control and Prevention)
Hyperthermia: Too Hot for Your Health (National Institute on Aging)
Extreme Heat: Tips on Preventing and Managing Heat (Centers for Disease Control and Prevention)
Additional Online Resources Outside MUSCHealthcom:
(MedlinePlus, is an excellent source of health information from the world's largest medical library, the National Library of Medicine. Health professionals and consumers alike can depend on it for information that is authoritative and up to date. MedlinePlus has extensive information from the National Institutes of Health and other trusted sources on over 650 diseases and conditions.)
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