Medac Health Services, P.A.

Of Special Interest

The Summer Heat Wave.... It is Crashing Down on Us

The summer brings many pleasures including great times at the swimming pool and beach. However, the heat can be very dangerous. This fact is especially true for the elderly, children, and people who are not acclimated to these conditions. Such dangers are in a continuum which includes heat exhaustion and heat stroke. Before we jump into the more severe forms of heat illnesses, let’s first explore the milder forms.

Heat edema presents with swollen hands, feet and ankles. This swelling is secondary to effects of the heat and not to be confused with the swelling that results from heart failure. Heart failure is more likely to present with shortness of breath and swelling (you should consult your physician with any concerns for heart failure). You might be familiar with heat edema. Have you ever been walking on a hot day and noticed that your rings were tighter and your hands felt swollen? This is usually heat edema and is of no real medical concern.

Heat cramps also represent a form of heat illness. The usual presentation is cramping of the shoulders and/or thighs after heavy work on a hot day. The cramps originate from a combination of electrolyte (salt) imbalance and dehydration. For example, a person who sweats and drinks only water is more likely to get cramps than a person who replaces electrolytes with sports drinks (such as Gatorade.) So if you are going to be working and sweating hard, then you may want to drink plenty of fluids that provide you with a balance of electrolytes (this does not include soft drinks—sorry) and water.

Let’s move on to the more severe forms of heat illness. Heat exhaustion and heat stroke lay on the deadly end of the spectrum. A hot environment, dehydration, and failure to heed the body’s warnings lead to heat exhaustion and heat stroke. Warning symptoms include weakness, nausea, headache, dizziness, muscle aches, muscle cramps, and lightheadedness. Heat stroke, the most severe form, can present with all these plus changes in thinking, such as confusion and hallucinations, and body temperatures greater than or equal to 104 degrees. Recognizing these warnings symptoms and following a few suggestions can save yourself a trip to the emergency department and might even save your life. Remember prevention is the key!

Make sure you are prepared. Drink plenty of fluids on hot days, especially when you are outdoors. Sports drinks and water are the best to drink. Wear light-colored, loose-fitting clothing. Try to schedule outdoor activities during cooler times of the day, while trying to spend most of your time indoors on humid, hot days. When exercising or working outdoors, frequently drink and mist yourself with a spray bottle. While we all are susceptible to heat illness, particular groups are at a greater risk.

Make sure that the elderly and debilitated have access to cool, air-conditioned environments. Also, children are especially vulnerable and should be protected. Remember coaches, young athletes are a high risk group to succumb to the dangers of heat. A high risk condition to remember is elevated humidity, which makes sweating less effective for cooling the body. Therefore, people who are new to areas with high humidity (tourists etc.) and when the hot or humid season is beginning, people should slowly ramp up their activity, to allow the body to become use to these conditions.

That’s all for now, enjoy the summer.

--Donald L. McLamb, Jr., M.D.

Dr. McLamb received a BS degree in Biology from Davidson College in Davidson, North Carolina, and his MD degree from the University of North Carolina School of Medicine at Chapel Hill, North Carolina. He completed his residency at Wishard Memorial Hospital and Methodist Hospital, both in Indianapolis, Indiana. Dr. McLamb is board certified in Emergency Medicine and has been a practicing physician with Eastern Carolina Emergency Physicians since 2003.