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Hot Time, Summer in the City

With the hot summer temperatures approaching, I am compelled to call and email my pals leaving the message "Hot enough for you?". Trite I know, but I cannot resist. 

One of my closest friends is from India. Once, in an elevator, a stranger asked him "Cold enough for you?". He actually thought for a while and then very politely answered that even a few degrees colder would be tolerable. He made no reference to either the wind velocity or the volume of snow. That's when I realized he needed some weather-talk lessons. Because he's a smart guy and leams quickly, he now anticipates comments about blizzards during the state boys basketball tournament and heavy rains after the peonies bloom. He also knows that the proper answer to "Hot enuf for ya?" is "It's not the heat, it's the humidity". He's actually correct. The more humid it is, the hotter we feel. Our bodies are amazing at maintaining what medical folks call homeostasis. Homeostasis means the balancing of body functions to keep the body working well. The body's first priority is to protect the brain and central organs (heart, lungs, gut) from any adversity (heat, cold, lack of oxygen).
An example of homeostasis is sweating when we are hot. Sweating is a way for our body to
cool down because as the sweat evaporates, it cools our skin, which in turn cools our inner organs. When the weather is hot and humid, we sweat but the sweat doesn't evaporate.  Therefore we are not cooled by the sweating, and our body temperature rises. In addition, we become dehydrated because of the sweating. If someone develops heat exhaustion they may be sweating heavily and their skin might feel cool and wet. Other symptoms of heat exhaustion are nausea, feeling faint, pale skin tone, rapid heartbeat, low fever.

If you or someone else is suffering from heat exhaustion you should...

• Move into the shade or to air conditioned space,
• Lie down and elevate your feet,
• Loosen or remove your clothes,
• Drink a cool (but not cold) beverage- water or a sports drink.

Do not drink anything containing alcohol because it will cause further dehydration. Cool the skin with tepid water and a fan.

Untreated heat exhaustion can worsen into the more serious heat stroke. With heat stroke people develop a high body temperature (104° or higher). People can experience personality changes, confusion or even go into a coma. They may have quick, shallow breathing, and their heart beats fast. One main difference between heat exhaustion and heat stroke is that people experiencing heat stroke stop sweating. So their skin feels dry but hot.

Heat stroke can be fatal. Treatment is the same as for exhaustion: remove clothes, move somewhere cool, moisten the skin, drink cool fluids. If symptoms are severe, or if someone is not improving, call 911.

As with any medical problem, prevention is easier and better than treatment. Use common sense, and the following guidelines to avoid heat related illness.

• Wear a hat or carry an umbrela if you are going to be in the sun. Your clothes should be loose fitting and light in color.  And you should wear sunscreen (this won't prevent heat illness, but is a good idea for other reasons).
• Drink lots of non-alcoholic beverages in order to stay well hydrated. Drink small amounts of fluid continuously, as opposed to large volumes only a few times a day. Signs of dehydration are decreased urine output or dark colored urine. Well-hydrated people have almost clear urine. If a baby stops wetting her diaper, that's a sign of dehydration.
• Plan outdoor activities during the cooler parts of the day (morning and evening). Take breaks during activities so that your body can cool. Sit in the shade or near a fan. If possible, postpone heavy work until a cooler day. Our pets are sometimes smarter than we are... watch your dog or cat...  what do they do on these hot summer days? They lie still in a cool place (our cats used to go to the basement for their naps). Follow their example. Slow down.

If you do fall victim to heat related illness, be especially careful for the following week or two because you will continue to be more sensitive to the heat for a while.

In the 10th annnual reader's poll, conducted by fhe Minnesota Women's Press, Jane Kilian, M.D. was voted as one of fhe Top Docs for "What Women Want! 2007".