FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

READER CONCERNED ABOUT HEAT STROKE, NOT GOLF STROKE

Question: Last summer a friend of mine became seriously ill on the golf course and had to be rushed to the hospital. The doctors said he had heat stroke. I'm concerned that I might overdo golfing this summer and develop heat stroke. How can I tell if I'm in danger?

Answer: Our organs operate efficiently in a very narrow range of temperatures, about 98 to 100 degrees Fahrenheit. The reason we can function well in a wide variety of environmental temperatures is that the human body has effective methods for controlling the temperature of the organs in the head, chest and abdomen.

In a warm environment the body generates more heat than it needs to keep the organs at their optimal working temperature. The body deals with this situation by pumping the warmed blood to areas where its heat can be released to the environment. This is why on a hot day you become "flushed" as the circulation in the blood vessels close to the surface of the skin is increased. Not only is the blood close to the surface, but as I'm sure you know the temperature exchange is augmented by the cooling effect of evaporation of sweat from the skin.

Normally these and other temperature-control mechanisms, including air exchange in the lungs, do a satisfactory job.

In some situations, however, such as prolonged exercise while in bright sunlight on a hot summer day, these methods may not be sufficient to keep the body temperature down where it belongs.

If the internal temperature of the body increases above the optimal level, the body's organs start to work less efficiently and this can produce telltale symptoms. A mild elevation, say to a temperature of 101 or 102, causes some general muscle weakness, nausea, headaches, dizziness, muscle cramps and clammy skin. This milder form of heat-related illness is called heat exhaustion. In the most extreme cases of heat illness, the internal temperature may reach 105 to 107 degrees and cause serious damage to the liver, kidneys, brain and heart. This is called heat stroke, and it may be fatal without immediate medical intervention.

Question: What can I do if I start having any of these symptoms?

Answer: Mild heat-related illness is fairly common. I think most people have worked or played in the hot summer sun until they were so hot and tired that they didn't feel well. This is mild heat exhaustion. The treatment for this is simple. Rest in the shade while drinking plenty of liquids. An equally effective alternative is to have a bit of water to drink, then take a quick dip in a swimming pool or lake. This lowers your body temperature and replenishes the water you've lost through perspiration. You will be back in action fast.

The most serious form of heat-related illness is heat stroke. One interesting but not always present symptom in heat stroke is a lack of perspiration even though the person is very, very hot. A person with heat stroke will be weak and confused. He or she may even become unconscious. Immediate medical attention is necessary to save the person's life.

If you think someone has heat stroke, call emergency medical services immediately. While waiting for the ambulance to arrive, move the victim into the shade. It will help lower the body temperature if you spray his or her bare head, chest and abdomen with cool but not cold water. Offer liquids to drink if the person is able, but above all else, call for emergency medical services.

I'd suggest that you have a good time playing golf this summer. Just be aware of the symptoms of heat-related illness. If you start getting hot and tired, head for the club house. Don't wait until you develop the full symptoms of one of these disorders.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.