By Martha A. Simpson, D.O., M.B.A.
Assistant Professor of Family Medicine
Ohio University College of Osteopathic Medicine

FOLLOWING COMMON SENSE TIPS CAN PREVENT HEAT-RELATED ILLNESS

This week’s column is in a slightly different format than most “Family Medicine” columns. Instead of replying to a specific question, I’m going to answer what might be termed a “composite question.” In the last few weeks, several people have asked me about heat-related problems, their prevention and management. With hot summer weather having finally arrived here in the Midwest, this seemed like a most appropriate subject.

There are several categories of heat-related illnesses, and most are linked to your level of activity in a high-temperature environment. This activity does not have to be outdoors -- it can be indoors in a non air-conditioned environment. As with most medical problems, it’s better to take preventive steps than to try to treat heat-related problems after they develop.

Heat edema is fairly common and occurs when you retain water and salt from the heat. Swelling of the hands and feet is typical with this disorder, and it’s treated by getting out of the heat and drinking more fluids.

Persons who are unaccustomed to extreme temperatures can have heat syncope. They become dizzy or faint when their body tries to cool down while in a hot environment. What happens is that the blood vessels dilate so the vessel wall is closer to the skin’s surface, allowing for better cooling through the skin. At the same time, the skin is cooling down as sweat evaporates from its surface. This process effectively dissipates more heat, lowers the temperature of the blood and reduces the body’s core temperature. However, the dilated blood vessels also cause a drop in blood pressure that can reduce the amount of blood going to the head and brain. This can lead to a fainting spell.

Again, prevention is the key. You should avoid exposure to extreme temperatures. If that’s not possible, I urge you, at the very least, to minimize the time you are exposed.

Heat Cramps are seen in athletes -- particularly runners -- who exercise in the heat. They get severe muscle cramps from low-sodium and fluid levels in their bodies.

A serious form of heat-related illness is called heat exhaustion. It is caused by a very heavy loss of fluids and salt from the body through sweating. The final stage of heat exhaustion -- called heat stroke -- can be fatal if not recognized and treated promptly.

So here are some commonsense tips for functioning in the heat and preventing heat-related problems:
• Don’t go out in the heat if you don’t have to.
• Do stay indoors in a cool, air-conditioned place.
• Do pull the shades and minimize your activity.
• Do wear loose-fitting, light-weight clothes.
• Don’t forget to drink plenty of fluids, but avoid caffeine, alcohol and too much sugar.

If you do not have air-conditioning, a fan can help. But when temperatures get over 90 degrees F, a fan is not enough to prevent a heat-related problem. In that case, use cool cloths, showers or ice packs to reduce your body temperature. Better yet, go to an air-conditioned mall or public library.

If you must go outside during a heat wave, go out in the early morning hours or evening. When outside, rest frequently in shady areas. Also remember to wear a wide-brimmed hat, loose, light-colored clothing and use a sunscreen.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnosis and recommend treatment for any medical conditions. Past columns are available online at http://www.FamilyMedicineNews.org.