Heat-related illnesses result from an imbalance between man and nature. Nature contributes high air temperatures, high humidity, the radiant energy of sunlight, and still air. You can't do much to change nature, but you can control the human elements that contribute to heat illnesses; undue exposure to sun and heat, unwise exercise, inappropriate clothing, and dehydration head the list.
In medical terms, heat can produce three distinct patterns of injury:
Heat cramps. Heat cramps signal dehydration severe enough to deprive muscles of the extra oxygen they need to exercise. The remedy: slow down, tank up with cool water, stretch out and gently massage the tight muscle, and get out of the heat.
Heat exhaustion. In heat exhaustion, body temperature is high, often above 103° F. Other symptoms include weakness, lethargy, loss of concentration, headache, and nausea; muscle cramps may also occur.
Heat exhaustion impairs mental clarity and judgment, so you may not recognize the problem as it develops. Be alert for early symptoms and take corrective action as soon as they appear. The remedy: Move to a cool place as soon as possible; remove clothing. Apply ice packs if they're available, cool fluids if not.
Heat stroke. There are two distinct forms of heat stroke. Classic heat stroke is the more common; it's the major problem during heat waves, which is why it's also called epidemic heat stroke. The typical victims are elderly people who stay in their stifling homes without air conditioners or fans. Many have chronic illnesses such as diabetes, and some take medications that reduce their ability to sweat. The other form is exertional heat stroke. The typical victim is a man who exercises vigorously in the first few days of a hot spell; many are young, and most are out of shape.
Heat stroke is a medical emergency. It starts out looking like heat exhaustion, but its symptoms are more severe, and they progress more quickly, as lethargy, weakness, and confusion evolve into delirium, stupor, coma, and seizures.
Survival depends on prompt transfer to an emergency ward for aggressive treatment. Expert metabolic and cardiovascular care is mandatory, but even in this era of high-tech medicine, the best way to lower a heat stroke patient's temperature is to immerse him in a bath of ice water or to spray him with cold water and turn on a strong fan.
Other summer woes
Sunburn — and suntan. There is no such thing as a healthy tan. Stay out of the sun, especially between 10 a.m. and 2 p.m. when its rays are strongest. Wear a wide-brimmed hat and light-colored, long-sleeved clothing. Even on hazy or cloudy summer days, put on a broad-spectrum sunscreen with an SPF rating of at least 15.
Dehydration. Summer heat stimulates sweating; perspiration will help keep you from overheating, but it will also dry you out. Fatigue, impaired concentration, excessive thirst, a salty taste in the mouth, dark-colored urine, and rapid weight loss are among the symptoms. The remedy is simple: fluids.
Insects. To avoid bites, don't choose bright clothing or sweetly scented personal care products that might attract insects. Wear long pants and long sleeves, particularly at dusk when insects are most active. Use insect repellents. Carry a bee-sting kit if you are allergic to insect stings, and discuss desensitization treatments with your doctor. Finally, inspect your skin for ticks at the end of a day in the country. If you see a tick, don't squash it into your skin. Instead, use tweezers to grasp the tick close to its mouth, then remove it with a slow, steady pull.
Hydration is essential, and it takes a lot of liquid to preserve your body's circulation and replace the fluid lost in sweat. Even if you're sedentary, you may need 10 to 12 cups of water a day in hot climates; if you exercise, you'll need much more. Cool liquids are best; despite the popularity of sports drinks, nothing beats water.
Hydration is necessary, but it's not sufficient to stave off summertime heat. Here are a few additional tips:
- Get away from the heat. An air-conditioned room is best, but even a fan will help. When you go out, stay out of the sun and avoid the midday heat as much as possible. Wear loose-fitting, light-colored garments.
- Don't exercise when it's hot or humid. If it's humid and above 80° to 85°, jump in a pool or work out in an air-conditioned gym. If you exercise outdoors, do it in the early morning or evening.
- Heed your body's warning signals; if you feel ill, get to a cool place, drink plenty of cool water, and be sure help is available if you don't improve promptly.
September 2008 update