Heat related health problems

Who can make a rainbow?

Al Roker’s weather map yesterday was just about every shade of yellow, red and orange. Other than the shores, there wasn’t a spot of blue to be seen. Simply put, it was a hot one. And today in Baltimore, it’s more of the same. With the heat index it will feel like 105 to 110 degrees. I guess if you’re in Vegas, where it is actually 108, that doesn’t seem so bad.

But as uncomfortable as it is, the one comfort we can always take with the weather is that it will soon pass. Yet, I was interested to learn this weekend that some of the effects of a prolonged heat wave may never pass.

9 days in Chicago

That disturbing information comes from a study released four years ago, but it’s still relevant, especially today as we brace for another scorcher. Researchers from the University of Chicago Medical Center followed 58 subjects who were admitted to 12 hospitals in the Chicago area during what has come to be known as the Chicago Heat Wave of 1995.

During this oppressive weather event, more than 600 people died over a period of 9 days. The true severity of the heat is best put into perspective with a look at the low temperatures. Over one two-day period the low didn’t dip below 89 degrees. Meteorologists consider this to be so rare a weather event that they say there is less than 1% chance of it ever happening again.

Long term effects

The UCMC team chose their subjects from more than 3,000 patients suffering heat-related health problems who were admitted to Chicago area hospitals between July 12 and July 20, 1995. All 58 subjects experienced symptoms of near-fatal heat stroke. Each was interviewed at the time of their discharge from the hospital, and again one year after their discharge.

Almost a full quarter of the subjects died within the year – most of them within the first three months. All of the remaining survivors suffered some amount of brain and nervous system impairment. Approximately half showed kidney problems and blood clots, while 10% of the group experienced malfunction of the lungs due to inflammation. After taking into account each subject’s report on his health conditions before their hospitalization, all of these side effects were judged to be a direct result of the heat stroke.

Perhaps the most significant finding was that age was not a factor among the subjects who died, in spite of the fact that the elderly are generally at greater risk of suffering heat stroke. Subjects ranged in age from 25 to 95, with the average age of the group being around 67.

The study also recognized the fact that because of overcrowded conditions in all of the participating hospitals during this crisis, the immediate care – which is critical with heat stroke – was not as comprehensive as it should have been, underlining how important it is to quickly seek medical attention when the first signs of heat stroke occur.

Beating the heat

If you live in one of the hot spots, you’ve probably heard the basic advice from your local TV newscasters: stay out of the sun, don’t eat heavy meals, drink plenty of water, avoid dehydrating beverages such as alcohol and coffee, and wear light clothing.

Beyond that good advice, however, everyone should know these signs of heat exhaustion and heat stroke: the skin may become flushed, accompanied by headache, nausea, disorientation and heavy sweating. As the body temperature rises the skin will become hot and dry and sweating will stop. As soon as these symptoms appear the victim must be cooled immediately, either with air conditioning, fans, or with lukewarm water. Cold water should not be used because it may cause shivering which raises the body temperature.

To further avoid heat related problems, Mary L. Hardy, MD, director of the Integrative Medicine Medical Group at Cedars-Sinai Medical Center, cautions that anyone who knows they’ll be exposed to the heat should do more than just drink plenty of water. She suggests adding a little diluted fruit juice containing vitamin C to your water. This will increase your level of antioxidants that can help protect cells and muscles from dehydration damage.

Replacing electrolytes that are lost when you sweat is a primary concern also. Electrolytes are electrically charged ions that your cells need to carry electrical impulses to other cells to maintain muscle and nerve control. In most heat related situations you won’t need to worry about electrolytes if you’re getting enough water. But if you begin to feel weak from dehydration you should look for a beverage containing sodium, potassium and magnesium, all of which can help replenish electrolytes. Sports drinks usually contain these minerals, but they also typically contain sugar and flavorings. So if you must resort to a sports drink, I suggest you dilute it with water.

Most importantly, you simply can’t neglect your body’s hydration cycle: optimize conditions that allow sweat to evaporate while constantly replacing the fluids lost through sweating.

Other than that, all we can do is wait for this to pass. After all, if Al Roker hasn’t figured out how to add a little more blue to the map, what chance to the rest of us have?

To Your Good Health,

Jenny Thompson
Health Sciences Institute

Sources:
“Near-Fatal Heat Stroke During the 1995 Heat Wave in Chicago” Annals of Internal Medicine, 1998,129:173-181
“Severity of Classic Heat Stroke Recognized” University of Chicago Medical Center Press Release, 8/1/98
“The 1995 Chicago Heat Wave: How likely is a recurrence?” ncdc.noaa.gov/pw/cg/chiheat
“Surviving Summer Scorchers” MSN Health, 7/15/02
“Even in the Amazon Jungles, Treatment for Heat Exhaustion is the Same as it is Right Here at Home.” Cedars-Sinai Medical Center Press Release, 8/18/99