The strokes of summer

Blame it on El Niño and climate change, we are one of the countries experiencing extremely hot weather. Last week, I got an urgent call from a friend’s helper. She was worried and wanted advice on what to do, as her employer, who is a senior and a diabetic, was having difficulty articulating her instructions.

She had been summoned to the room midafternoon and found her sweating profusely. Perusing her surroundings, neither the fan nor the air-conditioner was switched on and she had a strong hunch that her employer must have dozed off and was feeling the after-effects of the extreme heat. Subjecting her further to a battery of questions, I was relieved to know that my friend was not exhibiting any signs of motor weakness as she was able to go to the restroom by herself. A little apprehensive that it could be a possible cerebrovascular event or a stroke, I advised her to closely observe the patient, make sure that the room was cool, and ensure that she was given enough liquids. Traffic was a little challenging, so it would take time before I could reach them.

Heat-related illness. The Centers for Disease Control and Prevention defines heat-related illness as preventable and is classified into heat stroke, heat exhaustion, heat cramps, sunburn, and heat rash. Heat stroke is a medical emergency and recognition is of vital importance. Signs and symptoms may include a “temperature of 103 degrees Fahrenheit (39.4 degrees Celsius) or higher, hot, red, dry or damp skin, a fast strong pulse, headache, dizziness, nausea, confusion, losing consciousness or passing out.” Immediate action after calling 911 or the nearest health facility would include placing the patient in cooler surroundings and applying cool cloths to the face, neck, armpits, and groin, or giving the patient a cool bath to lower the body temperature. My friend was fortunate to have just suffered from heat exhaustion. This was my conclusion after doing a history and physical examination. She recounted that she had woken up drenched in sweat, felt cold and clammy, with a headache, felt nauseous, and was extremely tired that she promptly fell asleep after her help attended to her.

Who is at risk? The elderly, persons with high blood pressure, those on certain medications, and individuals whose occupation entails working in hot temperatures, such as construction workers, military personnel, or athletes, are at high risk. But please allow me to emphasize that any individual can suffer from heat exhaustion, even children who are sometimes oblivious to the heat when playing or engaging in outdoor activities. We were all children once and can easily identify.

What to do. Prevention is always key and one should not wait for signs of dehydration. Thirst, urinating less than usual, and experiencing dizziness or muscle cramps are clear signs that you are fluid-depleted. Sweating makes you lose not only water but also needed electrolytes. In children, signs may also include eyes that look sunken, less or absence of tears when crying, or in young infants, a sunken anterior fontanelle. Hydration is important across all age groups. For adults, try to also limit intake of caffeine, sugary, or alcohol-laden drinks. Other helpful measures include wearing light and loose comfortable clothing and avoiding being outdoors when temperatures are at their highest.

Plan your activities carefully for the day around these less-than-ideal times. Air-conditioned environments are recommended, but if it is not always possible or readily accessible, try to be in areas that provide adequate shade and free flow of air. If at home, you can opt to take a cool bath. Electric fans have limited cooling capacity. To block off the untoward effects of intense sunlight, apply sunscreen preferably with SPF15 or higher regularly, following the manufacturer’s instruction, and even if inconvenient, use that often forgotten umbrella, pull out, and start wearing those wide-brimmed hats. For athletes, learn to regulate your workout. Keep your meals light.

Summer for most of us is synonymous with travel and family bonding time. You may have heard of horror stories where a child or children were left in the car. As previously mentioned, they can also be at high risk, so never leave them unattended even when the air-conditioner is on.

In January, we were warned that we may be facing hotter weather in the second quarter of the year. To my knowledge, there are no available statistics on heat-related illnesses in the country. It would be unfortunate to add this to the ever-growing number of challenges that we as a nation are facing. These are preventable. Amongst the various forms, heat stroke is the worst that can happen, has far-reaching complications, may be irreversible, and can even lead to death.

Hydrate and stay cool, everyone.

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