I often am required to attend horse shows with my wife and daughter. In midsummer, the temperatures are frequently well above 100 degrees. Sitting in a stifling barn, I feel the sweat drip off of me, feel my heart beating, and when I stand up, I feel dizzy and lightheaded. I have had a heart attack and take medications to prevent a recurrence. These medications tend to lower my blood pressure and make me very susceptible to problems when the weather is hot. While I love watching my family compete, the summer horse show is, to be frank, torture!
During heat waves, many susceptible individuals are at risk of becoming dehydrated and having a heat stroke. Exposure to high heat causes profuse sweating, an increased heart rate and respiration as the body tries to maintain a normal temperature. Increased flow of blood through the lungs and skin helps reduce body temperature. Excessive heat exposure can cause a heart attack or stroke, particularly in people with cardiac problems. High blood pressure, diabetes or significant obesity increases the risk of heat-related illness. Medications can make coping with heat waves more difficult. Many tranquilizers interfere with the body's ability to cope with heat, as do drugs used to treat many psychiatric disorders. Beta blockers prescribed for high blood pressure or to prevent heart attacks and diuretics that promote fluid loss make coping with heat more difficult. Alcohol in excess leads to fluid loss, and by interfering with judgment, may result in inebriated people spending more time in the heat than they should.
Older persons are at particular risk of serious problems during heat waves. Aging blunts the thirst drive, making it difficult to recognize dehydration and the need to increase fluid intake. Research has shown that when fluid is withheld from anyone older than 70, it takes a much longer time for the body to replace the withheld fluid than it does in a younger person. And if fluid is not replaced, a condition called delirium develops that causes confusion, even less fluid intake and a vicious cycle of worsening dehydration and confusion.
Once dehydration occurs, the ability to regulate body temperature becomes compromised. The temperature can increase to 105 degrees or more. This, in turn, leads to damage of many organ systems and a high risk of death. Each year hundreds of older persons die from heat stroke, particularly if they live alone or in homes that do not have air conditioning. For many older people, problems with heat can occur without much exertion, but for younger individuals, spending a great deal of time outdoors during extreme heat or exercising when it is very hot, can be dangerous. Early problems suggesting issues with heat include dizziness or fainting, profuse sweating, cold and clammy skin, muscle cramps, a rapid heart rate, and nausea or vomiting. As the problem progresses, heat stroke can occur. Symptoms include increased confusion, unconsciousness, seizures and serious falls in blood pressure that can be life-threatening. If you have any of these problems, get out of the heat and drink plenty of fluids. Call 911 if the person becomes confused, disoriented or collapses. Recognize, too, the serious problems that can occur in older persons, and during heat waves, make sure to check on them frequently to assure that they have air conditioning and are coping with the heat.
Whether you are younger or older, healthy or suffer from chronic illness, be prudent in dealing with sultry summer days. But that does not mean that you must spend all your time indoors. Don't go outside during the hottest time of the day, and in a serious heat wave, make sure that you and everyone you know can spend time in a cool place. Drink liberal amounts of fluids, avoid alcohol and caffeine (a potent diuretic), and find out if any of the medications you are taking can increase the risk of dehydration and heat stroke. Follow this simple advice, and everyone should be able to survive the summer without incident.
Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at: DrDavidHealth.com.