Heat Stress MUST be Managed

Humans were born to live outdoors, and this planet is perfectly suited to providing for our physical needs. However, not all conditions or circumstances we encounter are conducive to our good health. We can't live long in a desert, or at the South Pole, inside an active volcano, or at the bottom of the Mariana Trench. These examples may seem ridiculous but they illustrate how humans must be aware of their circumstances in order to experience and explore some of the more extreme features of our planetary home. There are some situations that just require more planning & careful management if we choose to go there.

All East Texans are well aware of the heat & humidity our Summers are famous for - but not everyone living here is aware of how easy it can be to overheat. Heat exhaustion & heat stroke are extremely dangerous medical emergencies that affect thousands of otherwise healthy people every year. These life-threatening conditions are completely avoidable if we are intentional about prevention. The dangers of heat stress should not keep the majority of us from enjoying the outdoor activities we love. In the next couple of minutes I hope to share with you some good information about why and how to manage the Summer heat.

There are two different kinds of heat stress:

1) Exertional Heat Stress occurs when people are physically active and produce substantial metabolic heat from using their muscles. This does not require high environmental temperatures, but it is often exacerbated by working or exercising in combination with high heat.

2) Environmental Heat Stress occurs when the temperatures are high enough that our bodies can not manage the heat effectively through perspiration. The most vulnerable populations are the very young, or older folks, or anyone during periods of extremely hot temperatures. By the way, any temperature above 98 F is considered "extremely high" by the experts.

When our bodies get hot, they have natural mechanisms to cool us down and keep our organs functioning. Blood is directed to the surface of the skin and sweat glands excrete a saline solution that uses the phenomenon of evaporation to lower the skin temperature. This system is a real miracle and it requires no conscious effort on our part to engage it. Unfortunately, it only works up to a point, and when the body temperature approaches 104 F critical processes begin to fail.

There are six minor conditions that can result from overheating or too much sun exposure.

1) Sunburn - Most folks are unaware that sunburned skin suffers from impaired sweating. If your skin can not properly sweat then it can not manage the heat load. Sunburn can also cause fever and this further damages thermoregulation. If you have a significant sunburn then you should avoid high temperatures until the burn has healed.

2) Heat Rash occurs when sweat gland pores become blocked. This condition is known as Miliaria rubra, or more commonly, "prickly heat", and it can lead to secondary skin infections. When the sweat gland pores are blocked they do not sweat effectively and body temperature rises as a result.

3) Heat Cramps are brief, painful cramps of skeletal muscles that are usually preceded by twitching that can be seen or felt on the surface of a muscle. During a cramp the muscle produces a hard knot of uncontrolled contraction that can be extremely painful and recurrent. Heat cramps are a sure sign that your muscles are already dehydrated, accumulating waste products, and lacking the enzymes to function properly.

4) Heat Edema is a swelling of the hands and feet caused by the accumulation of lymphatic fluid. This usually causes only minor discomfort, but can become serious if shoes or finger rings become too tight and restrict blood flow. The medical cause of Heat Edema is currently unknown but results from the dilation of blood vessels and impairments in thermoregulation.

5) Heat Tetany is hyperventilation brought on by heat stress. Symptoms include muscle spasms and numbness with some tingling around the mouth.

6) Syncope (fainting or loss of consciousness) is the result of a circulatory failure where blood pools in the peripheral veins and does not adequately supply the brain with oxygen. This condition can be extremely serious as it can result in falls, and grave secondary injuries. Fainting is usually preceded by lightheadedness, dizziness, and a sensation of tunnel vision. People usually recover quickly once they lie down horizontally for several minutes.

Heat Exhaustion is a major condition that follows the symptoms listed above. This condition is a medical emergency and should be treated as such. When the heart cannot pump enough blood to both the skin and the organs to keep you cool and functioning then your life is in danger. Dehydration, reduced blood flow to vital organs, and constricted blood vessels are all contributing factors.

If you or anyone you observe displays the following signs or symptoms take immediate action:

a) generalized weakness or fatigue

b) headache

c) nausea or vomiting

d) dizziness or lightheadedness

e) increased heart rate, breathing, and muscle cramps

f) disorientation and profuse sweating

The above are all signs that treatment should begin immediately to prevent more serious heat injury.

Heat Stroke is a critically serious condition where elevated body temperature has exceeded 104 F and the central nervous system is in severe distress. Heat damage has already begun and dysfunction of the brain is imminent if immediate emergency action is not taken. Common symptoms include delirium, convulsions, or coma. Heat stroke can result in permanent brain damage or death in a short amount of time.

All the above symptoms can precede Heat Stroke and when presented with a change in mental status such as irrational, overly aggressive, and delirious behavior - Heat Stroke should be assumed.

So, all of that sounds pretty scary - and it is - but it can be prevented by practicing the following habits when you are working hard or in hot environments.

1) Always, Always, ALWAYS provide yourself and others with plenty of cool drinking water. Take a bottle with you wherever you go. Keep it handy, and take frequent draws from it even if you do not feel particularly thirsty. If you DO feel thirsty, do not wait to get a drink of water - just plan to take water breaks often and let yourself have that freedom. The job will get done, and the activities you are doing will still be there once you have hydrated yourself. This is by far the easiest measure you can take to stay healthy. (I should also note that coffee, sodas, and alcohol all contain water - but they also contain diuretic chemicals that dehydrate you. These beverages DO NOT COUNT toward proper hydration and in extreme temperatures they should be avoided.)

2) Limit your exposure to direct sun or high heat. This should be easy to understand; if you are working outside in the heat then take frequent breaks to cool down. You don't need to cancel your activity - you just need to manage it wisely. Some good options are:

a) Find shade or make your own. Pop-up canopies are cheap and easy to setup/take down.

b) Take your breaks indoors or where you can find some conditioned air.

c) Setup a high-velocity fan with an extension cord. Airflow helps evaporate that sweat.

3) Stay vigilant and make regular wellness checks on people nearby in high heat conditions. If you and your friends stay alert and watch out for each other then symptoms can be prevented or caught much earlier and this keeps a good time going.

I hope y'all found this information helpful and everyone stays healthy as we work our way through August!

Check back in next week for more thoughts & comments. ~ Steve

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I am posting here an essay I wrote for those of you who might have liked to attend my free clinic tomorrow, but already have other plans on your calendar. Feel free to reach out with any questions. F