Nikki Sommer, a nurse practitioner with the Key West Surgical Group, joined Good Morning Keys on Keys Talk 96.9/102.5FM this morning for Medical Matters.
With all this heat, it’s important to stay cool and hydrated. When heat overwhelms the body, it can be serious.
Sommer said, “It’s called heat illness, or you hear the term heat stroke in severe cases, that’s when it becomes a true medical emergency. So, living in Florida, in the Florida Keys, or just where it’s hot, I mean, I know I focus a lot on Florida, but as the summer months come, there could be high heat and anybody can be susceptible to heat illness or heat stroke, so if you’re in the sunshine, you like boating, fishing, diving, pickleball, which is really big down here, and I passed a big pickleball indoor court in Miami, and I was like, wow, that’s really taking off. Walking the beach, or you like to enjoy the doors all year round, the beautiful weather is a trigger for us to go outside, but it puts you at greater risk for heat-related illnesses, especially when the temperatures start to rise, and this is that time of year.”
How does our body keep us cool?
Sommer said, “Your body works incredibly hard to keep your internal temperature around 98.6 degrees. When you get hot, it has several ways to cool itself. So, you sweat, so normally when you’re sweating profusely, especially outside, that’s your body trying to regulate your body temperature. Your blood vessels near your skin usually see they get a little wider, they look a little bit more puffier, and then the sweat evaporates, carrying heat away from your body. So, these are all mechanisms to keep your body temperature cool. The problem is, in Florida, it is hot, and also humid. We battle this regularly, and there are other parts of the country that are humid, especially the Northeast, humidity prevents the sweat from evaporating efficiently. So, your body may be producing sweat, but if it can’t evaporate, it can’t cool you effectively. That’s why two people outside in the same temperature can feel completely different, depending on the humidity. When you go out west, it’s dry heat, you tend not to sweat. Here the humidity, you sweat a little bit differently. It affects the way your body regulates its temperature.”
It’s important to remember that heat illness doesn’t usually happen all at once.
Sommer said, “It progresses through stages. So, think of a traffic light. Green light means you might have some heat cramps, meaning you might have some cramping in your legs and your stomach. Yellow means heat exhaustion, and red means heat stroke. So, if you recognize that you’re in the yellow, we often can prevent reaching the red light, meaning heat cramps. The earliest warning sign, like I said, are painful muscle cramps. They’re usually in the legs, the arms, the abdomen. This can happen after prolonged periods of sweating and loss of fluids and electrolytes. That’s what we talked about last week when we spoke about dehydration, is making sure you’re taking in enough fluid, especially if you’re outside. The good news is that your body has a warning system, so you need to stop what you’re doing, move into the shade, again, drink water or an electrolyte containing beverage, and rest. The biggest thing is, don’t ignore the heat cramps, because then that progresses into worsening heat illness, or that big word that you hear, heat stroke. I know people use the little joke around, they’re like, I’ve been outside, I was sweating profusely, and now I have heat stroke, but if you have heat exhaustion or heat stroke, you really will not feel good. So, heat exhaustion is much more serious. That’s when you have heavy sweating, you feel weak, you have a headache, dizziness. If you start vomiting, if you have terrible nausea. If you feel like your heart is racing, but you feel pale, cool, and clammy, like a lot of people, their color will change. They’ll become very, very pale. They’ll feel like they’re going to pass out. There are still people with heat exhaustion who are still thinking clearly. They’re just tired and feel miserable. They know who they are, they know where they are. So, again, getting into air conditioning, removing excess clothing, drinking fluids, and resting. If they become worse, you need to seek medical care promptly, because heat stroke then becomes a medical emergency.”
Heat stroke is not just getting too hot, it means your body’s cooling system has completely failed.
Sommer said, “Your internal temperature rises rapidly, and your organs can suffer some damage. So, the big difference between heat exhaustion, heat stroke is what’s happening to the brain, instead of simply feeling weak, someone with each stroke may become confused, irritable, disoriented, having slurring speech like you’re actually thinking they’re having a stroke, stumble while they’re walking, these signs people can have when you’re having a real stroke, brain injury, becoming combative, any type of seizure or loss of consciousness, that is a sign that they could, if they’ve been out in heat, they could have heat stroke. If somebody who’s been out in the heat suddenly just isn’t acting right, and this is a lot for the elderly. We talk about people that are 65 years or older, although it can happen at any age, you need to treat it as heat stroke, and call 911 and get them immediate medical attention. Fishing is a big activity that everybody likes to do down here. Not only do people do it as a way of life on the weekend, boating, going to the sandbar, but especially for our tourists, they love to come down here and go fishing. So, you can be out on the boat for six hours, and you had a couple of beers, suddenly develop a headache and dizziness, and you tell yourself, yeah, I’ll be fine. A little later, you’re still out on the boat, and you’re not answering questions correctly, or you’re acting strange, your behavior is strange. This is no longer dehydration, so this is when it becomes a medical emergency. The same thing goes for mowing the lawn. A lot of times people want to mow the lawn because if it rains a lot, the grass grows faster during this time of year, so you want to get out there. The best time to do it is early in the morning, at 2 o’clock in the afternoon, you can definitely become overheated, and you could become nauseated. You sit down, you feel confused. The idea is not to push through. That is the time to seek some help.”
It’s a myth that only older adults get heat stroke.
Sommer said, “This time of year, I get a lot of tourists. One one guy in particular, he was out on the boat, he wasn’t drinking beer, he was just a little bit older, and his clothing was a little bit heavier than expected, and the day before it wasn’t so hot, he went again, and he came off that boat feeling pretty terrible. So, it can happen to anybody at any age, especially children and teenagers too, that are playing sports. There’s a lot of leagues that travel, especially down here. They’re the ones that’ll try and push through.”
Another myth is that if you’re sweating, it can’t be heatstroke.
Sommer said, “If you’re sweating, yes, it can be, because I did say, you’re profusely sweating and not feeling well. People with exertional heat stroke may still be sweating, but don’t rely on the sweat alone. Look at their mental status. So that’s the thing, if they’re sweating profusely, but they’re not behaving correctly, it’s a sign that something bigger is going on.”
Another myth is that a person can just sleep off heat stroke.
Sommer said, “If you feel fired, like you want to lay down and go to sleep, especially if you’re having all these other things going on. Heatstroke can damage the brain, kidneys, even the heart. It could just be that you’re completely dehydrated, and that’s why you’re feeling so sluggish. So, you need to seek medical attention right away.”
Who’s at higher risk for these heat-related medical emergencies?
Sommer said, “Adults over 65 infants and young children. Again, those young athletes that are outdoor playing, and they don’t want to let their teammates down, but they’re feeling overheated. Outdoor workers, especially here, we have a lot of workers that work outdoors. Athletes, again, tourists not accustomed to our climate, especially here in the Keys. Like, my husband just said to me that the heat here is different than the heat in Fort Lauderdale. He even felt the difference, he mentioned that to me. He goes, if it just feels hotter down by us, people with heart disease, diabetes, kidney disease, and who are obese, they are usually on certain medications, and that can interfere with the body’s ability to regulate body temperature. So there are certain medications, diuretics, meaning they help remove excess water in your body, beta blockers, that’s heart medication, some antidepressants, antihistamines, and psychiatric medications, Parkinson’s medications, even stimulants for ADHD can alter the body’s ability to regulate body temperature. Then we also have our favorite GLP one medications for diabetes and weight loss. They don’t cause heat illness directly, but a lot of times they decrease appetite and decrease your urge to want to drink. They also have side effects of nausea, vomiting, and diarrhea, so you’ve got to be careful when you’re on those medicines, and you’re going to be out in the heat, talk to your health care provider, make sure you’re aware of what can happen.”
What can be done for someone who is waiting for the ambulance to arrive?
Sommer said, “Move them into the shade, make sure they’re in a cool dry place. If they have on a lot of clothing, remove it. Wet the skin with cool water, especially if somebody is kind of lethargic, and you’re worried that they’re not going to be able to swallow. You can cool them down with cool water, fan continuously. If you have, like, a portable fan, plug it in, have the fan on them, ice packs to the neck, groin, and armpits. If they’re confused or unconscious, obviously, like I said, do not give them anything to drink, they could choke or aspirate, but rapid cooling is a priority.”
Prevention is the best practice.
Sommer said, “Drinking water regularly, wear lightweight clothing, make sure you use sunscreen and a hat, schedule your strenuous activities during the early morning or evening, take frequent breaks, and never leave children or pets in parked vehicles. Heat in Florida and down here is usually the hottest between 11am and 4pm, so, try and plan your activities, especially your outdoor chores, like mowing the lawn, or cutting down your palm fronds before 11 or after four. If you’re feeling thirsty, you’re getting dehydrated. If you see confusion, that means it’s a medical emergency and for all older patients down here, make sure if they woke up feeling they were fine in the morning and just different in the afternoon, there’s something going on. So call 911.”
For more information on how Key West Surgical Group can help, click here: https://www.keywestsurgicalgroup.com/