Despite the swings in the weather the past few weeks, we can be certain that the area is going to heat up and we will soon be facing the dog days of summer. With that in mind, I’d like to discuss heat cramps, heat exhaustion and heatstroke, which are related to each other but vary in seriousness. All three are typically caused by exercise or other strenuous activity in hot environments. Hoopfest is a good example of a situation where they can occur, but you should be aware that they can also occur in settings like a day at the lake or in a home that doesn’t have air conditioning.
The painful muscle spasms of heat cramps are often stronger and last longer than nighttime leg cramps you may have experience with. You can suffer from heat cramps in any muscle in your body, but they are most common in the calves, arms, abdominal wall and back.
To alleviate heat cramps, stop what you are doing, rest and cool down. It is a good idea to drink an electrolyte beverage, preferably one low in sugar. Gentle massage and stretching may also help get rid of the spasms. If your cramps haven’t gone away after about an hour, seek medical care.
Heat exhaustion is more serious than heat cramps, which can sometimes be a prelude to heat exhaustion. Signs and symptoms can develop suddenly or over time and include the following:
Weak, rapid pulse
Cool, moist skin with goose bumps
Initial treatment for heat exhaustion is the same as for heat cramps. If symptoms worsen, don’t improve within an hour, or you begin to see symptoms of heatstroke, seek medical attention immediately.
Heatstroke can permanently damage your brain, heart, kidneys and muscles, and it can be deadly. It happens when your core body temperature reaches or exceeds 104 F and is generally caused by prolonged exertion in a hot environment. Signs and symptoms of heatstroke, which requires immediate medical attention, include the following:
Confusion, agitation or irritability
Hot skin, dry or moist
Nausea or vomiting
Flushing or red skin
If you suspect heatstroke, call 911 immediately. Then get the affected person into the shade or somewhere indoors that is cool. Remove excess clothing and then cool him or her down with anything available. A cool tub of water, spray from a garden hose, ice packs and cool, wet towels are all things that may be easy to get a hold of to cool a person down while emergency services make their way to you. Ice packs and wet towels are most helpful if placed on the head, neck, armpits and groin.
Although we are all at risk from injury due to heat, keep in mind that children and older people are more susceptible. Pets and children should never be kept in a vehicle during hot weather, even with the windows down or air conditioning on. A child’s body heats up 5-7 times more quickly than an adult. On an 80 degree day, the temperature in a car is lethal in about 10 minutes.
People who are used to cooler climates and travel to hotter areas than what they are used to are also at greater risk. Some medications (vasoconstrictors, beta blockers, diuretics, antidepressants and antipsychotics) can affect your ability to stay hydrated and respond to heat. If you take any of these, be aware that your risk is increased.
Luckily, there are things you can do to prevent all three of these heat-related syndromes. I recommend wearing loose-fitting, lightweight clothing; protecting yourself from sunburn with sunblock and clothing; drink plenty of fluids and electrolyte drinks if you are sweating a lot; do not stay in a car parked in the sun; give your body time to acclimate; and take a break during the hottest part of the day.
Bob Riggs is a family medicine physician practicing at Kaiser Permanente’s Riverfront Medical Center. His column appears biweekly in The Spokesman-Review
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