Heat Can Kill - by Dr David Delvin

BEWARE – THE HEAT CAN KILL!

Did you know that excessive heat can kill you?

Unfortunately, it’s true. Furthermore, the older you are, the more vulnerable you are to hot weather. So if you’re over 50, you need to take care of yourself when our weather is at its warmest – or if you go on holiday to some sweltering country.

Furthermore, if your aged Mum or Mum-in-law is thinking of heading off to Athens or Rome at the height of summer, I suggest you advise her not to!

You see, in the last few years, doctors have begun to get very concerned about the effects of hot weather on the 50-plus generation. The increase in global temperatures has proved to be a real threat to the lives of those who are no longer in the first flush of youth.

The most extreme example of this phenomenon occurred in France back in 2003. There was a late summer heat wave – and the result was that the death rate climbed dramatically. Fourteen thousand elderly people died! And the older they were, the more likely it was that they would succumb to the heat.

That dreadful episode made headlines all over the world. But what is NOT generally known is that in the UK, the same heat wave caused about 2,000 deaths among older people.

Subsequent British summers haven’t been quite as hot as that. But each year, quite a lot of older folk have died during blistering days and humid nights in August and September. Indeed, in 2006 UK health authorities got so alarmed about the possibility of pensioners being killed by the heat that they issued a series of urgent warnings, urging OAPs to take special measures to keep cool.

For instance, on 9 August 2006 Westminster City Council’s health department came out with the following pretty good advice to ‘the elderly and vulnerable:’

  • · In a heat wave, stay INSIDE between 11 am and 3 pm;
  • · Pull the curtains across sun-exposed windows;
  • · Open your windows, if the temperature outside is cooler than inside;
  • · Drink plenty of cool water;
  • · If you have to go outside, wear a broad-brimmed hat;
  • · Wear light, loose clothing.

Frankly, I reckon there’s a high chance that this sensible advice saved some lives.

IS IT ALL A FUSS ABOUT NOTHING?

Now, if you’re an independent-minded sort of person you may well say: ‘Oh, this is all a fuss about nothing.’

But unfortunately, it isn’t. We can’t get away from the fact that whenever the temperature rises much above 25 degrees Centigrade -- which is 77 Fahrenheit in ‘old money’ -- the death rate starts to rise too.

I have seen a number of Senior Citizens who suddenly had heart attacks or strokes while they were perspiring in the intense heat of summer. Unfortunately, not all of them survived.

Sadly, such cases will become more frequent in the summertime if global warning continues – as it seems likely to do.

WHY DOES IT HAPPEN?

OK, so why do these things happen on hot summer days?

Well, it’s really because us human beings are creatures who are designed to operate in very moderate temperatures – and not at extremes. Our bodies are generally very comfortable between about 10 degrees Centigrade (that’s 50 degrees Fahrenheit) and around 20 degrees Centigrade (which is 68 degrees Fahrenheit). Outside those limits, we can rapidly become very uncomfortable indeed.

Fortunately, Nature has equipped us with special mechanisms in order to deal with extremes of temperature. So if the mercury starts rising too high, our internal systems respond like this:

  • We perspire – and the evaporation of the sweat cools us down.
  • The blood vessels in our skin widen – so releasing a lot of heat.
  • The hairs on our skin lay FLATTER – so as to trap less warm air against our bodies.

That’s all fine. But the problem is that after the age of about 50, these mechanisms don’t work so well. So as we get older, it becomes harder and harder to keep cool when the environment is hot.

As a result, more mature people are unable to control their own temperatures properly. To take a rather drastic example, if you stood your 95 year old Dad-in-law out in the sun for half an hour, his temperature might well go up to 38.3 degrees Centigrade (which is 101 Fahrenheit).

If you’re only – say – 60, the effect wouldn’t be so extreme. But your body temperature would start rising – in a way that wouldn’t have happened when you were 20.

Now a rising body temperature soon starts causing all sorts of problems – with the kidneys, the liver, the heart, and the brain – which is why a high temperature often leads to mental confusion.

Most importantly, a raised ‘temp’ soon makes you DEHYDRATED. That adversely affects the functioning of most of your organs. And critically, it makes the blood too concentrated.

That really is bad news, because the thickened blood starts to have difficulty getting round your body. The result may be a heart attack or a stroke. These disasters can occur surprisingly quickly.

WHO IS AT RISK?

Well, is anyone at special risk of being badly harmed by the heat?

Yes, the main categories of people who have to really take great care on hot days are:

  • The very old;
  • People who already have heart trouble;
  • People who have lung disorders (like emphysema or chronic obstructive pulmonary disease);
  • Folk with kidney problems;
  • The very young and pregnant women;
  • Those who are badly overweight;
  • Men and women with diabetes.

One more point about diabetes: when I practised in the tropics, I soon realized that high atmospheric temperatures were liable to mess up a person’s regular urine tests – because the urine was likely to become so concentrated. If in doubt during a hot spell, phone your doctor or Diabetic Clinic for advice.

CAN MEDICATIONS MAKE YOU MORE VULNERABLE?

Somebody recently asked me whether the pills he was taking could make him ‘at risk’ during heat waves. In fact, the answer in his case was ‘yes.’

As I’m sure you know, people aged over 50 are far more likely to be ‘on medication’ than younger folks are. And some of these pills could actually be less than helpful if you start getting very hot.

For instance, some diuretics (‘water pills’) and statins (‘cholesterol pills’) could become too concentrated in your bloodstream during very hot weather. However, do NOT stop taking medication without your own GP’s say-so.

HOW WOULD YOU KNOW THAT YOU WERE BEING AFFECTED BY THE HEAT?

So how would you know that hot weather was making you ill? Alas, you might not realize – because excess heat so rapidly causes confusion. But things to look out for include:

  • Pains in the arms;
  • Pains in the legs;
  • Pain in the tummy;
  • Giddiness;
  • Light-headedness;
  • Inability to co-ordinate the movements of your arms and legs.

Profuse sweating is of course a sign that you are hot. But beware of the ‘danger signal’ of SUDDENLY STOPPING SWEATING, even though it’s sweltering. This is a sign that the body’s heat regulation mechanisms are starting to give up.

WHAT CAN YOU DO TO PROTECT YOURSELF OR YOUR ELDERLY RELATIVES?

To protect YOURSELF on very hot summer days and nights, I think you should do the following things:

  • Don’t go out on long walks or excursions;
  • If you DO have to go out, or travel in a car or train, make sure you drink plenty of water. Last year, Stafford Ambulance Service was inundated with calls from people who were trapped in traffic jams on the M6 – and who were near to collapse from lack of drinks!
  • Don’t go out during the hottest part of the day.
  • If you have to be out, then for heaven’s sake don’t wear jackets, cardigans and so on. Open-necked shirts, T-shirts and thin cotton clothing should be the order of the day.
  • In the open, wear a hat that gives shade to the whole of your head – and preferably your neck as well!
  • If you feel hot, get yourself into the shade – or preferably into cool water, by taking a bath or a shower, or having a swim.
  • For the night-time, get yourself a decent FAN – or buy air-conditioning.

What about looking after your elderly relatives? Well, apart from following the above rules, perhaps the most important thing is to keep them WELL-HYDRATED. Lack of water can be a killer when one is 80 or 90.

Regrettably, it’s often quite difficult to persuade Granddad or Gran to drink enough water. Many older people have discovered that drinking fluids makes you want to go to the loo!

So, because they don’t want to have to get out of their chair or bed, they tend to MINIMIZE their fluid intake – which is the worst thing they can possibly do.

Therefore, you need to persuade them to drink. Eight glasses a day is a good target. Having a nice, ice-cold jug of water by the bedside at all times is an excellent plan.

Now, it is no secret that many of the ‘summer heat deaths’ that have occurred in recent years have been in Nursing Homes or similar institutions. After the 2003 tragedy, the French Government was so horrified by what had happened that they brought in new laws for care homes. These days, all such establishments in France must have a special ‘cool room’ into which vulnerable inhabitants can be moved in hot weather.

If you have elderly relatives in a home, it’s a good idea to visit it and ask what plans they have for very hot days and night.

Are there windows that open wide? Are there fans? Is there air conditioning? Do the staff take care to ensure that the old folks are well hydrated? Importantly, do they make any RECORD of how much a person is drinking?

These simple inquiries could save your loved one’s life.

TREATMENT OF HEAT SICKNESS

If you suspect that you, or any member of your family, are ill because of the heat, do not hesitate to contact a doctor. Speed is vital.

While waiting for help to arrive, turn on fans or air conditioning. Sponge the skin with cool flannels. If practicable, get ice bags, wrap them in a towel and place them near the affected person. You can even use bags of frozen peas! But don’t put ice or frozen things in contact with the skin, in case you cause damage.

Drinking a glass or two of water is vital, since it may stave off dehydration and even prevent death.

So that’s my advice for the hot weather. Good luck to you and yours during the many hot summers that we can doubtless now look forward to.

Personally, I’m off to buy some air-conditioning!

© 2007 Dr David Delvin / Retirement Matters Ltd. All rights reserved.