July 2013

Keep Cool In The Heat

No matter where you live in the U.S., it’s been tough to escape the heat! It’s even been unusually hot in Alaska. When we talk about getting overheated, we’re talking about several different conditions. As our bodies heat up, the conditions progress.

Normally when we get hot, we sweat; that’s how our bodies cool down. We can avoid dehydration by drinking plenty of fluids. (If you’re dehydrated your skin begins to tent – you can pick it up and it stays that way – and you either stop urinating or it becomes very concentrated and dark in color.) When we continue to sweat without drinking water and/or sports drinks to replenish fluids and electrolytes like salt – that’s when heat-related illness occurs. The first sign of heat-related illness is heat cramps, which are muscle spasms. I have had these and they are very unpleasant! Some people may, in addition, get a rash from excessive sweating.

The next phase is heat exhaustion. Outside temperatures (from the high 80s and up), combined with humidity, can lead to heat exhaustion if the body doesn’t have a chance to cool down and fluids aren’t replenished. Symptoms include a rapid but weak pulse, fast breathing and excessive sweating.

The last phase is heat stroke. The elderly, small children and people on certain medications, such as diuretics, may be more prone to heat stroke. This is a potential killer. The body temperature can rise above 106 degrees and a person may become delirious. The skin will become dry due to the inability to continue sweating, and he or she will have a rapid pulse.

What To Do
For mild heat cramps, drink sports drinks and eat some salty foods to replace the salt that is lost from sweating. If muscle cramps become severe, you may need to head to the ER for intravenous fluids and relief.

What about heat exhaustion? Move to a shady spot or get into a place with air conditioning as soon as possible. Drink salty fluids (like a sports drink or tomato juice). If you’re with someone showing heat exhaustion symptoms, be watchful that they remain alert. If they seem confused you may need to hold off on the fluids. Seek immediate medical attention.

If someone is suffering from heat stroke, call 911. While help is on the way, cool them down as much as possible by wetting their clothes and sponging them down with cool water. Ice packs applied to the groin, neck and underarms can be helpful. Getting a person with heat stroke to an ER is urgent since it can cause permanent brain damage.

Prevention Is The Key
Avoiding situations where you could fall victim to overheating is the best course of action. Days when outside temperatures hit over 90 degrees are perfect for heading to the movies or working out at the gym – not sitting on the beach! If you do head outside for any period of time, think ahead. Wear a hat and light-colored clothing that won’t absorb the sun’s heat. Bring plenty of water and drink every 15 minutes, regardless of whether you’re thirsty or not. If you’re doing any kind of physical activity, rest often in the shade. Along with looking after yourself, take care to check on elderly neighbors or relatives. You’ll want to be sure their AC is running or, if they’re dependent on fans to stay cool, that they’re drinking plenty of fluids and haven’t become woozy.

Be smart this summer. Stay cool, stay healthy!
– See more at: http://blog.sharecare.com/2013/07/30/stay-safe-when-temperatures-rise/#sthash.1JtKuKOc.dpuf

The More Things Change, The More Things Stay The Same

As a physician with conventional medical training, I often used to look at home remedies with skepticism. I have had several patients who have sworn that apple cider vinegar was good for whatever ailed them. Apple cider vinegar has been around for ages.Hippocrates used it to treat wounds; soldiers in the civil war used it for digestive problems and to prevent pneumonia and scurvy. Apparently Cleopatra used it to dissolve her pearls to make a love potion for Mark Antony.

Studies Showing Benefit

There have been recent studies done at the University of Arizona that have caused me to take a second look at apple cider vinegar. One study looked at 29 patients with either insulin resistance (prediabetes) or type 2 diabetes. They were given either a drink of vinegar, water and saccharine or placebo followed by a meal with 87 grams of carbohydrate. Compared to placebo, blood sugar decreased by 64% in the prediabetes group and 19% in the diabetes group.

Another study looked at weight loss in healthy women.The women were given a morning drink of vinegar or placebo followed by a bagel breakfast. Not only did the vinegar group have a 54% lower blood sugar one hour later, but they also consumed 11-16% fewer calories throughout the day.

Yet, another study found that taking a drink containing two tablespoons of apple cider vinegar along with eating one ounce of cheese before bedtime significantly lowered fasting blood sugars in the morning.

Some Cautions

There are potential safety and side effect issues. Obviously those allergic to apples need to avoid apple cider vinegar. Raw apple cider vinegar can contain bacteria, so it would be better to use the pasteurized form. Apple cider vinegar capsules can cause burning in the esophagus if they get lodged there. Apple cider vinegar can also irritate the stomach. There are potential drug interactions if a patient is taking digoxin, insulin or diuretics. Vinegar can lower potassium levels.


Of course, as with everything, moderation is the key. Taking a mixture of apple cider vinegar in juice or water in the morning may help with both blood sugar and weight control. It is important to discuss this with your doctor before you do it.


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