By Cindy Krischer Goodman, South Florida Sun-Sentinel
When a middle-aged man arrived Monday at HCA Northwest Hospital emergency room in Margate, Florida, with major muscle cramping from his feet to his shoulders. Dr. Craig Kushnir knew right away what was going on
“He was dehydrated,” the emergency room doctor said, adding that he has seen several patients with intense muscle cramping in the last few weeks as South Florida temperatures have climbed.
Doctors say all kinds of offbeat heat-related illnesses are cropping up from this summer’s extreme heat and sending people to local emergency departments. While heat stroke is one of the most worrisome health risks, the health impacts of scorching temperatures can include anything from horrible anxiety dreams, to painful kidney stones — to people being burned just by falling on the ground.
Rashes and burns
At Cleveland Clinic Florida, Dr. Aisha Subhani, chair of the emergency department, has had patients arrive with ghastly rashes. “They don’t understand why they are breaking out so badly and think they are having an allergic reaction to something,” she said. “Most end up just being heat rashes.”
Then there are the odd burns caused by the near-100-degree temperatures: Children who scorch their rear ends on the playground slide; the beachgoer who fries the bottom of his foot on the broiling sand; or the senior who falls and burns themself on the pavement.
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In Florida, where falls are the leading reason people visit emergency rooms, it can take only minutes when bare skin hits the heated asphalt to cause dangerous injuries.
“The burns can be pretty serious,” Subhani said.
Sunburns this summer also are intense. “You’ve got people who fall asleep on the beach, and wake up and they are toast with severe sunburns,” she said. “We have to treat them like a burn patient.”
Kidney stones
People in pain with kidney stones are frequent visitors to emergency departments this summer, too, doctors say.
Super-hot weather tends to trigger dehydration, which can lead to stone formation.
Dr. Raymond J. Leveillee, a urologist with the Center for Advanced Robotics and Urologic Care at Baptist Health Medical Group North, said Florida, for example, is a high-risk zone for kidney stones, particularly in the summer.
People don’t drink enough fluid and get dehydrated, increasing the chance that crystals can form, Leveillee said. While people outdoors lose fluids through sweating, those going into air conditioning are at risk too, he explains.
“In air conditioning, we can get dehydrated from water evaporating from our skin and not seeing it,” he said. “It’s important to keep your body temperature cooler, but also recognize even in the A/C you need to hydrate.”
The amount of fluid each person needs to drink varies based on how much they sweat, he says. A good way to measure is that you should urinate about a half-gallon of liquid each day.
Some smaller stones can be flushed out by drinking lots more water or lemon-lime drinks.
Leveillee advises anyone with signs of stones, such as pain under their rib cage that comes and goes, or has blood in their urine, to go to a doctor. “If you are in agony, go to an ER.”
Medication reactions
AARP has alerted its members that soaring temperatures put people — especially older adults — at risk for medication interactions. Certain medications reduce blood flow to the skin and interfere with your body’s ability to cool itself down. That makes it harder for someone to handle the heat.
“This issue is particularly important for older people because they tend to be on more medications,” said Kushnir at HCA Northwest Hospital. “If you feel weak and dizzy and are sweating like crazy, that can quickly progresses to heat stroke.”
Heart medications, antidepressants, antipsychotics, ADHD medications, anticholinergics prescribed for Parkinson’s disease and overactive bladder, antihistamines and decongestants can affect your heat tolerance.
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Other medications can cause dehydration, and may make the skin more sensitive to the sun, raising the risk of a rash or sunburn.
Medicines that make your skin sensitive in the sun and put you at greater risk for sunburn-like symptoms are antibiotics, antifungals, statins and diabetes medications.
Gastrointestinal illness
In extreme heat, leaving food in the car or outside on a table can cause it to spoil much faster than people are used to. Subhani at Cleveland Clinic says she has treated patients who are vomiting or have severe diarrhea that they eventually trace back to spoiled food.
Preterm birth
A study of close to 14,500 births by researchers at Kaiser Permanente found exposure to high temperatures, including in early stages of pregnancy, are associated with premature birth and stillbirth.
The study shows living with unusually warm temperature during weeks 1-7 and 15-21 in particular are associated with increased risk of pre-term birth and low birthweight.
In addition, the Centers for Disease Control and Prevention has found pregnant women are more likely to get heat exhaustion, heat stroke, or other heat-related illness sooner than non-pregnant women. When pregnant, women’s bodies must work harder to cool themselves down as well the developing baby. Pregnant women also are more likely to become dehydrated.
The CDC warns pregnant women to limit outdoor activities and drink plenty of fluids.
Sleep issues
Sleep experts are seeing an increase in people with insomnia and anxiety dreams stemming from the record heat.
If someone’s bedroom is too warm, natural temperature fluctuations in the brain and body can be affected, and not only can they have trouble falling asleep, but the hot air can interrupt their rest at various points throughout the night, said Dr. Jaime Tartar, research director with Nova Southeastern University’s Department of Psychology and Neuroscience in Florida.
“This is important because during REM sleep, we process our emotions, and interruptions to REM sleep can impair our daytime mood,” Tartar said.
Climate also can affect how you dream, and what you remember.
When your body is hot, dreams can become more vivid, unpleasant and cause you stress long after you wake up. You may even wake up feeling more tired and stressed than you did when you fell asleep.
Tartar recommends keeping the bedroom dark and cool, at an ideal temperature of 65°F.
Heat exhaustion and heat stroke are a risk, too.
Overall, these emergency medicine doctors say they are seeing patients with heat-related illnesses that could be prevented. “If you plan on hydrating once you start sweating, then it’s too late,” Kushnir says “You have to do it before.”
Sun Sentinel health reporter Cindy Goodman can be reached at [email protected].