Heat stroke: Hottest summer alert

You know it’s summer when suddenly, the temperature shoots up to 39°C (as hot as when you’re shivering with fever) and it is not uncommon for people’s tempers to flare up, too.

It’s sizzling hot you could probably fry an egg on the pavement. It is oh-so-hot you sweat as soon as you get out of the shower.

In the US, death from heat stroke has been reported among children (and pets, too) forgotten in vehicles by caregivers. Heat stroke (or sun stroke) is tagged as the “deadliest weather-related event.” It kills hundreds of people in the US every year.

With the alert up on heat stroke, we asked two doctors from Healthway, the largest chain of mall-based clinics in the country, to answer some of our concerns on this really hot topic. Here are excerpts from The Philippine STAR Q&A with Dr. Maria Alexandra C. Villapol, internal medicine, Healthway Manila and Dr. Jennifer Ann Luna Cantre, cardiologist, Healthway, SM The Block.

 PHILIPPINE STAR: What are the symptoms of a heat stroke?  How do I know I’m about to have one? What are the warning signs?

DR. MARIA ALEXANDRA VILLAPOL: Symptoms of a heat stroke include flushed skin, a high temperature of 40°C or higher, moist skin but some may have hot and dry skin, and a throbbing headache.  As the heat stroke worsens, the heart rate increases (normal is 60-100 beats per minute), because the body starts to compensate for the changes brought about by the extreme heat.  The breathing becomes rapid and shallow.  The person may also experience nausea or vomiting.  What may start as confusion and irritability may progress to a more altered mental state, and the person may have slurred speech, delirium, seizures, and coma.

DR. JENNIFER ANN LUNA CANTRE: Symptoms include weakness, dizziness, disorientation. When these symptoms are experienced while being exposed to hot temperatures, then it is possible that you are having a heat stroke.

Is it anything like a stroke?

DR. VILLAPOL: No, it is different from a stroke. A heat stroke is a result of prolonged exposure to high temperatures, especially if accompanied by physical exertion, such as running on a really hot day.

A stroke, or medically called Cerebrovascular Accident (CVA), is due to an accumulation of blood in the brain (hemorrhage) or a sudden interruption of blood supply to an area of the brain (ischemia).  Both types of stroke are most commonly caused by very high blood pressure.

DR. CANTRE: Although some symptoms of heat stroke are similar to strokes of cerebrovascular origin, these are two different things. The management for the two conditions also differs.

What should I do so I don’t get a heat stroke?

DR. VILLAPOL: To avoid a heat stroke, you should wear loose and lightweight clothing especially in summer.  Apply sunscreen with an SPF of at least 15 if you are going to be exposed to the sun, or wear a hat and sunglasses.  Keep yourself hydrated by drinking eight to 10 glasses of water per day.  If you are to join a sports activity, make sure that you are hydrated prior to the activity, periodically check your hydration status during and after the activity, and increase your fluid intake as needed.  If you are taking any medications, consult your doctor to make sure that these are adjusted accordingly.  And, if possible, avoid exposing yourself during the hottest time of the day.  If you want to do outdoor exercises, schedule it in the early morning or evening.

If I see someone suffering from a heat stroke, how can I help with first aid?

DR. VILLAPOL: The primary goal in the treatment of a heat stroke is to cool the overheated person.  You can help with first aid by bringing the person under the shade or indoors, removing excess clothing, applying ice packs or wet towels over the head, neck, armpits, and groin, and, if available, use fans or air conditioning.

DR. CANTRE: For lay people, the best thing to do if you see someone who is possibly suffering from a heat stroke is to remove the person from the area and put him/her in a well-ventilated/cool place and to make sure he/she is seen by a doctor immediately.

Who are at risk of a heat stroke?

DR. VILLAPOL: Anyone can develop heat stroke.  However, the following are at increased risk: adults over 65 years old, those in military training or sports done in hot weather, those suddenly exposed to hot weather they are not used to, those taking maintenance medications that limit fluids such as vasoconstrictors, beta-blockers, diuretics, antidepressants or antipsychotics, and those with certain health conditions such as lung disease.

What’s the worst thing that can happen when you get a heat stroke? Can you die?

DR. VILLAPOL: The worst thing that can happen is damage to the vital organs (such as the heart, brain, lungs, kidneys) and death, especially if the heat stroke is severe and there is a delay in the treatment.

DR. CANTRE: Yes, the worst case scenario for patients who develop heat stroke can lead to death because the increase in temperature results in cellular injury to various bodily systems which may result in multi-organ failure not compatible with life.

Is it true that with the summer heat, when we take a shower, we should avoid wetting our head first lest we get an aneurysm?

DR. VILLAPOL: No, this is not true.  An aneurysm is a bulge in the wall of an artery that is filled with blood, and is caused by weakness in the arterial muscle.  It is due to hardening of the arteries, aging, genetics, and uncontrolled high blood pressure. It can occur anywhere in the body.  Common locations are the brain, heart, and abdominal arteries. 

DR. CANTRE: Aneurysms are abnormalities in blood vessels caused by either elevated blood pressure or anatomic deformities. These are not caused by showers.

What clothes should we wear in the heat of summer?

DR. VILLAPOL: In summer, we should wear loose and lightweight clothing.  If we are active in sports, we should take note and follow the proper attire for these sports.

DR. CANTRE: It is best to wear clothes that can promote air circulation like cotton, linen, etc. Best not to wear thick clothes or two many layers.

Is there an anti-heat stroke diet? What foods should we eat to cool off this summer?

DR. VILLAPOL: Currently, there is no study-based, proven anti-heat stroke diet.  But there are home remedies that are thought to help with or prevent heat stroke.  These include the following: watermelon, onions, fruit juices, coriander, buttermilk, coconut water, and plums.  However, to be sure, consult your doctor and nutritionist first.

DR. CANTRE: No specific diet for heat stroke. Just make sure you are always well-hydrated. Make sure to drink plenty of water and eat fruits with high water content like watermelon.