Two days ago, Arman went out bike riding later than he normally did. Instead of biking at either 6 or 7 a.m., he did it at 10 a.m. this time—and on an extremely hot day. He went to the path he usually followed normally two to three times a week. Since it was a holiday, he biked a little farther than normal.
Then, something unusual happened. In no more than two minutes, he started to see spots and felt light-headed. He decided to get off his bike under the shade of a tree. He started to feel disoriented and leaned up against the trunk before passing out. His head hit something hard; fortunately he was still wearing his bike helmet.
Arman was so lucky that a number of strangers stopped and stayed with him. They gave him their water and sports drink, and he sat for a while. He felt nauseous and vomited up all the water he had ingested. Two persons insisted that he should not ride the bike. Another one brought his vehicle, put the bike at the back and drove Arman back to his home.
“It was unbelievable,” he recalled. “I don’t remember the faces of the people who helped me walked me through what had happened. I still can’t believe it happened to me. In hindsight, it makes perfect sense. I had no fluids prior to my ride, and didn’t start to drink until I had been riding for about half an hour in extreme heat and humidity. I was very fortunate.”
Arman was fortunate, but not Dante. He died due to a heat stroke. No one around him realized what was happening; he was hallucinating, stumbling around, acting like he was drunk or something.
Everyone left the house, and a few hours later, he was found
unconscious and was taken to the hospital, where he died several hours later. “Do not assume anything,” the doctor told the family members. “Especially during summer and the person has been out in the open under the sun for several hours.”
Every summer, people become ill while enjoying the outdoors. The culprit: heat exhaustion and heat stroke.
“Heat stroke occurs when the body becomes unable to control its temperature: the body’s temperature rises rapidly, the sweating mechanism fails and the body is unable to cool down,” the Department of Health (DOH) said.
“When heat stroke occurs, the body temperature can rise to 41 degrees Celsius or higher within 10 to 15 minutes,” the health department said. “Heat stroke can cause death or permanent disability if emergency treatment is not given.”
In April last year, a graduating student of the Philippine Science High School collapsed and reportedly lost consciousness during a graduation rehearsal at the school grounds. Although he was rushed to the nearby Philippine Children’s Medical Center, the doctors declared him dead on arrival.
Symptoms of heat stroke
According to the health department, symptoms of heatstroke include headaches, dizziness, weakness, skin rashes, high body temperature and, sometimes, the failure to perspire. Although perspiration is the natural means to cool the body, it may not be enough if the weather is very hot, the DOH warns.
Dr. William C. Shiel, Jr. in a medicine.net feature wrote that, symptoms of a heat stroke can sometimes mimic those of heart attack or other conditions. Sometimes a person experiences symptoms of heat exhaustion before progressing to heat strokes.
People with the following conditions are especially prone to heat stroke: alcoholism; chronic illnesses like heart disease; obesity; uncontrolled diabetes; Parkinson’s disease; the use of certain medications, such as diuretics and antihistamines; and use of some illegal psychoactive drugs. Older people are more prone to heat stroke.
Those living in Metro Manila and big cities are most likely to suffer from heat stroke during a prolonged heat wave, particularly if there are stagnant atmospheric conditions and poor air quality. In what is known as the “heat island effect,” asphalt and concrete store heat during the day and only gradually release it at night, resulting in higher nighttime temperatures.
“Heat stroke is not an accident,” says Dr. Marilyn J. Heine, an ER physician and member of the Pennsylvania Medical Society. “Over the summer, we see too many cases of heat-related illness in the emergency room, but it’s a condition that generally can be prevented with a little effort and lots of common sense.”
Heat cramps and heat exhaustion
Heatstroke, however, follows two less serious heat-related conditions: heat cramps and heat exhaustion.
“Heat cramps are caused by initial exposure to high temperatures or physical exertion,” the Mayo Clinic informs. “Signs and symptoms of heat usually include excess sweating, fatigue, thirst and cramps, usually in the stomach, arms or legs. This condition is common in very hot weather or with moderate to heavy physical activity. You can usually treat heat cramps by drinking water or fluids containing electrolytes, resting and getting to a cool spot, like a shaded or air-conditioned area.”
On the other hand, heat exhaustion occurs when you don’t act on the signs and symptoms of heat cramps and your condition worsens. Signs and symptoms of heat exhaustion include a headache, dizziness or lightheadedness, nausea, skin that feels cool and moist, and muscle cramps. Often with heat exhaustion, you can treat the condition yourself by following the same measures used to treat heat cramps, such as drinking cool, nonalcoholic beverages, getting into an air-conditioned area or taking a cool shower. If your symptoms persist, seek medical attention immediately.
Golden rules
Meanwhile, as heat is intense during the summer months, the health department issued these golden rules to those who travel along the road, hit the beaches or walk under the heat of the sun:
- Increase the amount of water or nonalcoholic drinks that you consume. Drink before you feel thirsty. Just a precaution: if you have a limit on the amount of daily fluid intake or you are taking water pills, consult your physician.
- Avoid drinks that contain caffeine, alcohol or large amount of sugar, as they will cause you to lose more body fluids.
- Stay inside, when and if possible. If you have access to air-conditioner, use it. Electric fans do not provide relief from heat-related illnesses when temperatures are in the mid-30 Celsius and above.
- Take a cool shower or a bath daily.
- Wear lightweight, light-colored, and loose-fitting clothing.
Under the sun
Should you be out there under the sun, do the following:
- Limit your outdoor activity to early morning and evening hours. Secretary Enrique Ona of the health department, however, advised the public to avoid exposure to direct sunlight from 10 a.m. to 3 p.m. From 12 noon to 3 p.m., you should avoid the sun at all costs; in fact, you should stay indoors between these hours.
- Refrain from too much exercise, especially if the weather is very warm. But if you can’t avoid doing exercise activities, be sure to drink at least 2 to 4 glasses of cool liquids every hour while doing exercises.
- Whether you’re walking or running, frequently take breaks under shaded areas.
- Sprinkle water over your skin or clothing, or keep a damp cloth on the back of your neck.
Protective gears
Other ways of protecting yourself from the heat of the sun include using an umbrella or wearing a hat, sunglasses and applying sunscreen.
A study done by dermatologists at Emory University in Atlanta last year found out that an umbrella could help shield skin from ultraviolet (UV) rays.
“The researchers found that any full-functioning handheld umbrella can block more than three-quarters of UV light on a sunny day,” DOH said, adding that a black umbrella is more preferable, as “these seem to do the job well, by blocking at least 90 percent of rays.”
Foods and watermelon
Dr. Benny Atienza of the Philippine Medical Association that advised people must abhor eating food that is salty, high in cholesterol and rich with carbohydrates to avoid heat stroke.
Unknowingly, most Filipinos don’t know that they can prevent the setting in of heat stroke and heat exhaustion just by eating watermelon, according to Dr. Willie T. Ong, an internist-cardiologist who is a staunch advocate of a healthy lifestyle.
“Watermelon has long provided a safe source of fluid for many desert regions in the world,” Ong explains. “Watermelon’s cooling effect comes from its component citrulline, which is converted to arginine in the body.”
Arginine is a substance that help remove ammonia from the body, says Ong, who was given the Outstanding Filipino Physician Award by the DOH in 2007.
He reports that, in South Africa, watermelon rind is placed on the forehead and temples to cool a headache. In India, just like in the Philippines, watermelon is sold by vendors everywhere during summer.
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