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By SARAH SHMERLING | Editor-in-Chief
Summer is officially in full-swing in Pacific Palisades and beyond—which means it’s time to pay extra attention to the signs and symptoms of heat-related illness, especially when spending time exercising outdoors.
“There’s a wide spectrum,” Dr. Gary Green with Primary Care Pacific Palisades – Saint John’s Physician Partners shared when talking about the differences between heatstroke and heat exhaustion. “The problem is some of the signs can be very subtle.”
Green explained that there are both acute and chronic cases of heat-related illness.
“For example, if somebody is exercising in the heat for several days in a row,” Green said, “they may be gradually getting dehydrated and then start experiencing heat illness.”
Symptoms to watch out for include fatigue, reduced mental acuity, nausea, vomiting, muscle cramps, dizziness, headache and excessive sweating.
“When they get really serious, lack of sweating can actually be a more serious thing,” he added. “It can be somebody who is exercising and now they’re not as responsive, it can be excessive sweating or lack of sweating—depending how severe it is.”
When it comes to heatstroke, which warrants immediate medical attention, symptoms include:
- a throbbing headache
- lack of sweat
- red, hot and dry skin
- a rapid strong pulse
- possible loss of consciousness
- cramps in arms, legs and stomach
He shared that while it’s important to be able to recognize the signs of heatstroke and heat exhaustion, the most important thing is prevention, especially in the midst of a heatwave.
Green explained the importance of “pre-hydration,” which is hydrating before going out and exercising. He said that if a person weighs themselves before and after exercising, if they have lost more than a pound or two, that’s probably water that needs to be rehydrated. A person who loses a pound, Green said, should drink at least 12 ounces of water during that time to replace it.
“In this part of LA, we’re fortunate that it typically does not reach very high temperatures,” Green said. “The worst-case scenario for heat illness is very hot weather that’s very humid and not much wind.”
One of the ways that humans dissipate heat is by evaporation, Green explained, so when it’s very hot and very humid, and when there’s no wind, it’s harder to get rid of that excess heat.
“Those kinds of situations fortunately are very uncommon in this part of town because we usually have a nice breeze and we’re by the ocean, and it’s usually not very humid and it doesn’t get too hot,” he said. “However, on those days where we get these very hot conditions, people in this area don’t have enough time to acclimatize.”
Green explained that in most cases, it takes about two weeks to get used to hot conditions, so when there is a sudden heat spell, people in the Palisades and other places with generally cooler weather don’t have a chance to adjust. When somebody has a chance to acclimatize, they typically start sweating at an earlier time when exercising and the volume of sweat increases.
He shared an example of a youth soccer team that is used to playing in the Palisades—where it’s generally cool and lower-risk for heat illness—who go to Bakersfield or the San Fernando Valley where it can be 30 degrees hotter.
“These kids are not acclimatized to that,” Green said, “so that can be a risk for heat illness.”
Some of the ways to prevent heat illness in kids who are exercising in the heat is allowing more breaks, having them cool off under the shade (perhaps in a tent), setting up a fan and encouraging additional water breaks.
When it comes to drinking beverages, Green said that things that have 5% carbohydrates are absorbed better than water, which is what most sports drinks offer.
“In addition, cold fluids are absorbed quicker than room-temperature or warm fluids,” Green said. “The optimal thing would be cold, 5% carbohydrate drinks with some electrolytes.”
He added that people are “much better” off when drinking a little bit throughout the exercise versus trying to drink it all at once, which does not get absorbed as well.
Green emphasized the importance of being aware of the heat index, which can be found through a smartphone.
“When it gets above a certain heat index, you should be canceling sporting events or restricting the activities,” Green said. “Again making accommodations, like having more water breaks or if it’s a sporting event and it can be moved, playing it in the early morning or late afternoon instead of during the heat of the day between 10 and 2.”
If someone recognizes the early signs of heat illness, the most important thing is to stop the exercise and hydrate. The person can also be brought indoors to an air-conditioned space—and it’s important to stay with them until symptoms subside or help arrives.
“If they are really losing consciousness or their temperature is going very high,” Green said, “then they need to be transported immediately to an emergency room.”
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