Even though more than half of the summer is over there are still a number of days left before winter. The heat can do a lot of damage to those who do not respect its power. When the body is exposed to intense heat for too long of a time, serious consequences can result. Fortunately, the body often gives warning signs that allow people to get out of the heat before serious injury occurs.

Heat is known to be a serious health hazard. In July 1995, there was a heat wave that resulted in temperatures over 100^oF in much of the country. It was estimated that 465 people died due to heat-related causes in the city of Chicago alone. Most of the people who died were elderly people who did not have air conditioning and many had other health-related problems. Fortunately, most forms of heat-related injury are milder and can easily be treated.

Heat injury from overexertion has a wide spectrum of severity and often a predictable pattern. The first stage of heat injury is called heat cramps. This usually occurs during exertion and after profuse sweating. The most-worked muscles tend to develop cramps after people have stopped exercising or exerting themselves. This is often due to salt depletion from heavy sweating. Drinking water doesn't help the problem, as water doesn't contain salt. Sports drinks, such as Gatorade, contain salt and can help prevent this form of heat injury.

The next stage of heat injury is heat exhaustion, which can occur with or without exertion. At this point, people start to feel lousy, with fatigue and headaches commonly occurring. People are generally dehydrated, with heavy sweating and need water, salt or both. The person's temperature may become elevated and slowly rise if the person doesn't get out of the sun. People may also feel dizzy, nauseous and may have muscle cramps. Vomiting and even fainting can occur in some people. Salt and water replacement and escape from the heat can treat most people with milder forms of this condition. People with severe forms of heat exhaustion and the elderly or those with other serious medical problems may require hospitalization.

The last stage of heat injury is heat stroke. In this stage, the body has lost the ability to control the body temperature. The person's temperature is usually greater than 105^oF and the person may actually stop sweating. People generally have a change in their level of consciousness and may become delirious or 'out of their senses.' Some even have seizures or go into a coma. Those who have been engaging in strenuous exercise may have muscle breakdown and even temporary kidney failure. Affected people require hospitalization and often need to be in the intensive care unit. It can also result in death in some cases.

Avoidance of heat injury is the best treatment we have. Those who are exercising in the hot sun need to recognize the early symptoms of heat injury. Drinking beverages with salt is preferred at least occasionally when replacing lost fluids. Pushing yourself while exercising is only good to a point and limitations need to be recognized. Marathon runners are common victims of heat injury, as the will to finish the race may replace common sense.

The elderly are much more susceptible to heat injury. Most cases of heat injury in the elderly are not related to exertion. Because of the normal aging process, older people are less able to regulate their temperature in extreme temperatures. In addition, many have other chronic diseases that increase their risk of heat injury. Some are bedridden or not able to get up and get themselves a glass of water due to difficulty in walking or getting around. The most commonly affected elderly are poor persons that live in poorly ventilated homes without air conditioning. The use of certain medications can increase the risk of dehydration and heat injury. Blood pressure medications and diuretics or 'fluid pills,' are the most common culprits. Other drugs that can increase the risk of heat injury include antihistamines, certain antidepressant drugs and some drugs used for psychosis and dementia. If you have an elderly friend or relative, make sure they have access to water and a nearby cool place when the weather gets hot and humid.

Though we all recognize that hot weather can be rather uncomfortable, it's important to realize that it can cause more serious health risks, including death. Learning to watch for the warning signs of heat injury and helping elderly friends and relatives can help prevent this condition. Sometimes, it's better to just head for the shade.

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