There was a time we shimmied and danced to this song….. now we just melt. The world is on fire (literally) so I want to offer some thoughts for your well being.
By a certain age, physicians have probably plied you with at least one medication: keep your cholesterol down, your heart rate controlled, your thyroid up, your blood pressure in range… that is just basic, not including the life saving cancer drugs. What happens too often, however, even with electronic medical records, is still lack of coordination. Many of my patients only see their primary care once or twice per year but have monthly specialists on the calendar. So here I have a few suggestions to empower yourself during the hottest summer on record.
First hydrate, hydrate hydrate. It’s the first thing they do if you call an ambulance or go to the hospital. Can’t have blood flow without pressure. Next get a blood pressure monitor at home. In about 20-30% of patients I have to actually stop their BP meds for wilting and barely able to get out of the chair! “But Doc I’ve been on these 20 years”. Ok but now with cancer or other issues even A fib, your blood pressure is probably much lower and you run the risk of having a stroke or collapsing for lack of blood flow, at minimum becoming very weak, lethargic and forgetful.
Take your pressure in AM then in eve and chart it daily. That way when you call your Doc you have real information. “I take these 4 meds and my BP is running 90/50”. No joke I see the iatrogenic issue so often (physician induced sickness). We don’t mean to over medicate but of you see them twice a year they can’t keep up. If they add a drug they almost never delete it.
Next in the heat take electrolytes. Salt, potassium, magnesium, electrolyte water all necessary now. You can’t possibly eat enough food to supplement in this heat.
If you are outdoors or exerting in any way drink something every hour. “Doc I carry this around all day” Really? well its 8 oz and they haven’t finished it yet. 8 glasses of liquid is minimum for normal temps not this inferno. The ambient loss of evaporated body fluids is constant. Easy trick, if your urine is yellow (and its not from a B complex vitamin), you are already dehydrated.) If you wait until thirsty you are in danger. Drink until urine is straw or clear and watch every time.
I used to get calls up north from patients in the ER in Florida…. every winter. They went fishing, didn’t keep up with fluids, then developed dehydration and even urinary track infections. Urosepsis is a leading cause of demise in the elderly.
Medications do not allow the body to self regulate. Patients will say,”I am drained, I feel awful”. I check and their pulse is thready and weak. So make the effort and for loved ones, especially those who can’t help themselves, to check BP, ask the primary care Doc about all the meds you are on and push fluids and electrolytes.
You can thrive in the heat wave if you pay attention, but by the time you are weak, you will be sick for days to recover. Stay cool, avoid sun, exercise in water with a hat and sunscreen, hydrate before and after. Drink something every hour- don’t just carry the bottle, use cooling towels on your neck.
If someone succumbs to the heat: Cool them fast, get ice packs under arms, in groin and top of head, get them hydrated. If passing out, onto floor with legs propped up to get blood to brain. Apply wet cool towels everywhere, call an ambulance so they can give IV hydration. Check for BP (now that they and you have a monitor) give sugar and electrolytes. Get to an air conditioned place and put on a fan.
You may think this is all common sense, but I see these issues every summer so someone reading needs this reminder. If you think it isn’t meant for you, it’s meant to remind all of us. Stay safe and smart and enjoy a wonderful and healthy summer.