Keeping it cool when it heats up
We are currently experiencing hot weather in Malaysia, with the Malaysian Meteorological Department (MetMalaysia) estimating that it will likely last until September (2024).

Too much heat is not safe for anyone, especially older people and those with health problems.

Therefore, it’s important to take precautions to protect yourself and get relief quickly when you are overheated.

Otherwise, you might start to feel sick or risk a heat-related condition that could result in dire health consequences.

Heat-related conditions include the following:

> Heat syncope

This is an episode of fainting or dizziness, which usually occurs when standing for too long, or suddenly standing up after sitting or lying, in hot weather.

Factors that may contribute to heat syncope include dehydration and lack of acclimatisation to hot weather.

Rest in a cool place, put your legs up and drink water to make the faint or dizzy feeling go away.

> Heat cramps

These are the painful tightening, or spasms, of muscles in your stomach, arms or legs.

Cramps can result from strenuous activity, as such activities can cause profuse sweating.

Sweating depletes the body’s salt and moisture; the low salt level in the muscles causes painful cramps.

Heat cramps may also be a symptom of heat exhaustion.

Stop the physical activity you’re doing and rest in the shade or a cool building.

Drink plenty of fluids, such as water and sports drinks containing electrolytes.

Do not consume alcohol or caffeinated beverages, which can be dehydrating.

> Heat oedema

This is a swelling in your ankles and feet when you get hot.

Put your legs up to help reduce the swelling.

> Heat rash

This is a skin irritation due to heavy sweating during hot and humid weather.

Heat rash looks like a red cluster of pimples or small blisters.

It is more likely to occur on the neck and upper chest, at the groin, under the breasts and in elbow creases.

Your skin may feel itchy or you may feel “prickly”, tingling pain.

Keep the affected area dry, use powder to sooth the rash and stay in cool areas.

> Sunburn

This is a sign of skin damage due to extreme or long sun exposure.

Sunburn affects your body’s ability to cool itself.

Your skin may appear red and tender, develop blisters, start to peel and be warm to the touch.

If you are sunburned, wear lightweight clothing, take cool showers, moisturise the affected areas and stay out of the sun until your skin is healed.

> Heat exhaustion

This condition is a warning that your body can no longer keep itself cool (through the body’s own internal temperature-regulating mechanisms).

It is a heat-related illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement of fluids.

You might feel thirsty, dizzy, weak, tired, uncoordinated, irritable, nauseated, and have vomiting, headache or muscle cramps.

You may also sweat a lot.

Your body temperature may stay normal, but your skin may feel cold, pale and clammy.

Your pulse rate will be fast and weak, and breathing will be fast and shallow.

Rest in a cool place and get plenty of fluids.

If you don’t feel better soon, get medical care.

Be cautious because heat exhaustion can progress to heat stroke.

> Heat stroke

This is a medical emergency and the most serious heat-related illness where the body’s temperature rises above 40°C.

It 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.

Heat stroke can cause death or permanent disability if emergency treatment is not provided.

Complications of heat stroke may include acute kidney failure, swelling or bleeding in the brain, organ failure, and even death.

The death rate from heat stroke can exceed 30%.

The earliest symptoms of heatstroke are profuse sweating, thirst and fatigue; hot, dry, flushed skin; strong, rapid pulse, followed by increased body temperature and shortness of breath; as well as headache, dizziness, nausea, vomiting and muscle spasms in the lower limbs.

However, some older people may experience atypical symptoms, such as confusion, collapse, or even coma, before they notice the early symptoms of heat stroke.

When a person has any of these symptoms, they should seek medical help right away and immediately move to a cooler place, such as under shade or indoors.

They should also take action to lower their body temperature with cool clothes, a cool bath or shower, and fans or air-conditioners.

Risk factors for older adults

Older adults are at higher risk for heat-related illnesses and death. If you start to feel too hot, move under some shade to get some relief from the sun and help lower your body temperature. — Filepic

Factors that put older adults at greater risk include:

Being unable to adjust quickly and efficiently to sudden temperature changes.

Chronic medical conditions that affect the body’s response to temperature.

Health problems such as heart, lung or kidney diseases.

Changes in skin caused by normal ageing.

Any illness that causes weakness or results in a fever.

Medications such as diuretics (which causes extra water and salt to be removed from the body), sedatives, tranquillisers, and some heart and high blood pressure medicines that may make it harder for the body to cool itself or sweat.

Being on several medications at the same time.

Being obese, overweight or underweight.

Drinking alcoholic beverages.

Living in places without air conditioning or fans.

Becoming dehydrated.

Tips to stay safe

Heat-related conditions are predictable and preventable.

Take these steps to prevent them during hot weather:

> Stay hydrated

Drink plenty of fluids so that the body can sweat to cool down and help maintain normal body temperature.

Drink water, fruit or vegetable juices, or drinks that contain electrolytes.

Avoid very sugary, alcoholic and caffeinated drinks, as these actually cause you to lose more fluid.

Don’t wait until you’re thirsty to drink.

If your doctor has told you to limit the amount you drink or has you on diuretics (also known colloquially as “water pills”), ask how much you should drink while the weather is hot.

> Replace your salt and minerals

Heavy sweating removes salt and minerals from the body that need to be replaced.

A sports drink can replace the salt and minerals (i.e. electrolytes) you lose in sweat.

If you are on a low-salt diet and/or have diabetes, high blood pressure or other chronic conditions, talk to your doctor before drinking a sports beverage.

> Stay cool

If you live in a home without air conditioning or fans, try to limit your use of the oven and stove to maintain a cooler temperature in your home.

Keep shades, blinds or curtains closed during the hottest part of the day; and open the windows at night.

Try to spend time during midday in a place that has air conditioning, e.g. go to a shopping mall, a public library or a friend’s home.

Even a few hours spent in air conditioning can help your body stay cooler when you go back into the heat.

Alternatively, you can take a cool shower, bath or sponge bath.

> Dress for the weather

Wear lightweight, light-coloured and loose-fitting clothes.

This will help your body cool down properly in hot weather.

Natural fabrics such as cotton may feel cooler than synthetic fibres.

Wear a wide-brimmed hat and sunglasses, and use umbrellas, when outside.

> Use sunscreen

Make sure to use a broad spectrum or UVA/UVB (ultra-violet A/B) protection sunscreen, SPF 15 or higher, when you are outside.

Reapply it regularly throughout the day, especially if your skin is being continuously exposed to the sun.

If you are swimming or sweating, reapply every two hours to prevent sunburn.

> Pace yourself

Cut down on exercise during the heat.

If you’re not accustomed to working or exercising in a hot environment, start slowly and pick up the pace gradually.

If exertion in the heat makes your heart pound and leaves you gasping for breath, stop all activity.

Get into a cool area or the shade, and rest, especially if you become lightheaded, confused, weak or faint.

Avoid outdoor exercising and other physical activity during the hottest part of the day, i.e. between 11am to 3pm.

It is best to schedule physical activity for a cooler time of the day, such as early morning or evening.

If you cannot avoid strenuous activity in hot weather, remember to drink plenty of water and rest in cooler areas.

If you have to go outside, try to limit your time out and avoid crowded places.

Plan trips during non-rush-hour times.

> Take extra precautions

People at higher risk should take extra caution.

If you care for children or the elderly, help them stay out of the heat.

If you notice symptoms of overheating that could lead to heat-related illnesses, take immediate action.

If you are on medications, ask your doctor if any of them make you more likely to become overheated or sunburned.

Do not leave anyone in a parked vehicle.

It is not safe to be in a vehicle if it is parked in the sun on a hot day.

The temperature inside your car can rise over 11°C in 10 minutes.

Avoid hot and heavy meals as digestion produces heat, which increases the temperature in your body.

> Use a buddy system

When working in the heat, monitor the condition of your co-workers and have someone do the same for you.

Heat-induced illness can cause a person to become confused or lose consciousness.

If you are 65 years of age or older, have a friend or relative call to check on you twice a day during a heat wave.

If you know someone in this age group, check on them at least twice a day.

Dr Tay Hui Sian is a consultant geriatrician and physician. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Wellness,Heatwave,hot weather,heat stroke,heat exhaustion,senior health
The current hot weather can have adverse effects on all of us, especially vulnerable groups like senior citizens.