Dealing with illness in dreadful hot weather
published in The Hippocratic Post,
26 July 2018
“What dreadful hot weather we have! It keeps one in a continual state of inelegance,” cried Jane Austen. Inelegance is the least of some people’s worries when it comes to the hot weather. For some health conditions, a heatwave can be distressing, and even dangerous.
Seven health conditions that are harder to cope with in the heatwave
In psoriasis, skin cells are replaced too quickly leading to silvery-red scaly patches on the skin. Whilst sunlight can help improve the condition (with phototherapy being a common treatment), overexposure to the sun can trigger a flare-up.
For some health conditions, a heatwave can be distressing, and even dangerous.
Lupus derives its name from the Latin for “wolf” since a rare facial rash resembling a wolf’s bite is possible; more common is a so-called “butterfly rash,” named after its shape across the face. Sunlight may exacerbate the rash.
Other symptoms of light sensitivity in lupus include feelings of tiredness, aching joints and even seizures.
Wounds can become worrisome during hot weather. Dehydration is probably the biggest danger: hydration assists healing by helping deliver oxygen and nutrients to the wound bed.
Wounds can become worrisome during hot weather.
Poorly controlled diabetes during the heatwave (through excessive consumption of ice creams or sweetened drinks, periods of inactivity and altered absorption of insulin in hot weather) can also pose a problem for wounds. Infection, reduced circulation and neuropathy can result and slow wound healing.
Becoming less active and drinking less water can slow down your gut and harden your stools.
Inflammatory bowel disease and infectious gastroenteritis can also flare in hot weather, perhaps through effects on the gut microbiome brought about through changes in diet or a physiological stressor.
Sweating is the secret to a constant core temperature. As sweat evaporates, it removes heat from the body, cooling it down. With about 3 million sweat glands, little body hair and relatively long, slim limbs, humans are particularly effective when it comes to sweating.
In individuals with cystic fibrosis, sweat is more salty. Signs of salt depletion in a heat wave include headaches, vomiting, lethargy, cramps and thirst; salt supplements may help.
Spinal cord injury
When your mobility is limited, it’s not so easy to access shady places or swimming pools; suncream can be hard to apply and clothing choices constrained: molded jackets (spinal braces) still have to be worn to support posture, but they are sheepskin-lined to protect the skin from rubbing and are uncomfortably hot.
People with high-level spinal cord injuries are unable to sweat below the level of injury, and so may overheat.
Fluid intake is restricted in heart failure to avoid overloading the heart; dehydration can though then result in hot weather, especially if you are also taking diuretics which will increase urine output. According to the British Heart Foundation, your dose of diuretic can be reduced or stopped for a while if it’s making you feel dizzy or dehydrated. Ask your doctor first.
Because your heart has to work harder during a heatwave, oxygen demand increases and angina can worsen.
The nurse’s view
Nurses then, may find themselves caring for sicker patients during a heatwave (as may other health care professionals). Just as they ensure that their patients are hydrated (and that medications are kept cool since many are temperature and light-sensitive), they must drink enough themselves. The Royal College of Nursing has produced a handy poster for nurses to check the colour of their urine to assess for signs of dehydration.
It’s easy, though, when overworked through staff shortages, to be under-hydrated. Banning water bottles in clinical areas when it’s hard to take a break is then unacceptable, and this practice was challenged at the recent RCN Congress. Nurses need to ‘rest, rehydrate and refuel’ to be able to care.