Posted in Health, news, weather

Heat Illness and Heat Stroke Explained

 

The National Weather Service will soon issue an “excessive heat warning” for many parts of the Southwest United States.  Phoenix received their first warning two weeks ago when their temperatures rose to 108 degrees.

What is an “excessive heat warning?”

This occurs “within 12 hours of the onset of extremely dangerous heat conditions”. This means that the heat index (air temperature and humidity) will be greater than 105 degrees for more than three hours a day for at least two days in a row and the night-time temperatures will not drop below 75 degrees. Although many of us may live in areas where this occurs each year, the onset can be one of the most dangerous times.  Symptoms such as heat cramps, heat exhaustion and heat stroke must be identified.

What are Heat Cramps?

At first when one feels symptoms, it may come in the form of heat cramps. Heat cramps are painful spasms that occur in the muscles of the arms and legs and even abdomen. We believe that when one loses fluids and salts from excessive sweating, cramps ensue. Its important in these cases to get the person out of the heat, hydrate them with sips of fluid and electrolytes and massage the body parts affected.

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What is Heat Exhaustion?

If one does not leave the heat and come indoors, the next risky event that can occur is heat exhaustion. This worsens as the victim sweats profusely becoming more and more dehydrated. They could also have cramps but nausea may ensue, they may look pale and clammy and their heart rate will increase to try to compensate for the lost fluid. These individuals may become dizzy, weak and even faint. Immediately bring the person indoors, lie them down, elevate the feet, give sips of fluid, cool down the body applying cool and wet cloths to the underarms and body, and contact medical authorities if symptoms continue or worsen.

 

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IMAGE FROM MEDSTAR

What is Heat Stroke?

Heat stroke will occur if a vulnerable person does not get out of the heat in time. It is a medical emergency and can be fatal. If an individual has heat stroke 9-1-1 must be called immediately. Bring the victim indoors away from sunlight, lie them down, remove unnecessary clothing, cool their body with cold compresses and watch for signs of rapidly progressive heat stroke in which they have difficulty breathing, seize or lose consciousness. If they are unconscious you cannot give them fluids. Only if they are alert, awake and able to swallow will you be able to give fluids. Do not give medications to reduce the fever such as aspirin or acetaminophen since their body may not be able to metabolize them properly and this could make matters worse.

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Who is vulnerable to heat related illness?

Young children and elderly individuals may have issues adjusting to the outside environment and may be more prone to dehydration. Those with medical conditions such as heart, lung, thyroid disease can be at risk as well. If you’ve ever suffered from heat stroke you can be vulnerable again. And many medications could make you susceptible such as diuretics, vasodilators and beta-blockers for blood pressure and antidepressants.

The biggest risk comes when we are unprepared. Having an unusual cool week prior to a heat warning could preclude many from taking proper precautions. Staying indoors, checking air conditioning and fan devices to make sure they work properly, wearing cooler clothing is just the beginning. Stocking up and planning to hydrate frequently is paramount because when death occurs to excessive heat, dehydration is the main culprit.

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Bring your pets indoors, and watch your kids, friends and family members frequently. If they are beginning to succumb to the heat, they may be quiet and not be able to voice it.

 

 

Avoid drinking alcohol in the heat. It can dehydrate you more and worsen the situation.

Avoid excessive exercise when outdoors and make sure to make use of shady areas.

The summer and early fall offer exciting and fun ways to enjoy nature. Don’t let the heat get to you. Remember….if you can’t take the heat, get out of the…..well heat…….

 

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

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Posted in Health, news, weather

This Year’s Hurricane Season: Predictions

June 1st marks the official start of Hurricane season and runs until November 30th.  September is usually the most active month.  Hurricanes are categorized by their wind speed as designated as the following:

 

Category I have sustained winds of 74 to 95 mph

Category II have sustained winds of 96 to 110 mph

Category III have sustained winds of 111 to 130 mph

Category IV have sustained winds of 131 to 155 mph

Category V have sustained  winds of over 155 mph.

In a given year, the Atlantic Ocean averages 12 hurricanes with 2 becoming “major” meaning a Category III or greater.  Hurricane Katrina in 2005 was at one point a Category V and when it hit landfall it was a Category 3-4 (depending on the source), tragically killing over 1800 people and causing $108 billion in damage.  The deadliest hurricane to ever hit US soil was the Great Galveston Hurricane of 1900 in which over 10,000 people died.

According to the National Oceanic Atmospheric Administration, The Weather Company and Colorado State University, the 2018 Hurricane season will be above average in activity, with possibly 14 named storms, 7 of which are expected to become hurricanes, 3 of which could become major hurricanes.

2017 was a particularly active hurricane season with three major hurricanes hitting the US.  Dr. Phil Klotzbach, of the Colorado State University Tropical Meteorological Project, stated in 2017, “While the tropical Atlantic is warmer than normal, the far North Atlantic remains colder than normal, potentially indicative of a negative phase of the Atlantic Multi-Decadal Oscillation (AMO). Negative phases of the AMO tend to be associated with overall less conducive conditions for Atlantic hurricane activity due to higher tropical Atlantic surface pressures, drier middle levels of the atmosphere and increased levels of sinking motion.”

This year he states, “Last season had near-record warm sea surface temperatures in the tropical Atlantic.”  He continues, “If El Niño were to suddenly develop, that would certainly knock down our forecast.”

El Nino is refers to a ocean-atmospheric interaction where sea surface temperatures rise near the equatorial Pacific, causing increase wind shear in the Atlantic equatorial region and has been linked to highly active hurricane seasons.

This year’s names for the 2018 Hurricane Season are the following

Atlantic

Alberto
Beryl
Chris
Debby
Ernesto
Florence
Gordon
Helene
Isaac
Joyce
Kirk
Leslie
Michael
Nadine
Oscar
Patty
Rafael
Sara
Tony
Valerie
William

 

Pacific

Aletta
Bud
Carlotta
Daniel
Emilia
Fabio
Gilma
Hector
Ileana
John
Kristy
Lane
Miriam
Norman
Olivia
Paul
Rosa
Sergio
Tara
Vicente
Willa
Xavier
Yolanda
Zeke

 

If I was going to predict on names alone, I’d forecast Helene, Isaac and Kirk to be doozies.

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How to prepare for the hurricane season

Preparation means starting early.

Make sure you keep informed of the latest alerts and official recommendations.

Evacuate when told to do so by city officials.

Many people will try to tough it out and unfortunately get walled up in their homes.  So make sure you have adequate water (1 gallon per day/person for at least three days) and 1/4 – 1/2 gallon/water/ per pet, except the fish obviously.

Canned foods, flashlights, medical supply kit, batteries, blankets, cash, medications in water proof containers should be set aside for disasters, and put important papers in waterproof/fireproof casings.

According to ready.gov, its recommended to do the following:

  • Hurricane winds can cause trees and branches to fall, so before hurricane season trim or remove damaged trees and limbs to keep you and your property safe.
  • Secure loose rain gutters and downspouts and clear any clogged areas or debris to prevent water damage to your property.
  • Reduce property damage by retrofitting to secure and reinforce the roof, windows and doors, including the garage doors.
  • Purchase a portable generator or install a generator for use during power outages. Remember to keep generators and other alternate power/heat sources outside, at least 20 feet away from windows and doors and protected from moisture; and NEVER try to power the house wiring by plugging a generator into a wall outlet.
  • Consider building a FEMA safe room or ICC 500 storm shelter designed for protection from high-winds and in locations above flooding levels.  

Always have an emergency plan, practice it with family members, discuss with distantly located relatives how you will notify each other of your safety, and stay tuned to your radio, TV, wireless emergency alerts encase evacuations are ordered.

   LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

Posted in Health, New Year's Eve, news, weather

Preventing Hypothermia this New Year’s Eve

Even those who live in desert states such as Nevada and Arizona run the risk of hypothermia this New Year’s Eve.

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The holidays flew by us way too quickly and left the wind chill in its wake.
Unfortunately with all the hustle and bustle this time of year, we tend to forget how dangerous the weather can be.  It would make sense to stay indoors, and for the most part we do….except for New Years.  All rules go out the door with this party.  The most exciting night of the year can sometimes be the coldest night of the year.  And the party ends up outside.  And do we don a ski mask, goggles, gloves, galoshes, thermal underwear, winter coat and ear muffs?  No. That would make the most unsexy New Year’s outfit. 
Throw some alcohol into the mix and this can be a deadly combination. The CDC estimates that 1300 deaths occur each year due to hypothermia.  So what is hypothermia?

What is hypothermia?

 Hypothermia is a dangerous drop in body temperature and can occur in minutes.   Human body temperature averages around 98.6 degrees F.  But hypothermia starts setting in at 95 degrees F with shivering, increase respiratory and heart rate, and even confusion.  We forget that glucose stores get used up quickly so hypoglycemia can ensue as well, making matters worse, especially in someone who is intoxicated.  Frostbite can occur as blood flow decreases to the tips of the ears, fingers, nose and toes. As hypothermia progresses,  the shivering and muscle contractions strengthen, skin and lips become pale, and confusion worsens. This can lead to severe hypothermia, eventually causing heart failure and/or respiratory failure, leading to a coma and if not reversed, death.

Hypothermia can mimic looking drunk

Someone who is hypothermic may slur their speech, stammer around and appear uncoordinated.  This sounds identical to your drunk buddy on New Year’s Eve.  Unfortunately, this can be deadly as many hypothermic partiers get written off as being drunk.
So if you suspect hypothermia, call for medical assistance.  Anyone you think is eliciting signs of hypothermia should be brought indoors, put in dry clothes, covered in warm blankets, and then wait for paramedics to arrive.  It’s important to try to warm the central parts of the body such as head, neck, chest, and groin,  but avoid direct electric blanket contact with the skin and active rubbing if the skin is showing signs of frostbite.

Why not use hot water to warm up a hypothermic individual?

Hot water will be too caustic and can cause burns. Remember, the body is shunting blood away from the ears, fingers, toes, hands and feet to warm the heart, brain and other vital organs.  The skin will be in a vulnerable state during hypothermia and frostbite and will burn the underperfused skin.

Alcohol increases the risk of hypothermia

We’re outside in the cold, not bundling up, dancing, sweating, becoming dehydrated. Add alcohol to the mix, and its deadly.  Here’s the scoop on alcohol toxicity.

Preventing hypothermia

When it comes to hypothermia, the best thing you can do is prevention.   It’s the biggest party of the year so prepare yourself by doing the following:
  • Wear multiple layers of clothing
  • Bring an extra pair of dry socks
  • Avoid getting wet (i.e. falling off a boat, getting splashed with champagne)
  • Change your clothes if you worked up a sweat dancing
  • Check with your medical provider if some of your medical conditions (i.e. hypothyroid) or medications (i.e. narcotics, and sedatives)  put you at risk for hypothermia
  • Avoid alcohol intoxication
  • Keep an eye on your more vulnerable buddies who include children, older individuals, and those with intellectual disabilities.
A Happy New Year should also be a Healthy New Year.  So be warm, dry, safe and have fun!!
smiley

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, news, weather

Wildfire Smoke Health Risks

As the California Wildfires roar into a second week, those residents lucky enough to escape the flames worry what consequences could result in inhaling the smoke.

What is in wildfire smoke?

According to the EPA, smoke emanating from forest and community fires may include any of the following:

  • Carbon monoxide, which competes with oxygen in the blood
  • Carbon dioxide, a respiratory byproduct
  • Wood particles
  • Formaldehyde
  • Acrolein – used as a pesticide
  • Benzene
  • Plastics, and those byproducts after incineration
  • and thousands of different respiratory irritants.

According to the EPA,

Smoke is composed primarily of carbon dioxide, water vapor,
carbon monoxide, particulate matter, hydrocarbons and other
organic chemicals, nitrogen oxides, trace minerals and several
thousand other compounds. The actual composition of smoke
depends on the fuel type, the temperature of the fire, and the
wind conditions. Different types of wood and vegetation are
composed of varying amounts of cellulose, lignin, tannins and
other polyphenolics, oils, fats, resins, waxes and starches, which
produce different compounds when burned.

What symptoms may individuals experience?

Some may have no idea they are breathing in harmful compounds that could affect their lungs and heart.  However, many may experience:

  • Cough
  • Wheeze
  • Difficulty Breathing
  • Chest Pain
  • Mucous Production
  • Dizziness/lightheadedness
  • Fatigue
  • Racing Heart (palpitations)
  • Exacerbation of their lung disease including COPD, asthma, chronic bronchitis
  • Exacerbation of heart conditions such as angina, heart attack, and cardiac arrhythmias.
  • Increased susceptibility to new lung infections as well as flu 

     

 

What are PM2.5s?

PM2.5 are particles less than 2.5 micrometers in diameter that are present in pollution and wildfire smoke that can penetrate deeply into the lung linings.  Larger, coarse particles 10 micrometers in diameter are called PM10.  Both impair lung function as they inflame the lungs and interfere with the work of alveoli that need to oxygenate the blood.  Moreover the small particles can use this pathway to enter the blood stream. Although the direct health impacts of the fine particulate matter is not clearly defined it is believed that increased PM2.5 levels increase the risk of lung and heart disease as discussed above.

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Lungs and alveoli (Image from ThoughtCo.)

Symptoms may begin at levels greater than 55 µg/m.

Which individuals are the most at risk?

  • Infants and Children
  • Elderly individuals
  • Those with chronic lung disease, including asthma and emphysema
  • Those at risk for heart disease and stroke
  • Those with diabetes
  • Smokers
  • Pregnant women
  • Those with chronic allergies
  • Pets

 

How can residents protect themselves?

Avoiding the area of wildfires is paramount.  Additionally, the following may be considered:

  • Avoid outdoors until air quality reports improve.  Do not rely on how “clear” the air looks.
  • Take heed of wind and air quality advisories.
  • Recirculate the air in your home and car.
  • Keep windows closed.
  • Consult with your medical provider to monitor blood pressure, heart rhythm, lung function and refill any medications you may need BEFORE you feel symptoms.
  • Be wary of facemasks sold as PM2.5 safe as many do not protect against the very small particles. Respirator masks labelled N95 or N100 may provide SOME protection against particulates but not against the toxic fumes such as formaldehyde and acrolein.

 

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician

 

Posted in Health, news, weather

Hurricane Jose Poses Nor’easter Threat

Atlantic Hurricane Jose and its northward course may bring Nor’easter like conditions to cities such as Boston and New York City.

Over the next few days its expected to travel past Bermuda as it goes northwest abutting at a safe distance the East Coast, but possibly making landfall in the Northeast as a tropical storm.

Waves are expected to reach 10 feet along the Carolinas and then up the Eastern Seaboard over the next few days.

The National Hurricane Center reports the following:

While Jose is currently forecast to remain offshore of the U.S.
coast from Virginia northward to New England, the large cyclone
could cause some direct impacts to these areas and any deviation to
the left of the NHC forecast track would increase the likelihood and
magnitude of those impacts. Interests along the U.S. east coast
from Virginia to New England should monitor the progress of Jose
through the next several days.

The NHC also reports that swells from Jose are likely, over the next few days, to affect the Bahamas, Hispanola, and Puerto Rico and then the U.S. East Coast by early next week.

 

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Image from Weather.com

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician

Posted in Health, news, weather

Thunderstorm Asthma Risks Rise During Monsoon Season

While monsoon season brings shifts in temperatures, it also brings heavy winds and thunderstorms.

Yet for an asthmatic this can be exceptionally dangerous.

“Thunderstorm Asthma” is a term used when a very windy storm can induce an asthmatic attack.

Last year, nine people died in Melbourne, Australia after a thunderstorm precipitated respiratory difficulties.

The storm, its believed, caused pollen particles to swell and rupture into much smaller particles, which were dispersed by wind.  The theory is that the immediate propulsion of much smaller (and more numerous) particles into one’s lungs was the recipe for asthma disaster.

We first learned of “thunderstorm asthma” in the 1980’s when epidemics occurred in parts of Europe, Australia and Iran. Environmental conditions change and asthma allergens meet the unsuspecting lungs.

Asthma is a respiratory condition in which inflammation causes the airways to narrow, restricting air flow and causing wheezing, shortness of breath and cough.  This bronchoconstriction can be deadly if the patient doesn’t receive enough oxygen. Bronchodilators, such as albuterol are used to dilate the airways and steroids are commonly given to decrease the inflammation.

If someone has baseline asthma, a storm forecast should warrant preparatory measures, including ensuring one has plenty of inhalers, and seeing their provider to determine if they are vulnerable to “tipping over”.  Many feel a false sense of security with rain as they believe it will wash away the dust.  As Melbourne witnessed, a thunderstorm can be just as deadly.

 

A variety of factors can cause asthma attacks including:

Pollen

Smoke

Alcohol

Cold air

Dust mites

Mold

Pet dander

Exercise

Laughing

Stress

Acid reflux/heartburn

Aspirin

Air fresheners, perfume, scents

Traffic and pollution

and more.

 

As we see, asthma is not solely caused by a Spring time flower particle. A variety of issues can trigger an attack.  If its sudden, unexpected, stressful and carries a concentrated variety of particles, this combination can be deadly.  Hence “thunderstorm asthma” can be a lung’s perfect storm…….

 

                                                                                                       LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

Posted in news, weather

Tropical Storm Julia, warnings issued for Florida, Georgia and S. Carolina

By Daliah Wachs, MD, FAAFP

Tuesday evening, the National Weather Service issued a warning that Tropical Storm Julia could dump 3 to 6 inches of rain along the northeast coast of Florida, Georgia and South Carolina coastlines.  The rain is expected through Friday. They warn that isolated rains of could dump up to 10 inches, prompting flash flooding. Florida Governor Rick Scott is urging residents to prepare and visit FLGetAPlan.com.

By 11 pm Tuesday night ET, Tropical Storm Julia was 5 miles West of Jacksonville Florida moving NNW at approximately 9 mph.  Per the National Hurricane Center, it had maximum sustained winds at 40 mph.  They report this “slow moving” storm is expected to produce heavy rainfall, but may weaken to a depression by Wednesday.

In the central Atlantic, Tropical Storm Ian is slowly gaining strength, reported to have 50 mph maximum sustained winds and moving NNW at 13 mph.  TS Ian is currently not a threat to land.  In the Pacific, Hurricane Orlene continues to weaken, its wind speeds currently at 85 mph as it moves north at 1 mph per the NWS.

Safety tips during hurricane season include the following:

  1.  Know what season you’re in. Hurricane season usually runs from June 1 – November 30th and peaks in early-mid September.
  2. Be prepared by:
    1. Knowing your evacuation routes,
    2. Preparing your home with shutters, boards and ensure your home is up to code to withstand hurricanes
    3. Ensuring you have necessities:  several days supply of water and non perishable food, medicines, first aid kit, flashlights, batteries, tools and important papers in waterproof packages
    4. Having radio access to monitor weather reports
  3. Stay indoors during the storm
  4. After the storm, venture out only once you’re sure the storm has passed. Be aware of and avoid downed power lines

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and board certified Family Physician