Every year I write about how heat can make people sick, change how their prescriptions interact with their bodies, and cause preventable illness. You would think I would take my own advice, but, alas, I ended up with heat exhaustion after being in and out of my car and hot houses during a heat advisory. I drank a lot of water and used the air-conditioning in my car, but more to the point, I believed that somehow I was exempt from developing such a silly condition as heat exhaustion.
There was nothing silly about it. First I just didn’t feel well. It wasn’t catastrophic. I just felt a little off. Then, and I think this is key, I felt a little nauseated so I stopped drinking enough fluids. Then I got a headache and diarrhea and got even more dehydrated, and by that point I was home from work, so I just went to bed. Because I was tired and not feeling well, I didn’t drink all night. I was in an air-conditioned house, and even so, I ignored my symptoms and got a classic case of heat exhaustion. I woke up confused, sweating, and vomiting later in the night, with a racing heart.
Fortunately, I was not so confused that I didn’t realize I was feeling sick because of the heat, and I was able to take some Zofran and drink ginger ale until I felt well enough to drink water. After several hours I felt a little better, but all day today I felt unwell and extremely fatigued. How likely is it that your average patient would be able to realize the problem, have anti-nausea medication at hand, and force herself to drink fluids while confused and nauseated? Not very likely.
I learned from this experience. Knowing the heat is dangerous did me no good whatsoever; I felt like I was safe. I wasn’t working out in the heat, I had air-conditioning, and I was drinking water (and coffee…bad me). I did not consider that getting in and out of an extremely hot car and driving short distances to go in and out of hot, stuffy houses might tax my system. In addition, I failed to consider my medications; I take a cardiac medication that increases my chances of heat exhaustion and heat stroke. I’ve written about all of this before, and still I was taken by surprise.
Clearly I need a reminder about heat-related illnesses. My symptoms were all classic for heat exhaustion. I did not go on to develop heatstroke, which is much more serious, probably because I did eventually end up inside in a cool place. Heatstroke is the next step and is a real emergency. Typically people with heatstroke are not sweating and have hot, dry skin. They have shallow, fast respirations and tachycardia. Other than that, the symptoms are similar but worse: severe headache, confusion progressing to unconsciousness, dizziness, vomiting, and even seizures. The worst sign to watch for, in yourself or others, is a cessation of sweating in extreme heat.
Nurses, heal yourselves: remember, as I did not, that we are susceptible to all the illnesses that our patients are. When the heat index climbs to more than 90 degrees, it’s a danger zone, so be careful!