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Interviewer: It's a fascinating statistic. Heat kills more people in the United States than any other natural disaster. We don't really think of it too much especially here in Utah. It's just something you have to deal with. But when you hear something like an excessive heat warning or advisory, you should pay attention. However, certain groups can be at higher risk than others for heat-related health issues.

Dr. Troy Madsen is going to help us better understand who should be vigilant when it gets really hot, how heat impacts those groups, and what to do about it. Dr. Madsen, first of all, who are the groups that you're concerned about when you find out that a heat warning has been issued?

Who's at Risk During Heat Waves?

Dr. Madsen: The people we really worry about are the very old and the very young. They have a tough time regulating their body temperature, which can lead to high temperatures, which leads to issues with the heat. If you're on certain medications, if you have certain medical conditions like heart conditions, kidney issues, previous issues with strokes, or neurologic conditions, obviously, we're talking about just all of us out there who potentially have issues and potentially could be exposed to heat.

But be sure to check in on these people. That's, I think, one of the scariest things is older people who don't want to ask for help, who may have air conditioning and the air conditioner doesn't work or it goes out or something happens and they don't call for help, and you go over to check on them and they're not responding or they've passed away. And unfortunately, that does happen during these heat waves, and I think that's where we see a lot of deaths. So check in on these people, family members, and friends.

And when you're out with babies and young children, be aware that if you feel hot, they feel really hot because, again, they have a tough time regulating body temperature. So you just have to make sure you're very aware of how they're doing and checking on them regularly and avoiding extreme heat with those individuals.

Heat's Impact on the Body

Interviewer: And how is heat impacting the body that is causing problems in the first place?

Dr. Madsen: Well, heat does a couple of things. One thing it does is it pushes blood away from the organs. And the way that happens is when you get hot, your blood vessels dilate. Part of that is to push the blood to the extremities and try to cool down your core. But you can imagine at the same time that blood is moving into your extremities, it's moving away from your essential organs, your heart, your kidney, your brain. And you're going to get less blood flow to those organs. And organs that are already at risk can then be kind of pushed over the edge, where you're just not getting the blood flow you need, and then that can cause a breakdown of the tissues there, and it's kind of like a stroke. The same thing happens with a stroke. You just don't get the blood flow you need to the brain, and then that causes problems where it doesn't have the blood flow and the oxygen it needs to function.

And with certain medications, those medications can also affect, number one, blood pressure, so they can cause problems with the blood flow to the organs. But medications can also affect your body's ability to regulate its temperature. Certain medications may make it so your body is just not responding as well to heat, and that internal temperature gets hotter than it might in someone else.

The other thing that heat does is just really high temperatures sometimes the cells in the body just can't handle it. It causes an actual breakdown of those cells, and then that process leads to more processes, inflammation, and then that can cause a lot of problems that we also think of with heat.

Recognizing Heat-Related Illnesses

Interviewer: And are there usually symptoms that accompany heat-related illness? Now I'm talking probably both healthy and individuals that might have underlying conditions or the very young and very old. Are the symptoms kind of always the same?

Dr. Madsen: Well, we always think of heatstroke, where you're actually getting confused, difficulty concentrating. People even pass out from that. So that's one way we look at it. And regardless of which category you fall in, either that at-risk group or just the average person, we can all experience those things. But then with some of these other conditions or some of these other issues, let's say you're having kidney issues, you may see your urine that turn brown, like a dark tea color. That can be an issue of muscle breakdown in the body, which then causes issues with your kidneys.

Certainly, if you're prone to strokes or have had issues in the past, you may have issues similar to strokes, weakness, difficulty with concentration, difficulty walking, balance, speech, those kind of things. Heart attacks are another issue as well.

So again, you can talk about the specific organs it affects, and you would think in those kinds of situations you would experience heart attack symptoms, stroke symptoms, and kidney issues. Or then the bigger picture of that heat exhaustion versus heatstroke, where you're really hot or so hot that you're having trouble focusing, concentrating, and then even passing out.

The Dangers of Prolonged Heat Waves

Interviewer: And heat can be kind of cumulative. So like the first day, you might feel fine, but two or three days later you might start noticing those effects. Is that the case?

Dr. Madsen: Absolutely. And probably the biggest thing I would think of there would be more of the kidney effects, where you're getting dehydrated, you're sweating a lot, you don't have enough fluid in your body, and three or four days later you could have at least some mild kidney failure. And even in some cases, that could range to even severe kidney failure, where your kidneys just aren't even working.

Protecting Yourself Against the Heat

Interviewer: And how can one protect themselves if one knows they're on medications or they have a condition that might make them vulnerable when a heat wave does come and they hear that there's an excessive heat warning or advisory from the National Weather Service? What can a person do to protect themselves from these things?

Dr. Madsen: Well, you know, the obvious answer is stay cool. We always tell people that, try and stay cool, but sometimes that's easier said than done. And you may not have air conditioning in your home. So if you can find some way to get to a place with air conditioning if a heat wave comes in, that's going to be essential.

If that's not an option, try evaporative cooling. That's something that's more effective here in Utah than in other humid areas, where you get a fan going, get a spray bottle with cold water, you spray it on yourself. That cold water then comes off your body and pulls heat off of it as it evaporates. So evaporative cooling can be very effective.

Keep Body Temperatures Down

You know, cool baths, things like that, anything just to get your body temperature down. And then certainly being aware of what you're doing, avoiding vigorous activities, working in the yard, doing strenuous activity during those heat waves, that's going to protect you as well.

Interviewer: And if somebody actually has a job where they have to work outside and they know they have one of the underlying conditions, is there some additional advice you could give that individual? Because perhaps staying in a cool bath might not be an option for them that day.

Dr. Madsen: Maybe not, unless you work at a pool.

Interviewer: Yeah, exactly.

Dr. Madsen: But most people don't have that luxury. Yeah, I think the biggest thing there is frequent breaks. Frequent breaks, get in the shade, consider taking a cool spray bottle to work, and make sure your boss is aware. This is one of those things where you just have to say, "Hey, I've got to take frequent breaks." You don't have to reveal your medical condition, but you can say, "Hey, I've got a condition where I just need to have breaks, and this temperature may be affecting me more than it's affecting you or some of the other workers here." So that would be my recommendation.

Interviewer: And I've seen some of those things that you can like wrap around your neck, you can soak in water and wrap around your neck or wrap around your head. Are those effective?

Dr. Madsen: To a certain point. It's funny. You try those things, and you'll find that immediately they feel great. But then within about 10 minutes, those things heat up . . .

Interviewer: Yeah.

Dr. Madsen: And you're like, oh, I've got this nice, wet washcloth around my neck. And then very quickly it's just insulating and holding the heat in. So they're super great when they're nice and cold. But just be aware of that and be aware that they may do more harm than good if you're leaving them on for a long period of time and if it's not really cold water.