The dangers of heat exhaustion
We are in a heat wave in southern England. While some may be ecstatic with this heat, as it relates to tanning and such, I am at the other end of the spectrum. So is my younger daughter.
I’ve had my say about the dangers of tanning as well as sun damage. I’ve already mentioned my sun allergies with rashes and such. But the big problem that public health officials would like to emphasise at this time, and rightly so, is heat exhaustion and heat stroke.
My younger daughter is susceptible to heat exhaustion. Despite the fact that she is a big water-drinker, the heat wears her out. Heat tends to make everyone rather lethargic. Hence, the desire to sit or sleep under a tree. My daughter complains of “not feeling well”. This usually equates to stomachaches or nausea. She does mention being “sick in the stomach”. But, unusually, it leads to diarrhea. Since heat exhaustion results from dehydration, diarrhea only worsens the dehydration.
Typical signs of heat exhaustion and dehydration are fatigue, headaches, nausea/vomiting, weakness, excessive sweating, paleness, and rapid pulse. If not treated early and appropriately with fluids and electrolytes as well as cool air, heat exhaustion can progress to heat stroke, which is especially dangerous. Heat stroke has led to death, even in young healthy individuals.
Heat stroke signs include confusion and coma, excessively high blood pressure and very rapid heart rate. Other signs of heat exhaustion are intensified. Those most at risk of heat stroke are infants, elderly and athletes who have to play in the heat. Heat stroke is a medical emergency and requires immediate attention.
So, if you’re going to have your fun in the sun, take the necessary precautions with adequate sun protection and adequate and frequent hydration with fluids, especially those with some electrolytes. I know if my daughter wears a hat, her susceptibility to exhaustion is reduced. However, she usually recognises when it’s time to get indoors or to a cooler place. For those who cannot recognise this, we should do our part to help them.
Menstrual headaches and menstrual migraines
I often get headaches for the few days surrounding my cycle, but I don’t believe I truly suffer from menstrual migraines. Yet, I do believe that some of those headaches are migraines and a few may be related to the menstrual cycle. However, I do not suffer from the regularity of true menstrual-related migraines.
Menstrual migraines are believed to be associated with the drop in estrogen that is seen at the end of a monthly cycle (and the beginning of menstruation). It can start anytime from about 2 days before the flow of menses and end a few days after. Migraine sufferers may only experience these headaches around their cycle, while others may have their migraines exacerbated by it. Yet, inexplicably, others may experience migraines outside this relationship.
Symptoms of menstrual migraines are similar to any other migraines. Some experience auras while others may not. The headaches are usually one-sided, though it may spread to the other side, and are usually described as pounding. The severity differs from individual to individual and episode to episode, but it can be quite severe. Other associated symptoms, such as visual disturbances, nausea/vomiting, dizziness, and confusion may be present.
I do get migraines and most of the time, I get the nausea/vomiting/dizziness more than the headache. It can be quite incapacitating. These migraines are usually triggered by some kind of stress, but sometimes the only “stress” I can identity is the start of the cycle. That is why I believe some of them are menstrual migraines. However, because I do not get them every month, I do not consider myself one of those who have a true diagnosis of menstrual migraines.
I make this clarification because in recent years, menstrual migraines have been getting public attention, especially when drug companies are trying to market medications for the treatment of such things. I am not a pill pusher and do not like the idea of taking a pill for anything and everything. However, I am not averse to taking some Tylenol for pain occasionally.
I may not get migraines, but I often get headaches around my cycle. I attribute this to the tightening in the muscles in my upper back and shoulders as a result of cramping. I know this must be the case because I can feel the tension as I do neck exercises to work it out, or when I massage myself and can feel the pain in the muscles from the scalp down to the upper back and shoulders. I just wish I had more willing masseurs. It’s hard to reach back and give yourself a massage without causing other parts of your arm to go sore.
Headaches are common, but it’s surprising that menstrual migraines are also very common amongst women. It may explain why migraines are much more common in women than in men.
Fiber, prune juice, stool softeners, laxatives, exercise for constipation
Following on my issues about constipation. I remember a colleague called in the maintenance man because the toilet was plugged up and she couldn’t unplug it. He joked about the women in the office and suggested they added fiber to their diet. She countered with, “But that would make it worse!”
Strange isn’t it that they recommend fiber for constipation? There are reasons for it, but sometimes it seems counter-intuitive. I guess it really depends on what the constipation problem is. If someone produces large, hard stools, but has a hard time passing it, fiber might not be a good option. Fiber bulks up stool and helps the bowels move. However, if you already have bulky stools, you wouldn’t want to bulk it up some more. If you have small, hard stools, fiber might help.
If stools are hard, some use stool softeners. They are not laxatives in themselves, but because they sometimes soften stools too much, some people complain they get diarrhea. Perhaps, the best suggestion for some of these people may be to drink more water. Or even juices. Some people feel apple or grape juice can induce diarrhea. But, the one juice most people associate with bowel movements is prune juice. Prune juice is probably ideal because it contains fiber and liquid. However, it does not work for everyone, either. Of course, nothing is ever 100% guaranteed to work. I’ve tried prune juice and sometimes, it can cause cramping when it takes effect.
I know lots of people who resort to over-the-counter laxatives. Some people actually abuse them, because they wrongly assume they have constipation when it may not be. Then, there are those anorexics who abuse them for the sole purpose of remaining thin. However, you look at it, laxative abuse is dangerous. For that matter, many doctors hate it when people use laxatives, especially when they don’t inform their doctors about their use. It may interfere with other medications or cause other problems that may be misdiagnosed.
Regular exercise is also supposed to be good as it keeps the body fit and functioning properly. Yet, how to gauge the effect of exercise is difficult. I’m not a couch potato, but neither am I excessively active. But, summer is here, so I should make a conscious effort to engage in real exercise every day.
Constipation, bloating and farting go hand in hand
One of my most common complaints, though not a serious health issue, is constipation. Now, I realise that to actually have a diagnosis of constipation it should be a change in bowel pattern, such that it is not normal to myself. Everyone’s bowel habits are different – some go twice a day, while others may not go more than once a week. I fall somewhere in between, but there are other symptoms I suffer when I know I have constipation. One of those symptoms is bloating. And last night was one of those severe nights of bloating.
I was unable to sleep because every position was uncomfortable. I felt I needed to vomit to release everything inside my stomach. The stretching of the bowels was painful and as I rubbed my belly for comfort, it felt like I was distended from pregnancy. A large, loud burp relieved some of the pain and distention, but immediately, it would build up again. I had to sit, leaning forward to ease some of the pain.
In the past, I would turn to liquid antacids for relief. It did not always help and for many years, I have taken nothing. Yet, last night I was wishing for some. I had to turn to a peppermint lozenge. Why? Because I know that mints are one of the no-nos for people who suffer from acid reflux. (It may be that I have a problem with acid reflux due to my love of mints, which may be the culprit for all this bloating.) However, I understand that the mechanism of action is that mints lower the pressure in the lower esophageal sphincter, that muscle that separates the end of the esophagus and the stomach. This muscle relaxes in order to allow food to enter the stomach and contracts to prevent food from returning to the esophagus. Mints act to relax the muscle, which exacerbates acid reflux. However, I felt I needed it to relax to release all the trapped air. Whether or not it worked, or whether the gas finally dissolved on its own, I cannot say. But, I do know that eventually, I felt sufficiently comfortable to return to bed.
Now, I’ve tried to identify the triggers for the bloating, but it never is constant. I can be eating the same thing day after day and not have a problem and then bang! I’m bloated. The one thing I can associate it with is constipation. If the bowels are blocked up at one end, gas cannot pass through that end. So, when I feel bloated, I try to burp. Excessive burping warns me that my bowels are blocked.
People may not find passing gas very pleasant, but it is a necessary and vital part of life. Kids love it, though – they think it’s hilarious. Now, one should be careful not to encourage them to fart too loudly in public or amongst crowds, but one should not discourage them from relieving themselves when necessary, either. They should do it tactfully and others should tactfully try to ignore it.
Oily fish with high omega-3 protects against macular degeneration
It’s interesting that a recent study regarding macular degeneration, which recommended eating oily fish to prevent progression of the disease, mentioned omega-3 but not lutein.
For the past few years, the antioxidant lutein was believed to be so beneficial that ophthalmologists recommended it to their patients. But, this new study shows mixed results. Of course, the focus was on omega-3, which showed to be protective for eye health against age-related macular degeneration. The use of additional antioxidant vitamins, unfortunately, seemed to negate the positive benefits in early macular degeneration. However, it did show benefit in advanced stages.
The recommendation on oily fish limits it to twice a week. Experts warn that too much oily fish would lead to accumulation of low levels of pollutants. So, every advice has a silver lining.
I eat quite a lot of fish and I wear glasses. I don’t have macular degeneration, but I suppose I should avoid taking vitamins in case I should develop macular degeneration and push it to an advanced state. Eat fish – don’t take vitamins. Take vitamins – don’t eat fish? The article did not address whether omega-3 or lutein had more benefit.
Esophageal cancer is common amongst alcoholics and smokers
I recently heard that an uncle of mine has been suffering from esophageal cancer for about a year and a half. My first reaction was, I’m amazed he has even survived that long. My second reaction was, yet another one in the family with cancer. Finally, it must have been his drinking. I do not recall this uncle smoking or drinking when I was younger, and it was very probable that he didn’t or he managed to hide it well. However, as he got older and underwent a midlife crisis, he became a heavy smoker and especially, drinker. He always appeared at functions drunk or extremely red-faced. That included my wedding and my mother’s funeral.
Alcohol-related illnesses are extremely costly. Similarly, smoking-related illnesses are a huge burden to the medical system. The combination, therefore, is enormous. But, though esophageal cancer is not rare, it does not get the same attention as other alcohol and smoking-related illnesses, namely, cirrhosis and lung cancer, respectively. But cancers of the stomach and esophagus are very common amongst smokers and drinkers. That is because the toxins from cigarettes and alcohol come in direct contact with the lining in the esophagus and stomach, causing damage.
My uncle has undergone surgery to remove the tumour. It is possible that he has managed to survive because all the tumour has been removed. He had had a feeding tube prior to the surgery and it was removed right after. Yet, he still has difficulty swallowing and eats very little. Consequently, he is very weak; though reports are that he is improving somewhat. His immediate family are frustrated because they feel he is not putting in much effort to eat and walk. Yet, it must be remembered that cancer weakens a person, and tumours have been shown to produce a chemical that causes depression.
Surgery is one option for esophageal and stomach cancers. However, sometimes the tumours are too extensive to be entirely removed. As a result, sometimes radiation is offered. Yet, radiation has its own risks, especially scarring and the possibility of radiation-induced tumours. Which ever course is taken, feeding tubes will often be necessary to provide adequate nutrition. With increasing ethical problems regarding feeding tubes, decisions to have the tubes placed and/or removed need to be made early on.
Having been physically and emotionally separated from my family for many years now, I do not have the inside scoop on my uncle’s condition. However, I have been able to make contact with several family members recently and I’m sure they’ll keep me updated. Unfortunately, as with many other cancers, the survival rate is low for esophageal cancer, so I can only look forward to hearing more bad news.
Death of emergency patient due to paramedic shift end
Unbelievable. Incredible. There are not enough exclamations to describe the kind of reaction an ordinary person would have to the story of a paramedic who put his own needs before that of a critically ill person.
Of course, the decision might not have been his, thus an investigation is pending. But, regardless of the authority who demanded that the paramedic end his shift, his first moral priority should have been for the welfare of the patient he was carrying. Though paramedics may not be bound by the Hippocratic oath, they essentially agree to similar codes of ethical conduct.
Imagine a doctor, in the middle of a life-saving code, deciding to go off shift. That just wouldn’t happen, not unless some extraordinary circumstances where another doctor is available and can take over immediately. In this case, a paramedic is called to transport a stroke patient to the hospital. He takes a detour to the ambulance station so that he can go off shift and another driver takes the patient to the hospital, where he ends up dying because he did not receive treatment immediately.
Now, you might argue that the patient would have died anyway. But, is that the way we should trivialise someone’s life. There was a possibility that he could have been saved had intervention taken place in the recommended time frame. As such, the patient arrived at the hospital outside of the time frame. (Remember the Natasha Richardson case.) The driver could have been excused for going off-shift had a driver been available along the way to the hospital, rather than off the route.
So, what was the motive for choosing to go off-shift rather than completing his route then returning to the ambulance station? Was there a demand for him to turn in? Or, did he just feel that his duty ended at such and such a time? Should you be in the emergency health field if you only want to work your shift and forget about it? What happened to overtime in cases of emergency? Surely, exceptions to limiting pay exists in such cases. It costs more in the long-run when you become too tight-fisted to allow for flexibility in shift work hours.
Transference of personalities through organ donation?
It sounds like something straight out of a horror story. In fact, I cannot recall the name of the book, but the plot still haunts me. The story involved a father, his triplet sons, and the fiancee of one of them. The eldest is a successful surgeon, following in his father’s footsteps. The middle son is fairly responsible and has a beautiful fiancee. The youngest is a scoundrel, who is jealous of his middle brother. The eldest, trying to save a young boy, loses his hand in a sawing machine. The father is extremely angry, as this affects the son’s ability to continue working. On the other hand, the black sheep is wasting his life. So, what does he do? He forces the youngest son to give up his hand to his brother. The son, of course, does not like it, but the father manages to amputate him and transplants the hand to the other son. You can guess what happens next. The evil hand takes over the new owner, causing him to do unspeakable acts that he would never have done. In the end, the father realises this and chops off the hand. (Sorry if I gave it away, but I can’t even remember the title of the book.)
This story came to mind when I read an article on the BBC about how some people would refuse a donor organ from a “bad” person. In fact, a scientist stated that some organ transplant recipients felt that they had taken on some of the donor’s characteristics. Though transference of personalities through organs cannot really be studied, and therefore, has been dismissed as a possibility, can we really be sure? How can we explain these recipients’ feelings? Is it the immunosuppressants making them feel different? I have heard of family members saying that the recipients acted differently from before.
Of course, organ donation is done under completely anonymous conditions, so that the recipient cannot pick and choose who their donors are, much less, know their personalities. But, I wonder, has anyone ever gone back to find out something about their donors, especially, if they ever experienced a change in personality? That would be a very interesting research topic. It may sound frivolous, but if there is any truth in it, would it change the transplant programme in any way?
Sun allergies prohibit my enjoyment of summer
Why is it that I always seem to “forget” the real reason I don’t like summer? My favourite season has always been fall, followed by spring. Though I don’t like extremes of weather, I always preferred winter to summer. Snow is fun, and of course, there are the holidays. But, beyond that, I always find it easier to dress in lots of layers, than to remove down to your birthday suit. After all, once you are down to that, you have no further to go, unless you have air conditioning.
I hate it when it is hot. I always associate it with being sweaty, sleepy, and just plain lethargic. I have never understood the mentality of lying out in the sun until you are baking. Of course, when it is so hot, there’s little you can do except lie down. But I’d prefer to do it in the shade.
But it’s not the frustrations I feel when the temperature rises that make me wish I could rush through summer. I love good weather and summer is ripe with it. As long as it is not too hot. Over the last two decades (after this long a time, how can I always forget?) I have developed a “sun allergy”. There’s some medical terminology that a dermatologist gave me once, but I forget what it is. I get a rash, even after brief (15 minutes) exposure in the sun. It does not seem to affect me in the winter, which perhaps explains why I keep forgetting. But it makes me also think that it’s not just the sun, but the heat. My theory behind this sun allergy is that the sun is more direct in the summer. It’s rays are more powerful, more intense, more hot. Even on cloud-filled hot days, I can develop the rash. Conversely, I have had, on occasion, rashes in the spring when we’ve had sunny but cooler, even cold and breezy, days. Unlike heat rash, which is found on sweaty areas of the body in hot weather, the sun rash mostly occurs on exposed areas. For example, you can see the tan lines on my feet from the sandals I wear, and in those areas, there is not a single rash. The most affected areas, obviously, are the hands and feet, because they are the least protected (or most exposed) in the summer. But, there was a time, when many joint areas were affected as well, regardless of protection, such as the shoulders and hips. It made suspect other problems, but in recent years, it has concentrated only on exposed areas.
One year, I was in Mexico and was so badly affected, I could only come out in the evenings. Even that wasn’t good enough. I was practically covered in a rash and the persistent heat did not help, even though I stayed indoors. The evening sun, though deemed safe for melanoma risk, exacerbated the rash in exposed areas.
The rash, like hives, poison ivy and heat rash, is extremely itchy. Unless someone has experienced any of these, they cannot understand how maddening it can be. It makes you curse the cause of the condition. I cannot afford to buy expensive steroid creams to help with the rash and itch, and have resorted to over-the-counter itch creams and allergy pills. They are not always helpful, but I have to give them a try sometimes. Another trick I’ve learned is to cool down the heat of the itch with ice or cold water.
I envy those who can tolerate the heat. It’s difficult to go around in long sleeves and pants all the time. So, I either have to choose to sweat or itch. Not an easy choice sometimes. And sun screens do not help, though I do use them to protect my skin. Even though they make me feel sticky. Every summer, I am reminded of my condition, when a brief encounter turns prickly, as it has in the last few days. And we’re not even officially in summer.
Irresponsible BBC reporting on the state of HIV therapy
I found the latest article on HIV and STDs on the BBC website extremely irresponsible and offensive. I realise that the point of the article was to encourage those with HIV to see a doctor and be treated, but the message does not come across that way.
It did state that the main focus of prevention is on the use of condoms. But this statement was made at the beginning. For the rest of the article, it was never mentioned again. In fact, the writer seemed to imply that condoms were completely unnecessary. The story’s focus was on how good anti-HIV treatment has become – so good, that the person could be considered no longer infectious. Because of this, the likelihood of the person passing on the virus was close to nil.
Never mind the fact that people have been shown to pass the virus on to their partners. The article passes this off as few and far between. Should this complacent attitude be what experts are advising?
There is no cure for HIV at this time, but antiviral therapy has helped to slow down the spread of the disease. Because the epidemic has been stopped, is this reason to say that we can all relax our vigilance?
It is no wonder that the younger generation shows no fears about sexually transmitted diseases.
