I measure the change in seasons by the cases I see at Family Medicine – Piedmont Plaza I.
In the winter, my patients come in with fever and runny nose, bronchitis and flu. Spring brings allergies. I know summer’s here when patients show up with bad cases of poison ivy, sunburn and worse. Most of us do fine with the heat, provided we drink plenty of water, but one person’s sweaty day is another’s heart attack.
I always look at a patient’s underlying health before I offer medical advice. And I’ll do the same here. So, here’s a list of summer safety tips -- with a family medicine twist from the primary care physicians at Wake Forest Baptist Health.
1. Practice Summer Heat Safety
Never leave an infant or young child alone in a closed car in the summer. That applies all year long, as far as I’m concerned, but in the summer a closed car heats up as much as 20 degrees in 10 minutes. I know you would never consider putting a child in the oven. So, don’t leave a baby in a closed car – even for an errand that should only take a minute. The same goes for an invalid or anyone else who can’t open the car door and get to a cool place on his own.
Keep the Kids Hydrated
Remember to drink plenty of water when you’re outside in the heat.
Children playing summer sports should drink water the night before a day of practice, and keep drinking all day long, before they become thirsty. People who work outside are at greatest risk. Bring a cooler with water so you don’t run out.
Monitor Seniors’ Medications
Older people or people with heart conditions, diabetes and other health problems will need to be extra cautious about heat.
That doesn’t mean they need to stay indoors all summer. Far from it. But they won’t have the stamina they once did. And they may be taking medication that interferes with warning signs for heat exposure.
Thirst, for example, is an early warning signal of dehydration. But some medicines make patients feel thirsty all the time, so they may not recognize thirst from overheating.
Medicines for depression, insomnia and poor circulation also put patients at risk for extreme heat.
If you know anyone at risk for heat stroke, check on him at least twice a day during a heat wave. And if you stop sweating, feel clammy and cold or dizzy get out of the sun and get help. You may be developing heat stroke.
2. Stay Safe Around Water
My advice here is short and sweet: Never let a child near water unattended. And watch him constantly. A child can drown in six inches of water, or wander from the shallow end of the pool to the deep end in a moment. Always wear an approved life jacket in a boat. And never mix alcohol and boating. With that said, enjoy yourself.
3. Protect Your Skin Against Sunburn
If you put sunscreen on at the beginning of a day of outdoor play or work and then forget about it, please rethink your approach.
Sweat and water wash away sunscreen, regardless of what the label says, so it’s best to reapply every hour or two. I preach protection because sunburn makes you more vulnerable to skin cancer later on in life.
A typical sunburn is the same as a first-degree burn. And if it blisters, that’s a second-degree burn.
As for treatment, the best is to wait for the sunburn to heal and avoid a second burn. It’s fine to use a moisturizer, with or without aloe vera, to soothe sunburn. Avoid creams with topical antihistamines, since they may sensitize a patient to that medication and lead to an allergic reaction.
4. Keep the Bugs at Bay
Mosquito bites are mostly an annoyance, but in rare cases mosquitoes may carry West Nile virus, encephalitis or other illnesses. Ticks, too, can be more than an annoyance. In rare cases ticks in this part of the country carry Rocky Mountain spotted fever. So, it’s best to avoid insect bites.
I advise patients to spray themselves and their clothes with insect repellent containing DEET. I know some parents worry about exposing children to DEET, but I tell my patients that the research has not found any measurable risk. As I said, Rocky Mountain spotted fever is rare, but deadly.
If you or someone in your family develops a fever that lasts more than three days, see a doctor, especially if you know of a tick bite. Most doctors in the region know to consider Rock Mountain spotted fever – even with a low-grade fever – and to treat with antibiotics. As for the itch caused by insect bites, over-the-counter cortisone creams work best.
5. Avoid Poison Ivy
The stuff grows everywhere – in the yard, beside the highway and in city parks. And if botany’s not your thing, follow the old adage: “Leaves of three, let it be.”
Most of us will develop some sort of rash from exposure to the oils in poison ivy and poison oak. The oil comes from the plant leaf and stem and can stay on your skin, clothes, shoes, work gloves – even your dog.
So, if you think you’ve been exposed to poison ivy, or poison oak, wash your skin and your clothes well with regular soap or laundry detergent. Once you’ve washed the oils away, the rash won’t spread. Then it’s going to run its 21-day course.
Treating a Rash
Those pink lotions don’t work. And it’s best to avoid those that contain antihistamines because you may develop an allergic reaction. A cortisone cream can help. You may even need a prescription strength cream. Antihistamines taken orally can help too. And doctors will prescribe a course of oral steroids for the worst cases, especially if the rash develops on your face or genitals. Again, the best treatment is prevention.
Practicing summer safety doesn't mean you can't have summer fun. Get out and mow the yard, throw a baseball around, pull some weeds – as long as you’re mindful of the season’s risks.