Columnist Dr. Cheryl Christy

Author's note: This column is intended for educational purposes only. It aims to highlight gaps in health knowledge, provide support and empower organizations to guide their members in creating effective health and wellness programs.

Last month, a single heat wave killed a thousand people in France in just three days. 85% of them were over 65. Air conditioning could have prevented many deaths, but if the power is out, you are back to square one. Right now, the National Weather Service has 200 million Americans under a heat alert. What is most surprising is that people who die in a heat wave are at home in a chair, sometimes with a fan running three feet away. Why?

After 60, the body’s cooling system weakens.

If you are 60 or older, your body quietly loses a large part of its ability to cool itself. Heat effects are not just an outdoor problem, something that happens to landscapers or athletes. Our body has a built-in cooling system. When you get too warm, your heart pumps more blood to the surface of your skin, where it can radiate heat into the air as you sweat. This system works well for most of your life. Somewhere after 60, that system weakens; you sweat less and later than you used to, and your temperature and thirst centers fail to alert you to an impending problem. An older heart has a harder time pumping all that extra blood to the skin, especially if it is already working against high blood pressure or heart disease. This alone does not mean you are frail; it is biology. For those who live in the south, it’s not the heat — it’s the humidity! Pay attention to the heat index, which is the temperature it feels like to your body when you factor in humidity.

Five mistakes dealing with a heat wave:

Trusting a fan to keep you safe.

There is a temperature at which a fan stops helping and starts hurting you. The CDC states that when the air in a room climbs into the mid-to-high 90s, an electric fan will not prevent heat-related illness. At 95 or higher, the air itself is hotter than your skin. Instead of carrying heat away from you, the fan is now blowing warm air across your body, which can elevate your core temperature. Use your air conditioner if you have one, or go somewhere that has one, a cooling center, library, shopping mall or a friend’s house.

Waiting until you feel thirsty to drink.

According to the National Institute on Aging, adults over age 60 have a less active thirst center than younger adults. In addition, dehydration thickens the blood, drops blood pressure, places a strain on the heart and kidneys and may cause dizziness, increasing the risk of a fall. Keep a water bottle or glass of water within reach to encourage hydration (unless your doctor has told you to limit your fluid intake). Monitor your urine color; if it is light straw, you are hydrated. If the urine turns dark and concentrated, iced tea color, then you may be becoming dehydrated. Plain water may not be enough, as sweating can make you lose salt and minerals. You may benefit from an electrolyte additive. Caffeine and alcohol are dehydrating.

Failing to notice your home is heating up degree by degree.

You begin to feel warm, tired and lethargic. Factor in the humidity. Hang a thermometer in plain sight to know the temperature. Close drapes and curtains facing the sun. Remember that the upstairs rooms are usually hotter than the downstairs rooms.

Misunderstanding the difference between heat stroke and heat exhaustion.

These are two dangerous stages to distinguish between. The signs of heat exhaustion include heavy sweating, cool, clammy skin, muscle cramps, feeling weak or dizzy, nausea, headache and a fast but weak pulse. Stop what you are doing, get into the shade or a cool location, lie down and apply cool, wet cloths to your neck, armpits and groin (where large blood vessels run close to the surface).

The second stage, which is a true emergency, is heat stroke. Dial 911 immediately. Your body’s cooling system has completely failed. Signs include confusion, slurred speech and changes in behavior. Skin is hot and dry, with a pounding, rapid pulse and throbbing headache, fainting or loss of consciousness. Place the individual in a cool shower or cold bath if possible, or apply ice packs and cold wet cloths to the same areas. Keep them there. Do not force fluids if confusion is present, as they may choke.

Misunderstanding the effects of medications and heat.

Diuretics used to treat high blood pressure or fluid retention pull fluid from your body, which can lead to dehydration. Beta blockers, another category of blood pressure medications, can reduce how much you sweat and lower the heart’s ability to pump extra blood to your skin. Another medication class called anticholinergics, which are in some bladder medications, antidepressants and over-the-counter sleep and allergy pills, can also directly shut down sweating. A word of caution: Do not stop taking your prescription; just be aware of its cumulative effect during the heat. Ask your provider about this to see if a medication or dose can be adjusted during summer heat waves.

This is another opportunity for the faith community to assist its members by developing an organized system of connection, such as a volunteer phone tree to call on the elderly during heat waves to ensure they are well, provided with evidence-based health information and offered appropriate resources.

Summary

Do not trust the fan alone on a seriously sweltering day. Monitor indoor and outdoor temperature and humidity levels. Know how your medications affect you in the heat. Drink fluids throughout the day. Monitor the color of your urine. Look for signs of confusion, hot, dry skin and pounding pulse. Be prepared to call 911.

If you or your organization has questions or needs further assistance with developing a health and wellness program, you can reach out to me on my blog at https://substack.com/@dnprn.

Dr. Cheryl Christy is a Baldwin County resident and registered nurse with nearly 30 years of experience. She holds master's degrees in nursing education and nursing practice and a doctorate in nursing practice. She is a member of Sigma Theta Tau, Phi Pi Chapter, a certified lay counselor and the author of "Voices for Healthcare," a health care blog.

Read her previous column titled "Surgical procedure post-op: What to expect" on www.GulfCoastMedia.com. Her blog can be found at https://substack.com/@dnprn.