What Is Heatstroke?

I got heatstroke once when I was hiking in Arizona. As I was coming down the mountain in the final mile, I was overwhelmed with a feeling of nausea and I started dry heaving. At the time I was confused about what was happening, because I thought I had been drinking enough water during the hike, and although I had run out a little while back, I didn't have any sweat on my body, nor did I feel overwhelmingly hot.

But dry, desert conditions  can cause sweat to evaporate so quickly, you don't even know you've been sweating. The risk for heat stroke increases with outdoor temperatures above 100 degrees Fahrenheit and with physical activity. Outdoor running is not recommended when it is above 85 degrees. Luckily for me, I wasn't too far from my car when I became sick.

How do you know if you might have heatstroke?
 The symptoms include: Mental status changes such as confusion, agitation, slurred speech, irritability, delirium, seizures and coma. Physical symptoms including nausea and vomiting, flushed skin, rapid breathing, racing heart, and headache.

How do you treat heatstroke?
Rapid cooling techniques include cold water or ice baths, cooling blankets, getting into an air conditioned space, drinking water, getting out of the direct sunlight, and cooling the skin with water and fanning. Severe cases of heatstroke require emergency intervention.

Fortunately, I got to my air conditioned car and found some extra water inside. If I had been hiking even 30 minutes longer, I wonder if I might have collapsed. It was a sobering experience, and one that taught me not to repeat it.

This is what I've done to avoid future heatstroke:

1. Do not do strenuous exercise outdoors when the temperature is >85 degrees.
    
2. Do not stay outdoors for prolonged periods of time when the temperature is > 100 degrees.
    
3. Drink lots of water in the heat. Two to four glasses per hour may be necessary.
    
4. Have a plan to escape the heat if necessary (a body of water, or air conditioned or shady space nearby).
    
5. Wear sunscreen, wide brimmed hats, and breathable clothing in light layers.

For more information about heatstroke, check out the Mayo Clinic website: http://www.mayoclinic.org/diseases-conditions/heat-stroke/basics/definition/con-20032814

References
https://cchealth.org/heat/prevention.php
http://www.mayoclinic.org/diseases-conditions/heat-stroke/basics/definition/con-20032814


If you have any questions about heatstroke, please log into your account and send us your question. We are here to help.  If you'd like to ask Dr. Val for a health tip, email your request to us at: weeklyhtblog@yahoo.com


Dr. Val Jones MD - Health Tip Content Editor

Health Tip: C. Diff Diarrhea And Stool Transplantation?

Clostridium difficile (known as 'C. Diff' for short) is a species of bacterium that can cause severe diarrhea requiring hospitalization. This bacterium normally lives in soil, water, deli meat, and human feces and we are exposed to it on a fairly regular basis. It may not cause symptoms until our normal intestinal bacterial colonies are disrupted by illness or antibiotics.

Our intestines have over 2000 different kinds of helper bacteria, all living in harmony when we are well. They assist in fermenting food and keeping out harmful bacteria. However, when we take antibiotics for an infection (such as pneumonia, skin, or urinary tract infections) the medicine kills the bad bacteria curing those infections, but at the cost of many "friendly fire" casualties in our intestines. This allows the C. Diff to reproduce rapidly, manufacturing toxins that trigger diarrhea by infecting the intestinal lining.

Many of the risks of a C. Diff infection are the same for any severe diarrhea: dehydration, kidney failure, ruptured colon wall, and in rare cases, death. It is more common to catch C. Diff after taking antibiotics (especially fluoroquinolones, cephalosporins, penicillins and clindamycin), or being in a hospital (because many patients take antibiotics there). It is 10 times more common in people over the age of 65.

Symptoms usually develop 5-10 days after starting a course of antibiotics. Symptoms can be mild (watery stool, 2-3 times a day) or severe (diarrhea 10-15 times a day wi
th fever, dehydration, nausea, swollen abdomen, or blood or pus in the stool). C. Diff has a characteristic foul odor that is familiar to healthcare workers caring for patients with this infection (I can usually tell if someone has C. Diff when I walk into their room. Ew. I know). You should see a doctor if you have three or more watery stools a day and symptoms lasting more than two days or if you have a new fever, severe abdominal pain or cramping, or blood in your stool.

There is a new strain of C. Diff emerging that is resistant to some antibiotics. Fortunately there aren't any strains (yet) that are resistant to all antibiotics. Those who catch C. Diff have a 20-30% chance of being re-infected from within. These bacteria produce spores (a reproductive structure with a shell-like coating) that can live on dry surfaces from weeks to months. The spores are immune to alcohol-based cleaning agents, but are destroyed by soap and water or bleach.

C. Diff is contagious, but spread can be avoided by careful hand washing, clothing and bedding laundering, and bleaching of all surfaces that may have come in contact with the infected individual. Pro-biotics (found in acidophilus tablets, yogurt, fermented cultures, and Kefir) may prevent C. Diff infection by shoring up the helper bacteria numbers in the gut. C. Diff can be killed by strong antibiotics such as Flagyl or Vancomycin, but they may have unpleasant side effects such as severe nausea and a bitter taste.

Fecal transplants are an emerging treatment for severe cases of recurrent C. diff infections. This involves re-populating the intestines with gut bacteria from another person. It is not yet approved by the FDA because it is hard to be certain that these transplants are free of unwanted infectious agents and viruses, though donors can be screened. Perhaps one day in the future, those of us with exceptionally healthy bowels will volunteer to be stool donors. If the Red Cross has blood banks, will they also eventually have stool banks?

Although you may shudder at the prospect of stool banks, they may be life-savers for those with chronic or resistant C. Diff infections.  Until then, I wash my hands with soap and water and eat yogurt (with live cultures) every day - to keep the C. Diff at bay!

References

http://www.mayoclinic.org/diseases-conditions/c-difficile/home/ovc-20202264
https://www.cdc.gov/hai/organisms/cdiff/cdiff-patient.html

If you have any questions about bacteria, please log into your account and send us your question. We are here to help.

Dr. Val Jones MD - Health Tip Content Editor

Health Tip Reader Question: What is Bursitis?

Did you know that our bodies have mini "air bags," located around our joints (the largest ones are in the shoulder, elbow, and hip) for protection? They are not actually filled with air - they are filled with fluid and are called bursae (plural). But they are designed to keep the joints buffered from impact. Sometimes these sacs become inflamed - usually from trauma or overuse.


When a bursa (singular) becomes inflamed, it's called "bursitis" - and it can look swollen due to expansion with extra fluid. So long as it doesn't also become infected, the treatment is rest and anti-inflammatory medications such as naproxen or ibuprofen. In chronic cases (longstanding bursitis), doctors will sometimes give a stronger anti-inflammatory - such as a steroid injection.

When a joint is infected, it usually becomes very red, warm to the touch, and the pain can be disabling. The infection can get into the blood stream and cause a fever.  If you think your joint may be infected, it's important to see a doctor right away.

Otherwise, if your "air bag" is acting up, the best thing to do is rest it and give it time to heal. Bursitis can be confused with arthritis (inflammation of the joint surface itself, not it's air bag) but bursitis is more likely to resolve, while large joint arthritis doesn't improve much without intervention (such as surgery) because the cartilage is permanently damaged.

For more information about how to tell the difference between bursitis and arthritis, check out the Mayo Clinic website.

References:
http://www.mayoclinic.org/diseases-conditions/bursitis/basics/symptoms/con-20015102
http://www.mayoclinic.org/diseases-conditions/arthritis/home/ovc-20168903

If you have any questions about bursitis, please log into your account and send us your question. We are here to help. If you'd like to ask Dr. Val for a health tip, email your request to us at: weeklyhtblog@yahoo.com