I’m generally not a big sweater.  But last evening as my wife saw me returning from chipping and putting a few balls around she noticed the large wet patches on my shirt.  “Did you end up going on a bike ride or is that just from hitting a few golf balls?”   I responded that is was, “All from just strolling around and hitting a few balls.”

This is the time of year in Tennessee when any kind of outdoor physical activity during the daylight hours is majorly sweat-producing.  Indeed, sometimes the heat can really cause a problem for people.  Specifically, there are three heat-related illnesses.  The mildest one is heat cramps with symptoms including muscle cramps, fatigue, thirst, and heavy sweating.  It can usually be treated by getting to a cool place, resting, and hydrating with water, sports drinks, or other rehydration drinks containing electrolytes.

The next, more serious, heat-induced condition is heat exhaustion.  If this hits you, you may notice the symptoms of heat cramps as well as rapid pulse, feeling lightheaded, nausea, headache, and sometimes, cool moist skin with goose bumps.  If you start noticing some of these symptoms, stop all activity and rest in a cool place, and hydrate (not with alcoholic or caffeinated beverages).

If untreated, heat exhaustion can go on to heat stroke, a potentially deadly condition.  In heat stroke the body temperature reaches 104 F or higher.  The skin may be moist or, worse, hot and dry, as the heat challenge overwhelms the body’s ability to cool itself by sweating.  In addition to all the symptoms of heat exhaustion, there may be confusion, agitation, irritability, and sometimes, fainting.  Heat stroke is a medical emergency requiring immediate treatment to avoid damage to the brain and other vital organs or even death.  If you are with someone exhibiting symptoms of heat stroke, call 911 immediately as this isn’t one to just treat on your own. While waiting, move the person to a cool place and cover with a wet sheet or spray with cool water and encourage hydration if they are able to drink.  Fan them to encourage evaporation of the water on them which will further cool them.

Heat-induced illnesses are not terribly rare.  One source lists heat stroke as the third leading cause of death in American athletes.  These cases would be what is called exertional heat stroke, where physical activity is a major player in the overheating.  There is also non-exertional heat stroke which occurs in a person not physically active but overwhelmed by a very hot environment.

There are a few other factors besides the temperature, humidity, and exertion that put someone at greater risk for heat illness.  These include poor hydration, alcohol intake, overdressing (especially if the clothing doesn’t allow evaporation of sweat), very young or old age, and certain medications such as beta blockers, antihistamines, and diuretics.

Mid-summer in Tennessee is still a good time to be outside, but limit your time in the heat of the day and keep hydrating to stay a long ways from these serious heat illnesses.

Andrew Smith, MD is board-certified in Family Medicine and practices at 1503 East Lamar Alexander Parkway, Maryville.  Contact him at 982-0835