Significant Heat in Southern Europe

heat

by new to pace.... - 2023-07-12 16:50:57

Here in florida i try not to go out in the heat of the day when the heat index is in the triple numbers.  I try to make sure i stay hydrated, drink more warm water, if though i am not thristy. Wear a wide brim hat and long sleeve blouses and no shorts when out in the heat.  Sun screen on parts of your body that  are  not protected.  Even on the cloudy days.             I did all the above before pacemaker and continue now, well almost.               New to Pace

Puffy hands and ankles

by Rch - 2023-07-12 19:50:16

Hi

Unrelated to pacemaker. I would think it's mostly the fluid shifts between compartments due to changes in electrolytes. I would suggest drink plenty of fluids like gatorade or the like, and try to avoid excessive heat. If symptoms persist please consult your PCP.

Self Care

by Penguin - 2023-07-13 04:24:39

Thanks for above comments (Rch & NTP) and concern expressed (Brady). I do understand and already adhere to the self care points, but don't know how super high temperatures might affect me.  

Rch - Re: electrolytes and fluid shifts. That makes a lot of sense.

Probably a dumb question but will drinking v.high quantities of water in high temperatures dilute electrolytes (I assume yes) or will the body naturally achieve a balance between fluid intake / sweating / electrolytes in high temperatures?  Also if drinking v.high quantities of fluids to counter sweating / heat - is it safe to take electrolyte powders preventatively or only reactively? I don't have any diuretics prescribed btw.

fluids and electrolytes

by Tracey_E - 2023-07-13 09:10:11

Penguin, not a dumb question at all! If you are drinking high quantities of water, yes it will dilute your electrolytes.

If you are sweating, take electrolytes/salt to replace what you've sweated out. I take them preventatively any time I am out in the heat, particularly if doing something to work up a sweat. I always pack salty snacks on summer hikes, put nuun in my water for pretty much any outdoor summer sport. 

If you are drinking and drinking but still thirsty, if your hands swell, those are all signs you need elecrolytes. 

Edema

by AgentX86 - 2023-07-13 10:21:19

In hot weather, the body needs to shed more heat so the surface capillaries dialate to allow the core body heat to dissipate through the skin, rather like a car's radiator. Water leaks through the capillaries and sweat glands so evaporation at the surface carries heat away.  Evaporation (phase change) is a very effective heat exchange process. Normally the body's lymph system clears excess fluids, back through the blood stream and everyone is happy. 

However, things don't always work as designed. The heart has to pump harder to move blood the dialated capilliaries. A lot of us don't have the excess heart capacity to pump the additional volume of blood because of the dialated capillaries and back to the heart.  Heart failure is an obvious problem but also kidney insufficiency and diabetes are major issues. Alsomany of the drugs we take contribute to the problem.  Blood pressure meds are dropping pressure before the excess capacity is needed. NSAIDs, sterroids, and anti-diabetes contribute.

To help, raise the legs, walk (seems counter-productive but helps circulation), use compression stockings, and stay indoors. Anything to help cool the body or help out the heart.

Above all, drink water. The process needs to work to shed heat, even if edema is a side-effect. If it's a significant problem, see your doctor.

Thanks AgentX & Tracey, E

by Penguin - 2023-07-13 13:13:24

Advice heeded - I've had recent blood checks which were negative for any nasties. Perhaps a bit of fluid shift to extremities is most likely as Rch suggests. My blood vessels are great at dilating in the heat! 

Agent X -  Ankles do get puffy after walking in the heat but you're right - moving is better than standing still.  I cannot queue in the heat without significant concern about fainting - no theme parks for me!  I've been found on many a hot day with my face pressed up against a fridge or cool slab of marble or lying down with my legs in the air. Makes me looks weird but it works and I no longer care if people stare! 

TraceyE - Thanks for heads up re: electrolyte replacement. Brain not working well today, I've muddled electrolyte replacement drinks with an OTC med which depletes them and which carries a warning. Doh!!

Sports drinks and gels are an excellent suggestion. I had forgotten the value of those things!  Thank you for the timely reminder. I will definitely buy some and add a sprinkle of salt to my water bottle too. You're so right that they will help.

swelling

by Tracey_E - 2023-07-13 13:23:14

I get significant swelling in my hands and feet during long races. My doc said if it goes away once I cool off, it's ok. If it stays, that's when it's time to call. 

Penguin, watch the label on sports drinks. Many of the popular ones are nothing but sugar, minimal electrolytes. Check running stores, runners are experts at electrolyes. 

Sports drinks

by AgentX86 - 2023-07-13 15:53:07

Tracey_E is right on the mark. I've not seen any Sports drink that had significant electrolytes, other than sodium and there is usually a LOT of that. Neither sugar or massive amounts of salt will help. As she says, read the labels. If anything is left out, look at their website.

Watering

by Lavender - 2023-07-13 16:52:38

My cardiologist nurse told me you can both overwater and under water!  I had gotten woozy a few months after getting my pacemaker. It was from sitting in the heat and drinking a lot of water. The nurse told me to eat pretzels now and then. The water diluted the sodium content of the blood. 
 

It is a balance. Dehydration can occur from not drinking enough water, as we know. 
 

I was never heat sensitive until I got the pacemaker. I stay OUT of heat and humidity when possible! I keep pretzels in the car!
 

Anyone who has been told to limit salt content should pay attention to what their doc says!  

Useful information - thank you

by Penguin - 2023-07-13 18:29:48

Thank you Tracey & Agent X re: warnings on sports drinks. I have seen the specialist sports gels / powders but I'm no athlete and won't be doing anything athletic in that kind of heat.  Point taken re: what is best to take though. 

Tracey - thank you re: swelling advice with fingers.  The taut skin feels weird and unnatural, so I will heed your advice. It has always gone down for me when the heat subsides, so good to know that it's nothing to worry about. 

Lavender - Re: Salt and keeping hydration in balance - I'm in agreement about treating salt with caution and personally haven't been told to limit salt as high BP hasn't caused an issue for me recently.  I've seen it used in water by sports people in the heat. 

The pretzels - carbs with salt crystals could be useful. 

I have a tricky relationship with humidity as described above and have never tolerated the extremes well. The swelling arrived after the PM - quite a few years in - but only in extreme heat.  Sounds like I need to be sensible and cautious. Brilliant advice from all. Many thanks.

Salt and pretzels

by AgentX86 - 2023-07-13 19:18:04

Late last summer I fell (stepped off the second rung) a ladder.  I fell backwards into one of my workbenches.  I hit the corner of the bench just under the bottom, floating rib but missed the kidney (nothing to spare, there).  I went to the ER to get checked out..

The relevence here is that when they did blood tests they found that I was seriously deficient in sodium.  I'd done my 10mi walk earlier, in the heat (didn't realize how much).  I drank water but probably not enough and didn't replace the salt that I sweat out.  They topped me off and checked me into their over-priced hotel for a two-night stay just to make sure I'd retain salt. 

The moral of the story: Too much salt is a bad thing for BP or if you have certain kidney issues (and too little for others).  I drink a pint of water after every 3mi lap of the neighborhood, and eat pretzels at the beginning of the third. I weigh myself before and after.  My goal is to have no difference.

Oh, and I painted the bottom rung of the ladder cerise, so that it doesn't look like the concrete floor. I don't need to be able to focus on it anymore (transition glasses don't focus well when looking at the feet).

Fall while on Antithrobotics

by Rch - 2023-07-13 22:51:01

Agent, I'm glad you didn't injure your head! I try not to climb ladders and if I do have to, like for changing light bulbs etc, I wear a helmet!⛑️ 

As to hyponatremia, I have read, one of the most common causes, in an otherwise healthy adult, is excessive free water intake or prescription drugs especially the diuretics, and the home treatment for most hyponatremias is free water restriction or change in medications! I don't know however, how exercise and heat influence the electrolyte flux in the face of free water or salt intake. I would think the only way to determine that would be through a blood test! 

Ladders & Hyponatremia

by Penguin - 2023-07-14 04:45:37

Agent - sodium depletion when taking heart drugs seems to occur from time to time and I've seen it in blood tests on older relatives. Fortunately I'm not prescribed anything that affects sodium.  As for your ladder - a cerise bottom rung sounds rather attractive and useful too!! I'm pleased that you didn't come to any serious harm.

Rch - Yes, determining what constitutes an excessive intake of water in extreme heat is what I was concerned about. How much is too much in temperatures that you've never dealt with before?  Other members of my party DO take diuretics, so I need to think about them too.  

We should have booked a holiday to Cornwall! 

Thank you for all of the excellent advice. I've taken it all on board and will keep my fingers crossed for less extreme weather in August. 

Electrolyte monitoring

by Gemita - 2023-07-14 05:33:14

Since electrolyte abnormalities are so common and could lead to dangerous symptoms and conditions quickly, including heart rhythm disturbances, it makes prompt testing all the more important.  Of course prompt testing is something that is not always immediately available and delays in diagnosis could lead to worsening symptoms as we recently discovered with low phosphate levels.

I think it is time for a simple at-home electrolyte test kit to be developed that could give an early indication of a problem, like say a diabetes monitor gives a warning of low or high blood glucose levels.   I realise a full electrolyte blood test panel provides important additional information about body fluids, including our blood acid/alkaline balance (blood gases), but does anyone know whether a simple home monitoring device for electrolytes exists or how close we are to getting one?

simple test

by Tracey_E - 2023-07-14 09:18:24

I've never heard of one but being very active and living in a tropical climate, I've learned to be very aware of how I feel. For me it's usually extreme thirst, swollen hands, leg cramps. 

It's a lot easier to prevent it than fix it after it happens. If you are sweating a lot, assume you need to add salt/electrolytes and do it proactively by adding it to your water (that you should already be sipping if you are in the heat!). Especially if you are on a diuretic. Even if you are on a low sodium diet. This is your free pass to have a few pretzels or chips.

Gemita --Electrolyte test

by Gotrhythm - 2023-07-14 15:25:10

Hear hear! That's the best idea I've seen in a long time.

Speaking as one who has a sodium retention problem but has trouble getting it tested before the BP crashes, I have wished for something like the glucose monitor diabetics wear, but hadn't thought of a home test kit.

You are brilliant. How can we get the attention of makers and marketers of home tests?

Home monitoring of Electrolytes

by Gemita - 2023-07-14 15:51:34

https://www.kaliumhealth.com/technology

https://www.kaliumhealth.com/therapeutic-areas

https://ahsn-nenc.org.uk/graftworx-monitoring-solution-for-dialysis-patient/

Gotrhythm, take a look at the above link/s.  I think the technology is there already and some patients who receive kidney dialysis are able to be monitored at home for example.  After all, we are monitoring so much ourselves today, why not common electrolytes like potassium, sodium.  My husband has been hospitalised for electrolytes so many times now after either collapsing at home or in the street which is no good at all.  If we got early signs from a monitor when to seek help, we would all be in a much safer place.

Cerise

by Lavender - 2023-07-15 22:42:48

Be honest now-you know that a lot of you looked online to see what is Cerise?!🍒🚨📍💄LOL