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When it gets hot outside, doctors begin to call for common sense in the sun. Particular emphasis is placed on wearing a cap or a hat. Why? The consequences of not having a headgear can be not only serious, but also permanent. For MedTvoiLokona, they are described by a neurologist Dr. Olga Milczarek from SCM Clinic in Krakow.
- For the human brain, the limit temperature is 39,9 degrees Celsius
- When it is exposed to higher temperatures, the brain literally starts to boil
- In hot weather, this can happen quickly. When the first symptoms of overheating appear, you need to act. However, it is forbidden to drink cold drinks or cool down with cold compresses
- More information can be found on the Onet homepage.
Assistant professor at the Department of Pediatric Neurosurgery, Institute of Paediatrics, Jagiellonian University Medical College in Krakow, active researcher and teacher. She completed her specialization in neurology in 2013. She completed her specialization internship in pediatric neurology at the Department of Child and Adolescent Neurology of the Institute of Mother and Child in Warsaw. For many years he has been cooperating with neurosurgical centers all over Poland as an intraoperative neurophysiologist.
Monika Mikołajska, Medonet: When a heat wave approaches Poland, all doctors appeal to protect the head when going outside. Why is it so important?
Dr. Olga Milczarek, neurologist: This is an extremely important issue, but it is not only about the headgear, but also about the clothes we wear in hot weather. It largely determines whether our body will be able to maintain adequate thermoregulation. When it comes to protecting your head, this is key to avoiding sunstroke. It is a condition in which, as a result of sunlight, the tissues of the head – skin, but also the central nervous system (CNS), such as the meninges, overheat. And let us remind you that it is in the CNS that the thermoregulation center is located (exactly in the hypothalamus – editor’s note).
In medicine, we also talk about heat stroke – a concept broader than the aforementioned sunstroke. We talk about it when the body overheats as a result of various factors (not only the sun). This can happen even when we are in a hot room, without being able to cool down.
What happens to us when, under the influence of heat, the thermoregulation center begins to “deteriorate”?
When the tissues are overheated, the body ceases to distinguish what temperature is appropriate for it, it stops regulating this temperature, in other words – to give up excess heat. It happens when the body heats up to at least 39,9 degrees Celsius. We stop sweating then, which means that the body cannot cool down. This is the most dangerous moment, the moment of life threatening.
On the beach, we often hear someone saying to another person: but your skin is hot, you better get out of the sun. In saying this, people usually do not realize that they are talking about a situation where life is at stake. Because we are very little away from sunstroke and what it brings with it.
What happens to the brain itself when it overheats?
Figuratively speaking, he just starts to cook. The temperature of the tissues, i.e. the skin, meninges and the brain cells themselves, increases so much that they begin to boil and are no longer able to regulate the body temperature, and thus protect deep tissues from further overheating. This is the temperature limit of 39,9 degrees C that I was talking about. Of course, the skin or the subcutaneous tissue can be much hotter. However, for a brain, which is thermally sensitive, exceeding 39,9 degrees Celsius can mean death.
What symptoms does an overheat experience?
Such a person experiences heart palpitations, dizziness appears, the skin becomes pale, then dry, contact with the environment is disturbed, delirium may appear, and a very strong headache may appear. There is often nausea, vomiting, and unconsciousness may occur. In such cases, you must go to the hospital or call an ambulance.
I know from experience that people often do not realize what is happening to them, that it is dangerous and you should get out of the sun as soon as possible. Many people find it almost impossible for them to overheat. Meanwhile, a long lazy lounging in the sun with the intensity of radiation we have today is out of the question.
Can we indicate the first symptom after which we should leave the sun as soon as possible?
It is definitely a feeling of weakness. We start to get stuffy, weak, our heart beats faster. If you feel dizzy, it will be the last call to hide in the shadows.
Is the mere transition to the shadow enough?
This is definitely not enough. It is very important to cool down the body gradually. So we drink cool drinks at or close to room temperature in small sips. It is worth applying cool compresses, preferably on sensitive areas, such as the neck, forehead, armpits, groin. We avoid cold drinks and wraps. Such action – due to the constriction of blood vessels – even makes it difficult to expel heat from the body. The same rule applies to burns.
Is it possible to estimate how quickly overheating can occur, i.e. reaching this temperature limit of 39,9 degrees Celsius, in a situation when we are in the sun with an exposed head?
Unfortunately, it is impossible to indicate the time after which sun exposure becomes dangerous – it is an individual matter, depending on many factors. However, it can be said that overheating is usually the fastest in young children and also in the elderly. In seniors, there is little subcutaneous tissue, often there is also less hair – this accelerates the heating of the body. In addition, the thermoregulation center is not so efficient in them. In children, on the other hand, the heat regulation center is not yet fully effective, and the subcutaneous tissue is just growing – that’s why we put hats on kids, both in heat and cold weather.
A lot depends not only on the appearance, but also on the circumstances. For example, whether we play sports or just walk, whether we are in a hot but shaded place, or whether we are lying on a beach in full sun. The possible ailments of a given person are also important, e.g. some skin diseases may favor greater or faster absorption of solar radiation. The same happens in patients taking certain cardiac medications.
The maximum time spent in the sun – with the head covered – is two hours, others say 45 minutes to an hour. Meanwhile, often people relaxing by the water spend long hours in the sun.
It used to be said that sport is good for health, but sport is not healthy on a hot day. Especially when we grow it with our heads uncovered.
Playing sports on a hot day becomes very risky, especially if we have not taken care of head protection. We must be aware that the heart rate increases when we are active. 120 beats per minute is the limit at which sport is efficient. Athletes take care not to exceed it. On a hot day, there is also a high temperature, which can increase the heart rate by 20-40%. And let’s not forget about the greater loss of electrolytes. The combination of these factors makes sports in such conditions simply dangerous. Heart rhythm disturbances may then occur.
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Another thing is the clothes in which we play sports. It is often made of synthetic, low-breathable fabrics.
Exactly. This is important not only when you are active, but also during hot days. Then we should remember about loose, preferably bright clothes made of natural materials. We should avoid clothes that tighten the body and restrict movement. These rules also apply to headgear. A cap or hat should not be oppressive in any way, but should also protect our eyes, but also protect the neck. Remember – the head and neck are the places where thermoregulation is most effective, where the blood flow is greater. For example, when someone has a fever or is overheated, cold compresses are given not only to the forehead, but also to the nape of the neck.
Coming back to the headgear in hot weather. From what the doctor says, an ordinary baseball cap, a popular baseball cap is not enough on a hot day …
Definitely not enough, although of course it is better than nothing. However, a hat with a larger brim will be much better, which will also perfectly cover the face. A fishing hat will also be good.
The most important thing is to follow the rule: prevention is better than cure and not allowing the risk of overheating. We do this, as I said, by wearing the right clothes, but also of course drinking the right amount of water – a minimum of eight cups a day. It is best when it is highly mineralized, because on a hot day we lose these minerals faster. Tomato juice rich in potassium and water with the addition of honey, which will be a source of glucose – fuel for the brain, are also very good.
What we cannot forget about protection against heat is the need to perceive the organism as one, comprehensively. It is not enough just a ventilated T-shirt, or just a hat, or just applying sunscreen (it depends on how much sunlight the skin absorbs – red) or just drinking water. All these treatments are important for maintaining balance in the body.
However, if overheating does occur, when should we call an ambulance? When are we no longer able to help ourselves or another person?
Professional help should be called in when there is a disturbance of consciousness or when neurological symptoms such as confusion, delirium, problems with keeping contact, loss of consciousness occur. These are life-threatening situations that require hospital assistance.
Could overheating end up with permanent brain damage?
Definitely yes. Long-lasting overheating disturbs blood circulation, which in turn may lead to CNS hypoxia.
Did you see the doctor with such a case?
Fortunately, we’ve always managed to get our patients out of overheating. However, I remember a 72-year-old patient who dug the entire garden under the bright sun. A handkerchief was tied around his head, which he sometimes soaked in cold water. This protection did not fulfill its role. It started innocently – in the evening you had a headache, nausea and vomiting appeared. When he was brought to the hospital, he was already in a pre-coma. This patient came to the ICU with a severe ischemic stroke, a complication of circulatory centralization, caused by a sunstroke. His condition was very serious, he had deep hemiparesis, aphasia, he practically did not speak at all. He was saved, but the neurological effects will stay with him for the rest of his life.
Another cautionary example is the case of a 30-year-old woman who ended up in the ICU where my friend worked. The patient was extremely dehydrated, had very serious electrolyte disturbances, entered a coma. She also had permanent neurological deficits, years later she developed complications in the form of neuropathy (peripheral nerve damage – ed.).
We are at the very beginning of the holiday and the heat will certainly pour out of the sky more than once again. What do you, as a nervous system specialist, would like to pay special attention to?
First of all, I wanted to appeal for common sense and follow the path of the golden mean. After all, it’s not about shutting yourself up in the heat of the heat and not going anywhere, but also not about frying in the sun all day. Let’s leave when the heat subsides, that is after 15-16 or in the morning. Let us also appreciate the seemingly small things. Airy, loose clothing, a hat, smearing the skin with sunscreen, frequent drinking of water – these activities can decide what our next life will look like. The patients I told you about are the proof.
We encourage you to listen to the latest episode of the RESET podcast. This time, we asked Orina Krajewska what, according to her, a holistic approach to health is. How to combine the three aspects – body, spirit and mind to enjoy balance and good health? You will hear about this and many other aspects of the topic in the latest episode of our podcast.