Heat And The Elderly


DEAR DR. DONOHUE: My mother is 92 and lives by herself. She’s quite independent and does well. A neighbor takes her grocery shopping, and we take her to other places she has to go. She is extremely set in her ways.

I offered to have her home air-conditioned. She won’t hear of it. She says she’s used a fan all her life, and she likes to keep the windows open.

I worry about someone her age tolerating heat, and it gets very hot here. Can you provide some arguments that would change her mind? — D.A.

ANSWER: Your offer to air-condition your mother’s home is a kind gesture and has lots of merit. I’m not about to challenge your mother. She has successfully lived a long life, and I could learn from her. People in the past lived comfortably without air conditioning.

Your mother does have to be on guard for dehydration and heat sickness.

During hot summers, everyone has to stay well hydrated. Older people’s sense of thirst is not as reliable an indicator of fluid needs as is younger people’s thirst sense. She should sip water all day long, or she can choose any beverage she likes, including tea. Cooled drinks help keep the body cooled.

Evaporation is the chief means the body has for staying cool. Not only is an older person’s thirst sensation blunted, but so is the ability to sweat. Evaporation of sweat cools the body. I don’t mean visible sweat; the sweating I mean is imperceptible but constant. Her fan helps evaporate that imperceptible sweat. However, with a reduced capacity to sweat, older people are at greater risk of suffering from a heat injury.

Increased body heat increases the body’s need for oxygen, and that stresses the heart.

On very hot days, how about inviting your mother over to your house until the hot spell breaks?

DEAR DR. DONOHUE: I have a problem that I am reluctant to talk to the doctor about. It’s a rectal itch. I have tried many preparations, but they haven’t worked. What would you suggest? — L.F.

ANSWER: I’ll mention a few self-remedies, but if the itch doesn’t leave promptly, see a doctor. Too many conditions are responsible for such an itch, and each one has a different treatment. Psoriasis, pinworms, eczema and Bowen’s disease are a few of the conditions causing a rectal itch. The doctor isn’t going to faint when you mention this problem. It’s a very common complaint.

Make a couple of diet changes. Stop taking anything that has caffeine. The same goes for citrus fruits, tomatoes and chocolate. If these are the culprits, two weeks away from them should break the itch.

Use moist cotton balls in place of toilet paper. Or you can use commercial products like Tucks.

Take an antihistamine before going to bed. Itching usually worsens at night.

Those are enough home remedies.

DEAR DR. DONOHUE: Last December, my husband called the paramedics when I did not respond to him. They rushed me to the hospital when I began convulsing. I have no recollection of any of this. When I woke one week later, I was in the ICU. I was told that I had broken-heart syndrome. I also was told it has to do with blood pressure. Can you confirm that there is such a thing? — A.

ANSWER: Broken-heart syndrome is for real. It’s a recent addition to the catalog of illnesses. Japanese doctors first described it, and called it Tako-tsubo cardiomyopathy. Cardiomyopathy is a heart illness that affects the heart muscle, not the heart arteries or heart valves.

The classical case is one where a person develops severe chest discomfort preceded by physical or emotional stress. The emotional stress could be the unexpected death of a loved one. An EKG shows a pattern that replicates the pattern of a heart attack. The heart’s function is greatly compromised. It doesn’t pump blood like it should, and that can lower blood pressure. Seizures are not included in the list of symptoms. However, a drop in blood pressure also drops the flow of blood to the brain. That can trigger seizures.

The explanation for this is a surge in the body’s stress chemicals that affect heart function. Damage to the heart muscle isn’t permanent. The heart returns to good health in a matter of weeks.

You didn’t mention any prior stress. Do you recollect any?

On the plus side, your heart arteries are in good shape, and you ought not to suffer a recurrence.

The booklet on congestive heart failure does not address broken-heart syndrome specifically, but it does detail a more common condition, its treatment and its prognosis. Readers can obtain a copy by writing: Dr. Donohue — No. 103W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$5 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have weak kidneys due to type 1 diabetes. My doctor has me eating three fruits a day and four vegetables. He limited my meat to 6 ounces daily. Does this limitation of meat benefit my kidneys? — E.L.

ANSWER: Many times, when the kidneys aren’t working up to par (weak kidneys), doctors put their patients on a reduced-protein diet. It slows the decline of kidney function. That’s why your doctor limited your meat (protein) intake.

DEAR DR. DONOHUE: Is distilled water bad for drinking? Can you chew too much gum? My husband chews about four pieces every day. — P.M.

ANSWER: Distilling water involves boiling water and condensing the water vapor by cooling it. Components dissolved in the water are left behind. You can drink distilled water. You will miss out on the minerals contained in most water and on fluoride added to city water, but you can get these elements in other ways.

If you chew too much sugar-containing gum, you promote cavities. Too much sugarless gum can cause diarrhea. Four sticks are not too much.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

© 2011 North America Synd., Inc.

All Rights Reserved.


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