I tell all my patients especially the seniors being very sensitive to dehydration more during the Hot Summer months to stay well hydrated even if it means they have to go more often to the bathroom!

Dehydration would increase risks of Heat exhaustion or even heat stroke peaking in the Summer months. Record high temperatures has been noted in many parts of the world including the US with serious heat waves still coming.

Temp. of 104 F or more with symptoms of nausea, vomiting, confusion, especially in elderly, seizures especially in infants and children, shortness of breath, loss of consciousness, and even coma have been reported .

Dehydration could be heat-related disease and it can go on in a viscous cycle. so, if someone is exposed to sun and not getting enough drinking water, then he or she will get dehydrated which it can get much worse quickly with more body fluid and electrolytes loss with vomiting such as Sodium, Potassium, Calcium Bicarbonate.

So, I advise my patients to increase fluid intake, hold off or decrease diuretic dose ( water pill) which patient takes regularly all year round for various medical conditions such as hypertension, leg edema( swelling) or Congestive Heart Failure where a perfect balance is needed as to avoid dehydration or become fluid overloaded and short of breath when diuretics are stopped and thus for those patients , they must be followed closely by treating physicians to achieve this balance.

On the other hand, those who choose to exercise during extreme summer heat, should be advised to change the exercise timing to a cooler time of the day like early morning or evening with frequent water breaks. I remember when I was coaching Soccer, I used to give mandatory frequent water breaks to prevent dehydration and heat exhaustion.

Now, comes to examining patients of suspected dehydration, they usually have dry mouth, dry tongue, poor skin tone and even sunken eyes mostly noted in children and seniors. Dehydration could be mostly prevented by taking plenty of fluids when playing or working in the Sun. Additionally replace electrolytes lost by giving ( Pedialyte for Children ) for example.

In case of workers such as construction workers or those who work outdoors, they need to adjust working hours to avoid peak hours of sun- heat usually around noon, work in late hours of day ( evening and night ) if possible, use light clothes, use sunglasses, sunblock , stay indoors or air conditioned areas during those times. Never leave children or animals especially on hot days in closed cars.

So, if you suspect some one having a heat stroke, this individual should be moved to a shaded area, apply cool fluids, ice to lower body temperature. Also, give oral and intravenous fluids with replacing electrolytes such as Sodium and potassium according to their measured levels shown on blood test.

For those who have to walk for a long distance as a part of religious duty to be fulfilled during Pilgrimage to Mecca for example as most walking done under the sun for millions of people gathered over there,they are frequently reminded to drink lots of fluids and then use bathroom and drink fluids again to stay well hydrated and cooled down. Some folks fail to stay well hydrated and they end up falling unconscious or going into coma along with high incidence of acute renal failure requiring emergency Hemodialysis resulting from ( Rhabdomylosis) which is simply breaking down of the muscles with toxic products( Myoglobin) deposited in the Kidneys causing acute shut down. Blood work confirms markedly abnormal kidney functions and high potassium which can cause Cardiac arrest and hence the urgency of Hemodilaysis.

Sadly, few patients recover from acute renal failure as majority become dialysis-dependent , never recover Neurologically and become ventilator-dependent and requires long term care with feeding tube for nutrition and so on. This has cost Billions of wasted Healthcare dollars which are mostly preventable!

The simple measures is to take plenty of fluids, avoid long periods of sun exposure, move if you can to a shaded or a cooler spot . Use Ice packs, and seek prompt Medical Help as clearly those who present late in the Emergency Room have fallen into deep coma and renal failure both are mostly irreversible with high mortality rate.

Global warming is a real! We can Not ignore that and even now after US is out of Paris Agreement. We can at least educate the public globally to prevent heat exhaustion and heat strokes . But also recognize the early symptoms and implement appropriate measures as our Summers are Not getting any cooler!