Naomi the Wordsmith

I have Fabry disease. One of its symptoms is not sweating normally – this can be not at all or way too much.

Before I was on treatment, I didn’t sweat at all. Now I do, but not as much as I should. And, if I get a fever, I often don’t sweat during, but later, when I’ve cooled down, I get really sweaty. And when you no longer have a fever, getting sweaty just means you get super cold.

So naturally, this puts me at greater risk of heat sickness. Every summer I get heat rashes, and heat exhaustion that threatens to become heatstroke.

It happened again a few days ago, and I very narrowly dodged hospital. It’s taken several days to fully recover, but I feel back at it now.

I decided to do some research into the various heat sicknesses to keep myself healthy with some preventive medicine and to pass on what I learned.

Let’s start with the mildest.

Heat rash (also called prickly heat)

Heat rash is uncomfortable, but the good news is you’ll be fine after a few days.

Symptoms

• Small, raised spots
• Feeling itchy and prickly
• Mild swelling
• Rash looks red on white skin and is harder to see or looks grey/white on brown or black skin
• Symptoms are the same in adults and kids
• Rash can appear anywhere on the body and spread, but don’t worry – it’s not contagious

How to treat heat rash yourself

You must keep your skin cool so you don’t sweat. Sweat irritates the rash. Though this is easier said than done on hot, humid days, like summer in the UK.

Keep your skin cool

• Wear loose cotton clothing
• Use lightweight bedding. I’ve just got a sheet at the moment.
• Take cool baths or showers. This one sadly doesn’t apply to me because I’ve got nerve pain that reacts badly to cold or heat. Mid-range is best for me.
• Drink plenty of water to stay hydrated. I have to drink 3 litres of water a day anyway for my health condition, but that doesn’t mean I’m exempt from this rule. I still drink around a litre more than usual. Sips every now and then get you pretty far.

How to calm prickly itching

• Put something cold against the rash, like a damp cloth or towel-wrapped ice pack, for up to 20 minutes
• Tap or pat the rash, don’t scratch it, you don’t want to injure the skin and risk infection
• Don’t use perfumed shower gels or creams

Pharmacists can help with heat rash

They might recommend calamine lotion, antihistamine pills or hydrocortisone cream for people over 10yrs.

See a GP if it doesn’t improve after a few days or your baby has a rash and you’re worried.

Causes of heat rash

It’s usually caused by sweating lots. Sweat glands get blocked and the trapped sweat creates a rash a few days later. Babies get it because they can’t control their temperature well.

Heat exhaustion and heatstroke

Heat exhaustion doesn’t need emergency medical help if you can cool down within 30 mins. If it turns into heatstroke, it’s a medical emergency.

Symptoms of heat exhaustion

• Tiredness
• Dizziness
• Headache
• Feeling sick or being sick
• Sweating way too much, pale and clammy skin, or getting a heat rash
• Cramps in arms, legs and stomach
• Fast breathing or fast heartbeat
• A high temperature
• Super thirsty
• Weakness
• The symptoms of heat exhaustion are the same in adults and kids, although kids can get irritable too
• If someone’s showing signs of heat exhaustion, they need to be cooled down and given fluids

How to cool someone down

1. Move them to a cool place
2. Take off all the unnecessary clothing they’re wearing, like a jacket or socks
3. Get them to drink a sports or rehydration drink, or cool water
4. Cool their skin – spray or sponge them with cool water and fan them. Or you can use cold packs, wrapped in cloth, putting them under the armpits or under the neck
5. Stay with them until they’re better. They should start to feel better and cool down within 30 mins.

How to get help for heat exhaustion

Contact 111 (this number is for UK specific readers) if:

• You or someone else have symptoms of heat exhaustion you’re struggling to treat or you need advice about

Call 999 right now if:

• You or someone else have signs of heatstroke, including:
• Still feeling unwell after 30 mins of resting in a cool place, being cooled and drinking fluids. (I think I was on the verge of needing this because it took a couple hours for me to recover. But recover I did. Still, I can’t recommend you to not follow medical advice and do the silly thing I did, can I?)
• A very high temperature
• A fast heartbeat
• A seizure
• Hot skin that’s not sweating and might look red (harder to see on brown and black skin)
• Fast breathing or shortness of breath
• Confusion and clumsy, uncoordinated movements
• Loss of consciousness
• Put them in the recovery position if they lose consciousness while you’re waiting for help
• Don’t drive yourself to A&E (ER for US readers). The person on the emergency number will advise you what to do.

This site has great info on how to do the recovery position.

Preventing heat exhaustion and heat stroke

You’re at high risk of heat illness during hot weather or vigorous exercise. To prevent heat sickness:

• Drink more cold drinks, especially if you’re active or exercising
• Wear light-coloured, loose clothing
• Avoid the sun between 11am and 3pm. And also be aware of how humidity can reduce your body’s ability to cope with heat. That’s what caused my heat exhaustion this time.
• Avoid drinking too much alcohol
• Avoid extreme exercise
• If you’re inside on a boiling hot day, close the curtains, close the windows if it’s hotter outside than in your home and turn off electrical equipment and lights that get hot

This prevents dehydration and helps your body keep itself cool. Children, older people, and people with long-term health conditions are more at risk of heat exhaustion and heatstroke.

Dehydration (another very bad thing)

Dehydration means your body’s losing more fluids than you’re taking in. If it’s not treated, it can get really serious and life threatening. Babies, children and older people are more at risk of dehydration.

Symptoms of dehydration in adults and children

• Feeling thirsty
• Dark yellow, strong-smelling pee
• Peeing less than usual
• Feeling dizzy or lightheaded
• Feeling tired
• Dry mouth, lips and tongue
• Sunken eyes
• Did reading this list make you feel thirsty? I had to have a drink writing this.

Signs a baby is dehydrated

• A sunken soft spot on top of their head
• Sunken eyes
• Few or no tears when they cry
• Not many wet nappies
• Being drowsy or irritable

Causes of dehydration

• Diabetes
• Vomiting or diarrhoea
• Heatstroke/being in the sun too long
• Drinking too much alcohol
• Sweating a lot after exercise
• A fever
• Meds that make you pee more

How to treat dehydration

• Drink water
• If you’ve been sick or feel sick, small sips at first

A pharmacist can help

They recommend oral rehydration solutions, which replace the sugar, salts and minerals your body’s lost through dehydration. Homeostasis is the best thing for your body.

Ask for an urgent GP appointment or get help from NHS 111 if:

• You’re feeling unusually tired or your child is drowsy
• You’re confused and disorientated
• You feel dizzy when you stand and it doesn’t go away
• You have dark yellow pee or you’re peeing less than normal (or your baby has less wet nappies)
• You or your kid are breathing fast or have a fast heart rate
• Your baby or child has few or no tears when they cry
• Your baby has a soft spot on their head that sinks inwards

These are all signs of serious dehydration needing urgent treatment. I’ve been admitted to hospital via ambulance before for dehydration. Don’t underestimate how fast it can sneak up on you and become life-threatening.

So we’ve reached the end of my public health message

Thanks to the NHS for this incredibly useful information. And like I said, if you’re not from the UK, contact the relevant medical service in your country if you need to.

Stay safe this hot, hot summer. Stay cool – in more ways than one.

And please like and share these tips – they really can save lives.