Each year, locals and tourists take full advantage of the sunshine to either romp or vegetate under the sun. Even “natives”, however, often fail to appreciate that San Diego is, in actuality, a desert (albeit an irrigated one) and this poses some definite risks to sun worshippers. Other things come up, of course, as well. This will be a brief overview of things that everybody should be aware of.
Let’s start with the sun. It’s bright, except for when it’s not. Did you realize that you’re at greater risk to get sunburned on a cloudy day, rather than a sunny one? While the clouds may block some ultraviolet light rays, many penetrate anyway. Add to this the fact that most people don’t bother to apply sunscreen when the weather is cloudy, the result are surprise sunburns for the unsuspecting (the result of UVB rays).
The other type of ultraviolet light exposure, UVA, is more likely responsible for longer term skin issues such as premature wrinkling, thinning of the skin, and skin cancers. Be aware that UVA rays are capable of penetrating through most clothing and the first few inches of water in the ocean or lake.
Bottom line: stock up on plenty of sunscreen, the higher the SPF (sun protection factor), the better, and consider UV resistant hats and clothing. [It used to be that most people woefully underapplied sunscreen lotion to their bodies. Now, with the advent of spray cans, it’s much easier to protect your body. You shouldn’t spray directly onto your face. This is where you want to apply a high SPF lotion to your nose and ears, the most vulnerable location for skin cancer. Wearing a hat can also provide an added SPF of 4 for your forehead.]
Hydrate smartly. Our bodies generate sweat to cool us down when we’re hot. Most understand that it’s easy to get dehydrated with prolonged outdoor activity in the heat, but did you know that you can make yourself sick by drinking too much water?
Sweat contains water AND salt (specifically, sodium). Problems arise when one tries to replace only the lost fluid, without addressing the sodium needs. Lowering a body’s sodium concentration (such as through dilution by rehydrating using plain water) can – at the mildest – cause muscle aches, dizziness, headaches and GI distress, and – at worst – may lead to seizures, coma, and/or death. This “hyponatremia” is seen in athletes, especially newbie runners in marathons who drink water at every water station regardless of thirst. Another worrisome group are senior citizens who, upon watching news reports of impending heat waves, overhydrate in panic, causing their salt levels to drop. They then experience dizziness/unsteadiness resulting in falls that may cause broken hips and other bones.
Hyponatremia is easily prevented by including salt replacement in the planning for hot weather. For short periods of activity (e.g. < one hour), plain water should be fine. Anything longer should be accompanied by an electrolyte solution of some type. These aren’t perfect, but they’re better than plain water. What to do if you feel dizzy? If you’ve been drinking lots of fluid, don’t assume that you didn’t drink enough and are still dehydrated. Rather, consume some salt. Consuming as little an amount as one or two salt packets (chased down with a shot of Gatorade aka my “sports medicine Margarita”) can often resolve the muscle cramps, headaches, dizziness, and other related conditions.
Treatment for all acute injuries is ice. Ice is Nice. Always. Applying heat to a fresh injury feels good at the time, but it promotes tissue swelling and results in more discomfort the next day. Instead, apply ice to the affected region(s) for up to 20 minutes at a time. Also, to avoid frostbite, avoid placing the ice pack directly upon your skin. So, remember that if you injure your back and apply heat first, you’ll likely be stiff and hurting the next morning. Apply ice instead and you may dodge a painful bullet.
Treatment for rattlesnake bites is car keys. Hustle your posterior to the nearest hospital emergency department ASAP for anti-venom in order to salvage the bitten part! Do not delay by applying a tourniquet and trying to suck out the poison – it doesn’t work and you’ll delay the much more important anti-venom.
Prevent overuse injuries by gradually increasing an activity over time. In endurance athletes, we recommend the 10% rule, i.e., never increase one’s total mileage or activity time from one week to the next by more than 10%. Stretching and icing of troublesome areas after the activity can also be helpful.
Use of anti-inflammatory agents in hot weather, particularly before an event, can increase the chances of developing hyponatremia, as discussed above. Stick with acetaminophen before/during a race and/or if you have certain medical issues involving blood thinners.
For most people, however, use of these meds after an injury has occurred should be fine, but check with your physician if unsure.
Finally, in these Covid times, be sure to carry a simple mask. Not necessary to wear if one is properly physically distanced but should be available for unavoidable prolonged close contact. Make them fun to look at – the world can use all of the humor it can get about now….
Dr. Pearson is an experienced family and sports medicine physician practicing in the heart of Carlsbad Village. He works with Olympic athletes and weekend warriors, and was the Medical Director for the Carlsbad 5000 for many years. Learn more at www.medicine-in-motion.com.