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Feeling the Heat

 

I’m generally not a big sweater.  But last evening as my wife saw me returning from chipping and putting a few balls around she noticed the large wet patches on my shirt.  “Did you end up going on a bike ride or is that just from hitting a few golf balls?”   I responded that is was, “All from just strolling around and hitting a few balls.”

This is the time of year in Tennessee when any kind of outdoor physical activity during the daylight hours is majorly sweat-producing.  Indeed, sometimes the heat can really cause a problem for people.  Specifically, there are three heat-related illnesses.  The mildest one is heat cramps with symptoms including muscle cramps, fatigue, thirst, and heavy sweating.  It can usually be treated by getting to a cool place, resting, and hydrating with water, sports drinks, or other rehydration drinks containing electrolytes.

The next, more serious, heat-induced condition is heat exhaustion.  If this hits you, you may notice the symptoms of heat cramps as well as rapid pulse, feeling lightheaded, nausea, headache, and sometimes, cool moist skin with goose bumps.  If you start noticing some of these symptoms, stop all activity and rest in a cool place, and hydrate (not with alcoholic or caffeinated beverages).

If untreated, heat exhaustion can go on to heat stroke, a potentially deadly condition.  In heat stroke the body temperature reaches 104 F or higher.  The skin may be moist or, worse, hot and dry, as the heat challenge overwhelms the body’s ability to cool itself by sweating.  In addition to all the symptoms of heat exhaustion, there may be confusion, agitation, irritability, and sometimes, fainting.  Heat stroke is a medical emergency requiring immediate treatment to avoid damage to the brain and other vital organs or even death.  If you are with someone exhibiting symptoms of heat stroke, call 911 immediately as this isn’t one to just treat on your own. While waiting, move the person to a cool place and cover with a wet sheet or spray with cool water and encourage hydration if they are able to drink.  Fan them to encourage evaporation of the water on them which will further cool them.

Heat-induced illnesses are not terribly rare.  One source lists heat stroke as the third leading cause of death in American athletes.  These cases would be what is called exertional heat stroke, where physical activity is a major player in the overheating.  There is also non-exertional heat stroke which occurs in a person not physically active but overwhelmed by a very hot environment.

There are a few other factors besides the temperature, humidity, and exertion that put someone at greater risk for heat illness.  These include poor hydration, alcohol intake, overdressing (especially if the clothing doesn’t allow evaporation of sweat), very young or old age, and certain medications such as beta blockers, antihistamines, and diuretics.

Mid-summer in Tennessee is still a good time to be outside, but limit your time in the heat of the day and keep hydrating to stay a long ways from these serious heat illnesses.

Andrew Smith, MD is board-certified in Family Medicine and practices at 1503 East Lamar Alexander Parkway, Maryville.  Contact him at 982-0835

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Allergy in East Tennessee

Oh, the sneezing and sniffling and runny noses and itchy eyes that are all around us this time of year.  And it’s not just your imagination – Knoxville ranks as the fifth worst city in the country for allergy sufferers.  That comes as no surprise to the legions of residents who this spring are dealing with all that sneezing and sniffling.  Add on the headaches, fatigue, cough, and popping in the ears, and you have a real damper on your enjoyment of spring and summer.  Further complications to allergy can include asthma flare-ups, sinus infections, ear infections, and sleep disturbance to name just a few.

Estimates vary, but up to about 20% of the population suffer from allergy, and about 20% of allergy sufferers also have asthma.  That doesn’t even include a category called non-allergic rhinitis (rhinitis is the medical term for an inflamed runny nose).  These folks have all the symptoms of allergy, but upon testing, come up negative.  There are seven different types of non-allergic rhinitis and each is treated a bit differently from true allergy. We won’t delve further into all that, but it is one reason why treatment of allergy symptoms isn’t a one size fits all proposition.

Diagnosis of allergy often involves simply recognizing the symptoms and doing a trial of an over-the-counter antihistamine such as Claritin, Allegra, Zyrtec or one of their generic equivalents.  If that does the job, it’s sometimes not a bad way to go.  If not, it’s probably time to check in with your physician.  Treatment options will include:

  • Environmental control measures and allergen avoidance: These include keeping exposure to allergens such as pollen, dust mites, and mold to a minimum
  • Medication management: Patients are often successfully treated with oral antihistamines, decongestants (if high blood pressure is not a problem), Singulair, or nasal steroids, antihistamines, or anticholinergics to name only some of the available options.
  • Immunotherapy (allergy shots): This treatment may be considered more strongly with moderate or severe disease or poor response to other treatment options.

Specific allergens can be identified by skin testing or blood testing, with skin testing generally being deemed the most precise.  So, who should have allergy testing?  Allergy testing can have several benefits.  First of all, it can identify those who have non-allergic rhinitis.  These folks will generally not respond to traditional antihistamines and need other approaches.  Secondly, allergy testing may identify certain allergens to which the person can reduce their exposure.  For example dust mites, mold, animal dander or cockroach are indoor allergens which can be reduced by a variety of methods.

Finally, for those who are not getting good relief despite meds, immunotherapy may be a good option.  Its success rate is generally over 80%, although it usually takes a few months to see improvement.  The entire process may take a couple years to establish and maintain the benefits.  But for those who habitually sneeze and sniffle their way through the day in misery, often grabbing meds on a daily basis, it can be well worth while.

So if the sights and smells of this beautiful East Tennessee spring and summer are being blurred by watery eyes and masked by a runny nose, check in with your doctor and see what can be done!

Andrew Smith, MD is board-certified in Family Medicine and practices at 1503 East Lamar Alexander Parkway, Maryville.  Contact him at 982-0835.

Same day in office allergy testing is available at Trinity’s main office in Fort Sanders West.  Consider our unique model of allergy injections which offers at home shots saving you the hassle of coming to the doctor’s office three times a week or taking time off from work.  Call 539-0270 to schedule an appointment to discuss these options.

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Save money by seeing your own doctor

In the world of high healthcare prices there are several online services cropping up that hope to improve price transparency for patients 

In this example, you can see the range of costs for a routine screening colonoscopy. It seems like you’d be saving a bundle by shopping around at various specialists. But did you know that Trinity physicians, Dr Allsop and Dr Pardue, are expertly trained to perform colonoscopies?  Our price is less than one-half the LOWEST price listed here and under $1000.  We work with most insurances and our price for uninsured patients is the same as those with insurance. We don’t have double standards. We offer the same low price to everyone. 

So by seeing your own doctor you can save the most on services you need. Call our office today to discuss scheduling your colonoscopy. 

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Direct Primary Care open house tomorrow in Maryville

Trinity Direct of Maryville will host their monthly open house tomorrow, May 17th, from noon to 1pm.  Dr. Hone and her staff will be on hand to discuss the DPC program, its benefits, and options.  Please come to hear how a Direct Primary Care membership offers improved access to less expensive primary care.

Don’t wait for Washington or Nashville to decide how you should obtain your healthcare.  You can be part of a healthcare revolution and take back ownership.

Bring your questions and your friends.  This will be an informative and educational time.

For more information call the Trinity Direct of Maryville office at 980-8551.

The office is located at 1515 E. Lamar Alexander Blvd. Maryville, TN 37804.

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