After you've weathered rain and snow, flu season, and oh-so-many months cooped up indoors, you're more than ready for some hot fun in the summertime. But before you suit up for your first swim or lace up for that first hike, remember that the hot months also bring a number of health risks for active women. Fortunately, the much-anticipated good times can be yours, as long as you head into summer prepared. Every one of these warm-weather foes is highly preventable, usually with a minimum of effort. Here's how to beat summer's hot potatoes.
"Dehydration is the single most important health issue in summer," says Christine Wells, Ph.D., professor emeritus of exercise science at Arizona State University. "And drinking fluids is the only answer." Start hydrating the night before you plan to be doing any outdoor exercise: at least 8 ounces the night before, and another 2 cups (16 ounces) two hours before you work out.
"Sweat rates can double in a hot, humid environment, so a woman might need to drink twice as much when she's active on a hot day," says Susan M. Kleiner, Ph.D., author of Power Eating (Human Kinetics, 1998). That means putting away at least 18 cups of fluids per day, instead of the cool-weather minimum of 9 cups. During your workout, refresh with 4-8 ounces every 20 minutes. And when you return home, drink enough to replace what you sweat out -- if you lose a pound of water weight during a run, replace it with a pint of water.
Salt tablets are useless, says Wells. But for intense workouts of more than an hour, you'll need electrolytes, the salts that help your body retain fluids. "All the sports drinks have electrolytes," she says. "Drink the one that tastes best to you."
Extreme dehydration leads to heat exhaustion, a common malady for both competitive athletes and regular exercisers. If you're exercising on a hot day and start to feel headachy, nauseated, and/or a little woozy, as if you stood up too fast, stop immediately, rest in the shade, and drink a lot of water. The wooziness is caused by a drop in blood pressure, which resulted from blood going to the skin -- and not enough going to the rest of your body -- to try to regulate your temperature. Cooling down and resting allows your blood to go from your skin back into general circulation, and rehydrating by drinking a lot keeps your blood volume up (which increases your blood pressure, returning it to normal).
If you ignore these symptoms, you run the risk of heatstroke, a life-threatening shutdown of the body's thermo-regulating system. "Heatstroke occurs when you stop sweating, get the chills or faint," says Wells. "Then it's 911 time."
This common summer malady is an infection in the outer ear canal caused by bacteria-rich water. It's easy to diagnose: The pain centers on the outer ear, and if you tug the top of your ear, it'll hurt. Your ear may also be swollen and red.
Prevention is hands-down the best medicine, says Michael Benninger, M.D., otolaryngology chief at Henry Ford Hospital in Detroit. If you've ever had swimmer's ear before, you're prone to get it again. "So make a 50-50 mixture of rubbing alcohol and white vinegar, and put a few drops in each ear after you swim," advises Benninger. The rubbing alcohol is drying, and the acidic vinegar creates a bacteria-hostile environment. If an infection takes hold anyway, the alcohol/vinegar mix may abort it if you catch it early. But chances are you'll need to get prescription antibiotic drops. "If it's painful, draining, and/or your hearing has decreased, get medical attention," says Benninger.
"As soon as spring comes, we see more tendinitis, stress fractures, muscle pulls, and other overuse injuries," says Lewis Maharam, M.D., president of the New York chapter of the American College of Sports Medicine. "If you haven't kept up training over the winter, make sure you ease into a sport, don't jump in." The more time you spend stretching and strength training right now, the less likely you'll be sidelined with an injury come July.
Most blisters result from poorly fitting shoes or from sweat-soaked socks, when the wet, heavy fabric rubs against your skin. "Wear socks made of [fabrics like] CoolMax or SmartWool," says Christine Wells. "They can prevent blisters because they don't absorb as much sweat."
If you already have a blister, try the trick used by distance runners: Goop Vaseline on the trouble spot, put on your socks and shoes, and hit the road. Your sock may be gooey, but the Vaseline will reduce friction and the blister won't irritate you. If the blister is a mild one, a Band-Aid or a piece of moleskin or second-skin (without Vaseline) should provide enough protection for you to continue running, biking or hiking.
Once a blister forms, resist the urge to pop it. "That's just normal body fluid inside, and if you pop it, it's more likely to get infected," says John Wolf, M.D., chairman of dermatology at Baylor College of Medicine. If it pops on its own, keep it clean and apply antibiotic cream. Should an infection develop, get to a doctor right away: Because they remove a large area of protective skin, blisters run a higher risk of developing bad infections than minor cuts and scrapes; if a blister gets infected, see a doctor immediately.
Plant punch: Poison ivy, oak and sumac
Enemies to hikers and mountain bikers, these plants cause nasty rashes that can last for two weeks. They thrive in summertime, growing almost everywhere in the States except Hawaii, Nevada and Alaska (poison ivy doesn't grow in California, and sumac is found only in the Eastern states). Because they vary so much in size and color depending on where in the country they're growing, poison oak and ivy can be hard to identify. So it's best to simply avoid any shrub or vine with three leaves on one stem. (Remember the old saw, "Leaves of three, let them be.") Poison sumac has paired, pointed leaves, sometimes with greenish-white berries. A new over-the-counter cream called IvyBlock helps keep the plant oils from being absorbed by the skin, so it's worth a try if you know you'll be near these plants.
If you think you touched either oak, ivy or sumac, do not touch your face, other body parts or even other people because you could spread the plant oils that cause the rash. Go home and scrub all exposed areas with soap and warm water; then wash your clothes. If you develop an itchy rash, treat yourself with cool, wet compresses and an over-the-counter hydrocortisone cream to combat swelling and itch. "If it's a significant case -- where the rash is spread over much of your body, especially on the face or near your eyes, see a doctor," Wolf says. "You might need an oral cortisone."
Cold sores/fever blisters
Exposure to sunlight causes these nasty little lip sores to flare up. That's because UV rays react with the dormant cold-sore virus and cause it to reactivate. Always keep your lips coated with a lip balm containing sunscreen. If you do get a sore or fever blister, continue to keep it coated with balm, and try to avoid the sun until it goes away.
OK, we all know how important it is, but not nearly enough of us actually use sunscreen: One-third of people who spend time outdoors don't. Meanwhile, the American Academy of Dermatology reports that melanoma -- which is often linked to sun exposure -- is increasing steadily, claiming about 7,300 American lives in 1999.
Never head outdoors without a liberal coating of a broad-spectrum (blocks both UVA and UVB rays) sunscreen of at least SPF 15. "Apply it 30 minutes before you leave the house so it will bind to your skin," says Wolf. "And if you'll be sweating or swimming, use a water-resistant sunscreen, and reapply it every two hours." Also, limit sun exposure by scheduling outdoor exercise before 10 a.m. or after 4 p.m., to avoid the most potent rays.
If you've been careless about applying the sunscreen, you may be able to prevent sunburn pain if you act quickly by taking ibuprofen or aspirin right away. "Because sunburn takes six to eight hours to fully develop, you can stop a lot of the redness and pain before it starts by taking these. They both block prostaglandin, a chemical that develops the sunburn," says Wolf. He also recommends a tepid bath -- not hot because it will inflame the irritated skin -- laced with oatmeal, a good skin soother. And if you develop a sunburn that gets itchy and begins to peel, Wolf says to take Benadryl, which will quell the itchiness.
A new vaccine for Lyme Disease
In spring and summer, the woods are thick with a new crop of young ticks itching for a warm body. And if they're deer ticks or Pacific Coast black-legged ticks, they may well be carrying Lyme disease. Although it's not fatal, this disease can debilitate: Symptoms, which vary greatly and may not appear until weeks after the bite, include a long-lasting "bull's-eye" rash (either at the bite site or elsewhere), fever, aches, chills and, in untreated people after about two months, chronic arthritis. (There is a blood test to detect Lyme, but it's not always reliable.)
The good news for people who live in Lyme-disease regions (the East Coast, Minnesota, Wisconsin and northern coastal California) is the introduction of a vaccine in 1999. The vaccine isn't effective until you've had three shots -- usually over a year, though some doctors give it on a six-month schedule. In the meantime, wear light-colored clothing and inspect for the tiny, round, black ticks after each outing. The Centers for Disease Control recommend using an insect repellent containing DEET. (DEET is the only chemical that effectively keeps ticks away, and the CDC considers it safe at the doses detailed on the repellent's packaging.)
If you do find an imbedded tick, pull it out carefully with tweezers and clean the wound with antiseptic. If a rash develops, an antibiotic should prevent more serious symptoms from developing. If caught early, you'll need three to four weeks of an oral antibiotic like amoxicillin. If caught a few weeks later, you may need penicillin shots for four weeks. Because antibiotics are less effective once the disease has taken hold, you may require another round of oral or injected antibiotics.
Read: The American Red Cross First Aid & Safety Handbook (Little Brown, 1992); FastAct Pocket First Aid Guide (FastAct, 1999); The Complete Idiot's Guide to First Aid Basics (Alpha Books, 1996); The Outward Bound Wilderness First Aid Handbook (Lyons Press, 1998); The American Medical Association Pocket Guide to Emergency First Aid (Random House, 1993). Visit: the American Red Cross Web site, www.redcross.org, and the American Medical Association's Web site, www.ama-assn.org/consumer.htm.