As summer temperatures climb, pharmacists say the heat can do more than make people uncomfortable – it can also reduce the effectiveness of medications and increase the risk of dehydration and other heat-related health problems.

Lisa Heiken, PharmD, a pharmacist, medications exposed to extreme temperatures can lose their effectiveness, particularly those that require refrigeration, such as insulin.

Any medication, if it's left in extreme temperatures, can degrade the effectiveness. Heiken says that includes over-the-counter meds such as Tylenol, ibuprofen, or supplements such as vitamin C or magnesium.

She adds that heat and cold can damage refrigerated medications, making them potentially less effective when patients need them most.

Many people also unknowingly store medications in one of the worst possible places – the bathroom. Although medicine cabinets are common, the humidity created by showers can break down tablets and capsules over time.

Don’t use a medicine cabinet

“A lot of bathrooms unfortunately do have medicine cabinets, and we don’t recommend you leave medication in the medicine cabinet as those rooms tend to have high humidity and the humidity is what breaks down medication.”

Instead, she recommends storing medications in a cool, dry location elsewhere in the home, such as a hallway closet.

Summer errands can also put medications at risk.

“Like leaving your child in the car, same with your medications. Your medications can be affected, even by short times in extreme temperatures so we do recommend that if you’re stopping by the pharmacy that you make your next stop at home, especially if you have refrigerated medications.”

Heiken advises anyone who accidentally leaves medication in a hot car not to throw it away immediately. Instead, patients should contact their pharmacist, who can assess factors such as how long the medication was exposed to heat and whether it may still be safe and effective to use.

Meds can make you vulnerable to heat/sun

Beyond proper storage, some medications can make people more susceptible to heat-related illnesses.

“A lot of heart and blood pressure medication can cause people to become dehydrated faster or dizziness as a side effect in general and so when you add heat and dehydration on top of that, that obviously will compound that problem,” Heiken explains.

Heiken encourages anyone taking antibiotics and certain other medications, to make sure to use sunscreen, wear protective clothing or stay out of the sun because the drugs can make you more sensitive to sunlight.

Bottom line, Heiken says, don’t blow off a discussion with the pharmacist when you begin taking a new medication.

“Opting into the counseling will allow you to better understand your medication and prevent future issues like dehydration and dizziness.”

As temperatures remain high throughout the summer, Heiken said a few simple precautions — proper storage, staying hydrated and understanding medication side effects — can help keep medications effective and people safe.

Lisa Heiken is the manager of OSF Eastland Pharmacy in Bloomington, Illinois.

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B-roll-Medication and weather

Illinois averages 10 days with temperatures at or above 90 degrees each year, according to the Illinois State Climatologist. 

In typical summer fashion, temperatures are reaching the 90-degree mark this week.

This summer weather puts many people at risk for heat exhaustion and heat stroke. Not only outdoor workers, but kids, older adults and those without working A/C in their buildings could be affected.

Brian Curtis, MD, vice president chief medical officer of OSF Medical Group, says preparation and awareness are keys to staying safe in the summer heat.

“You’ll go from heat exhaustion before you get to heat stroke,” Dr. Curtis says. “Heat exhaustion is where people are cool, clammy, sweating profusely, and they may have some nausea or vomiting. They usually have some severe muscle cramping with it.”

If heat exhaustion is not recognized and treated quickly, Dr. Curtis says heat stroke can then happen.

“With heat stroke, they’ll have dry skin, a temperature of 102-103 degrees, they’ll be confused or passed out,” Dr. Curtis says. “That’s a medical emergency, a 911 call. Whereas with heat exhaustion, you need to get them out of the heat, get them into a cool environment, and get them some liquids.”

Dr. Curtis says hospitals see heat stroke patients every summer, especially during longer stretches of hot and humid weather. He says higher humidity causes our bodies to not be able to cool as easily.

But these dangers don’t just affect outside workers or athletes playing sports in the summer. Dr. Curtis says the main excessive heat victims are middle-aged people, but kids and older adults are more susceptible.

“Because they don’t heat and cool themselves as easily, they’re more prone to get it, and we tend to be more vigilant with them,” Dr. Curtis says.

Heat exhaustion or heat stroke aren’t solely seen outside, either.

“If you get into the mid or upper 90s, we have some people around here who still don’t have air conditioning. You can get heat exhaustion and heat stroke within a building,” Dr. Curtis says. “When people don’t have air conditioning, that’s when you really see a lot of the elderly develop heat exhaustion within their own homes.”

Prevention of heat exhaustion and heat stroke

- Drink plenty of liquids (water, fruit juice, sports drinks)

- Avoid dehydrating liquids like alcohol and caffeinated beverages

- Take frequent breaks

- Get out of the sun and into the shade

- Use sunscreen and avoid getting sunburnt

- Use the buddy system: Keep an eye on each other

Dr. Curtis adds the effects of heat stroke can be long-lasting, or even lead to death.

“People die of it every year, or they have debilitating conditions afterwards,” Dr. Curtis says. “Once you’ve had heat stroke, you tend to be more susceptible to the heat as you go forward. Your body does not regulate as well and so you can be more prone to develop it in the future.”

For More Information

When it comes to extreme temperatures, play it safe. Know the warning signs of heat stroke and take the proper steps to prevent it.

Symptoms of Heat Exhaustion

• Profuse sweating
• Water depletion (causes extreme thirst)
• Weakness
• Dizziness
• Salt depletion (causes muscle cramps)
• Nausea
• Vomiting
• Fainting
• Headache

Symptoms of Heat Stroke

• Body temperature greater than 104° F (main sign)
• No sweating in hot weather
• Neurological problems such as confusion, unconsciousness, and seizures
• Rapid breathing
• Increased heart rate

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For most adults, spring and summer thunderstorms bring the annoyance of driving in a downpour.

But others dread this time of year for migraines triggered by the environment.

What are migraines?

Aminat Ogun, MD, a family medicine physician at OSF HealthCare, describes migraines as episodic disorders that cause severe, throbbing headaches, usually on one side of the brain.

The list of triggers is, unfortunately, long.

“Emotional stress can trigger migraines. Moving, changing jobs, other stressful life situations,” Dr. Ogun says. “A change in sleeping habits can trigger a migraine. Skipping a meal. Your diet: wine, aged cheese, coffee withdrawal and foods high in nitrates.”

Other common triggers include hormones, bright lights, loud sounds and changes in altitude. A propensity for frequent headaches can also run in the family, Dr. Ogun says.

You can prepare

Dr. Ogun says not much is known about weather-induced migraines. But most medical professionals agree there is some evidence for migraines caused by changes in barometric pressure.

How can you prepare?

“Up and move,” Dr. Ogun says, tongue firmly planted in cheek.

More realistically, watch the weather forecast. If there’s a chance for a lot of dust or smoke in the air (think areas like California or Arizona), plan to limit time outside.

Stock up on medication after talking with your health care provider. Dr. Ogun says over-the-counter medicine like ibuprofen will help with pain and can even be taken ahead of when you know a migraine is coming.

“They could have a headache diary where they write down what causes their headaches, where the pain is located, how long does it last, symptoms and what treatment helps,” Dr. Ogun adds.

If your migraines are more frequent, feel different, or come with other symptoms like confusion, neck rigidity, weakness in the arms or legs, fever or chills, see a doctor right away. Some of those symptoms may be signs of a heart attack or stroke.

Any head trauma, like a sports injury or a car crash, should also be checked on by a doctor.

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It’s the dead of winter, and you need to run to the mailbox or let your dog out. It’s just a minute, you think. A sweater and sandals will be fine.

Not so fast, says Maddy Draper, APRN, a health care provider at OSF OnCall who sees cold weather injuries often. She says exposure to frigid temperatures can have serious consequences.

Types of cold weather injuries

• Frostnip: Draper says this is a mild form of frostbite where exposure to cold temperatures turns the skin pink or red. Your skin may feel burning or numb.

“The numbness typically goes away with rewarming,” Draper says.

• Frostbite: This is a more severe case of cold exposure. Your skin may be numb and appear yellow, white, gray or black. It may feel waxy and have blisters.
   
• Hypothermia: This is when the body’s temperature drops below 95 degrees.

“There are different stages,” Draper explains. “The first is our natural response of shivering. It gets more severe. The person may get confused and have lethargy, memory loss and slurred speech. It can lead to a coma and death.”

Inside, too?

Yes, there’s a risk for these injuries inside, too, Draper says. Notably, there have been cases of infants getting hypothermia.

“The room may be too cold, and they’re not dressed appropriately,” Draper says. “If they’re in a bassinet or crib with just a onesie and it’s cold, that can lead to hypothermia.”

Signs of infant hypothermia are bright red skin and decreased energy. Sleep experts use a thermal overall grade scale (TOG) to suggest how much clothing a baby should wear to sleep depending on the temperature of the room.

Treatment

Draper says she usually sees cases of frostbite and hypothermia sent to the emergency department. Providers will rewarm you with warm water or blankets and may provide warm liquids to drink, warmed oxygen through a mask and nasal tube or heated fluids through an intravenous line (IV) or other methods. Medication can also help with pain and blood flow.

“The hospital has more imaging resources to see the impact of the tissue damage,” compared to urgent care, Draper says.

For frostnip, you can take steps to warm up at home.

“It’s not as fast as possible. It’s not as hot as possible. It’s just that gradual warming,” Draper says. “Get off your cool or wet clothes immediately. You don’t want to stick your hands or feet into hot, steaming water. Just warm water.”

That’s because hot water can burn your skin. And if your skin is numb, you may not feel the burn before the damage is done. If water is not available, you can place your hands in your armpits. And handle the sensitive skin gently. Don’t rub or massage it. If your feet are affected, get off your feet.

Prevention

Draper says older adults, people who work or do activities outside (like hunters or hikers), unhoused people and people with medical conditions (like peripheral artery disease, diabetes and Raynaud’s disease) are at a higher risk of cold weather injuries. Getting stranded in a vehicle without proper protection is also common in the winter. Drinking alcohol or using drugs may lead to you losing consciousness outside. And smoking impacts blood circulation, putting you at a higher risk, Draper says.

Some ways to beat the cold:

• Dress in layers. You can always take a layer off, but you can’t put one on if you leave it at home. Make a hat, scarf, gloves and winter boots part of your wardrobe. Make sure the clothes aren’t too tight to allow for blood circulation. And look for water-resistant garments when buying clothes.
   
• Have winter weather supplies, like blankets, flares, a first aid kit and food, in your vehicle.
   
• Be well fed and hydrated. Body fat, though unhealthy in excess, helps us stay warm. For drinks, avoid alcohol and caffeinated beverages.
   
• During outdoor activities, take breaks and go with a buddy. Keep a close eye on kids who may not realize how cold they are. Come inside to change from wet to dry clothes. Let others know your plans and when you’ll be back. If you’re not back in time, that’s a sign you may have fallen victim to the cold, and help should be sent.

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Running in the cold

It’s important to exercise year-round for your physical and mental health. Clare Spires, an exercise physiologist at OSF HealthCare, has some tips to stay active in the winter.

• Before you even pick up a weight or lace up the running shoes, set standards for yourself.

“Even if you can just make the goal to do something that day,” Spires says. “It doesn’t need to be an hour or hour-and-a-half workout. It can be 30 or 45 minutes. It can be at home, at a gym or outside. But just making those goals possible and achievable.”

• Workout in the daylight. This can give you a mood boost and, if you’re outside, ensure you have enough light to be safe. Try working out on your lunch break or just when you have 20 minutes to spare, Spires suggests.
   
• If the outdoors is not nasty (like a blizzard), a walk or run outside is doable, Spires says. Just keep your safety in mind.

“Check the weather forecast. Use shoes that have more traction for those slippery sidewalks. Stay hydrated. Dress appropriately,” Spires advises.

Proper attire includes layers of sweat-wicking fabrics, and gloves and hats to warm your hands and head. Also, have a safety plan that includes access to first aid and a phone. Workout with a buddy when you can.

Also, know your limits. Spires says if you wouldn’t go to the gym for two hours, don’t shovel snow for two hours. Do it in five-to-10-minute chunks.

“We also use something called the rate of perceived exertion (RPE) scale,” Spires explains. “It’s one to 10. Ten would be the hardest exercise you’ve ever done. One is just sitting on the couch. We ideally like people to stay in that four to six moderate intensity range. So, if you think shoveling snow is in the four to six range and not creeping up to an eight or nine, that would be appropriate for you to do.”

On the positive side, Spires adds that depending on your location, you can branch out and try workouts like snowshoeing, ice skating or sledding.

“It’s fun to try new hobbies that are going to get you more active,” Spires says.

• When snowed in and working out in your home, use your surroundings to your advantage. For example, Spires suggests going up and down the stairs a few times with breaks in between.

“You can do different body weight exercises like jumping jacks or squats,” Spires adds. “You can get creative and use soup cans, water bottles or even bottles of hairspray to add a little bit of weight or intensity to your workout.”

Just like working out outside, Spires says to be aware of your surroundings. Am I on carpet or hardwood, which may be slick? Is there a stray cord or a wandering child I could trip on? Is there a counter or dresser nearby for me to catch my balance?

Read more about how to keep your body in top shape on the OSF HealthCare website

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Spring allergies will be here soon. If you’re suffering from a runny or congested nose, watery or itchy eyes or sneezing, it’s tempting to grab the first medicine that catches your eye at the pharmacy or rifle through the bathroom drawer for some pills you’re hanging on to.

Not so fast, says Maddy Draper, APRN, a health care provider at OSF OnCall. She says it’s important to know what to take and when in order to avoid side effects that can be serious.

What to take

Draper says an antihistamine like Astepro, Zyrtec, Allegra or Benadryl is a typical first line of defense.

“There are also decongestants for severe nasal congestion or sinus pain and pressure,” Draper adds. Sudafed is a well-known decongestant.

If a more severe case brings symptoms like face swelling or wheezing, Draper says treatment could be a steroid like Flonase or prednisone.

For more chronic (in other words, long term) allergy cases, the U.S. Food and Drug Administration says a provider may recommend immunotherapy to build up a tolerance. This could be an injection or a tablet under the tongue.

Misuse

It may not seem like over the counter allergy medications are ripe for misuse, but it can happen.

Draper says antihistamines, especially Benadryl, can make you drowsy. If you take too much or take it at the wrong time, you could, for example, find yourself sleepy behind the wheel. Or your attentiveness at work or school could suffer.

On the flip side, Draper says Sudafed can make you jittery, irritable or cause heart palpitations (the feeling of an irregular heartbeat). This could be a big issue, she says, for people with a heart condition.

“We want to avoid nasal sprays for people with nasal trauma. Things like a deviated septum or nasal sores,” Draper adds. “Putting something up the nose could cause further tissue damage.”

Draper says to take medication as directed by your provider. Or if it’s over the counter, follow the label instructions. She says these medications typically take a couple days to start working. So don’t be tempted to take an extra dose if you’re not seeing relief right away.

Think of the children! (and seniors)

Children and seniors may be more impacted by the side effects of allergy medications. An older adult who takes Benadryl, for example, may be drowsy to the point that they fall and suffer a serious injury.

So, Draper says providers will typically start with an antihistamine that doesn’t make you super drowsy. She says Zyrtec is approved for ages six months and up, and that’s often where providers will start.

“Any antihistamine label is going to tell you to consult your provider for use under the age of two,” Draper says. “So you’ll need to be seen by a provider or your pediatrician.” This could be a virtual visit or a message to your provider in your patient portal.

Plan ahead

Draper says knowing your allergy triggers and acting accordingly is key to avoiding unpleasant symptoms. For example, you know grass clippings will cause an allergic reaction, but you have no choice but to mow the lawn.

“Primary care providers and allergists typically recommend starting the medication prior to exposure,” Draper explains. “If you know you’re going to be outside on that windy, dry day to mow, start the antihistamine a couple days prior so it can fully take effect.”

If you can’t get a handle on a known allergy, or if you have unexpected allergy symptoms, Draper says it’s never a bad idea to go to an urgent care.

Or if you find yourself looking for an over the counter medication option: “Just ask the pharmacist,” Draper suggests. “They’ll give you recommendations.

“There’s usually a specific aisle for allergies,” she adds. “Find the right antihistamine. Flonase is another big one we see people use.”

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Breathe in fresh air

High school athletes across the country will soon feel the heat when teams begin practices for several sports including football, cross country and soccer. 

Health experts say it's important to stay safe, especially when it comes to practicing during the grueling August temperatures. 

According to the National Center for Catastrophic Sport Injury Research, heat stroke is the third-most common cause of sudden death among high school athletes behind cardiac arrest and traumatic brain injuries.

Dr. Faheem Ahmad, a family practice physician with OSF HealthCare, says athletes can experience anything from feeling tired because of heat exhaustion, to symptoms of heat stroke, which can include fainting, loss of consciousness and a body temperature above 103 degrees.

“The summer heat is very dangerous for so many different reasons, and it is important to know and identify those risk factors associated with heat related illnesses, particularly the athletes, their coaches and the staff who work with them," Dr. Ahmad says. 

Other signs of heat stress include headaches, nausea, body pain, muscle cramps and dry mouth. Dr. Ahmad says hydration is key, so take frequent water breaks and drink sports drinks with electrolytes.

Health Highlights Video With Chyrons

Health Highlights Video Without Chyrons

These are probably a few things you’ve heard once, or a thousand times, over the years by a parent, teacher or coach.

However, roughly 5.4 million basal and squamous cell skin cancers are diagnosed each year, affecting more than three million people (some individuals have more than one skin cancer). Skin cancers are by far the most common type of cancer in the United States. The American Cancer Society says this is probably due to better skin cancer detection, people getting more exposure to the sun, and people living longer.

But what are we forgetting? Tim Smile, MD, is a radiation oncologist with OSF HealthCare. He breaks down key tips for people to remember before heading outside.

"A lot of people wear a nice baseball hat that covers their faces really well, but the tops of your ears, neck, and even the front of the top of your sternum area can get exposure to the sun without you realizing it,” Dr. Smile says. “Keep an eye on those areas and make sure you're applying sunscreen there." 

Just because it's overcast, doesn't mean the UV rays aren't there.  Dr. Smile says you can still get burnt.

And, don't forget your lips! Use lip balms with SPF protection.  Dr. Smile adds your lips can get sunburned and lead to skin cancers due to UV exposure.

Video Version With Chyrons

Video Version Without Chyrons

Warmer temperatures bring the return of pesky insects, especially at dusk.

Experts say while most bug bites are not serious, there are times when you need to see a health care provider immediately.

Most bites can be treated quickly

Andrew Zasada, MD, an internal medicine physician at OSF HealthCare, says treatment of most minor bug bites (think mosquito or bee) is down to a science.

First, move away from the area so the bugs don’t bite you again. If the insect left a stinger behind, gently remove it with tweezers.

“Put some ice on the bite site. Wash it gently. Put a little calamine or hydrocortisone on it. Keep it elevated,” Dr. Zasada says.

Don’t scratch the bite site. Leave it alone and let it heal. For children who may find it difficult not to itch, put a Band-Aid over the bite. You can take an antihistamine like Benadryl, Allegra or Zyrtec for itching and ibuprofen or acetaminophen for pain.

If you notice a rapid worsening of symptoms in the 30 to 45 minutes following the bite, or if the wound is not healing over several days, it may be a sign of a more serious problem. See a health care provider.

Serious insect bites

Dr. Zasada says in the Midwest, two types of spiders come with dangerous fangs: black widow and brown recluse.

“These bites can cause tissue destruction at the bite site,” Dr. Zasada explains. “The venom is very potent. It can cause cell death. It’s very irritating.”

If the venom gets into your bloodstream, then chest pain, muscle cramps, sweating and nausea could follow. Dr. Zasada says black widow and brown recluse bites are “very rarely” fatal, but the illness they bring is quite unpleasant.

If you think you’ve been bitten by a black widow or a brown recluse, see a health care provider right away. Your local urgent care is equipped to treat insect bites, but if your symptoms have worsened, the Emergency Department at your local hospital may be the best destination.

Another serious condition to keep an eye on after a bug bite is an allergic reaction known as anaphylaxis.

Symptoms of anaphylaxis include shortness of breath, wheezing and a drop in blood pressure. Dr. Zasada says some people with known allergies may have an EpiPen handy and can inject themselves to alleviate symptoms. Regardless, immediate attention from a medical professional is still needed.

 Leave the critters alone

It’s inevitable that a stroll through the neighborhood will bring an encounter with an insect like an ant or mosquito. But Dr. Zasada says spiders that pack a punch don’t want to mess with humans. They tend to come out at night and live in wooded areas or a dark space in the back of a garage.

In other words, don’t mess with them, and they won’t mess with you.

“When you take clothing out of storage, shake it to make sure there are no spiders,” Dr. Zasada suggests. “When you clean the garage, don’t sit on anything that’s been stored there for a while. Dust it off first.”

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A veteran urologist, Uwais Zaid, MD, has heard the comparisons.

Pain from a kidney stone is like giving birth.

“It’s true,” says the man who provides care at OSF HealthCare in Alton, Illinois.

“It’s horrible. They just can’t get comfortable. They’re writhing around in pain,” Dr. Zaid says of people suffering from a calcification-turned-blockage in the urinary tract.

“When the kidney gets obstructed, everything gets swollen upstream. That causes everything to get stretched out,” Dr. Zaid explains. “And it hurts a lot. Your body responds with severe pain in the flank area. It’s a sharp, stabbing pain.”

Other signs: you suddenly start feeling an urgency to urinate or your urine is anything but clear or yellow.

All those unpleasant symptoms are why prevention of kidney stones is key. It starts with what you put in your body.

Drink plenty of water, Dr. Zaid says. Doctors even recognize a “kidney stone belt” in the southern United States where people deal with sweltering weather and dehydration.

Avoid excess salt and sugar in your diet. That means cut back on soda and sweet tea. Too much meat, nuts and leafy vegetables can also cause problems.

“Other risk factors include a family history of kidney stones. Chronic diarrhea can cause dehydration and a loss of electrolytes,” Dr. Zaid says.

For small kidney stones – less than five millimeters across, or about the size of an eraser on the end of a pencil – a provider may see if the stones can pass out of your body through the urethra on their own. Medication can help with that.

But for trickier stones, there are several ways doctors can intervene. Dr. Zaid says providers can blast sound waves at the kidney stone from outside the body to break the stone apart. A doctor can send a camera through the urinary system, find the stone, use a laser to fragment it and remove the pieces. For larger stones – two to four centimeters – surgery involves an incision through your back to reach the stone, break it apart and remove it.

If you have symptoms of a kidney stone, don’t try to tough it out. Your symptoms may subside, but there may still be issues that could turn serious. Instead, see a doctor right away. They will perform a CT scan or ultrasound to find the cause of the pain, then develop a treatment plan.

“If the kidney remains obstructed for several weeks, that can lead to kidney damage,” Dr. Zaid warns. “If the kidney stone causes urine to get infected upstream, that can lead to sepsis, which is a life-threatening infection.”

Learn more about kidney stones on the OSF HealthCare health library and the OSF HealthCare blog.

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