Rajiv Gandhi Government General Hospital (RGGGH) saw another patient with heat stroke - a 70-year-old woman from Ambur.
The septuagenarian collapsed at home on returning after a prolonged wait at a ration shop under the blistering sun. As rising heat levels could be harsher in extremes of age, doctors emphasised the need for the elderly to take precautionary measures.
E. Theranirajan, dean of RGGGH, said the elderly woman was admitted to RGGGH and was diagnosed with heat stroke after excluding all other causes. She was on ventilatory support. “One of the clinching diagnoses for heat stroke is metabolic acidosis and elevated creatine phosphokinase-MB level, an enzyme found in the muscles,” he said.
He said that elderly persons with cardiovascular diseases, particularly coronary artery disease, obesity, and those on medications for hypertension, diabetes are at a high risk for heat-related illness.
D. Thangam, senior assistant professor, Department of Geriatric Medicine, National Centre of Ageing, explained: “Elderly patients with multiple health conditions and taking multiple drugs for conditions such as those involving the nervous system or psychiatric illnesses should be careful, as the compensatory mechanism of the body for extreme heat is not active as in healthy individuals not taking any medications.”
It is important for such elderly patients to consult their doctors and get their pills and dosages checked. “We see many patients who continue to take drugs longer than the prescribed period and forget to turn up for periodic reviews. Several patients on anti-depressants equate psychiatric drugs as sleep medications and do not go for doctors review. These drugs can put them at risk for heat illnesses,” Dr. Thangam said.
Elderly should not take any drugs without the doctor’s advice. Similarly, even common cold medicines like antihistamines can make them prone to heat illness as they can suppress the sweating mechanism. Unnecessary drugs should be avoided, the geriatrician added.
Common precautions advised for other vulnerable groups and pregnant women apply for the elderly too. “They should not go out in hot daytime or do strenuous physical work like exercise in extreme hot climate. Heat can cause dehydration and electrolyte imbalances. This can cause changes in their mental status, making them less responsive, disoriented. There may be refusal to eat, nausea and vomiting. Caretakers should be aware of such things especially when the elderly are also disabled or have dementia and cannot take care of themselves,” Dr. Thangam said.
Patients with minor heat-related symptoms are seen in the outpatient department (OPD). “We also see patients with electrolyte imbalance, renal failure probably aggravated by this extreme heat; those who are already vulnerable due to illness and medications end up with these problems when extreme heat acts as another insult. We are creating awareness among the elderly in the OPD and are educating caregivers,” she said.
