Staying Healthy in the Summer
Dr. Jonathan Berz shares how to stay hydrated on hot summer days, how to stay cool if you don't have AC, water safety tips, how to treat bug bites and other summer safety tips.
Featured Speaker:
Learn more about Jonathan Berz, MD
Jonathan Berz, MD
Jonathan Berz, MD is a general internal medicine physician at Boston Medical Center and Director of the Preventive Medicine Residency Program.Learn more about Jonathan Berz, MD
Transcription:
Melanie Cole (Host): We hear a lot about keeping our children safe in the summertime around water and bug bites and things, but we don’t often think about adults and what we can do to keep ourselves healthy in the summer. My guest is Dr. Jonathan Berz. He’s a general internal medicine physician and Director of the Preventive Medicine Residency Program at Boston Medical Center. Dr. Berz, if we had to start with what you feel are the most important aspects of summertime safety and summertime health for adults, what would that be?
Dr. Jonathan Berz (Guest): Well I mean I guess first of all the summer is obviously a wonderful to be outside and to exercise and start to kind of do some preventive medicines, but while being outside as you alluded to earlier, just taking some common sense precautions. I mean first of all, the sun and sun exposure, and so really anytime you’re out in the sun, really you can start by doing it every morning is putting on sunscreen with at least an SPF of 15 and that can be either chemical sunscreens or the barrier sunscreens with zinc. Sunscreen is one big one. Being wary of heat and humidity, so some days when the humidity is lower and the heat is lower obviously you’re going to be lower risk for overheating and dehydration, but as we’re getting into August here and the humidity is rising, you’re higher risk for overheating and dehydration, so just generally being mindful of what the temperature is, and if you’re going to be exercising outside, doing it in the cooler times of the day, so ideally in the morning if you can or in the evening and then making sure you’re well hydrated and one tip I give whether you’re out working in the heat because it’s your job or you’re going to go out exercising in the heat is actually pre-hydrating, so drinking plenty of fluids in the hours before you’re going to be outside can really help prevent dehydration as you’re out there.
Host: So important really all those points. So let’s talk about some of the things that – when you just mentioned about SPF. We were never really aware of the risks if we’re boomers or older, if we’re using sunscreen now as you recommend, are we decreasing the risk from the damage we did at a younger age, or is the damage already pretty much done?
Dr. Berz: My understanding is that – I’m not a dermatologist – is that no it’s not too late to prevent more damage from being done. Even if you’re 34 years old and you spent your childhood in the sun. It’s definitely not too late. You should definitely be using sunscreen every day, and again minimum of 15 ideally 30 or a little higher is even better and that’s been shown to prevent not only through the aging of the skin, I think for a lot of people it’s the looks that probably motivates you more than the scare of skin cancer, but the aging of the skin is really prevented by the sunscreen, but also yeah the risk of skin cancer is lowered by the daily use of sunscreen. So that’s even on days – I recommend it even on days when you’re just going to be doing your usual stuff. Not necessarily days when you go to the beach, obviously you’re using sunscreen those days, but you have days when you’re walking to work and you’re walking to work you’re outside exposed, so really it should be part of your daily practice like you brush your teeth in the morning, your dermatologist would say put on your sunscreen every morning.
Host: Another thing that summer brings are a lot of parties, which means drinking, eating, speak to us about inhibitions in the summer Dr. Berz, and maybe the increased alcohol use or we’re eating potato salad and hot dogs and things we might not always indulge in, in the wintertime. What do you want us to know about our nutrition, and thereby exercise and trying to keep that good balance?
Dr. Berz: Yeah I mean on the one hand you’re right, there are lots of fun temptations in the summer to overindulge and like you said hot dogs or hamburgers and maybe alcohol, and sort of the flip side of it is summer is a time when there’s really amazing fruits and vegetables, fresh fruits and vegetables available locally so counter that hot dog or hamburger with a plate of salad or tomatoes or some fruit or whatever, and then as far as the alcohol is concerned, more and more evidence is showing us that even – there’s really no safe level of alcohol consumption when it comes to long term health effects, but that being said we generally say for women limit your daily intake to one or fewer drinks per day, and men two or fewer drinks per day, and you know if you stay within that range then you’re going to be healthier. And then finally alcohol does have sort of a dehydrating effect and probably will increase your susceptibility to heat illness. So if it’s a really hot day, you want to be focused on nonalcoholic beverages and hydrating with those.
Host: So if it’s a really hot day and we’re around water and as far as water safety, we always encourage our children to wear life jackets but we ourselves, we think we’re adults, we can swim, we don’t always do that. Tell us about what water safety measures we should take as adults, whether we’re at the beach or at a lake or at a pool.
Dr. Berz: Of course it’s going to vary on the setting. You know if you’re in a pool and you’re there for exercise, of course you won’t be wearing a life vest, but probably you should be swimming with someone else around. So it’s probably not a good idea to be swimming alone, even in your home pool or your neighborhood pool. It’s probably good to have someone else there, and if you’re out in a more wild environment like the ocean or like a lake or a pond, then you know it really depends on the setting, but having other people there, being sure you’re comfortable with your own swimming skills, and of course paying attention to whatever posted signs are there, especially if you’re on the beach. You’re looking out for the tide, is the undercurrent of risk, should you be avoiding the ocean at a certain time and those types of things.
Host: So now what about things like bug bites and there’s ticks and we should be giving ourselves tick checks and there’s all kinds of things flying around in the summer. What would you like us to know about the importance of doing those preventive things?
Dr. Berz: Sure yeah, I mean especially in New England where we are here, but also in many other places in the country, probably the two most important insects you want to avoid are as you mentioned ticks and then also mosquitos. As you know in the northeast, especially ticks carry Lyme disease as well as other tick borne illnesses and then mosquitos of course in addition to the uncomfortable bite which is a minor issue, there are some mosquito born illnesses such as West Nile and then the less frequent more rare Eastern Equine Encephalitis and so taking some sort of common sense preventative measures is definitely something you should do and the first thing would be using – if you’re going to be out in a woodsy place or a place where there’s more ticks and more mosquitos, using an insect repellent and really all insect repellents are not created equal. So CDC and others who have looked at this would say DEET is the most effective insect repellent, and generally speaking if you’re out in a field, in the woods, or in a time of day where there’s lots of bugs, you want to be applying DEET to your skin, and in addition to that another measure you can take, is actually you either buy clothes or impregnate it with permethrin, or you can spray it on your clothes. So especially for those who are spending a lot of time in the woods and in fields where there’s ticks really everywhere, it is really important to be doing those two things. You mentioned tick checks and this has even been studied a bit about how to prevent Lyme disease. So coming in after you’ve been out in the woods or in the field for the day, checking you and your family for ticks, and they can be as small as a sesame seed. They can be very small and in looking at your clothes, ideally you’re wearing light colored clothes, you can see the ticks better that way, and some people would even say take those clothes and put them in a hot dryer for just a few minutes and that will kill any ticks that are on them, and then of course if you do find a tick on you, not to panic. It takes ticks really about 72 hours, 3 days before they can transmit Lyme disease. If you find a tick on you, crawling around you, take it off, kill it, no problem. If you find a tick on you that’s embedded, you want to try to figure out how long it’s been on you. If it’s been on you 36 hours or less, it’s very, very unlikely that will transmit Lyme disease so you can pluck it off with tweezers. If it’s 36 hours or more, in that case you probably want to ask your doctor should you take a preventative medicine for Lyme disease or should you just watch and wait for any symptoms to appear, at which time you can get treatment for Lyme disease. The antibiotics that are used for Lyme disease are highly effective.
Host: What great information. Thank you for that, and what about things like heat exhaustion. We’ve talked about hydration. So what about the symptoms that we should be aware of if we’re out in this heat for heat stroke or heat exhaustion and what we can do about that?
Dr. Berz: Sure, yeah I mean so as far as how you’re feeling, you’re going to look at – of course if today is particularly hot, higher than 95 degrees in particular, particularly humid and to put a number on it for those of you who are interested, really a day when the humidity is 70% or higher, those are the high risk days because really it’s very hard for your body to cool in those types of temperatures and humidity. So you’re going to be looking out for, are you feeling faint? Are you feeling dizzy? If someone else is with you, are you acting more irritable than usual? These are some signs of early heat illness. You really want to get yourself out of the heat, out of the sun if that’s happening. Of course staying hydrated ideally with cool, cold liquid is key during the day and if you are exercising or working outside, just making sure you’re taking frequent breaks where you’re hydrating, getting out of the sun, even getting cold towels, using ice and placing them around your neck or around your body can help cool you down. So those are some kind of common tips I would use. Heat illness can be really dangerous and potentially life threatening so you really want to pay attention to those symptoms.
Host: It’s great information as we wrap up, give us your best advice, what you think are the most important bits that we’ve talked about today that you want people to know about staying safe, staying healthy in the summer and using that great summertime to really encourage exercise and healthy eating to get us healthier.
Dr. Berz: Yeah I mean I think just sort of summarizing the things we’ve talked about, I mean again enjoy your time outside. It’s a great time to really practice preventative medicine because you’re getting exercise, you’re taking advantage of the great local produce, but yeah remembering to always put on that sunscreen, to always stay hydrated and if you are in a very hot situation, making sure of taking breaks, getting out of the sun so you don’t get overheated.
Host: It’s great advice. Thank you so much Dr. Berz for joining us today and sharing your expertise, and that wraps up this episode of Boston Med Talks with Boston Medical Center. Head on over to our website at bmc.org for more information and to get connected with one of our providers. If you found this podcast informative, please share with your friends and family, share it on your social media so that we can all get this great information together, and be sure to check out all the other interesting podcasts in our library. Until next time, I’m Melanie Cole.
Melanie Cole (Host): We hear a lot about keeping our children safe in the summertime around water and bug bites and things, but we don’t often think about adults and what we can do to keep ourselves healthy in the summer. My guest is Dr. Jonathan Berz. He’s a general internal medicine physician and Director of the Preventive Medicine Residency Program at Boston Medical Center. Dr. Berz, if we had to start with what you feel are the most important aspects of summertime safety and summertime health for adults, what would that be?
Dr. Jonathan Berz (Guest): Well I mean I guess first of all the summer is obviously a wonderful to be outside and to exercise and start to kind of do some preventive medicines, but while being outside as you alluded to earlier, just taking some common sense precautions. I mean first of all, the sun and sun exposure, and so really anytime you’re out in the sun, really you can start by doing it every morning is putting on sunscreen with at least an SPF of 15 and that can be either chemical sunscreens or the barrier sunscreens with zinc. Sunscreen is one big one. Being wary of heat and humidity, so some days when the humidity is lower and the heat is lower obviously you’re going to be lower risk for overheating and dehydration, but as we’re getting into August here and the humidity is rising, you’re higher risk for overheating and dehydration, so just generally being mindful of what the temperature is, and if you’re going to be exercising outside, doing it in the cooler times of the day, so ideally in the morning if you can or in the evening and then making sure you’re well hydrated and one tip I give whether you’re out working in the heat because it’s your job or you’re going to go out exercising in the heat is actually pre-hydrating, so drinking plenty of fluids in the hours before you’re going to be outside can really help prevent dehydration as you’re out there.
Host: So important really all those points. So let’s talk about some of the things that – when you just mentioned about SPF. We were never really aware of the risks if we’re boomers or older, if we’re using sunscreen now as you recommend, are we decreasing the risk from the damage we did at a younger age, or is the damage already pretty much done?
Dr. Berz: My understanding is that – I’m not a dermatologist – is that no it’s not too late to prevent more damage from being done. Even if you’re 34 years old and you spent your childhood in the sun. It’s definitely not too late. You should definitely be using sunscreen every day, and again minimum of 15 ideally 30 or a little higher is even better and that’s been shown to prevent not only through the aging of the skin, I think for a lot of people it’s the looks that probably motivates you more than the scare of skin cancer, but the aging of the skin is really prevented by the sunscreen, but also yeah the risk of skin cancer is lowered by the daily use of sunscreen. So that’s even on days – I recommend it even on days when you’re just going to be doing your usual stuff. Not necessarily days when you go to the beach, obviously you’re using sunscreen those days, but you have days when you’re walking to work and you’re walking to work you’re outside exposed, so really it should be part of your daily practice like you brush your teeth in the morning, your dermatologist would say put on your sunscreen every morning.
Host: Another thing that summer brings are a lot of parties, which means drinking, eating, speak to us about inhibitions in the summer Dr. Berz, and maybe the increased alcohol use or we’re eating potato salad and hot dogs and things we might not always indulge in, in the wintertime. What do you want us to know about our nutrition, and thereby exercise and trying to keep that good balance?
Dr. Berz: Yeah I mean on the one hand you’re right, there are lots of fun temptations in the summer to overindulge and like you said hot dogs or hamburgers and maybe alcohol, and sort of the flip side of it is summer is a time when there’s really amazing fruits and vegetables, fresh fruits and vegetables available locally so counter that hot dog or hamburger with a plate of salad or tomatoes or some fruit or whatever, and then as far as the alcohol is concerned, more and more evidence is showing us that even – there’s really no safe level of alcohol consumption when it comes to long term health effects, but that being said we generally say for women limit your daily intake to one or fewer drinks per day, and men two or fewer drinks per day, and you know if you stay within that range then you’re going to be healthier. And then finally alcohol does have sort of a dehydrating effect and probably will increase your susceptibility to heat illness. So if it’s a really hot day, you want to be focused on nonalcoholic beverages and hydrating with those.
Host: So if it’s a really hot day and we’re around water and as far as water safety, we always encourage our children to wear life jackets but we ourselves, we think we’re adults, we can swim, we don’t always do that. Tell us about what water safety measures we should take as adults, whether we’re at the beach or at a lake or at a pool.
Dr. Berz: Of course it’s going to vary on the setting. You know if you’re in a pool and you’re there for exercise, of course you won’t be wearing a life vest, but probably you should be swimming with someone else around. So it’s probably not a good idea to be swimming alone, even in your home pool or your neighborhood pool. It’s probably good to have someone else there, and if you’re out in a more wild environment like the ocean or like a lake or a pond, then you know it really depends on the setting, but having other people there, being sure you’re comfortable with your own swimming skills, and of course paying attention to whatever posted signs are there, especially if you’re on the beach. You’re looking out for the tide, is the undercurrent of risk, should you be avoiding the ocean at a certain time and those types of things.
Host: So now what about things like bug bites and there’s ticks and we should be giving ourselves tick checks and there’s all kinds of things flying around in the summer. What would you like us to know about the importance of doing those preventive things?
Dr. Berz: Sure yeah, I mean especially in New England where we are here, but also in many other places in the country, probably the two most important insects you want to avoid are as you mentioned ticks and then also mosquitos. As you know in the northeast, especially ticks carry Lyme disease as well as other tick borne illnesses and then mosquitos of course in addition to the uncomfortable bite which is a minor issue, there are some mosquito born illnesses such as West Nile and then the less frequent more rare Eastern Equine Encephalitis and so taking some sort of common sense preventative measures is definitely something you should do and the first thing would be using – if you’re going to be out in a woodsy place or a place where there’s more ticks and more mosquitos, using an insect repellent and really all insect repellents are not created equal. So CDC and others who have looked at this would say DEET is the most effective insect repellent, and generally speaking if you’re out in a field, in the woods, or in a time of day where there’s lots of bugs, you want to be applying DEET to your skin, and in addition to that another measure you can take, is actually you either buy clothes or impregnate it with permethrin, or you can spray it on your clothes. So especially for those who are spending a lot of time in the woods and in fields where there’s ticks really everywhere, it is really important to be doing those two things. You mentioned tick checks and this has even been studied a bit about how to prevent Lyme disease. So coming in after you’ve been out in the woods or in the field for the day, checking you and your family for ticks, and they can be as small as a sesame seed. They can be very small and in looking at your clothes, ideally you’re wearing light colored clothes, you can see the ticks better that way, and some people would even say take those clothes and put them in a hot dryer for just a few minutes and that will kill any ticks that are on them, and then of course if you do find a tick on you, not to panic. It takes ticks really about 72 hours, 3 days before they can transmit Lyme disease. If you find a tick on you, crawling around you, take it off, kill it, no problem. If you find a tick on you that’s embedded, you want to try to figure out how long it’s been on you. If it’s been on you 36 hours or less, it’s very, very unlikely that will transmit Lyme disease so you can pluck it off with tweezers. If it’s 36 hours or more, in that case you probably want to ask your doctor should you take a preventative medicine for Lyme disease or should you just watch and wait for any symptoms to appear, at which time you can get treatment for Lyme disease. The antibiotics that are used for Lyme disease are highly effective.
Host: What great information. Thank you for that, and what about things like heat exhaustion. We’ve talked about hydration. So what about the symptoms that we should be aware of if we’re out in this heat for heat stroke or heat exhaustion and what we can do about that?
Dr. Berz: Sure, yeah I mean so as far as how you’re feeling, you’re going to look at – of course if today is particularly hot, higher than 95 degrees in particular, particularly humid and to put a number on it for those of you who are interested, really a day when the humidity is 70% or higher, those are the high risk days because really it’s very hard for your body to cool in those types of temperatures and humidity. So you’re going to be looking out for, are you feeling faint? Are you feeling dizzy? If someone else is with you, are you acting more irritable than usual? These are some signs of early heat illness. You really want to get yourself out of the heat, out of the sun if that’s happening. Of course staying hydrated ideally with cool, cold liquid is key during the day and if you are exercising or working outside, just making sure you’re taking frequent breaks where you’re hydrating, getting out of the sun, even getting cold towels, using ice and placing them around your neck or around your body can help cool you down. So those are some kind of common tips I would use. Heat illness can be really dangerous and potentially life threatening so you really want to pay attention to those symptoms.
Host: It’s great information as we wrap up, give us your best advice, what you think are the most important bits that we’ve talked about today that you want people to know about staying safe, staying healthy in the summer and using that great summertime to really encourage exercise and healthy eating to get us healthier.
Dr. Berz: Yeah I mean I think just sort of summarizing the things we’ve talked about, I mean again enjoy your time outside. It’s a great time to really practice preventative medicine because you’re getting exercise, you’re taking advantage of the great local produce, but yeah remembering to always put on that sunscreen, to always stay hydrated and if you are in a very hot situation, making sure of taking breaks, getting out of the sun so you don’t get overheated.
Host: It’s great advice. Thank you so much Dr. Berz for joining us today and sharing your expertise, and that wraps up this episode of Boston Med Talks with Boston Medical Center. Head on over to our website at bmc.org for more information and to get connected with one of our providers. If you found this podcast informative, please share with your friends and family, share it on your social media so that we can all get this great information together, and be sure to check out all the other interesting podcasts in our library. Until next time, I’m Melanie Cole.