Thursday, July 28, 2011

Summer Sweating (Marin IJ)

Summer is officially in effect. It’s time for Beer-bques, beach bumming, and picnicking in the rapidly browning grass. There are many things to love about summer, but one thing few of us love is summer sweat. Yes, for many, summer is the season of sweating. Now, we all know that perspiration plays an important bodily function. By coating our bodies with moisture, it promotes evaporative heat loss and keeps us from over-heating and shriveling like slugs in the sun. Still, most folks don’t think that sweating is cool. Sweat stains on t-shirts and salty dribbles down the forehead (not to mention clammy hands and soggy feet) are embarrassing and distracting. Or, perhaps you’re like me and sweat profusely whenever you visit the doctor’s office – in my case to the point of disintegrating the disposable paper sheet on the examining table; an odd response, indeed, for someone who works in the medical field.

Luckily, I have a sweat expert in the family. My wife Angela is a contributing writer for the International Hyperhidrosis Society (, the foremost provider of support and informational resources to the world’s community of excessive sweaters (that is people who sweat a lot, not those who excessively wear sweaters). Hyperhidrosis is an actual medical condition characterized by excessive sweating above and beyond what is needed to keep the body cool. Those with hyperhidrosis may sweat four or five times more than normal - regardless of external conditions - and their sweating is so extreme that it interferes with daily life. Now, someone with that level of lather should probably seek professional help, but for the rest of us who just want to curtail the average summer slather, here, adapted from the work of my in-home sweat consultant, are some tips.

  • First of all, remember that sweat plays a critical role in keeping you cool in hot temperatures. The key to keeping your body’s air conditioning working properly is hydration. Drink early, drink often, and drink again. Limiting fluid intake is most definitely not a healthy approach to sweat suppression. You can help your natural cooling system by using a vaporizer or atomizer to spray a light mist of water under your arms. As the water evaporates your body will naturally cool.

  • Dress for summer sweat-ccess. Wear loose, lightweight, and light-colored clothing. Choose natural, breathable fabrics, such as cotton, or hi-tech fabrics designed to “wick” moisture away from your skin.

  • Sun-damaged or burned skin is not as effective at dissipating body heat and can have lasting consequences. Protect your skin and stay cooler by avoiding the peak sun hours. Sunscreen is a hot topic right now, and you should know that there is quite a bit of misleading advertising out there and not all sunscreens are created equal. New FDA regulations have been issued, but companies have at least one year to comply with these sensible new standards. Nonetheless, you should stay sunburn safe if you stick to sunscreens that are 1) SPF 15 to SPF 50, 2) have both UVA and UVB protection and 3) make sure to re-apply frequently.

  • If you sweat profusely from your forehead and/or face, consider wearing a wide-brimmed or long-billed hat. As with your clothing, your hat should be lightweight and light-colored. Coolibar hats, among others, have earned a “seal of recommendation” from The Skin Cancer Foundation.

  • When it’s hot outside and especially during summer exercise sessions, temperatures inside shoes and socks can reach 120 degrees Fahrenheit. Choose lightweight, breathable or ventilated shoes or sandals and use sweat absorbing inserts (such as Summer Soles). When wearing socks, choose pairs that wick moisture away from your feet such as those designed for athletes and hikers. Absorbent foot powders and antiperspirants can also be used on feet to minimize sweating and moisture buildup.

  • Bust armpit wet marks by changing your antiperspirant routine. Choose a soft-solid formula and apply antiperspirant to underarms once in the morning and again prior to bedtime. Application twice daily—and especially before bedtime—has been shown to be more effective. Gently massaging the antiperspirant into the skin may be useful. You can consider using a stronger over-the-counter antiperspirant such as Certain Dri or Secret Clinical Strength (active ingredients; aluminum chloride and aluminum zirconium trichlorohydrex). To avoid irritation, only apply antiperspirant to completely dry skin. If you suffer from an annoyingly sweaty face, consider applying an antiperspirant along your hairline. Follow the application tips mentioned above, but test the product on a tiny area of skin first to make sure that it won’t cause irritation.

Wow, thanks honey, that’s a lot of good perspiration inspiration. Before we wick away this topic, however, I should note that there are quite a few serious medical conditions that are associated with sweating. These include, and are not limited to – infection, heart disease, adverse medication effects or overdose, thyroid or endocrine disease, and certain types of tumors. New patterns of sweat, or sweat associated with other concerning symptoms (like the feeling of a rhino stomping on your chest) should trigger you to seek medical evaluation.

And finally, to reiterate, if you think you suffer from excessive sweating (hyperhidrosis) or your sweat is not adequately controlled by over the counter products, you should talk to a dermatologist about other treatment options. These include: prescription antiperspirants, iontophoresis (machines like Fisher Galvanic and Drionic) and Botox injections. Dr. John Maddox, chief of dermatology at San Rafael Kaiser, told me that the time to seek help for sweating is when it “becomes such an everyday problem that it affects life and work – such as not being able to type because one’s hands slip off the keyboard.” I suppose, for me that means I shouldn’t ever pursue a career as a professional patient. As for those of us who find themselves sweating more in the summer... “Regular sweat in the summer time?” says Dr. Maddox, “Don’t sweat it!”

Be Ready to Get Ready (Marin IJ)

For many of us, “disasters” are unexpected daily travails – a missed connecting flight, a blown hot water heater on the day the in-laws arrive, or, worst of all perhaps, the DVR failing to record True Blood. These, indeed, are events that are difficult or impossible to plan for, but they’re trivial compared to true disasters like Hurricane Katrina. The thing about actual disasters is, that while they’re quite common across the world at large, they’re (thankfully) rather rare in one’s personal experience. I recall just two in my lifetime – the 1989 Loma Prieta quake and the Y2K computer glitch. Oh wait, Y2K turned out to be as bland as a saltine, so let’s make that just one. With such infrequency, it’s easy to become complacent about potential threats lurking in our environment – namely floods, fires and quakes. This is true even among first responders (like me); after all, it’s hard to maintain focused preparation for an event that may never happen, and if it does, it will likely be with little warning. As Kevin J. Kitka, an emergency physician in Joplin, Missouri and a responder to the region’s recent EF-5 tornado wrote, “You never know that it will be the most important day of your life until the day is over.” Most of us in the Bay Area have learned to live with the possibility of another major earthquake. We take comfort in strict building codes and governmental readiness on the local and state level. But while complacency is comfortable, it can be dangerous. Skeptical? Consider what happened earlier this year in Christchurch, New Zealand.
“One minute we were sitting [and] contemplating a gentle walk to the Art Gallery,” writes Dr. Elizabeth Mowat, a Brit visiting Christchurch this past February. “[The] next minute the immense glass front of the hotel was looming precariously towards us then crashing down around us with nowhere to hide!” “I was talking on Skype one minute,” writes another witness “and the next the screen went blank and computers were crashing onto the ground all around me. I ran to the doorway, but the floor was shaking so much I couldn't stand, so I just got down into the foetal position and started praying.”
In sum, the Christchurch earthquake killed 182 and caused major infrastructure damage, leaving areas of the city virtually uninhabitable. It was a minor tremble on the devastation scale compared to what happened in Japan and Haiti, but nonetheless crushing to Kiwis – especially because it seemed like they had a handle on earthquake preparedness. Christchurch had, after all, survived a larger quake (7.1) in September of 2010 with no causalities, and the city’s building codes, EMS response strategy, and public education programs have served as a model for other fault-centric locales. Take, for example, their long-running quake preparedness TV commercial focused on “Fix. Fasten. Forget.” The ad starred two comic characters that just couldn’t seem to figure out proper safety procedures (like fastening the water heater). One envisions a Kiwi version of Beavis and Butthead, but nonetheless, the message seems to have resonated (with over 90% of surveyed residents recalling it.)
So how come, despite all this, Christchurch suffered horribly? What went wrong? Well, mostly, it was bad luck: the quake struck in midday when many people were out and about, it occurred along a rather obscure fault (one not thought to be high risk), and it caused significant ground liquefaction (similar to what happened to the SF marina in 1989). It was thought that any cataclysmic earthquake in Canterbury (the region on the South Island where Christchurch is located) would radiate out from the Great Alpine Fault. Yet both recent quakes occurred along other faults and in highly populated areas that were not fully prepared. Helen Clark, the former prime minister of New Zealand, acknowledged this not long after the quake. “Clearly the level of building resilience in Christchurch was not up to, in every case, dealing with this shallow and quite severe shock. I guess it will be back to the textbooks now to see what further work needs to be done to really ramp up New Zealand's resilience.”

So, what lessons can we in the Bay Area take from the Christchurch experience? 1) In a seismically active region such as ours, expect the unexpected and realize that you may not be as secure as you suppose. Says Dr Jason Eberhart-Phillips, public health officer for Marin County, “The 182 deaths resulting from this relatively small [Christchurch] magnitude event should heighten public awareness of the need to get ready for the much larger quake that is expected in the Bay Area in coming years.” Hence, 2) a few minutes of preparation now could serve you quite well in an actual disaster. A good place to start is with a simple family disaster plan and with disaster supplies (check out for classes and manuals). The Red Cross also has an excellent supply checklist ( including basics like non-perishable food, flashlights, and diapers – enough for three days. And, as a Christchurch witness states, “Have plenty of bottled water, when it stops coming out of the tap it is not nice to consider the consequences.”
Other sensible additions include medications (a week supply,) extra batteries, cash and a crank radio. In the Bay Area you would probably want to tune into KCBS 740 or KGO 810. Keeping your car’s gas tank half full at all times and having a back-up (non-electrical) charging mechanism for your phone are other practical tips. Finally, let’s recognize that day-to-day disasters will still occur and in times of need, having a back-up DVR can make an awful lot of sense.