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Taming the DOG DAYS.

Why the heat makes us feel like hell.

Getting overheated in hot weather is not one of summer's pleasures. Most people with MS--80% to 85% in many studies--suffer from unusual heat intolerance. Two of the most common heat-related symptoms are weak ness (with its effect on mobility) and blurred vision. I live with MS and have experienced heat-related symptoms for 30 years.

"For many people with MS, anything that elevates body core temperature can lead to worsening of existing symptoms or reappearance of symptoms that have been present previously," said Christopher T. Bever Jr., MD, a neurologist at the University of Maryland School of Medicine. But he stressed that this worsening is not the same as having a real attack or exacerbation: "That's not at all what we think is going on. It's reversible, and that's why we tell people, `Go see your son in a soccer game, but do what you can to stay out of the heat. If you get overheated, don't panic. You haven't precipitated an exacerbation. Just be careful so you don't fall down or have difficulty get ting home. Once you get back in the air conditioning, you should be OK.'"

The transmission by nerve fibers of electrical impulses--the messages sent by your brain to the rest of your body--is exquisitely heat-sensitive. It is even more so if nerve fibers' myelin insulation is lost. And the familiar concept of a single core temperature throughout the body (98.6 degrees) is an oversimplification. There can be tiny differences in temperature at different points in the body, and these are very difficult to measure.

What matters to those of us with MS are temperatures in the central nervous system--the brain and spinal cord. In some people with MS (myself included), just a few breaths on a hot summer day can cause big functional impairment--long before there is an increase in body temperature that would show up on a conventional thermometer. (Note that some individuals with MS are not heat-sensitive but cold-sensitive; small decreases in body temperature can cause them problems, particularly in terms of muscle spasticity.)

Luckily, there is another side to the coin. It's not much harder to lower body temperatures ever so slightly than it is to raise them.

"Those who are extremely sensitive to a temperature increase respond quickly to a decrease," noted Floyd A. Davis, MD, a neurologist at Rush-Presbyterian St.

Luke's Medical Center in Chicago. "They'll often notice that sucking on ice or having a cool drink will keep the body temperature down just that small amount that's necessary to prevent a worsening of symptoms. Generally, if just a tenth of one degree worsens symptoms, improvement occurs with an equivalent lowering."

Day-to-day living has a way of requiring us to be in many less-than-optimum situations. See the page at right for some helpful hints.

David W.E. Smith, MD is a professor in both the Department of Pathology and the Buehler Center on Aging at Northwestern University Medical School in Chicago.
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Title Annotation:caring for heat intolerance symptoms
Author:Smith, David W.E.
Publication:Inside MS
Geographic Code:1USA
Date:Jun 22, 2000
Words:499
Previous Article:Web Sites for Summer Fun.
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