Healthy Wealthy & Wise Dr. William T. Choctaw, MD, JD
The Healthy Wealthy and Wise Podcast, with Dr. William T. Choctaw, MD, JD is a monthly podcast that focuses on personal growth and development by exploring a range of topics related to mental and physical health, personal wealth, leadership, and interpersonal relationships. Dr. Choctaw draws on his 75yrs experience and 50 plus years of surgical practice since graduating from Yale University School of Medicine.
Each month, we strive to provide our listeners with mental, physical, and spiritual strength by giving actionable advice, tips, guidance, and information to help them achieve their own personal, professional, and spiritual goals. We consider the health of the mind, body, and spirit paramount as a single unit that provides a cumulative strength greater than the individual parts, to strengthen the whole person.
We appreciate the natural differences in need between men, women, adults, and children. We recognize that the power to be happy is within each of us and under our control. We embrace technology and identify how it is applicable to our daily success. We address the entire human experiences from generation z to the baby boomers.
We’re passionate about the total person, and helping our listeners build and lead a full, well-rounded and happy life. So, tune in every month for an inspiring, encouraging, and informative podcast!
Healthy Wealthy & Wise Dr. William T. Choctaw, MD, JD
Global Warming’s Impact on Health: How to treat Heat Stroke and Heat Exhaustion
Are you aware of the drastic effects global warming can have on your health? Heat-related conditions such as heat cramps, exhaustion and stroke are on the rise, and it's crucial to recognize the signs and symptoms to safeguard your health. Listen in as I, Dr. William T Choctaw, draw upon my 50 years of medical practice to bring you the life-saving knowledge you need for these increasingly hot times. From handling heat exhaustion and stroke to the importance of hydration, we'll empower you with the tools to stay safe, especially for our vulnerable elderly and youth.
But this episode isn't just about physical health. We're also delving into the mental and emotional aspect. How can we harness the therapeutic power of forgiveness in our relationships? What are the cornerstones of a successful relationship? Let's explore these topics together and learn how respect, trust, and communication can lead to stronger, healthier bonds. Remember, change starts with you. Subscribe to our podcast and join us on this enlightening journey to better health and stronger relationships. Make sure to not miss this episode.
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The Host, Dr. William Choctaw; MD, JD, is a healthcare leadership expert, possessing a Medical Doctorate from the Yale University School of Medicine, and a Jurist Doctorate from Western University. Over a span of 50 years practicing medicine, he has served as Chief of Staff, Chief of Surgery, and as a member of the medical executive committee at Citrus Valley Medical Center over a 10 year period. Also, while practicing at Citrus Valley Medical Center, he served as Chief Transformation Officer, (developed a Robust Process Improvement/Lean Six Sigma program). Dr. Choctaw lectures nationally and internationally on medical leadership issues for hospital staffs, executives, and managers. He served as a Physician Surveyor on the Joint Commission. He's the author of 2 books, "Medical Malpractice: A Physician's Guide to the Law" and "Transforming the Patient Experience: A New Paradigm for Hospital and Physician Leadership, published by the Springer Publishing Co. He’s the President of Choctaw Medical Group, Inc., a clinical practice and medical legal consulting firm for medical staff executives, physician leaders, and hospitals.
Good morning. I'm Dr William T Choctaw and I will be your host today on the Healthy, wealth and Wives podcast. This podcast is part of our leadership master class series on having members of the public to understand and learn more about healthcare and other related issues. The whole idea is based on the fact that knowledge is power, and our plan and our purpose is to impart what knowledge that we've experienced, to pass it on to you so that it will on you will find it empowering and will subsequently use it to help yourself and those that around you. Our subject for today is do you have heat exhaustion or heat stroke? And it's important to learn the signs and symptoms. So we're going to talk about heat exhaustion or heat stroke and have you to learn and understand the signs and symptoms.
Speaker 1:I believe knowledge is power. I believe life is about being of service to others. I believe leaders can change the world. As always, I'd like to go over an outline that we're going to have for our discussion today. As I said, we're going to talk about heat exhaustion and heat stroke and how your knowledge of what this means and what's involved the pathophysiology, if you will can help you and those around you as you go forward. We're going to look at the scope of the heat issue. We're going to look at the difference between heat cramps, heat exhaustion and heat stroke how do you make the diagnosis and how do you treat it?
Speaker 1:These podcasts are based on my 75 years of experience and my over 50 years of experience as a general surgeon in private practice. As I said, this is part of our masterclass series and we started this series because we think that so many times we as individuals tend to be overwhelmed by circumstance, by the news, by those around us, and part of that occurs because we forget or we lose sight of the fact that we have a tremendous amount of personal power that's within us mentally, spiritually and physically and that by tapping into just a smaller part or larger part rather of that personal power, we can mitigate a lot of the things that we go through and end up having a much healthier and happier life. Part of that ability to mitigate situations around us is tapping into the fact that in the present environment, we have access to much more information that ever in the lifetime of humankind in the form of a handheld computer, ie our smartphone. Doesn't matter which type of smartphone you have, but you have access at the tip of your fingers is my point. So anything you want to know, you can look up. Any question you have, you can look up, and, of course, that's been accentuated now by the fact that we have the artificial intelligence and the various chatbots that are part of our super ability to search online. So let's go into our topic.
Speaker 1:Regardless of which side of the argument you're on regarding global warming, global warming does exist. Now, whether you believe it exists to the point that we're to the point of almost annihilation, or whether you think it's just a routine growth factor that's normal in our normal lives, the reality is it does exist and what we have learned is that, over time, because of global warming, our planet is getting hotter. Our planet is getting hotter and, as a result, we are dealing with maladies and illnesses and situations that we did not deal with before or have to deal with before. Now you may ask yourself well, why is this, dr Choctaw? What's changed? What's different? It goes back to appreciating what the human body is. I like to think of the human body as a super duper computer and, as with any very, very highly skilled entity, it has to operate in a certain environment for maximum functionality. Let me say that again, for any maximum in any human body or computer to get the maximum benefit out of it, or for it to function maximally, it has to operate in the very best possible environment. And indeed, when we talk about things like heat stroke or heat exhaustion, what we're talking about is a change in that environment so that the functionality of the entity, ie us, the humans, is not maximal. And not only is it not maximal, it ends up being a danger to us because we can end up losing our lives.
Speaker 1:So we're going to break down heat related illnesses into three very simple categories. The first category is heat cramps, the second category is heat exhaustion and the third category is heat stroke. Obviously, heat stroke is the most serious, thus the term stroke in the title. So let's start with the least involved of these entities and that's heat cramps. Now, all of us have participated in sports and we've observed sports where during the game or during the course of competition, someone will stop and have to sit down or lay down because they get a cramp, because they get a painful feeling, usually in their leg, and most of times with some rest and relaxation and in hydration the cramp would go away or we sort of walk it off, if you will. So for the most part, today we're gonna concentrate on heat exhaustion and heat stroke. As I said, the heat cramp basically we've all experienced it. It's minimally difficult to deal with and it's not something that we have to worry about a great deal. However, it's genesis is in the same area that can progress the more serious problems.
Speaker 1:So let's go back to the environment that we were talking about earlier. The World Meteorological Organization has reported this year that July has been the hottest month ever recorded on earth. Let me say that again the World Meteorological Organization has reported that July of this year has been the hottest month ever recorded on earth. What does that say? That says whether you believe that global warming is is not a problem. Our earth is changing, and it's changing in a way or in ways that requires that we adapt faster and more efficiently. If not, we will be in danger of illness and subsequent death.
Speaker 1:The temperature external temperature, environmental temperature that's most associated with heat stroke is usually 104 degrees or above. The temperature that's usually associated with heat stroke is an environmental temperature of 104 degrees or above. Now let me caution you here Just because it is 104 degrees outside does not mean it's 104 degrees wherever you are. Example what if you're in a small room that does not have air conditioning and has poor ventilation We'll talk about this a little later that 104 degrees can be less and you can still have issues of heat exhaustion or heat stroke. You may say well, what is the normal body temperature? The normal body temperature is 98.6 degrees. Compare the normal body temperature is 98.6 degrees. Now we started talking about how it was important for the body to be able to operate within a certain environment to have maximal functionality. That environment is 98.6 degrees normal body temperature. So when you in a situation where your body temperature begins to rise, you are now entering into an emergency situation from your body's perspective mentally, physically and spiritually and your body then goes into certain protective modes to try to mitigate any type of long-term or immediate damage. So let me repeat that real quick Normal body temperature is 98.6. If the ambient or the outside temperature reaches 104 degrees 104 degrees you're susceptible to developing a heat stroke. However, if you are inside a room or a car where the temperature outside is not 104 degrees, you can still be in an area that you may develop a heat stroke or heat exhaustion, and we'll expand that a bit later as we go on.
Speaker 1:In terms of scope of this problem. I'm talking about heat exhaustion, heat stroke. The frequency of heat waves in the United States has been steadily increasing, from two per year in the 1960s to over six per year per day. The frequency of heat waves you hear it on the news. The weather person will say we're having a heat wave today or this week used to be about two per year in the 1960s. Now we're up to six per year in 2023. Extreme heat kills more Americans than hurricanes, floods or any other weather related emergency. My point is that this is a solid problem that most of the times we don't think of that much about, and my intent here is not only for you to think about it, but for you to be educated so that you can take care of yourself, your loved ones or those that you come in contact with. In Phoenix, arizona, this year alone, 2023, in the summertime, the temperature soared above 110 for more than 30 consecutive days. Let me say that again In Phoenix, arizona, this year, summer of 2023, the temperature soared above 110 for more than 30 consecutive days in a row. So if you were to live in this area.
Speaker 1:You have to be extremely careful about heat exhaustion and heat stroke, because now we know that it's deadly and we'll talk about who is, and is not, most susceptible to this particular problem. When you develop heat stroke, the ultimate cause of mortality is the organs. All of your organs begin to fail. Why? Because you've created an environment where they cannot function, and they certainly cannot function in the proper manner.
Speaker 1:Well, some of the contributing factors to heat stroke or heat exhaustion, other than the temperature itself, include things like dehydration. Example. Let's say you decide to go with your friends hiking, but you didn't hydrate very well even before going on the hike. Now, this is regardless of where you decide to hike. So if you start off dehydrated and not been properly hydrated, and then you put yourself in a situation where the heat is extremely high, or certainly higher than normal, you're increasing your risk of heat exhaustion or heat stroke.
Speaker 1:If you're wearing heavy or dark clothing many times in an environment where the temperature is very high, that can be a contributing cause. And also if you're drinking alcohol. This tends to be one of the issues that we tend to ignore or not want to think about. But alcohol is not your friend. It is not your friend. It affects many different parts of the body, not to mention which involving your ability to think clearly, to think rationally, to make good decisions. It also has other types of physical impacts on the body where it makes it difficult for your body to decrease its own temperature. In other words, one of the ways that the body protects us from heat stroke and injury is the body has a way of lowering the body's own temperature. Drugs like alcohol inhibit the body's protective ability and consequently results in you, more likely than not, in a situation where you would develop heat exhaustion or heat stroke.
Speaker 1:There are various members of the population, as you might expect, to extremely susceptible, or more susceptible, if you will, to heat exhaustion or heat stroke. As anticipated, the very, very young children, babies very susceptible to heat exhaustion or heat stroke. So you have to be extra careful doing times of high temperature to protect the young or the children. Likewise, the very old or the elderly are very susceptible to heat exhaustion and heat stroke, and so you have to be very careful to make sure that the elderly are properly taken care of. Even if you're not elderly, if you're taking medications, certain prescription medications, like for heart disease or hypertension. These can be contributing factors to you developing heat stroke and or heat exhaustion. Why? Because some of these medications may be diuretics, which means that one of the ways that they treat your hypertension is that they increase you going to the bathroom to urinate, to eliminate more and more water, and so they remove water from the body to mitigate your blood pressure problem Well in the process. If you are physically in a situation where you need that water at that particular time, that can make things more difficult for you. So you want to be aware of those.
Speaker 1:Respectors. If you're in a situation where there's sudden temperature changes let's say you were meeting up with friends and you go somewhere, maybe to a concert, and it's very, very crowded, and you wear a certain clothing that maybe are not the best or applicable for that particular environment you want to be aware of that. If you have problems with obesity, many times your body temperature may be more uncomfortable than others. So, again, you want to be particularly aware of that. And another, more subtle risk factor is humidity. Now, we don't have to be meteorologists meteorologists but as the temperature goes up, sometimes the humidity goes up. I learned very early on being a product of the deep south that we had more humidity in the south than, say, one would see or experience in California. And my point is that if you're in an area where the temperature maybe is not 104 degrees but it may just be 100 degrees and it's high humidity, that is the same because it increases your body temperature. So there are none of different variables that you have to be aware of to protect yourself and those around you. And I'm going to suggest to you that you sort of take the mentality as a position and you think not only about how you can help yourself, but if you're out and out and about and you see someone who you think may be in distress, then you also reach out and be your brother's keeper or your sister's keeper.
Speaker 1:So let's talk about the signs and symptoms though heat exhaustion and heat stroke. Well, obviously the body temperature increases. As I said, the normal body temperature is 98.6. But let's say, if you were to have a thermometer on hand, depending on where you are, and you were to measure this person's temperature, it's gonna be higher than 98.6. And keep in mind, the body is designed to maintain that 98.6 level. So it's doing a lot of things to try to keep that temperature where it's supposed to be. But obviously many times the body can be overwhelmed if we put it in a circumstance that it cannot mitigate the problem.
Speaker 1:One of the other symptoms of heat exhaustion or heat stroke is confusion. The person is there but they're just not really there and you're talking to them or they're saying stuff that doesn't make sense and you're looking at them and you aren't really sure whether they're looking at you or not. These may be subtle signs of confusion that may be either heat stroke or heat exhaustion. Loss of consciousness obviously is a very, very serious situation. Many times individuals who have heat stroke or heat exhaustion may not be sweating. Certainly early on the heat exhaustion stage they will be sweating profusely, but many times when they get to the heat stroke stage they are not sweating and this again is a very serious, a very ominous sign. Fast breathing, obviously you would expect that Some patients may become nauseated or may even begin to vomit or may even have seizure.
Speaker 1:So basic bottom line you start with hydration, always, always, always. Water is your friend. Okay, if you remember nothing else from this podcast, remember water is your friend. Alcohol is bad and, as we mentioned, those of us who are at the extremes of age, either the very, very young or the very, very old, we are least able. We're more susceptible, if you will, to very, very high levels of heat and developing problems with heat exhaustion and heat stroke. Well, how do you distinguish between the two? Remember I said there were three things in the areas we talked about. The initial area of heat cramps Again, something that we probably all experienced is certainly seen and that tends to be minor and we can do very minor things like just rest briefly, drink some liquids, cold liquids, and usually that will go away. But we're concentrating on this particular presentation with heat exhaustion and heat stroke. So let's distinguish between the two. Let's take the less serious, heat exhaustion. So heat exhaustion is more serious than heat cramps but not as serious as heat stroke.
Speaker 1:Heat exhaustion many times is characterized by headache. The person may start, may begin to complain that they're beginning to get a headache. They will certainly complain or say that they feel thirsty. They'll want something to drink. They may be sweating excessively and you can just tell that by looking at them where they're sweating all over their temperature. If you were to take it, would be high. It was certainly be higher than 98.6. They may be nauseated. They may also, at the same time, have muscle cramps and difficulty walking or discomfort from that. They may also be lethargic. They may be moving very slowly, very carefully, low energy, not able to move around very, very quickly. These are all signs and are symptoms of heat exhaustion and you want to immediately address these issues.
Speaker 1:Now let's turn to the most serious, the absolute most serious heat stroke. As the name implies, these individuals will be breathing very, very fast because one of the ways the body is trying to compensate for this high temperature is rapid breathing. Likewise, the pulse will be very, very fast. The heart is going to be moving very, very fast because it's quickly trying to get good blood around to different parts of the body, to cool different areas as best as it can. Many times, ironically, individuals, when they get to this more serious heat stroke stage, they may not be sweating a lot, and that actually is not a good sign. That's a bad sign. So, again, if the person is not sweating and you know that they've been overwhelmed by the heat, that really is one of the signs and symptoms that suggests that they're in an emergency situation. They may be dizzy, their skin may be dry and hot and they may be not lethargic, but in the process of going unconscious, they may be fading in and out as you're trying to talk to them and, as we mentioned, you want to be very, very careful of young children and babies or infants. Their bodies are not equipped to deal with these extremes of heat or these extreme situations, just because they haven't developed those mechanisms as well, among other things, and so they're easily overwhelmed. So let's say you're out of the park and you're reading your favorite book and you see someone who maybe has been jogging and you see them sort of go down and to you they look like they're in distress and certainly, as a good Samaritan, go over to them and ask them if they're okay. If you have water, some liquid with you, take that and offer them a drink, because many times that can be life-saving for someone.
Speaker 1:One of the things I think is very important for us to do that we humans don't do very well, is listen to your body. Your body is extraordinarily sophisticated, extraordinarily sophisticated particularly at the brain and all the way down, and so when there's danger around you, your body will start to warn you. Your brain will say something like I'm just not feeling very well, are you sure you want to go on a five-mile walk right now, your body will say I'm really sort of hungry, I want to get a bite to eat, I want to just sit and get a bite to eat. Listen to your body. Your body is there to protect you and so, even though you have overriding potential or ability with your prefrontal cortex, listen to your body, because it really is tri-lil. So let's talk about treatment. Again, we've mentioned it with the heat cramps Stop the activity, rest, drink a liquids and allow the cramps to subside. And also, in terms of treatment, listen to your body and hopefully, don't even go into the activity. But if you're there, listen to your body and stop.
Speaker 1:If you're in a situation where you observe what you believe is a heat stroke again not heat cramps, not heat exhaustion, but an actual heat stroke based on some of the things that we talked about the first thing you want to do is, if this person has just had a heart attack, you want to call 911. First thing you want to do, call 911. As you're beginning to start, help and apply some type of mitigating therapy to this person. Have the person lay down flat, if possible. If you can have them to elevate their extremis, maybe on something that you can put under their legs just to get their feet elevated slightly Obviously. If you have water or some type of cold liquid, you want to try to give that to them if they are conscious. If you can do any type of cooling measures span or anything try to do that. If you have cold compresses, something you can rag or something that you can web and just put around them, that would be helpful. If they're wearing shoes and socks, remove them, and many times that helps to allow them to cool down. A lot of these things are basic common sense types of things, but again, I want to encourage you to intervene as a good Samaritan to help your fellow brother or sister to survive. So let's sort of summarize what we said To beat the heat, if you will, to avoid heat cramps, more importantly, heat exhaustion and heat strokes.
Speaker 1:First, we want to know that it occurs in individuals who are very, very young and very, very old. These individuals were most susceptible. And I want to add a third category of people who are very susceptible to heat exhaustion and heat stroke, and these are men and women who work outside, who work outside, whose jobs require that they work outside of a building. They are exposed to the elements six to eight to 10 hours a day, and obviously much more alike than you and I who work inside, to develop things like heat stroke or heat exhaustion. So the three main categories of people who are susceptible are children, older adults, adults who work outside, individuals who are taking medication, individuals who are obese, and so certainly you also want to avoid alcohol.
Speaker 1:So where does heat exhaustion occur the most? Again, if you are outside and in a crowd. Many times that can be a problem, particularly if the temperature is over 100 degrees. If you're in a house where the temperature may be just 80 degrees outside, but you're in a house or in a structure that has poor ventilation, let's say with a lot of people the environment doesn't have to be 100 degrees outside, because if you're in an area if the environment is just 80 degrees outside and you're in a crowded house with poor ventilation, that temperature inside could be over 105 degrees. Let me say that again If you are in a house that is hot because of a lot of people around you and the house is not air conditioned, even if the outside temperature is not extreme, meaning not greater than 80 degrees your inside temperature where you are in that house let's say you're at a party or something like that can be over 100 degrees and the same effect occurs on your body Many times.
Speaker 1:Individuals who are in these crowded situations are also drinking. So you have all these factors that are combining to put you in a serious situation physically and mentally. Please be aware of that. Go outside, stop the drinking, drink some water. If you see friends and colleagues who have gone through this, certainly try to also assist them.
Speaker 1:At the same time, one area that I really want to leave with you when you think about heat exhaustion and heat stroke is the danger of the automobile. Let me say that again. One area that I want to leave with you when you think about heat exhaustion or heat stroke is the car, the automobile. You've all heard of the tragic situations of children being left in the car when it's hot outside and end up dying because of the heat. Similar type things can occur with adults If you are locked in a car for some reason, or if you're in traffic and it's getting very, very hot and you have a lot of cold mobilities. You just want to be aware of that To do those things. You can mitigate those things occurring. Take water with you always and do those things that can help you to lower your body temperature.
Speaker 1:In summary, climate change is obviously a contributing factor to the global warming that's occurring in our country and in the world. Whether we can agree or disagree about what the exact effects are of climate change a global warming, there is no question that global warming is a contributing factor. In my judgment, the three most common issues of bobbing heat and us physically tend to be heat cramps, heat exhaustion and the more serious heat stroke. Please be aware that water is vital to our survival and to our maximal functionality. Keep it close by and I use good judgment in terms of activities that do not put us into situations where we end up exposing our bodies to extraordinary amounts of heat, which can cause damage and danger and ultimate death. Remember, heat stroke is a much greater cause of mortality among us than we realize. We just need to be aware of the danger so that we can still do our activities, but just do it in a safer way. When you suspect that you're being overwhelmed or a colleague is being overwhelmed by heat, stop all activity, rest, cool and hydrate. Stop all activity, rest, cool and hydrate If you're in a situation where you think the person is experiencing a heat stroke, please call 911, because this is a life-threatening circumstance and you want to make sure that person gets the maximum treatment to survive.
Speaker 1:Knowledge is power, as always. I'd like to end with my basic principles. Number one. Principle number one God is in charge. I am a position of faith and it has been my faith and God that has sustained me over these 50 plus years. But for that faith I would not be here today.
Speaker 1:Second no bad days. I don't have any more bad days. I decided about 30 years ago that I'd had enough bad days. So I either have good days or great days, but I don't have bad days. Next principle I learned that don't sweat the small stuff, and most stuff is small. Whatever I am worried about or whatever I perceived as being negative to me or around me is usually never as bad as I think it is. So I keep that in mind so I can put it in perspective and not unnecessarily mentally, physically and spiritually go through things that are unnecessary.
Speaker 1:Next principle forgiveness is therapy. So whenever I'm in a situation where I perceive that someone has said or done something that I find negative, I immediately forgive them. It does not matter who's right or wrong. I just immediately forgive, and I found forgiveness to be therapeutic. And my final principle is that everything is a relationship. Relationships are based on three things mutual respect, mutual trust, good communication. If you have those three things in your relationship, you have a good relationship. If you do not have those three things, then you have work to do. Please remember, we would like to have you to subscribe to these podcasts. I go to your browser and put it wwwbusfroutcom forward, slash 210-1003. That's wwwbusfroutcom forward, slash 210-1003. And, as always, be the change that you want to see in the world. Thank you, have a terrific day.
