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Robert Schwaner

Left, Dr. Robert Schwaner, medical director of the Department of Emergency Medicine and chief of the Division of Toxicology at Stony Brook University Hospital. Right, Dr. Jennifer Goebel, emergency room doctor at Huntington Hospital. Left file photo from Stony Brook University; right from Northwell Health

With summer in full swing on Long Island, local doctors urge residents to stay hydrated and remain aware of the potential health effects from heat and sun, particularly for vulnerable age groups.

“We worry about our elderly population,” said Dr. Jennifer Goebel, emergency room doctor at Huntington Hospital. “They have a little less reserve and can become dehydrated very easily.”

Part of the challenge for the elderly population is that their efficiency in sweating isn’t as high as it was when they were younger, doctors added.

People with heart disease and/or diabetes can also be at risk as the heat index rises.

This summer has reached numerous temperature records around the country and the world. On Monday, a buoy in the Florida Keys measured a temperature of 101.1 degrees, breaking the previous world record for sea surface temperature set in Kuwait Bay in the Persian Gulf. 

Locally, in anticipation of a heat advisory for this Thursday, July 27, the Town of Huntington has opened several cooling centers, including at the Dix Hills Ice Rink and the Dix Hills Park Swimming Pool, as well as at the Elwood and Manor Field Spray Parks.

Amid high temperatures, doctors suggested residents make sure they drink enough water, particularly when active outdoors.

“Water is not light, but you should have enough access to as much water as you need,” said Dr. Robert Schwaner, medical director of the Department of Emergency Medicine and chief of the Division of Toxicology at Stony Brook University Hospital.

Before he attended medical school, Schwaner worked for a few years seal coating driveways. The heat helped the driveways but not the people working on them. Schwaner said he could go through several gallons of water each day.

Signs of heat exhaustion

People can display a variety of symptoms of heat exhaustion.

For starters, they can get headaches and nausea. That, Schwaner said, can be problematic, as both of those can also be signs of other problems.

“Those are the earliest things you start to feel,” Schwaner said. “If you don’t pay attention, it could be a slippery slope.”

People can also develop myalgia or pain in a muscle or group of muscles. Heat can also cause muscle cramping, aching and dizziness.

When body temperature exceeds 104 degrees, that person can also experience confusion or become unconscious.

“We advise any patient or bystander to call 911 for medical attention,” said Goebel.

Before medical help arrives, people can help by providing water or ice and removing equipment such as protective masks or chest protectors during sporting events.

“Small things can go a long way before medical attention” arrives, Goebel added.

People often develop problems with their thinking and central nervous systems when body temperatures climb in the heat.

When he was a fellow at Bellevue Hospital, Schwaner saw some fit athletes who were confused or aggressive come to the hospital. Sometimes, they couldn’t recognize friends and family members who brought them in for medical help.

Water wins

Doctors urged people to choose water when the temperature and heat index rise.

“People forget that water is always the best,” Goebel said. “We recommend that people stay away from coffee, tea and soda,” which can go through their systems rapidly.

Doctors particularly cautioned against consuming alcohol during extreme heat.

Adult beverages “already put people behind the eight-ball in terms of dehydration,” said Schwaner.

Weekend warriors

Adults who work all week sometimes race out on the weekends, hoping to recapture some of their previous athletic glory from their younger years.

These would-be athletic superstars, often described as “weekend warriors,” are more likely to suffer from torn hamstrings, rotator cuffs or anterior cruciate ligament damage than from heat-related injuries.

“Most weekend warriors can’t last long enough” running at top speed or racing around on a field to develop heat-related injuries, said Schwaner.

People can improve their heat resilience by doing aerobic exercise for 15 to 20 minutes twice or three times a week, Schwaner noted. “You can rev up the body’s ability to cool yourself,” he said.

Canadian wildfire smoke reduced the amount of sunlight reaching the ground over Long Island. Photo by Terry Ballard from Wikimedia Commons

Brian Colle saw it coming, but the word didn’t get out quickly enough to capture the extent of the incoming smoke.

Dr. Jeffrey Wheeler, director of the emergency room at St. Charles Hospital in Port Jefferson. File photo from St. Charles Hospital

The smoke from raging wildfires in Quebec, Canada, last week looked like a “blob out of a movie” coming down from the north, said Colle, head of the atmospheric sciences division at Stony Brook University’s School of Marine and Atmospheric Sciences. As the morning progressed, Colle estimated the chance of the smoke arriving in New York and Long Island was “80 to 90 percent.”

Colle, among other scientists, saw the event unfolding and was disappointed at the speed with which the public learned information about the smoke, which contained particulate matter that could affect human health.

“There’s a false expectation in my personal view that social media is the savior in all this,” Colle said. The Stony Brook scientist urged developing a faster and more effective mechanism to create a more aggressive communication channel for air quality threats.

Scientists and doctors suggested smoke from wildfires, which could become more commonplace amid a warming climate, could create physical and mental health problems.

Physical risks

People in “some of the extremes of ages” are at risk when smoke filled with particulates enters an area, said Dr. Jeffrey Wheeler, director of the emergency room at St. Charles Hospital in Port Jefferson. People with cardiac conditions or chronic or advanced lung disease are “very much at risk.”

Dr. Robert Schwaner, medical director of the Department of Emergency Medicine and chief of the Division of Toxicology at Stony Brook University Hospital. Photo from Stony Brook University

Dr. Robert Schwaner, medical director of the Department of Emergency Medicine and chief of the Division of Toxicology at Stony Brook University Hospital, believed the health effects of wildfire smoke could “trickle down for about a week” after the smoke was so thick that it reduced the amount of sunlight reaching the ground.

Amid smoky conditions, people who take medicine for their heart or lungs need to be “very adherent to their medication regimen,” Schwaner said.

Physical symptoms that can crop up after such an event could include wheezing, coughing, chest tightness or breathing difficulties, particularly for people who struggle with asthma or chronic obstructive pulmonary disease.

When patients come to Schwaner with these breathing problems, he asks them if what they are experiencing is “typical of previous exacerbations.” He follows up with questions about what has helped them in the past.

Schwaner is concerned about patients who have had lung damage from COVID-related illness.

The level of vulnerability of those patients, particularly amid future wildfires or air quality events, will “play out over the next couple of years,” he said. Should those who had lung damage from COVID develop symptoms, that population might “need to stay in contact with their physicians.”

It’s unclear whether vulnerabilities from COVID could cause problems for a few years or longer, doctors suggested, although it was worth monitoring to protect the population’s health amid threats from wildfire smoke.

Local doctors were also concerned about symptoms related to eye irritations.

Schwaner doesn’t believe HEPA filters or other air cleansing measures are necessary for the entire population.

People with chronic respiratory illness, however, would benefit from removing particulates from the air, he added.

Wildfire particulates

Dr. Mahdieh Danesh Yazdi, an air pollution expert and environmental epidemiologist from Stony Brook University’s Program in Public Health. Photo from Stony Brook University

Area physicians suggested the particulates from wildfires could be even more problematic than those generated from industrial sources.

Burning biomass releases a range of toxic species into the air, said Dr. Mahdieh Danesh Yazdi, an air pollution expert and environmental epidemiologist from Stony Brook University’s Program in Public Health.

The U.S. Environmental Protection Agency has done a “fairly decent job” of regulating industrial pollution over the last few decades “whereas wildfires have been increasing” amid drier conditions, Yazdi added.

In her research, Yazdi studies the specific particulate matter and gaseous pollutants that constitute air pollution, looking at the rates of cardiovascular and respiratory disease in response to these pollutants.

Mental health effects

Local health care providers recognized that a sudden and lasting orange glow, which blocked the sun and brought an acrid and unpleasant smell of fire, can lead to anxiety, which patients likely dealt with in interactions with therapists.

As for activity in the hospital, Dr. Poonam Gill, director of the Comprehensive Psychiatric Emergency Program at Stony Brook Hospital, said smoke from the wildfires did not cause any change or increase in the inpatient psychiatric patient population.

In addition to the eerie scene, which some suggested appeared apocalyptic, people contended with canceled outdoor events and, for some, the return of masks they thought they had jettisoned at the end of the pandemic.

“We had masks leftover” from the pandemic, and “we made the decision” to use them for an event for his son, said Schwaner.

When Schwaner contracted the delta variant of COVID-19, he was coughing for three to four months, which encouraged him to err on the side of caution with potential exposure to smoke and the suspended particulates that could irritate his lungs.