Willhelm Uhthoff, German ophthalmologist, was the first doctor that with increased body temperature Multiple Sclerosis (MS) patients may exhibit increased symptoms. As an ophthalmologist he noticed a transient increase in visual impairment. After physical exertion, MS patients may have an increase in optical neuritis, fatigue, spasticity and even cognitive symptoms.
Uhthoff’s findings led to the “hot bath” diagnostics for MS
in the 1950s. Patients suspected of having MS would be dunked into a hot bath and observed for an increase in symptoms. If you literally needed help getting out of the bath you were thought to have MS. Thankfully, hot bath tests are no longer administered. Uhthoff’s findings have eventually led to advent of cooling gear for MS patients.
Later research has shown that even a one degree heat increase may hamper nerve conduction for MS patients. Patients with greater levels of demyelination tend to be more sensitive to temperature increases.
Did you know? In the August 31, 2010 issue of “Neurology” seasonal variations in lesion development were noted. Between March and August, lesion development was 2-3 times higher than between September and February.
Combating Uhthoff’s Syndrome
Avoid the heat of the day
Try to plan your outdoor activities and more strenuous jobs during the early morning hours. Pace yourself and take a 10 minute break for every 20 minutes of sun exposure or physical exertion. Breaks should be done indoors, in the shade or someplace where temperatures are cooler.
Review the weather forecasts and plan certain tasks ahead of time. If the temperature will be cooler in a few days try to postpone tasks until then.
Stay in air-conditioning whenever possible. I supplement air conditioning by having a floor fan blowing on me the majority of the day. If you do not have central air conditioning, considering getting either a portable air conditioner or window unit. You can also “borrow” air-conditioning while at the movies, windows shopping at the mall or reading a book at the public library.
Drink Water
You must stay hydrated in warmer weather. You should be consuming approximately 1 cup of water ever 15-20 minutes. You can sweat up to 2 quarts/hour so staying hydrated is critical. Cool water is absorbed more readily than ice cold or hot water. One tactic I use is to drink one glass of water every time I fill up my glass and then take a full glass with me. I have also used an egg timer to remind me to drink water … it’s irritating, but effective.
Alcohol, carbonated and caffeinated beverages should be avoided in the heat. These beverages can give you a false indicator you are hydrated or work as a diuretic to actually rid your body of fluids.
Rules of thumb for inadequate water intake:
Dress Appropriately
Wear lightweight, light-colored, loose-fitting clothing that breathes. Wear a hat, UV protected glasses and sun block. Stash a spare set of clothing in your car to change into if your clothing gets drenched with sweat.
Considering purchasing cooling gear and wear it. You can also try to qualify for free cooling gear from the MSAA http://mymsaa.org/msaa-help/cooling-products/
I also keep ice packs in the freezer and will take them with me on car trips. I will put the ice pack between me and the seat to try and keep my core temperature cooler. You can pack a ice chest of water and ice packs to keep you both hydrated and cool.
When possible, I will also wear shorts and sandals to destinations and change once I arrive at the location.
Acclimatize
Acclimatize to your environment by gradually increasing your exposure to hot environments and/or activities. Full acclimatization takes approximately 2 weeks for your body to adjust in the heat. Be especially careful, if you are traveling to or vacationing in an area significantly warmer than where you live.
The first 90 degree day of a hot summer may be scorching, but come mid-August a 90-day may actually provide some relief.
Eat smaller meals of cool foods
Your body temperature rises when you digest meals. The bigger the meal the larger the temperature increase you will experience. Try to eat smaller, but more frequent meals to stay cooler.
Have you ever noticed that many restaurants have seasonal menus? Summer menus tend to be lighter fare of cooler foods. Try to avoid meals like hot soups and hot beverages. Stick to lighter and cooler meals like fresh fruits and vegetables. Salads and cold sandwiches can be good choices.
Exercise
Exercise can help you manage MS symptoms, increase your overall health and help you fare better in the heat. You should consult your doctor prior to beginning and exercise regimen, but this can pay significant long-term benefits.
If you are highly susceptible to overheating, consider enrolling in a water exercise class. These classes may possibly be supported by your local NMSS chapter or YMCA/YWCA. Water therapy can minimize temperature increases while providing the benefits of exercise.
Parking
Many of you have heard of heat-related deaths in cars. Car temperatures can quickly exceed 140 degrees during the summers so park in the shade whenever possible. Use sun shields and crack windows when and where it makes sense.
If someone else is driving you, see if they will drop you off at the entrance prior to parking.
If you do not have a handicapped placard or plate discuss it with your neurologist on your next visit. Many newer cars may have a remote start feature to begin cooling off your car before you reach it.
Cool Off
When I get home I may feel somewhat overheated, I will go to the freezer and pull out an ice pack or 4 and lay on them. Twenty minutes later I will feel so much better. If I string too many tasks together, I'll definitely pay the price now and again later.
Remember to pace yourself and listen to your body. If you find yourself overheating take a break. Find a cool place or some shade and sit down for a drink of water. Give your body a fighting chance against the heat.
I hope this is helpful information and others will also post their tips on staying cool!
Uhthoff’s findings led to the “hot bath” diagnostics for MS
in the 1950s. Patients suspected of having MS would be dunked into a hot bath and observed for an increase in symptoms. If you literally needed help getting out of the bath you were thought to have MS. Thankfully, hot bath tests are no longer administered. Uhthoff’s findings have eventually led to advent of cooling gear for MS patients.
Later research has shown that even a one degree heat increase may hamper nerve conduction for MS patients. Patients with greater levels of demyelination tend to be more sensitive to temperature increases.
Did you know? In the August 31, 2010 issue of “Neurology” seasonal variations in lesion development were noted. Between March and August, lesion development was 2-3 times higher than between September and February.
Combating Uhthoff’s Syndrome
Avoid the heat of the day
Try to plan your outdoor activities and more strenuous jobs during the early morning hours. Pace yourself and take a 10 minute break for every 20 minutes of sun exposure or physical exertion. Breaks should be done indoors, in the shade or someplace where temperatures are cooler.
Review the weather forecasts and plan certain tasks ahead of time. If the temperature will be cooler in a few days try to postpone tasks until then.
Stay in air-conditioning whenever possible. I supplement air conditioning by having a floor fan blowing on me the majority of the day. If you do not have central air conditioning, considering getting either a portable air conditioner or window unit. You can also “borrow” air-conditioning while at the movies, windows shopping at the mall or reading a book at the public library.
Drink Water
You must stay hydrated in warmer weather. You should be consuming approximately 1 cup of water ever 15-20 minutes. You can sweat up to 2 quarts/hour so staying hydrated is critical. Cool water is absorbed more readily than ice cold or hot water. One tactic I use is to drink one glass of water every time I fill up my glass and then take a full glass with me. I have also used an egg timer to remind me to drink water … it’s irritating, but effective.
Alcohol, carbonated and caffeinated beverages should be avoided in the heat. These beverages can give you a false indicator you are hydrated or work as a diuretic to actually rid your body of fluids.
Rules of thumb for inadequate water intake:
- Thirst is an indication that you are already mildly dehydrated
- Dark yellow or musky urine indicates a water shortage.
- Not going to the bathroom is another indication that you are not drinking enough water.
Dress Appropriately
Wear lightweight, light-colored, loose-fitting clothing that breathes. Wear a hat, UV protected glasses and sun block. Stash a spare set of clothing in your car to change into if your clothing gets drenched with sweat.
Considering purchasing cooling gear and wear it. You can also try to qualify for free cooling gear from the MSAA http://mymsaa.org/msaa-help/cooling-products/
I also keep ice packs in the freezer and will take them with me on car trips. I will put the ice pack between me and the seat to try and keep my core temperature cooler. You can pack a ice chest of water and ice packs to keep you both hydrated and cool.
When possible, I will also wear shorts and sandals to destinations and change once I arrive at the location.
Acclimatize
Acclimatize to your environment by gradually increasing your exposure to hot environments and/or activities. Full acclimatization takes approximately 2 weeks for your body to adjust in the heat. Be especially careful, if you are traveling to or vacationing in an area significantly warmer than where you live.
The first 90 degree day of a hot summer may be scorching, but come mid-August a 90-day may actually provide some relief.
Eat smaller meals of cool foods
Your body temperature rises when you digest meals. The bigger the meal the larger the temperature increase you will experience. Try to eat smaller, but more frequent meals to stay cooler.
Have you ever noticed that many restaurants have seasonal menus? Summer menus tend to be lighter fare of cooler foods. Try to avoid meals like hot soups and hot beverages. Stick to lighter and cooler meals like fresh fruits and vegetables. Salads and cold sandwiches can be good choices.
Exercise
Exercise can help you manage MS symptoms, increase your overall health and help you fare better in the heat. You should consult your doctor prior to beginning and exercise regimen, but this can pay significant long-term benefits.
If you are highly susceptible to overheating, consider enrolling in a water exercise class. These classes may possibly be supported by your local NMSS chapter or YMCA/YWCA. Water therapy can minimize temperature increases while providing the benefits of exercise.
Parking
Many of you have heard of heat-related deaths in cars. Car temperatures can quickly exceed 140 degrees during the summers so park in the shade whenever possible. Use sun shields and crack windows when and where it makes sense.
If someone else is driving you, see if they will drop you off at the entrance prior to parking.
If you do not have a handicapped placard or plate discuss it with your neurologist on your next visit. Many newer cars may have a remote start feature to begin cooling off your car before you reach it.
Cool Off
When I get home I may feel somewhat overheated, I will go to the freezer and pull out an ice pack or 4 and lay on them. Twenty minutes later I will feel so much better. If I string too many tasks together, I'll definitely pay the price now and again later.
Remember to pace yourself and listen to your body. If you find yourself overheating take a break. Find a cool place or some shade and sit down for a drink of water. Give your body a fighting chance against the heat.
I hope this is helpful information and others will also post their tips on staying cool!
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