CPR is a lifesaving technique that can help you resuscitate someone whose heart has stopped beating. This could happen for a number of reasons such as a drug overdose, drowning or sudden cardiac arrest. They can suffer from permanent brain damage or die if you don&rsquo;t get them the help they need&mdash;and quickly.

Performing CPR can seem intimidating. After all, you don&rsquo;t want to feel responsible if something goes wrong.&nbsp;During a cardiac emergency, 70 percent of Americans feel helpless or unsure of what to do. Many are afraid of hurting the victim. But if you&rsquo;re ever in an emergency situation, being well equipped with the skills and knowledge to perform Hands-Only CPR will make you feel confident in your abilities. Research shows that chest compressions are just as effective as CPR with rescue breaths within the first few minutes of sudden cardiac arrest.

Before performing CPR

<ul>
	<li>First, check the scene. Make sure that it&rsquo;s safe to proceed before walking over and asking if the person needs help.</li>
	<li>If it is in fact an emergency situation, call 911 or delegate someone else to call.</li>
	<li>If there is someone nearby, ask them to immediately grab an automated external defibrillator (AED)&mdash;a portable device that can send electric shocks to the heart.</li>
	<li>Check to see if the victim has a pulse and is breathing.</li>
	<li>Do not wait longer than 10 seconds to decide to do CPR. Occasional sounds of gasping for air do not constitute breathing. Begin CPR immediately if you don&rsquo;t hear normal breaths.&nbsp;</li>
</ul>

How to perform CPR 
Make sure the person is on their back. Get down next to their neck and shoulders and keep your arms straight. Position yourself above the person who is unconscious and put your hands, fingers interlocked, directly on their sternum. Then, begin to &ldquo;Push Hard, Push Fast&rdquo;&mdash;advice from the American Heart Association (AHA).&nbsp;Make sure your compressions are at least two inches deep for adults and children and 1.5 inches for infants. They should be fast too&mdash;100 to 120 compressions per minute. As a reference, push to the beat of the Bee Gees song &quot;Stayin&#39; Alive.&quot; The AHA also released new CPR guidelines in 2017 which state that adults no longer need to stop and give rescue breaths if someone needs CPR. Instead, they should continue doing compressions.

And they should not stop performing compressions until the following happens: the person shows signs of life, a paramedic arrives on the scene, the scene becomes unsafe to continue or an AED becomes available.

If there is an AED available, do CPR until it is turned on and the defibrillator pads are applied to the person&rsquo;s skin. Gillespie does not want people to be scared of using an AED. &ldquo;The CPR and AED guidelines are designed to be very simple for somebody who has no specific training in them,&rdquo; she says. The device will walk you through how to use it once it&rsquo;s turned on.

What happens if you get tired? 
If you&rsquo;re doing CPR correctly, then it will become exhausting. Every two minutes, or anytime you see someone becoming visibly tired, swap out. Before switching, be sure the next person to perform CPR is completely ready, positioned exactly opposite the person currently performing CPR, to avoid any delays. A pause can lead to decreased blood flow to the brain, so swap quickly.

Mistakes to avoid 
Often times people don&rsquo;t push hard or fast enough because they worry about causing injury. People can easily heal from a broken rib, but CPR can save a life.

Many people also assume that you have to be certified to perform CPR. However, that&rsquo;s not the case. All 50 states have Good Samaritan laws that protect you from getting sued if you were trying to help.

Want to get certified? Search for a course near you by heading to the <a href="https://www.redcross.org/take-a-class/cpr/performing-cpr" target="_blank">Red Cross&rsquo;s site</a>.

Find your CPR beat 
If the Bee Gees are not your music style, there are plenty of other songs you can do CPR to. Here are some good options:

<ul>
	<li>&ldquo;Hips Don&rsquo;t Lie&rdquo; by Shakira</li>
	<li>&ldquo;One Week&rdquo; by Barenaked Ladies</li>
	<li>&ldquo;Rock Your Body&rdquo; by Justin Timberlake</li>
	<li>&ldquo;Cecilia&rdquo; by Simon &amp; Garfunkel</li>
	<li>&ldquo;Work it&rdquo; by Missy Elliot</li>
	<li>&ldquo;Crazy in Love&rdquo; by Jay Z and Beyonc&eacute;</li>
	<li>&ldquo;Float on&rdquo; by Modest Mouse</li>
</ul>

Sites like Spotify also have specialty curated CPR playlists filled with songs that are between 100 and 120 beats.

No matter your taste in music, knowing how to perform CPR may one day help you save a life.

Medically reviewed in March 2020.

How to Save a Life: Plus Beats to Help You Perform Better CPR

Kamaaina are already pretty savvy when it comes to staying safe at the beach. Endless precautions are instilled in your subconscious&mdash;remain relaxed if caught in a riptide, don&rsquo;t walk on wet rocks, never turn your back to the ocean and &ldquo;when in doubt, don&rsquo;t go out.&rdquo; Still, the promise of an epic surf session can supersede internal warnings and there are other dangers to be aware of during beach time. The following are some beach safety tips for kamaaina and malihini alike.

Stay near lifeguards 
It&rsquo;s not just visitors who succumb to the ocean. On the neighbor islands, residents account for nearly 25 percent of all drownings, while on Oahu, 40 percent of total drownings are locals. Monty Downs, MD, an emergency physician practicing on Kauai, says he&rsquo;s not sure why the percentage is higher on Oahu but, on average, locals are more &ldquo;akamai&rdquo; than visitors when it comes to ocean activities. Rather than running into trouble in strong currents, kamaaina tend to encounter accidents with big waves, get knocked off rocks while opihi fishing, or suffer from heart attacks near water. That&rsquo;s why Dr. Downs recommends that everyone frequent beaches with lifeguards.

If you&rsquo;re in an area without lifeguards, however, make sure to spot the nearest rescue tube. These flotation devices are designed to assist people in the water by supporting their weight. Downs also voluntarily serves as president of the Kauai Lifeguard Association. This non-profit group, in close partnership with another non-profit called the Rescue Tube Foundation, has been instrumental in installing more than 200 rescue tubes around Kauai, as well as 140 on Maui, 25 on Hawaii Island, and 2 on Oahu. An estimated 150 people have used the devices over the past decade on Kauai. Downs estimates that 20 would have otherwise lost their lives.

Practice safe skincare 
Skin cancer is the most common cancer in the U.S. Basal and squamous cells are the two most common types of skin cancer. The least common, and most lethal, is melanoma. If cancerous cells are caught early enough and haven&rsquo;t spread beyond the skin, however, there is a 98 percent five-year survival rate. Skin cancer is frequently found and treated at this stage.

Skincare also requires attention at the beach. The good news is that the death rate of melanoma, a form of skin cancer, caused by exposure to sunlight and UV radiation, is lower in Hawaii than the rest of U.S. According to a Blue Cross Blue Shield report on its members from 2018, Hawaii&rsquo;s rate of skin cancer was just 1.8 percent, compared to 4.3 percent nationally.

It&rsquo;s unclear why rates are so low in Hawaii but local speculation is that beachgoing savvy may extend to skincare. Everyone is at risk for skin cancer, though people with lighter skin are more susceptible. Sunburns early in life, severe sunburns or blisters and lifetime exposure are among the risks for skin cancer. JoAnn Lepke, a board-certified nurse practitioner who specializes in dermatology recommends using water resistant sunscreen with an SPF of 30 or higher and to reapply every 40 to 80 minutes if you&rsquo;re sweating or spending time in the water and no less than every two hours.

&ldquo;The sooner a skin cancer is detected, the more likely it can be treated with good results,&rdquo; says Lepke, who also recommends routine screenings.&nbsp;&ldquo;An extraordinary number of patients who I have seen for a full-body skin exam had no idea they had skin cancer that was discovered upon exam.&rdquo;

Remember, effective January 1, 2021, Hawaii will ban the sale of over-the-counter sunscreen products with the chemicals oxybenzone and octinoxate to help mitigate their harmful impacts on coral reef.

&ldquo;Try to use zinc and/or titanium (mineral-based) sunscreens which provide a physical block to the sun, rather than a chemical block,&rdquo; says Lepke, who adds that wearing ultraviolet protection factor (UPF) clothing that&rsquo;s tightly woven to protect skin, along with hats, helps. Don&rsquo;t forget about your eyes either. Be sure to wear sunglasses that block against UVA and UVB rays to reduce the risk of developing cataracts.

Don&rsquo;t swim in brown water 
Stay out of the ocean any time you see a Brown Water Advisory issued by Hawaii&rsquo;s Department of Health. Organizations like Surfrider Foundation also regularly report coastal water pollution, including high levels of enterococci bacteria (from feces), on their social media pages to help keep people free of illness.

As a rule of thumb, avoid swimming in the ocean after heavy rainfall when pollution run-off enters waterways or if there has been a recent burst pipe in the area. Moreover, don&rsquo;t swim if you have any <a href="https://www.sharecare.com/health/bacterial-infections/article/how-spot-warning-flesh-eating-infection">open wounds</a>.

Sharks 
Sharks like to feed in brown, murky water, which is another reason to avoid swimming in it. That said, the odds of being bitten by a shark are rare, with only three to four bites per year, which is low, particularly when considering the number of residents and visitors who frequent our shores.

Nonetheless, there are things you can do to mitigate the chances of an encounter.

<ul>
	<li>Don&rsquo;t swim alone and keep close to lifeguards.</li>
	<li>Don&rsquo;t swim at dusk, dawn, or during the evening when some shark species move closer to land to feed (tiger sharks are active all times of day).</li>
	<li>Don&rsquo;t swim if you are bleeding.</li>
	<li>Don&rsquo;t splash excessively.</li>
	<li>Immediately remove speared fish from the water.</li>
	<li>Don&rsquo;t wear shiny jewelry or high-contrast clothes.</li>
</ul>

If you do happen upon a shark, move slowly and calmly, without provoking or harassing them.

Be aware of other marine life 
Box jellyfish have thin, barbed tentacles capable of inflicting a painful sting. The theory is that they move to shallow waters to spawn based upon lunar and tidal cycles, and they routinely appear 8 to 10 days after a full moon. Waikiki is a hot spot for box jellyfish. More than 900 beachgoers were stung on Memorial Day 2019.

The University of Hawaii&rsquo;s Waikiki Aquarium has an <a href="http://waikikiaquarium.org/box-jellyfish-calendar" target="_blank">online calendar</a> indicating when you&rsquo;re most likely to encounter these invertebrates. Portuguese man o&rsquo; war, akin to jellyfish, have long tentacles and can even sting while out of the water, where you will most likely find their small blue bladder bubbles dotting the shoreline.

Jellyfish can sting people who are wading or swimming in the water. Beached and dying jellyfish can still sting so keep small keiki from picking them up and don&rsquo;t step on them if barefoot. If you are stung, seek a lifeguard for help. If no lifeguard is available, rinse the area in sea water, not freshwater, and do not scrub it. Once home, gently remove the stinger with tweezers, not your hands as that can lead to further stings. Stings to the eyes and mouth can be more severe so be sure to contact a doctor if anyone in your family is stung there. It&#39;s also a good idea to get a tetanus booster shot if you are stung and haven&rsquo;t had a booster in the last 10 years. Contact your doctor immediately if you have severe symptoms from a jellyfish sting, such as difficulty breathing or swallowing, chest pain, extreme pain, or persistent symptoms after the sting.

There are other marine animals to avoid, such as sea urchins. They cause puncture wounds if you come into contact with them because their spines embed in your skin. Remove the spine like you would a splinter, and if the pain does not go away, see a doctor. Sometimes spines deeply bury into a person&rsquo;s skin and cause various harmful reactions.

Finally, don&rsquo;t forget that coral is teeming with bacteria. Be cautious near reefs and don&rsquo;t walk or stand on them, especially because doing so harms the living ecosystem. If you accidentally stub your toe or cause an open wound, call your doctor, as serious complications can arise from infection.

Medically reviewed in April 2020.

Akamai Beach Safety Tips

It&rsquo;s that time again. The Atlantic hurricane season, when storms form in the Atlantic Ocean, runs from June 1 through November 30, peaking in the summer. The 2020 season was the most active on record, with 30 storms.

If you live in an area that could be affected by a hurricane or tropical storm and don&#39;t have a plan, it&#39;s time to prepare. Fortunately, extreme weather typically gives you a heads up.

&quot;You will usually have plenty of notice when a hurricane may hit your area,&quot; says R. Preston&nbsp;Wendell, MD, FACEP, Medical Director for&nbsp;Trident Health Emergency Departments&nbsp;in Charleston, South Carolina. &quot;Take it seriously and be as prepared as you can be.&quot;&nbsp;

What makes a hurricane 
Hurricanes are exceptionally large storms that almost always form above water and can gradually make their way toward land. They commonly involve fast winds, lots of rain and rising tides, and may change speed or course over time.&nbsp;Hurricanes weaken once they hit land, though high winds, heavy rain and flooding can still wreak havoc in the days following.

If you hear there&#39;s a hurricane watch in your area, it means one is possible within 48 hours. A hurricane warning means one will likely occur within 36 hours, in which case it&#39;s important to have a plan.

Hurricane winds are categorized on a 1 through 5 basis using the Saffir-Simpson Scale. A Category 1 hurricane indicates winds between 74 and 95 miles per hour (mph). Some damage can be expected, from snapped trees to power outages.

On the other end of the spectrum, a Category 5 hurricane means winds will be at least 157 mph, and damage will almost certainly be catastrophic, rendering affected areas uninhabitable for long periods of time. In 2018, Hurricane Michael became the first Category 5 storm to make landfall in the United States since Hurricane Andrew in 1992.

Devising your plan 
Long before you make preparations for any specific hurricane, you should take time to create an overall emergency plan with your family. Learn your evacuation route and designate a place to stay if it becomes too dangerous to shelter at home. Arrange how you&#39;ll communicate if there&#39;s a power outage and find out how to get alerts and updates&mdash;such as via social media or radio broadcasts&mdash;from local authorities. Make sure your whole family knows the plan.

Crucially, you should consider family members with different needs. &quot;If you are responsible for young children or an elderly parent, the situation can change from manageable and survivable to dangerous really quickly,&quot; says Dr. Wendell.

For seniors or people with health or mobility issues, be aware that extreme weather may worsen health conditions. You should anticipate an extended period of time during which you may not have access to regular care. If an electric medical device is being used, call your fire department and electric company before a hurricane to alert them that you have it, and consult with the manufacturer to see if it can run on batteries or a generator. (Always check a device&#39;s settings before you begin using it again after a power outage.)

Make sure any designated shelter is able to accommodate your loved one&#39;s medical needs. If they are in a care facility, ask the managers about their hurricane policy. &quot;They may expect you to transport your family member,&quot; says Wendell. &quot;You need to know what their plan is and what they expect of you.&quot;

Plan for your pets, too. Keep dogs and cats close and make sure they&#39;re wearing tags or they&#39;re microchipped. Since certain evacuation centers won&#39;t allow animals, contact area shelters or your local department of animal control beforehand to ask about accommodations.

Whether you&#39;re staying or going, secure loose outdoor items like garbage cans and children&#39;s toys if you have time. You may also want to look into acquiring a generator in case you&#39;re without power for a long time. If it seems like you&#39;ll evacuate, the Centers for Disease Control and Prevention (CDC) advises you to shut off your main gas valve and main power switch.

What to have on hand 
Should you stay in place, it&#39;s best to have certain&nbsp;<a href="https://www.sharecare.com/health/emergency-preparedness/article/how-prepare-hurricane-tropical-storm">supplies</a>&nbsp;with you. These will sustain you and your family if you&#39;re homebound for a period of time, or if certain utilities (such as electricity or water) or services (supermarkets or drugstores) aren&#39;t available. Key provisions to have on hand include:

<ul>
	<li>Water:&nbsp;The CDC recommends at least 5 gallons per person, which should last up to five days. Buy supplies, like iodine tablets, to help ensure the safety of your drinking water.</li>
	<li>Food:&nbsp;Non-perishable goods are ideal. Make sure they&#39;ll last up to five days. Don&rsquo;t forget baby formula if you have an infant.</li>
	<li>Medications:&nbsp;Keep your remaining supply in a watertight container.</li>
	<li>Personal items:&nbsp;These include soap, toothbrushes and toothpaste, baby wipes, diapers and tampons or pads.</li>
	<li>Safety supplies:&nbsp;Have a <a href="https://www.sharecare.com/health/first-aid-safety-preparedness/slideshow/first-aid-essentials-not-bandages">first-aid kit</a>, face masks, radio, fire extinguisher, sleeping bags and at least one flashlight. Don&#39;t forget extra batteries. Make sure your carbon monoxide detector is working.</li>
	<li>Contact lists:&nbsp;Phone numbers and email addresses are key for reaching family, friends or help. Write them down or program them into your phone (which should be fully charged, of course).</li>
</ul>

If an evacuation is pending, you may want to have a go bag set with these items. Remember to fill your car with gas and be prepared to take off should an evacuation be called.

When to go 
If a hurricane is approaching, when should you stay home and when should you listen to officials and move to a safer area?

In short, &quot;If they recommend you should go, you should go,&quot; says Wendell.&nbsp;Don&#39;t ignore evacuation orders.&nbsp;Shut off your gas, electricity and water if there&#39;s time. Take essentials only&mdash;your phone, IDs, medications, money and go bag&mdash;and leave.

Officials may also tell you to wait it out at home, which can be safer in some circumstances. If that&#39;s the case, remain indoors during the hurricane and stay tuned to news reports.

When the hurricane&#39;s passed 
If you left town or were evacuated, you may be tempted to return home immediately after the storm is over, hoping to resume life as usual&mdash;but that might not be possible. &quot;You may think it&#39;s fine to go back,&quot; says Wendell. &quot;But trees could still fall, there may be debris everywhere, roads may be damaged and power lines may be out. It simply may not be safe to just drive up to your house and check on things.&quot;

Wait for authorities to give the go-ahead, and heed their instructions closely. Steer clear of wreckage and debris, avoid downed power lines and stay away from&nbsp;<a href="https://www.sharecare.com/health/first-aid-safety-preparedness/article/ways-stay-safe-during-flood">floodwater</a>, which may spread disease or carry hazardous chemicals. Even if it seems shallow, just a few inches of water can sweep you off your feet, and 12 inches can move a small car.

Once you&#39;ve arrived home, let your loved ones know you&#39;re safe and take photos of damage for insurance claims. &quot;Then you&#39;re going to want to check your gas line, your water,&quot; says Wendell. If there was a flood, throw out food that may have been contaminated and don&#39;t turn on dampened electrical devices. If you use a generator, be aware of the potential for carbon monoxide poisoning and keep it far from the house&mdash;at least 15 or 20 feet.

Finally, whether you remained home or evacuated, understand that services may take a while to start up again. &quot;Grocery stores are going to be down. Pharmacies are going to be down. Gas may be out,&quot; says Wendell. &quot;<a href="https://www.sharecare.com/health/managing-your-health-care/article/what-to-expect-in-the-er">Hospitals</a>&nbsp;are going to be extremely crowded because many doctors offices will be closed.&quot; Police and emergency medical services may be limited, too, he adds. Depending on the damage, it could be a long time before they&#39;re back up to speed.

In that case, says Wendell, &quot;Pay attention to what your local government is saying about what services are available, what services are closed and when closed services will reopen.&quot;

Guidelines like these&mdash;listening to officials, being cautious and preparing however you can&mdash;will help keep you safe through the next hurricane and the others to come.

Medically reviewed in May 2019. Updated in May 2021.

Sources:

Centers for Disease Control and Prevention. &ldquo;Natural Disasters and Severe Weather: Preparing for a Hurricane or Other Tropical Storm.&rdquo; October 1, 2019. Accessed April 22, 2021. 
Centers for Disease Control and Prevention. &ldquo;Natural Disasters and Severe Weather: Stay Safe After a Hurricane or Other Tropical Storm.&rdquo; October 2, 2019. Accessed April 22, 2021. 
Centers for Disease Control and Prevention. &ldquo;Preparedness and Safety Messaging for Hurricanes, Floods, and Similar Disasters.&rdquo; June 2018. Accessed April 22, 2021. 
NASA.gov. &ldquo;What Are Hurricanes?&rdquo; September 3, 2014. Accessed April 22, 2021. 
National Ocean Service/National Oceanic and Atmospheric Administration. &ldquo;What is a hurricane?&rdquo; February 26, 2021. Accessed April 22, 2021. 
National Ocean Service/National Oceanic and Atmospheric Administration. &ldquo;What is the difference between a hurricane watch and a warning?&rdquo; February 26, 2021. Accessed April 22, 2021. 
National Hurricane Center and Central Pacific Hurricane Center. &ldquo;Saffir-Simpson Hurricane Wind Scale.&rdquo; 2021. Accessed April 22, 2021. 
National Oceanic and Atmospheric Administration. &ldquo;&lsquo;Average&rsquo; Atlantic hurricane season to reflect more storms.&rdquo; April 9, 2021. Accessed April 22, 2021. 
National Oceanic and Atmospheric Administration. &ldquo;Record-breaking Atlantic hurricane season draws to an end.&rdquo; November 24, 2020. Accessed April 22, 2021. 
Centers for Disease Control and Prevention. &ldquo;Natural Disasters and Severe Weather: Reentering Your Flooded Home.&rdquo; July 6, 2020. Accessed April 22, 2021. 
National Weather Service/National Oceanic and Atmospheric Administration. &ldquo;During a Flood.&rdquo; 2021. Accessed April 22, 2021. 
Chris Dolce. &ldquo;The Four Category 5 U.S. Hurricane Landfalls Prove Why You Should Be Prepared Before Hurricane Season Begins.&rdquo; The Weather Channel. May 4, 2020. 
Office of Cybersecurity, Energy Security, and Emergency Response. &ldquo;Using Portable/Emergency Generators Safely.&rdquo; 2021. Accessed May 6, 2021.

This Atlantic Hurricane Season Could Be Bad—Prepare With These Expert Tips

Last year, five high school football players died from heat stroke. Shocked? You should be. After all, <a href="https://www.sharecare.com/health/first-aid-for-natural-exposures/what-is-heat-stroke">heat stroke</a> is entirely preventable. Yet this wasn&rsquo;t the first such incident. According to the Annual Survey of Football Injury Research, 51 football players have died from heat stroke since 1995, 40 of them high schoolers.

The word doesn&rsquo;t seem to be getting out, or those who play sports and stay active aren&rsquo;t hearing it. At one high school in Kentucky, six players were hospitalized with heat exhaustion symptoms during a single practice; at another, in Oregon, almost an entire team went to the hospital suffering from&nbsp;<a href="https://www.sharecare.com/health/bone-joint-muscle-health/what-is-rhabdomyolysis" target="_blank" title="What is rhadomyolysis?">rhabdomyolysis,</a>&nbsp;a condition in which heat and dehydration cause muscle tissue to break down. Three of the team needed surgery.

So if young and well-conditioned athletes like high school football players can be so severely affected by the heat, what about mere mortals like us? Well, we&#39;re in danger, too. According to the Centers for Disease Control (CDC), heat waves claim more lives per year than hurricanes, tornadoes, floods and earthquakes combined. An average of 350 people die each year from&nbsp;<a href="https://www.sharecare.com/health/emergency-preparedness/summer-heat-injury" target="_blank" title="What are some summer heat injuries?">heat-related illnesses.</a>

How do you keep your family safe without hiding indoors in the air conditioning all summer? Follow these five steps.

1. Understand how high temperatures affect the body.&nbsp;Heat-related illnesses happen when the body can&#39;t keep itself cool. As the temperature rises, your body tries to cool down by sweating. When you don&rsquo;t drink enough liquid to support all that sweating, the result is&nbsp;rapid dehydration.&nbsp;Humidity makes things worse: When there&#39;s moisture in the air, sweat doesn&#39;t evaporate as efficiently.

2. Know your risk factors for heat stroke.&nbsp;Some people are more likely to experience distress in the heat than others. If you&rsquo;re overweight or have diabetes, you need to be especially careful. Thyroid disease and respiratory infections also make people more susceptible to heat.

3. Be alert for signs of trouble.&nbsp;Here are the progressive signs of&nbsp;heat exhaustion&nbsp;and heat stroke:

<ul>
	<li>Muscle cramping and weakness</li>
	<li>Headache</li>
	<li>Dark urine (which signals dehydration)</li>
	<li>Low fever</li>
	<li>Nausea</li>
	<li>Fast heartbeat and pulse</li>
	<li>Hot, dry skin (no sweat)</li>
	<li>High temperature</li>
	<li>Dizziness</li>
	<li>Mental confusion or disorientation</li>
	<li>Loss of consciousness</li>
</ul>

4. Practice prevention.&nbsp;Don&rsquo;t exercise outdoors&nbsp;between 10 a.m. and 2 p.m. unless absolutely necessary. If you have to exercise or do outdoor work in the hot sun, take frequent breaks in the shade. (Bring your own shade if necessary.) Postpone particularly strenuous tasks until evening or early in the morning, and don&rsquo;t exercise in the heat if you already have a fever. Never remain in a hot car yourself or leave children, pets or older people in a car, even for a few minutes.

5. Take steps to stay cool. When you do exercise or work outside, follow these rules:

<ul>
	<li>Drink water frequently, whether or not you&#39;re thirsty.</li>
	<li>Add ice cubes to your water bottle.</li>
	<li>Check your urine. If it&rsquo;s dark-colored or there&rsquo;s not much of it, drink more.</li>
	<li>Avoid drinks with caffeine or lots of sugar.</li>
	<li>Don&rsquo;t drink alcohol, which is dehydrating.</li>
	<li>Replace lost sodium and minerals by drinking&nbsp;electrolyte-boosting sports drinks&nbsp;or eating salty foods.</li>
	<li>Wear light-colored, loose-fitting, breathable clothing such as cotton, and avoid synthetic fabrics, which trap the heat.</li>
	<li>Carry a spray bottle, and spritz yourself with cold water.</li>
	<li>Don&rsquo;t jump straight into a strenuous activity; work up to it gradually. (For example, walk, then jog, then run.)</li>
	<li>If you have to wear heat-trapping protective clothing or equipment, take it off during breaks.</li>
	<li>Don&rsquo;t exercise in the heat for more than 90 minutes at a time.</li>
	<li>Be aware that sunburn can affect your body&rsquo;s ability to release heat.</li>
</ul>

Medically reviewed in August 2018.

Football Players, Heat Stroke and You

It&rsquo;s hard to go anywhere in Hawaii without running into at least one free-roaming cat. These include feral cats, <a href="https://www.sharecare.com/health/emergency-preparedness/slideshow/ways-prepare-pets-next-emergency">pets</a> allowed to roam, and lost and abandoned animals. Cats are everywhere&mdash;in large feral colonies, roving through neighborhoods and in private residences. Whether you love them or consider them a nuisance, cats are omnipresent. It&rsquo;s important to understand how they could affect your health.

Free-roaming cats pose unique health and conservation concerns. They are considered an invasive species that will hunt and kill native species, including endangered birds such as the Palila and Uau, according to the Hawaii Invasive Species Council. Cats may also carry the parasite, Toxoplasma gondii, which is a threat to the Hawaiian monk seal and native birds such as the Alala and Nene. Exposure to this single-celled parasite can also be dangerous for some people, especially pregnant women.

There is no simple solution for this public health threat. Feral cats are the same species as the common house cat that people have kept as pets for millennia. Eliminating them in large numbers is a poor response that many animal lovers oppose. Being aware of the risks associated with cat-related illnesses and learning how you can help free-roaming cats in your community can help you protect yourself and your family.

Toxoplasmosis: A parasite with a unique lifecycle 
One of the best-known infections associated with cats is toxoplasmosis. This is a parasitic infection that relies on felines, including cats, to reproduce. The parasite can only reproduce in the gut of an infected cat. Once the parasite reproduces, cats will shed huge numbers of oocysts (think of them as parasite eggs) for one to three weeks in their feces. The oocysts can then enter soil and waterways. &ldquo;We&#39;re talking about millions of eggs [oocysts],&rdquo; explains Michelle Barbieri, DVM, MS, Wildlife Veterinary Officer for NOAA Pacific Islands Fisheries Science Center. She continues, &ldquo;those eggs [oocysts] live in the environment for a really long period of time, many months, up to a couple years or so. Then, even though the cat is no longer excreting those eggs [oocysts] in its feces, they&#39;re still in the environment.&rdquo;

Once T. gondii oocysts are in the environment, the parasite can infect intermediate carriers such as rodents or birds. Larger animals that are raised for human consumption, like pigs, can also become infected. The parasite affects brain and muscle tissues of these intermediate carriers. Rodents with toxoplasmosis will often lose their fear of cats making them easier prey. Cats that consume one of these intermediate carriers will then become infected with the parasite. They can also become infected by exposure to oocysts in their environment by drinking contaminated water or cleaning themselves after playing in dirt where oocysts are present.

People can get toxoplasmosis in the following ways:

<ul>
	<li>Eating undercooked meat from an infected animal (such as infected pork)</li>
	<li>Handling infected cat feces</li>
	<li>Gardening in areas where cat feces are or have been present, and not thoroughly washing hands before eating</li>
	<li>Drinking water or eating food that may be contaminated by cat feces</li>
</ul>

Keep in mind, some form of contact or ingestion is required to become infected with toxoplasmosis. As Sarah Park, MD, head of the Hawaii Department of Health&rsquo;s Disease Outbreak Control Division explains, &ldquo;if the average person is walking by a feral cat or is some distance from a feral cat, they&#39;re not going to be at risk.&rdquo;

What does toxoplasmosis do to people? 
For the average, healthy person, toxoplasmosis won&rsquo;t cause any serious problems. &ldquo;Our immune system deals with it and it&#39;s never usually a problem,&rdquo; says Dr. Park. &ldquo;At most, when you get infected, you might have some fever and feel unwell for a while, but it&#39;s not really a problem or a concern.&rdquo; Many people have had toxoplasmosis at some point without realizing it, she points out.

Although toxoplasmosis is often nothing to worry about, sometimes people with healthy immune systems can suffer from eye damage due to ocular toxoplasmosis. Symptoms include pain, red eyes, decreased or blurred vision and possible tearing. An ophthalmologist can diagnose ocular toxoplasmosis and determine the correct course of treatment.

Aside from rare ocular infections, toxoplasmosis can have devastating effects for those with compromised immune systems and pregnant women. Pregnant women themselves aren&rsquo;t at risk, but their unborn fetuses can suffer major neurological problems, developmental delays, blindness and even death.

Toxoplasmosis is treatable, but treatment often won&rsquo;t completely kill the parasite. In most cases, only pregnant women, infants and those with compromised immune systems require treatment as healthy people tend to recover without it.

Toxoplasmosis is a danger to wildlife, too 
Hawaiian monk seals are beloved members of the local wildlife. Their numbers are currently relatively stable at around 1,400 animals spread throughout the Hawaiian Island chain, including the Northwestern Hawaiian Islands, thanks to direct conservation efforts. Toxoplasmosis is lethal to this endangered species, which is already under pressure from climate change, lack of prey and pollution, particularly <a href="https://www.sharecare.com/health/health-society/slideshow/what-know-ocean-trash-hawaii">ocean trash</a>.

&ldquo;We are certain that we have had at least 11 monk seals die from toxoplasmosis. And that is a very conservative number,&rdquo; says Dr. Barbieri. That&rsquo;s about 0.8 percent of the entire population. Since monk seals are wild animals, it&rsquo;s impossible to know exactly how many become infected and die from toxoplasmosis since it could happen at sea and their bodies may never wash up on shore. The true number could be far higher.

&ldquo;The risk to monk seals is much bigger than just a cat being on the beach,&rdquo; says Barbieri. &ldquo;It is the risk of that pathogen being flushed from anywhere land to sea, and we probably have that happening pretty much circumferentially around the islands.&rdquo;

Cat scratch disease is also a problem 
Cat scratch disease (CSD) is another infection linked with free-roaming cats, particularly kittens, Park cautions. Cats may carry fleas that are infected with a type of bacteria, called Bartonella henselae. People, especially kids under 15 years old, who handle cats with fleas that carry the Bartonella bacteria can become infected. The germs can spread when an infected cat bites or scratches a person breaking their skin or if it licks a scab or open wound.

Symptoms of cat scratch disease include:

<ul>
	<li>Low-grade fever</li>
	<li>Papule (lump) or pustule (pimple) at infection site</li>
	<li>Tender, sore lymph nodes one to three weeks after exposure</li>
</ul>

Like toxoplasmosis, most cases of CSD in healthy people will resolve on their own without treatment. As Park says, &ldquo;you can use antibiotics, but it may not go away immediately.&rdquo; Rarely, complications may arise from CSD in young children and those with a weakened immune system.

Preventing the spread of cat-related illness 
By far, the best way of preventing cat-related diseases is to keep cats indoors. &ldquo;Keeping cats indoors is better for wildlife, humans and the cats themselves,&rdquo; says Barbieri. Indoor cats are less likely to be exposed to toxoplasmosis or get fleas that carry Bartonella. They also live longer than outdoor cats.

Anyone who is pregnant or at risk for toxoplasmosis due to a weakened immune system should avoid cleaning litter boxes or handling cat feces in any way. Additionally, gardening in areas where cats are or may have been present increases the risk for the infection. Be sure to fully cook meat before eating and wash any products or utensils such as counters or cutting boards that have come in contact with raw meat with warm, soapy water. Wear gloves and thoroughly wash your hands with soap and water for at least 20 seconds after gardening or handling raw meat to prevent exposure to T. gondii. Do not pet or handle unfamiliar stray cats. This is particularly important for children who are more susceptible to CSD.

Unfortunately, feral cats usually can&rsquo;t be adopted, and there are simply too many of them to expect to find homes for all of them. To help reduce their numbers, there are several low-cost Trap-Neuter-Release-Monitor (TNRM) programs available. The Hawaiian Humane Society, HI CatFriends and Hawaii Cat Foundation all provide TNRM services. On Oahu alone, an estimated 6,000 cats are sterilized each year. Any cat with a notched ear has been spayed or neutered. Those numbers are promising, but so far, that&rsquo;s not enough to significantly curb the homeless cat population. In order to drastically reduce their population, &ldquo;you pretty much have to spay and neuter 80 to 90 percent of the cats that are available,&rdquo; says Barbieri.

If you are interested in helping the feral cat population, consider volunteering at a local animal or cat advocacy group, or donating to one of these organizations. Some of these groups include the <a href="https://www.hawaiianhumane.org/" target="_blank">Hawaiian Humane Society</a>, the <a href="https://www.oahuspca.org/" target="_blank">Oahu SPCA</a>, the <a href="http://www.mauihumanesociety.org/" target="_blank">Maui Humane Society</a>, the <a href="http://www.hihs.org/" target="_blank">Hawaii Island Humane Society</a>, the <a href="http://kauaihumane.org/" target="_blank">Kauai Humane Society</a>, the <a href="https://lanaicatsanctuary.org/" target="_blank">Lanai Cat Sanctuary</a>, <a href="http://www.hicatfriends.org/" target="_blank">HI CatFriends</a> and the <a href="https://www.hicat.org/" target="_blank">Hawaii Cat Foundation</a>.

Medically reviewed in April 2019.

Hawaii’s Feral Cats Could Harm Your Health

Along with backyard barbeques, picnics and humid hikes on summer days, come bug bites&mdash;lots of them. Some may simply go unnoticed while others are so itchy and swollen you may be willing to try an array of over-the-counter remedies, like hydrocortisone creams or oral antihistamines, to get some relief. Even annoying insect bites aren&rsquo;t usually cause for alarm, but some may require medical attention.

Even seemingly harmless bug bites can lead to complications. In other cases, insect bites and stings that aren&rsquo;t dangerous for some people could trigger allergic reactions in others. Meanwhile, certain insects could spread infections, such as Lyme disease, Zika virus or Rocky Mountain spotted fever (RMSF), in parts of the United States and other locations around the world.

So how do you know if your nagging bug bite is anything to be concerned about? The answer to that question depends on what bit you, how your body reacts to the bite and whether or not it becomes infected, according to Miriam Zylberglait, MD, an internist at&nbsp;<a href="https://www.sharecare.com/group/aventura-hospital-and-medical-center">Aventura Hospital and Medical Center</a>&nbsp;in Miami, Florida.

&ldquo;In general, bug bites are benign conditions,&rdquo; says Dr. Zylberglait. &ldquo;However, they may cause different types of complications, which could be as simple as a rash, but could also include more serious problems, like skin infections or allergic reactions.&rdquo;&nbsp;

What bit you? 
Some bugs are stealthy. You might not realize that you&rsquo;ve been bitten until it&rsquo;s too late. In some cases, you may not even be sure of what landed on your skin. Usually a bug bite or sting isn&rsquo;t cause for alarm, but there are certain situations that may require medical attention:

Ticks: If you find an engorged tick embedded in your skin, it has probably been there a while. Ticks don&rsquo;t start feeding for 24 hours or more after planting themselves on your skin and it usually takes around 36 to 48 hours of feeding for them to transmit certain diseases.&nbsp; &nbsp;

Not all ticks found in the United States carry pathogens, but some blacklegged ticks can transmit infections, such as Lyme disease and anaplasmosis. American dog ticks, Rocky Mountain wood ticks and brown dog ticks can spread Rocky Mountain spotted fever. Ticks that spread these diseases are typically found in certain parts of the United States, particularly the northeast or mid-Atlantic region, northern California and the north-central states (Minnesota, Wisconsin, and Michigan).

Most people with Lyme disease&mdash;roughly 70 to 80 percent&mdash;develop a bulls-eye rash, but not everyone will. Other signs of a tick-borne illness include:

<ul>
	<li>Chills</li>
	<li>Joint or muscle aches</li>
	<li>Swollen lymph nodes</li>
	<li>Nausea</li>
	<li>Vomiting</li>
	<li>Stomach pain</li>
	<li>Fever</li>
	<li>Red or purple-spotted rash</li>
	<li>Fatigue</li>
	<li>Headaches</li>
</ul>

If blood tests confirm that you have <a href="https://www.sharecare.com/health/lyme-disease/article/is-it-lyme-disease-something-else">Lyme disease</a>, the bacterial infection can be effectively treated with antibiotics.

&ldquo;Lyme disease symptoms may go beyond the typical rash and can also affect your joints and long-term heart health if not appropriately treated,&rdquo; says Zylberglait. Some of these longer-term issues could include muscle and joint pain, arthritis, memory problems and nerve damage depending on how far the disease has progressed.&nbsp;

In most cases, early treatment of Rocky Mountain spotted fever and anaplasmosis with antibiotics can reduce the risk of serious complications. If left untreated, both can be life-threatening.&nbsp;

Venomous spiders: Most <a href="https://www.sharecare.com/health/first-aid-safety-preparedness/article/what-to-do-if-you-have-a-spider-bite">spider bites</a> are harmless and only result in some redness, swelling or itchiness. Spider bites can often be treated by simply cleaning the area with mild soap and water and applying a doctor-prescribed antibiotic cream to prevent an infection. If you were bitten in the arm or leg, it might also be helpful to apply a cool, damp cloth to the area and keep it elevated. You may need antibiotics if the bite becomes infected (more on that later on).

Bites from black widow,&nbsp;brown recluse and other venomous spiders, however, can trigger more serious reactions. &nbsp;You may not always be able to see what bit you but if you do catch a glance, keep in mind that brown recluse spiders usually have a violin-shaped pattern on their body near their legs. Black widows have a large round body, with a red or orange hourglass marking on their under belly. See your doctor if you have:

<ul>
	<li>Pain and swelling that extends to your stomach, back or chest</li>
	<li>Stomach cramping</li>
	<li>Sweating or chills</li>
	<li>Nausea</li>
	<li>Body aches</li>
	<li>Dark blue or purple area towards the center of the bite that may turn into a large wound</li>
</ul>

If you&rsquo;ve been bitten by a black widow, and you&rsquo;re experiencing severe pain, your doctor may recommend an injection of antivenom&mdash;a medication that helps to stop the effects of the toxins that have entered your body. And in some cases, a brown recluse bite may cause an ulcer or lesion to form, which will require further medical treatment. It&rsquo;s also particularly important to see your doctor if you haven&rsquo;t had a tetanus booster within the past five years.

Mosquitos: Certain mosquitos can spread infections, including West Nile Virus, <a href="https://www.sharecare.com/health/zika-virus/article/what-men-should-know-about-zika">Zika virus</a>, dengue fever and malaria. These infections aren&rsquo;t as much of a concern in the United States as they are in other parts of the world, but they&rsquo;re not completely out of the question. In 2016 and 2017, there were major Zika virus outbreaks in states like Florida and Texas, so it&rsquo;s important to be aware of any reports of local transmission. However, if you&rsquo;ve recently traveled to Africa, Asia, South America, the South Pacific and any other high-risk regions, it&rsquo;s especially important to watch out for possible warning signs of mosquito-borne diseases, such as:

<ul>
	<li>Fever</li>
	<li>Joint pain</li>
	<li>Red-itchy eyes</li>
	<li>Aches and pain</li>
	<li>Nausea</li>
	<li>Rash</li>
</ul>

&ldquo;It&rsquo;s very important for you to communicate to your physician that you were in any of these areas recently so that they can think through the proper diagnosis,&rdquo; Zylberglait says.

There are not many specific treatment options for mosquito-borne illnesses but acetaminophen can help reduce your fever. Your doctor may also advise you to stay hydrated and rest as much as possible. Malaria requires specific drugs to kill the parasite, but treatment depends on which parasite is involved, as well as your age and symptoms. Treatment may also differ for women who are pregnant.

Although rare, some mosquito-borne diseases could lead to more serious problems. Some people with West Nile virus may develop meningitis or encephalitis (inflammation of the brain), which may require additional treatment and a hospital stay involving intravenous fluid treatment, breathing support or nursing care. Severe dengue fever could cause internal bleeding and other complications. See your doctor immediately if you develop:

<ul>
	<li>Stomach pain or tenderness</li>
	<li>Persistent vomiting</li>
	<li>Bleeding from nose or gums</li>
	<li>Restlessness or irritability</li>
	<li>Bloody stool or vomit</li>
</ul>

Recognizing allergic reactions 
Like peanuts, dust, pollen and other allergens, some people are allergic to specific bugs. Insects that can trigger allergic reactions include mosquitos, kissing bugs, bees, wasps and fire ants. A typical reaction for those who are not allergic may include pain, swelling and redness that&rsquo;s confined to the sting or bite area. But if you&rsquo;re having an allergic reaction, the symptoms may be more severe. Allergic reactions can cause:

<ul>
	<li>Hives, itching or swelling in areas beyond the sting site</li>
	<li>Abdominal cramping</li>
	<li>Vomiting, nausea or diarrhea</li>
	<li>Tightness in the chest or difficulty breathing</li>
	<li>Swelling of the tongue or throat</li>
	<li>Difficulty swallowing</li>
</ul>

In severe cases, insect bites can trigger a life-threatening allergic reaction, called anaphylaxis, an emergency that requires immediate medical attention and treatment with epinephrine, corticosteroids and antihistamines. Symptoms include dizziness, a sharp drop in blood pressure, loss of consciousness or cardiac arrest (sudden loss of heart function), usually within 5 to 30 minutes&mdash;sometimes up to an hour&mdash;of getting the bite.

&ldquo;While the bite might not look so dangerous and may be very benign for the majority of people, it could be very serious for you,&rdquo; says Zylberglait. &ldquo;If you recognize these symptoms, you should seek help immediately.&rdquo; And if you know you have allergies, make sure you have your injectable epinephrine pen with you at all times, so you can self-administer your medication that way.

Spot warning signs of infection 
Regardless of the insect, a bite or sting could become infected if you&rsquo;re scratching or picking at the area, because bacteria, such as streptococcus and staphylococcus epidermidis, are commonly found on the skin, Zylberglait explains. If left untreated, infected bug bites could lead to a deeper, more dangerous skin infection called cellulitis, which requires treatment with antibiotics. You should see your doctor as soon as possible if you have symptoms of cellulitis, such as:&nbsp;&nbsp;

<ul>
	<li>Fever</li>
	<li>Chills</li>
	<li>Swelling, redness or red streaking around the bite area</li>
	<li>Cold sweats</li>
	<li>Nausea</li>
	<li>Trouble concentrating</li>
	<li>Blisters, pus or drainage</li>
	<li>Swollen lymph nodes</li>
	<li>An area that&rsquo;s warm or painful to the touch</li>
</ul>

Prevention is best&nbsp; 
Avoid insect bites and stings with the help of protective clothing and repellents. It&rsquo;s also important to plan ahead when traveling and take extra precautions if you&rsquo;re traveling to areas where mosquito- and tick-borne diseases are common. In some cases, your doctor may suggest receiving certain preventive vaccines or medications in preparation for your trip, Zylberglait notes.

And if you&rsquo;ve had a previous allergic reaction to an insect bite, she adds, make sure you are familiar with any symptoms or red flags, in case it happens again.

Medically reviewed&nbsp;in June 2019.

Bug Bite Symptoms You Should Never Ignore

Making the decision to undergo hip or knee replacement surgery is a big deal. While you may be looking forward to the idea of being pain-free and moving around more easily, it&rsquo;s important to have a realistic outlook of the process.

Knowing what steps to take before the procedure&mdash;and what to expect after&mdash;can help ease any fears you may have about surgery and can help set you up for a successful recovery.

From operating room to recovery room 
A typical hip or <a href="https://www.sharecare.com/health/knee-replacement-surgery/article/know-before-you-go-knee-replacement">knee replacement surgery</a> usually takes a few hours. Once the procedure is complete, you&rsquo;ll be moved to a recovery room where you&rsquo;ll be monitored while you wake up from the anesthesia.

&ldquo;You can expect to be in the recovery room for a couple of hours, until the hospital staff determines you&rsquo;re stable enough to move to a regular hospital floor,&rdquo; says Ugo Ihekweazu, MD, an orthopedic surgeon at the <a href="https://www.sharecare.com/group/texas-orthopedic-hospital">Texas Orthopedic Hospital</a> in Houston.

What to expect during your hospital stay 
After the anesthesia wears off and you&rsquo;re settled into your regular hospital room, you&rsquo;ll likely feel tired. You may also start to feel pain, in which case the nurses will give you pain medication and ice for any swelling you&rsquo;re experiencing at the surgery site.

Despite the discomfort you may experience, a big emphasis is often placed on moving around as soon as you&rsquo;re able to tolerate it. &ldquo;In some cases, that means getting up and walking even a few hours after surgery,&rdquo; says Dr. Ihekweazu.&nbsp;

You&rsquo;ll likely meet with a physical therapist who can show you how to properly use a walker, crutches or other assistive devices you may use to help you get around.

&ldquo;Physical therapy is probably the most important thing that patients are doing at the hospital after the procedure,&rdquo; says Ihekweazu.

Your post-surgery hospital stay could range from one night to a few days, depending on the procedure. &ldquo;Recovery from hip and knee replacement surgery has improved considerably even over the last five to 10 years,&rdquo; says Ihekweazu. &ldquo;Historically patients would stay in a hospital for a week, maybe two. Now people have gone from staying in the hospital two to three days to an overnight stay. That&rsquo;s the standard of care over the last couple of years.&rdquo;

Shorter hospital stays are due in large part to improvements in surgical and anesthetic techniques, explains Ihekweazu. &ldquo;Surgeons are using more minimally-invasive techniques so there&rsquo;s less muscle damage, and patients are able to get up and walk pretty quickly after hip or knee surgery.&rdquo;

Discharge day 
The day after surgery, depending on how you&rsquo;re feeling, your doctor may start talking about whether you&rsquo;re ready to go home. But everybody is different&mdash;some people may feel eager to get home; others may not feel up to it right away.

&ldquo;No one will rush you out of the hospital before you&rsquo;re ready,&rdquo; says Ihekweazu. &ldquo;The key thing is safety. We want patients to go home when they&rsquo;re safe to do so.&rdquo;

Before you&rsquo;re cleared for discharge, your doctor may want to confirm your ability to successfully do certain tasks on your own, including:

<ul>
	<li>Getting in and out of bed</li>
	<li>Walking with the use of a walker or crutches, and climbing a few stairs</li>
	<li>Eating, drinking and using the bathroom</li>
	<li>Moving your joint, especially bending and straightening the knee after a knee replacement</li>
	<li>Performing any recommended home exercises</li>
	<li><a href="https://www.sharecare.com/health/bone-joint-injuries/article/proven-ways-control-pain-surgery">Managing pain</a> with the prescribed treatment plan</li>
</ul>

Once you&rsquo;re ready, and you&rsquo;ve been approved for discharge, you&rsquo;ll likely meet with a member of the hospital staff (often called a discharge planner) to go over any instructions you need to follow while recovering at home, including:

<ul>
	<li>How to properly clean and care for your surgical wound</li>
	<li>How to spot the warning signs of possible complications</li>
	<li>How to care for your new knee or hip</li>
</ul>

Creating an optimal post-surgery home environment 
Setting yourself up for success once you get home from the hospital requires putting in some legwork <a href="https://www.sharecare.com/health/bone-joint-muscle-health/slideshow/ways-prepare-joint-replacement-surgery">before your procedure</a>. A specialist at the hospital can also help you prepare for a successful transition back home.

One of the main components is making modifications around your home to ensure safety. An occupational therapist may even come to do a home evaluation. The Arthritis Foundation recommends:

<ul>
	<li>Eliminating clutter to make getting around easier and to reduce the risk of falls</li>
	<li>Elevating low furniture&mdash;like seats, beds and even toilets&mdash;to make getting up easier</li>
	<li>Installing a seat in the shower as well as grab bars</li>
	<li>Moving frequently-used items&mdash;like pots, pans and plates&mdash;to places where you can easily access them</li>
	<li>Strategizing ways to eliminate unnecessary trips up and down stairs&mdash;for example, if your bedroom is upstairs, creating a space for sleeping on the main floor</li>
</ul>

While assistive devices are also helpful after surgery, you may need to wait until after your procedure to see exactly what you&rsquo;ll need. That said, having certain items on hand right away can be useful, such as:

<ul>
	<li>Ice packs, to help soothe pain and inflammation at the surgical site</li>
	<li>Comfortable, loose clothing that&rsquo;s easy to get on and off and move around in</li>
	<li>Reachers and grabbers to help you get items stored up high and down low</li>
	<li>A walker basket, to help you move things around more easily</li>
	<li>A chair on wheels, to make it easier to get around when you&rsquo;re not up for walking</li>
	<li>Compression stockings or TED hose to help reduce the risk for blood clots</li>
</ul>

You may also want to take time before surgery to enlist friends and family. &ldquo;Any time you have a big operation, there&rsquo;s going to be a phase of uncertainty where you&rsquo;ve got to rely on other people,&rdquo; says Ihekweazu. &ldquo;If you&#39;re fortunate to have a big network of family and friends, I would activate them. I would ask them to come visit you in the hospital and at home and to go on those long walks with you after surgery that help with your rehab.&rdquo;

Ihekweazu adds that building that support system can play a big role in supporting your emotional health, as well.

Moving for a successful recovery 
If you&rsquo;ve had a <a href="https://www.sharecare.com/health/bone-joint-injuries/article/know-before-you-go-hip-replacement">hip replacement</a>, the best thing you can do once you&rsquo;re home is get up and walk, do stretching exercises and make sure you&rsquo;re moving every day, says Ihekweazu. &ldquo;For most hip patients, there&rsquo;s not really any expectation to do outpatient physical therapy,&rdquo; he notes.

The scenario is somewhat different if you&rsquo;ve had a knee replacement. &ldquo;Most surgeons would want their total knee replacement patients to be in some sort of outpatient physical therapy program as soon as they leave the hospital,&rdquo; says Ihekweazu.

The reasoning? According to Ihekweazu, surgeons may be concerned that certain patients don&rsquo;t sufficiently move their knees after surgery, creating the potential for stiffness that could persist for several months. Taking part in physical therapy can help you regain range of motion, strength and balance.

Remember that it&rsquo;s not uncommon to need help getting around at first. &ldquo;Most patients after hip and knee surgeries go home with a walker and use it for about two to four weeks after the procedure,&rdquo; says Ihekweazu. That can vary depending on how active you were prior to the surgery. &ldquo;The more active you were beforehand, the quicker you&rsquo;ll be able to get around without the walker.&rdquo; When you no longer need a walker, you may still benefit from using a cane for another few weeks to a month.

Just don&rsquo;t push it. &ldquo;The most important thing is to be safe,&rdquo; adds Ihekweazu. &ldquo;Don&rsquo;t try to rush yourself off of a cane or walker.&rdquo;

Regaining a sense of normalcy 
As the weeks go by during your recovery, you may start to wonder when you&rsquo;ll get back to your old life. According to Ihekweazu, it typically takes six to eight weeks post-surgery for most patients to feel pain-free, while it&rsquo;s not uncommon to take up to three to six months overall to start feeling normal again. Every patient is different, of course, and recovery times vary depending on your circumstances.

Check in with your doctor about any questions you may have, such as:

<ul>
	<li>When can I resume normal activities? &nbsp;</li>
	<li>When can I drive again?</li>
	<li>When can I return to work?</li>
	<li>When can I travel again?</li>
</ul>

&ldquo;Have a conversation with your doctor,&rdquo; says Ihekweazu, &ldquo;and go from there.&rdquo;

Medically reviewed in November 2018.

What to Expect After Joint Replacement Surgery

Learn why some people are more susceptible to mosquito bites.

4 Types of People Mosquitos Love to Bite

Biking is a great way to get around town and avoid traffic while getting a good workout. Thanks to biki, a bike sharing service, it&rsquo;s easy for anyone in Honolulu to ride around in style. This low-impact cardio activity can improve your aerobic abilities, but it&rsquo;s critical to stay safe while riding. Get ready for your next cycling adventure with these safety tips.

Wear a properly fitted helmet 
A helmet is absolutely crucial for a safe ride, no matter your age. In the City and County of Honolulu, it is illegal for anyone under the age of 16 to ride a bicycle without a helmet. Each brand of helmet will have different fit instructions and sizing, so be sure to read instructions carefully to find the one that works for you.

Check your bike 
Do the brakes work? Are the tires properly inflated? Do you have reflectors on the frame and wheels of your bicycle, as well as the pedals? Does the bike fit your height? These are all things to consider before your ride.

Be seen 
Most bike accidents happen at night, no matter what time of year. Try to plan any rides during the day. If you have to ride in the dark, be sure to wear reflective gear. Regardless of time of day, wearing bright clothing makes you visible to both cars and people. In the heat of the day, clothes made out of moisture wicking material will provide some relief from heat.

Plan your route 
Consider how many cars or pedestrians you may encounter on your route or if certain paths or streets will be very busy. Think about the terrain as well&mdash;will you encounter some gravel or dirt trials? If you&rsquo;re an inexperienced cyclist, try sticking to paved bike paths and lanes.

Be mindful of cars and pedestrians 
When riding on the road, cyclists should obey traffic laws as if they were a car. Use hand signals to alert drivers of turns. Watch out for parked vehicles too. Drivers may open doors without warning, which can knock an unsuspecting cyclist off their bike. Note that it is illegal to ride a bike on the sidewalk in business districts, such as Waikiki in the City and County of Honolulu. In areas where you can ride on sidewalks, cyclists should yield to pedestrians.

Limit distractions 
Don&rsquo;t ride with headphones in your ears or music blaring from your phone. If you need to take a phone call or send a text, stop cycling and move off of the road. Don&rsquo;t try to do either mid-ride. The more distractions you have, the greater your risk for a bike accident.

Use a bell or your voice 
Any cyclist should assume pedestrians do not see or hear them approaching, especially from behind. Attach a bell to your bike or use your voice to alert anyone that you are approaching. Indicate with your voice whether you are passing on the right or left.

Don&rsquo;t cycle under the influence 
Cycling after a few drinks is extremely dangerous. Call a friend or use a ride-sharing app to get a car home instead.

Before starting any new activity, be sure to speak to your doctor first. They can confirm you are healthy enough for exercise.

Medically reviewed in April 2020.

The Insider’s Guide to Healthy Hawaii: 8 Tips to Bike Ride Safely

While images of tornadoes may be beautiful in photographs, they can be deadly and wreak havoc on residential homes, businesses and natural habitats. Their strong gusts&mdash;which can reach up to 250 miles per hour&mdash;can tear the roofing off of houses, pavement off of the ground and flip cars and trains; they&rsquo;re often accompanied by lightning and hail; and they can last anywhere from a few seconds to a few hours.

Unfortunately, &ldquo;You can&#39;t outrun a tornado,&rdquo; says Matthew Carrick, MD, a trauma surgeon at <a href="https://www.sharecare.com/group/medical-city-plano">Medical City Plano</a> in Texas. But there are some ways you can prep and stay safe during these massive wind storms.&nbsp;

How to prepare for a tornado 
It&rsquo;s important to understand the difference between a tornado watch and a tornado warning. &ldquo;A tornado watch just means conditions are right for a tornado, so be careful,&rdquo; says Carrick. They often appear as a warning on your cell-phone or as a brief interruption while you&rsquo;re watching the news. Listen to see if the <a href="http://www.weather.gov/" target="_blank">National Oceanic and Atmospheric Administration</a> (NOAA) has any updates and make sure that you can get to shelter if needed.

A tornado warning, on the other hand, means that a tornado has actually been detected so you should seek shelter as soon as possible.

Here are a few steps to ensure your family is prepared for a tornado:

<ul>
	<li>Plan ahead and create a family plan for emergency situations. Include where you would go, what you would need and a list of emergency phone numbers.</li>
	<li>Pick a safe space in your house that offers the best protection for your family and pets. A basement, cellar or other lower-level room free of windows is your best bet. If your home doesn&rsquo;t have a basement, then a bathroom, closet, laundry room or pantry will work. Visit <a href="https://www.ready.gov/tornadoes" target="_blank">Ready.gov</a> for ways to build a safe room.</li>
	<li>Have an emergency supply kit on hand which includes emergency medications, water, food supplies and batteries for a battery-operated radio or TV. Your supply kit should also include <a href="https://www.sharecare.com/health/injuries-wound-trauma/slideshow/how-to-treat-common-injuries" target="_self">first-aid items, like Band-Aids</a>, in addition to helmets and hard-soled shoes for every family member.</li>
	<li>Know what a tornado looks and sounds like. &ldquo;The roar is similar to a freight train,&rdquo; says Carrick. Depending on your geographic location, the sky might have a greenish tint and there may be hail.</li>
	<li>If you live in a tornado warning area and you get an alert, make sure to get to your safe space until you&rsquo;re in the clear.</li>
</ul>

Get in, get down and cover up 
The most important tip for staying safe during a tornado is to get in, get down and cover up.

<ul>
	<li>Get in: Get inside and go to the center of your family&rsquo;s safe space. &ldquo;Get away from the windows. Go to the middle of the house, where&rsquo;s there&rsquo;s the most walls,&rdquo; suggests Carrick.</li>
	<li>Get down: Get down to the lowest level of your house. Some homes have built-in storm cellars depending on where you live geographically.</li>
	<li>Cover up: Use a blanket, a pillow or a mattress to cover yourself. If the room has a bathtub, get into it and place the mattress over your head. You can also go underneath a table or something sturdy to take cover. To keep your family safe, wear a helmet and strap your child into a car seat if you happen to have one close by.</li>
</ul>

If you live in a mobile home, there&rsquo;s only one thing you can really do: &ldquo;You need to leave that mobile home and seek shelter in a durable, solid building,&rdquo; says Carrick. Have a designated establishment picked out ahead of time. This is especially important if you live in an area which frequently has tornadoes.

What to do if you&rsquo;re not at home 
Tornadoes can form unexpectedly&mdash;and quickly&mdash;so knowing how to protect yourself and your family when you&rsquo;re outside the home is vital.

<ul>
	<li>In a public space. If you&rsquo;re at a place of worship, get to a center structural area. &ldquo;Try to get under the pews and get away from the windows,&rdquo; says Carrick. If you&rsquo;re out shopping, stay in the mall storage room or mall restroom while you wait. Again, go somewhere far away from where the windows might blow in and crouch down and cover your head.</li>
	<li>On the road. Most tornado related deaths happen from flying debris and falling trees. The safest place to be is in a shelter, so try to get to one if at all possible.</li>
</ul>

If you see a tornado or flying debris, pull over to the side of the road and park. Find a low-lying area away from trees. Contrary to what you might think, you want to be in an open area. &ldquo;Don&#39;t seek shelter under an overpass,&rdquo; says Carrick. Bridges and highway overpasses can be dangerous because they pick up the speed of wind. Keep your seatbelt fastened, duck your head below window level and cover yourself with a cushion or blanket if possible. &nbsp;If you have kids in the car, strap them into their car seat.

What to do post-twister 
&ldquo;If you&#39;re trapped in your house, don&#39;t try to do too much to get out,&rdquo; says Carrick. Instead, he suggests lightly tapping on some of the wood, or whatever is trapping you. That way, first responders will hear the tapping and locate you. Moving around broken pieces of wood or furniture could cause it to collapse on you. As long as you&rsquo;re not stuck, stay put.

&ldquo;If your house has been blown down and you&#39;re safe, you don&#39;t want to start searching through your house until one of the authorities has come and cleared it,&rdquo; says Carrick. Protruding electrical wires could be very dangerous.

Be careful and cognizant of your surroundings. If your home lost power as a result of the tornado, opt to use a flashlight rather than a candle. They&rsquo;re safer, especially if the conditions are still unknown. If you&rsquo;re not at home, only head back when authorities say it&rsquo;s safe to do so.

Tornado Preparedness: Your Guide to Staying Safe During a Tornado

Mention September 11 to most Hawaii residents, and the date will conjure a national tragedy. But to some, particularly on Kauai, that day is also set in memory for a different reason. It&rsquo;s when Iniki, the most destructive hurricane to strike Hawaii on record, made landfall in 1992. The storm killed at least six people, injured more than 1,000 and cost billions of dollars in damage.

In recent years, Hawaii has seen active hurricane seasons cause significant harm across the islands. While none made a direct hit, there were several close calls, along with tropical storms that did make landfall, causing flooding on Big Island, Maui and Kauai.

Hurricane preparedness is always important in Hawaii, and residents should take extra care as the Pacific Hurricane season arrives. The season begins May 15 in the Eastern Pacific and June 1 in the Central Pacific, peaks in late summer and runs through the end of November.

&quot;You will usually have plenty of notice when a hurricane may hit your area,&quot; says&nbsp;R. Preston&nbsp;Wendell, MD, FACEP, Medical Director for&nbsp;Trident Health Emergency Departments&nbsp;in Charleston, South Carolina. &quot;Take it seriously and be as prepared as you can be.&quot;

What makes a hurricane 
Hurricanes are exceptionally large storms that almost always form above water and can gradually make their way toward land. They commonly involve fast winds, lots of rain and rising tides, and may change speed or course over time.&nbsp;Hurricanes weaken once they hit land, but high winds, heavy rain and flooding can still wreak havoc in the days that follow.

The continental United States&rsquo; West Coast does not get hurricanes for two primary reasons. First, hurricanes that form in the northern hemisphere in the Pacific Ocean blow west or northwest, away from the mainland. Second, hurricanes are fueled by warm waters&mdash;and the cool waters along the Pacific coastline sap storms of their strength.

Hawaii, on the other hand, due to its ocean location, sees its fair share of tropical storms and hurricane near-misses, along with the occasional direct hit&mdash;like Hurricane Iniki.

If you hear there&#39;s a hurricane watch in Hawaii, it means a storm is possible within 48 hours. A hurricane warning means one will likely occur within 36 hours, in which case it&rsquo;s important to have a plan. The&nbsp;<a href="https://www.nhc.noaa.gov/?cpac" target="_blank">Central Pacific Hurricane Center</a>, under the National Oceanic and Atmospheric Administration (NOAA), gives current projected cyclone activity within 48 hours.

Hurricane winds are categorized on a 1 through 5 basis using the Saffir-Simpson Scale. A Category 1 hurricane indicates winds between 74 and 95 miles per hour (mph). Some damage can be expected, from snapped trees to power outages.

On the other end of the spectrum, a Category 5 hurricane means winds will be at least 157 mph, and damage will almost certainly be catastrophic, rendering affected areas uninhabitable for long periods of time. Hurricane Iniki was a Category 4 storm, with winds that hit 145 mph.

Devising your plan 
Long before you make preparations for any specific hurricane, you should take time to create an overall emergency plan with your family. Learn your evacuation route and designate a place to stay if it becomes too dangerous to shelter at home. Arrange how you&rsquo;ll communicate if there&rsquo;s a power outage and find out how to get alerts and updates&mdash;such as via social media or radio broadcasts&mdash;from local authorities. Make sure your whole family knows the plan.

Crucially, you should consider family members with different needs. &ldquo;If you are responsible for young children or an elderly parent, the situation can change from manageable and survivable to dangerous really quickly,&rdquo; says Dr. Wendell.

For seniors or people with health or mobility issues, be aware that extreme weather may worsen health conditions. You should anticipate an extended period of time during which you may not have access to regular care. If you or a loved one uses an electric medical device, call your fire department and electric company before a hurricane to alert them that you have it, and consult with the manufacturer to see if it can run on batteries or a generator. (Always check a device&#39;s settings before you begin using it again after a power outage.)

Make sure any designated shelter is able to accommodate your loved one&#39;s medical needs. If they are in a care facility, ask the managers about their hurricane policy. &quot;They may expect you to transport your family member,&quot; says Wendell. &quot;You need to know what their plan is and what they expect of you.&quot;

Plan for your pets, too. Keep dogs and cats close and make sure they&#39;re wearing tags or they&#39;re microchipped. Since certain evacuation centers won&#39;t allow animals, contact area shelters or your local department of animal control beforehand to ask about accommodations.

Whether you&#39;re staying or going, secure loose outdoor items like garbage cans and children&#39;s toys if you have time. You may also want to look into acquiring a generator in case you&#39;re without power for a long time. If it seems like you&#39;ll evacuate, the Centers for Disease Control and Prevention (CDC) advises you to shut off your main gas valve and main power switch.

What to have on hand 
Should you stay in place, it&#39;s best to have certain&nbsp;<a href="https://www.sharecare.com/health/emergency-preparedness/article/how-prepare-hurricane-tropical-storm">supplies</a>&nbsp;with you. These will sustain you and your family if you&#39;re homebound for a period of time or if certain utilities (such as electricity or water) or services (supermarkets or drugstores) aren&#39;t available. Key provisions to have on hand include:

<ul>
	<li>Water:&nbsp;The CDC recommends at least 5 gallons per person, which should last up to five days. Buy supplies, like iodine tablets, to help ensure the safety of your drinking water.</li>
	<li>Food:&nbsp;Non-perishable goods are ideal. Make sure they&#39;ll last up to five days. Don&rsquo;t forget baby formula if you have an infant.</li>
	<li>Medications:&nbsp;Keep your remaining supply in a watertight container.</li>
	<li>Personal items:&nbsp;These include soap, hand sanitizer, toothbrushes and toothpaste, baby wipes, diapers and tampons or pads.</li>
	<li>Safety supplies:&nbsp;Have a <a href="https://www.sharecare.com/health/first-aid-safety-preparedness/slideshow/first-aid-essentials-not-bandages">first aid kit</a>, face masks, radio, fire extinguisher, sleeping bags and at least one flashlight. Don&#39;t forget extra batteries. Make sure your carbon monoxide detector is working.</li>
	<li>Contact lists:&nbsp;Phone numbers and email addresses are key for reaching family, friends or help. Write them down or program them into your phone (which should be fully charged, of course).</li>
</ul>

If an evacuation is pending, you may want to have a go bag set with these items. Remember to fill your car with gas and be prepared to take off should an evacuation be called.

When to go 
If a hurricane is approaching, when should you stay home and when should you listen to officials and move to a safer area?

In short, &quot;If they recommend you should go, you should go,&quot; says Wendell.&nbsp;Don&#39;t ignore evacuation orders.&nbsp;Shut off your gas, electricity and water if there&#39;s time. Take essentials only&mdash;your phone, IDs, medications, money and go bag&mdash;and leave.

Officials may also tell you to wait it out at home, which can be safer in some circumstances. If that&#39;s the case, remain indoors during the hurricane and stay tuned to news reports.

When the hurricane&#39;s passed 
If you left town or were evacuated, you may be tempted to return home immediately after the storm is over, hoping to resume life as usual, but that might not be possible. &quot;You may think it&#39;s fine to go back,&quot; says Wendell. &quot;But trees could still fall, there may be debris everywhere, roads may be damaged and power lines may be out. It simply may not be safe to just drive up to your house and check on things.&quot;

Wait for authorities to give the go-ahead, and heed their instructions closely. Steer clear of wreckage and debris, avoid downed power lines and stay away from&nbsp;<a href="https://www.sharecare.com/health/first-aid-safety-preparedness/article/ways-stay-safe-during-flood">floodwater</a>, which may spread disease or carry hazardous chemicals. Even if it seems shallow, just a few inches of water can sweep you off your feet, and 12 inches can move a small car.

Once you&#39;ve arrived home, let your loved ones know you&#39;re safe and take photos of damage for insurance claims. &quot;Then you&#39;re going to want to check your gas line, your water,&quot; says Wendell. If there was a flood, throw out food that may have been contaminated and don&#39;t turn on dampened electrical devices. If you use a generator, be aware of the potential for carbon monoxide poisoning and keep it far from the house&mdash;at least 15 or 20 feet.

Finally, whether you remained home or evacuated, understand that services may take a while to start up again. &quot;Grocery stores are going to be down. Pharmacies are going to be down. Gas may be out,&quot; says Wendell. &quot;<a href="https://www.sharecare.com/health/managing-your-health-care/article/what-to-expect-in-the-er">Hospitals</a>&nbsp;are going to be extremely crowded because many doctors&rsquo; offices will be closed.&quot; Police and emergency medical services may be limited, too, he adds. Depending on the damage, it could be a long time before they&#39;re back up to speed.

In that case, says Wendell, &quot;Pay attention to what your local government is saying about what services are available, what services are closed and when closed services will reopen.&quot;

Guidelines like these&mdash;listening to officials, being cautious and preparing however you can&mdash;will help keep you safe through the next hurricane and the others to come.

Sources:

Centers for Disease Control and Prevention. &ldquo;Natural Disasters and Severe Weather: Preparing for a Hurricane or Other Tropical Storm.&rdquo; October 1, 2019. Accessed April 22, 2021. 
Centers for Disease Control and Prevention. &ldquo;Natural Disasters and Severe Weather: Stay Safe After a Hurricane or Other Tropical Storm.&rdquo; October 2, 2019. Accessed April 22, 2021. 
Centers for Disease Control and Prevention. &ldquo;Preparedness and Safety Messaging for Hurricanes, Floods, and Similar Disasters.&rdquo; June 2018. Accessed April 22, 2021. 
NASA.gov. &ldquo;What Are Hurricanes?&rdquo; September 3, 2014. Accessed April 22, 2021. 
National Ocean Service/National Oceanic and Atmospheric Administration. &ldquo;What is a hurricane?&rdquo; February 26, 2021. Accessed April 22, 2021. 
National Ocean Service/National Oceanic and Atmospheric Administration. &ldquo;What is the difference between a hurricane watch and a warning?&rdquo; February 26, 2021. Accessed April 22, 2021. 
National Hurricane Center and Central Pacific Hurricane Center. &ldquo;Saffir-Simpson Hurricane Wind Scale.&rdquo; 2021. Accessed April 22, 2021. 
National Oceanic and Atmospheric Administration. &ldquo;&lsquo;Average&rsquo; Atlantic hurricane season to reflect more storms.&rdquo; April 9, 2021. Accessed April 22, 2021. 
Centers for Disease Control and Prevention. &ldquo;Natural Disasters and Severe Weather: Reentering Your Flooded Home.&rdquo; July 6, 2020. Accessed April 22, 2021. 
National Weather Service/National Oceanic and Atmospheric Administration. &ldquo;During a Flood.&rdquo; 2021. Accessed April 22, 2021. 
Chris Dolce. &ldquo;The Four Category 5 U.S. Hurricane Landfalls Prove Why You Should Be Prepared Before Hurricane Season Begins.&rdquo; The Weather Channel. May 4, 2020. 
Office of Cybersecurity, Energy Security, and Emergency Response. &ldquo;Using Portable/Emergency Generators Safely.&rdquo; 2021. Accessed May 6, 2021. 
National Oceanic and Atmospheric Administration. &ldquo;Hurricane Iniki Assessment.&rdquo; September 1993. Accessed May 12, 2021. 
Chris Dolce. &ldquo;Eastern Pacific Hurricane Season Officially Begins This Weekend &ndash; Here&#39;s Why It Matters for the U.S.&rdquo; The Weather Channel. May 9, 2021. 
NASA.gov. &ldquo;Could a Hurricane Ever Strike Southern California?&rdquo; October 17, 2012. Accessed May 12, 2021. 
Scientific American. &ldquo;Why do hurricanes hit the East Coast of the U.S. but never the West Coast?&rdquo; October 21, 1999. 
Katy Galimberti. &ldquo;25 years later: Hurricane Iniki still one of Hawaii&#39;s most devastating storms.&rdquo; AccuWeather. July 1, 2019.

This Pacific Hurricane Season Could Be Bad—Prepare With These Expert Tips

Some bites and stings are harmless, others could send you to the emergency room.

Ouch, What Bit Me? 10 Common Bug Bites

If you take certain medicines, you may also want to take some extra precautions before heading out into the sun. That&rsquo;s because some drugs have the little known side effect of leaving you more prone to sunburn, and raising your risk of skin cancer. Since many of the medications are commonly used, and even potentially lifesaving, the solution isn&rsquo;t to stop taking them&mdash;it&rsquo;s to employ some common sense sun-protection measures to safeguard your skin.

The drugs in question include antibiotics, antidepressants and even pain relievers you&rsquo;d use for something as minor as a headache. &ldquo;These medicines contain ingredients that may cause photosensitivity, a chemically induced change in the skin that makes it unusually sensitive to sunlight,&rdquo; says Jill Stegall, a pharmacist at Trinity Health in Waterloo, Iowa.

Photosensitivy 101 
There are two forms of photosensitivity: photoallergy and phototoxcity. A photoallergy is an immune response that occurs after you&rsquo;ve used a medication repeated times. &ldquo;The sun&rsquo;s ultraviolet (UV) rays change the structure of the drug, so it&rsquo;s seen by the immune system as a foreign invader,&rdquo; explains Stegall. The allergic response&mdash;an itchy rash that can have red bumps, scaling, and oozing&mdash;usually develops one to three days after taking the drug. The outbreak can spread to all parts of the body, not just the areas that were exposed to sun.

Phototoxicity is more common and occurs when UV rays interact with your medication, causing exposed skin to burn more severely or more quickly than normal&mdash;sometimes within just a few minutes. &ldquo;Some of the phototoxic drugs are dose-dependent, so the higher the dose, the more likely you are to have a reaction,&rdquo; says Stegall.

Red alert/Burning issue 
It&rsquo;s easy to discount the dangers of a sunburn&mdash;after all, the pain, swelling and possibly even blistering usually go away in a few days. But don&rsquo;t underestimate their impact: Sunburns can do lasting damage to your skin, causing mutations in the DNA of sun-exposed cells that can develop into skin cancer.

At least one drug, the blood pressure medication hydrochlorothiazide, has even been directly linked with an increase in skin cancer as a result of its ability to enhance the harmful effects of sunlight. &ldquo;A recent study found the risk of developing nonmelanoma skin cancer (the less risky kind) was up to seven times greater in people who took the popular blood pressure drug for more than 10 years. Of course, heart attacks and strokes are far bigger killers than skin cancer, so it&rsquo;s important to continue taking all medications as prescribed&mdash;and improve your sun-protecting behavior at the same time.

Meds that don&rsquo;t mix well with the sun 
There are multiple classes of drugs that cause photosensitivity, and antibiotics are one of the &ldquo;worst offenders,&rdquo; reports Stegall. Here&rsquo;s a list of the meds she says are particularly problematic.

<ul>
	<li>Acne medications: sulfa drugs like sulfamethoxazole/trimethoprim (Bactrim, Septra), tetracyclines like doxycycline, minocycline and tetracycline</li>
	<li>Antibiotics: fluoroquinolones like ciprofloxacin (Cipro) and levofloxacin (Levaquin), sulfa drugs and tetracyclines</li>
	<li>Antidepressants: amitriptyline, St. John&rsquo;s wort</li>
	<li>Antifungals: voriconazole</li>
	<li>Antihistamines: cyproheptadine, diphenydramine (Benadryl), ranitidine, Claritin</li>
	<li>Antipsychotics: chlorpromazine</li>
	<li>Cholesterol-lowering drugs: statins like atorvastatin, provastatin and simvastatin</li>
	<li>Diuretics: furosemide (Lasix), hydrochlorothiazide</li>
	<li>Heart medications: amiodarone, a drug that regulates your heart rhythm. About 10 percent of people taking have a reaction to sun.</li>
	<li>Non-steroidal anti-inflammatory drugs (NSAIDs): ketoprofen, naproxen, piroxicam, ibuprofen</li>
	<li>Oral contraceptives and estrogens</li>
	<li>Seizure medications: lamotrigine, carbamazepine</li>
	<li>Type-2 diabetes medications: glipizide, glyburide</li>
</ul>

Prescription medicines that are most likely to be photosensitizing often come with a sun sticker, a yellow label bearing an icon of the sun with a slash through it, says Stegall. The fine print of the label reads that you should avoid prolonged or excessive exposure to sunlight while taking the drug. If you&rsquo;re not sure if the medications you take may make you more sun-sensitive, check with your doctor or pharmacist. Also keep in mind that any photosensitivity risk may still be present once you have stopped taking the medication.

Who&rsquo;s at risk 
There&rsquo;s no sure way to know if you&rsquo;re going to be one of the unlucky people who finds out the hard way that their meds don&rsquo;t mix with the sun. Everyone who takes a photosensitizing medicine won&rsquo;t have a reaction. Even if you have an instance of sun sensitivity, it doesn&rsquo;t mean you&rsquo;re guaranteed to have another if you continue using the drug.

While these types of reactions can happen to anyone, those who are already more sensitive to the sun&mdash;including fair-skinned people with light-colored eyes&mdash;are more prone to experiencing one.

Protect yourself 
If you take these medicines, it&rsquo;s crucial to be especially diligent about protecting yourself from UV exposure every day, year-round&mdash;not just when you&rsquo;re having fun in the sun. While you&rsquo;re likely to spend more time outside in the summer, many medications mainly react with UVA rays, which are present with relatively equal intensity during daylight hours throughout the year. And you don&rsquo;t have to be at the beach or the pool, or even outside, to experience a reaction. &ldquo;I&rsquo;ve even seen it happen to someone driving in a car,&rdquo; says Stegall. That&rsquo;s because the side and rear windows in a car aren&rsquo;t specially treated the same way the windshield is to prevent UVA rays from penetrating. Salon tanners should take note too. Exposure to the UVA light used in tanning beds can also trigger these reactions.

To keep from seeing red, heed this advice:

<ul>
	<li>Avoid prolonged exposure to sunlight, especially between the high-intensity hours of 10 a.m. and 2 p.m..</li>
	<li>Wear sun-protective clothing, including wide-brimmed hats, sunglasses and long-sleeved shirts and pants made of tightly woven fabric.</li>
	<li>Apply a broad-spectrum (meaning it protects against both UVA and UVB) of at least SPF 30 or higher sunscreen to all exposed skin every day. Be sure to reapply every two hours or more if you&rsquo;re swimming or sweating&mdash;even if you&rsquo;re using water-resistant sunscreen.</li>
</ul>

If you still experience a photosensitivity reaction despite taking these precautions, don&rsquo;t stop taking the drug without talking to your doctor first. &ldquo;Avoid any more sun exposure and consult with your doctor, who may reduce the dose or switch you to a different medication,&rdquo; says Stegall.

Are Your Meds Making You More Prone to Sunburn?

It&#39;s Saturday afternoon and your son has come down with a fever. Or maybe your husband sprained his ankle on a jog. Your doctor&#39;s office is closed until Monday and you&#39;re not sure the situation is serious enough for a trip to the emergency department. There&#39;s a third option: urgent care.

Urgent care centers treat a range of serious, but non-life-threatening health problems, like mild illnesses, minor fractures, strains, sprains and skin rashes.

&ldquo;They&rsquo;re typically available 365 days a year, on weekends and evenings,&rdquo; says Michael Kaplan, MD, a family medicine doctor from CareNow Urgent Care in Houston, Texas.

Urgent care facilities are ideal if your healthcare provider (HCP) or primary care physician&rsquo;s (PCP) office is closed or booked though the coming weeks or months, especially during the <a href="https://www.sharecare.com/covid19">COVID-19 pandemic</a>. The centers typically offer same-day treatment, accept most forms of insurance&mdash;although some don&rsquo;t take Medicaid&mdash;and don&rsquo;t require an appointment.

Where you go for care matters 
Illness and injury can happen without warning and leave us questioning where to go&mdash;especially if the problem seems severe. But not all health troubles need to be addressed in the ER.

Studies have shown that a significant proportion of ER visits can be treated in an urgent care setting, Dr. Kaplan explains. Relying on ERs in these situations can contribute to overcrowding, and people who need medical help most may not be able to get it. Visiting your local urgent care instead can lessen the burden on emergency workers&mdash;and help you access the appropriate treatment faster.

Services provided at urgent care centers can vary, Kaplan adds, but they normally include on-site X-rays, labs and occupational medicine, which is devoted to treating work-related injuries.

In many parts of the country, patients can visit urgent cares for flu shots and COVID-19 tests, as well. If you are being tested for or have <a href="https://www.sharecare.com/health/coronavirus/article/what-does-coronavirus-do-to-body">symptoms of COVID-19</a>, be sure to alert the staff. Remember to wear your mask to the appointment and follow all office safety and social distancing rules.

Urgent care centers can also treat:

<ul>
	<li>Fevers</li>
	<li><a href="https://www.sharecare.com/health/injuries-wound-trauma/slideshow/how-to-treat-common-injuries">Cuts that need stitches</a></li>
	<li>Dehydration, such as from food poisoning</li>
	<li><a href="https://www.sharecare.com/health/first-aid-safety-preparedness/slideshow/common-bug-bites">Bug bites</a></li>
	<li>Last-minute prescription refills</li>
	<li>Minor fractures, like fingers or toes</li>
	<li>Non-life-threatening infections like the flu, urinary tract infections and strep throat</li>
	<li>Mild to moderate asthma issues</li>
</ul>

Take note, too, that the price difference between a hospital trip and an urgent care trip can be staggering. &ldquo;The average urgent care visit costs about $150,&rdquo; says Kaplan. &ldquo;A typical ER visit starts close to $800 or more.&rdquo;

When urgent care isn&#39;t enough 
Don&rsquo;t be careless with your health in the name of time or money. In an emergency situation, your life is what matters most. Some illnesses or injuries can&#39;t be treated at urgent care.

&ldquo;Acute problems, such as heart attacks or severe abdominal pain&mdash;any life or limb-threatening conditions&mdash;need to be treated in an ER,&rdquo; Kaplan explains. Emergency room nurses prioritize the sickest patients first. If you&rsquo;re in a dire situation, they&rsquo;ll take you ahead of others whose problems might be less serious.

Life-threatening emergencies include injury or illness that could result in death, brain damage or organ failure, such as:

<ul>
	<li>Chest pain</li>
	<li>Shortness of breath, including heavy, rapid or irregular breathing</li>
	<li><a href="https://www.sharecare.com/health/stroke/article/what-you-need-know-about-stroke">Signs of a stroke</a>, like a sudden and severe headache, sudden weakness on one side, confusion, loss of balance or trouble speaking&nbsp;</li>
	<li>Loss of consciousness or head injuries</li>
	<li>Potential loss of limb</li>
	<li>Heavy bleeding</li>
	<li>Gunshot or knife wounds</li>
	<li>Seizures</li>
	<li>Second- or third-degree burns</li>
	<li>Fever in an infant under three months old</li>
</ul>

Anyone having <a href="https://www.sharecare.com/health/suicide-and-suicidal-behavior/article/how-to-help-someone-contemplating-suicide">suicidal thoughts</a> should be immediately evaluated in an emergency room, too. If you or <a href="https://www.sharecare.com/health/suicide-and-suicidal-behavior/article/risk-factors-for-suicide">someone else is at risk</a> but not actively planning to complete a suicide, call the National Suicide Prevention Hotline at 1-800-273-TALK or text NAMI to 741741&mdash;and encourage others to do the same.

Urgent care can&rsquo;t replace your HCP 
It&rsquo;s comforting to know urgent care can help in a pinch, but you should still keep routine appointments with your HCP. &ldquo;They offer preventive medicine services like <a href="https://www.sharecare.com/health/vaccines-and-immunizations/slideshow/essential-adult-vaccines">immunizations</a> and screenings,&rdquo; Kaplan explains. &ldquo;They also provide essential care and management for ongoing chronic diseases.&rdquo;

Your HCP keeps track of conditions, medications, tests and procedures over time, as well. They get to know you personally, including your body&rsquo;s unique quirks and special medical needs. This helps them advocate for you if you&rsquo;re sent to a new specialist, undergoing diagnostic tests or being hospitalized.

&ldquo;And, of course, they often can take care of urgent care-like visits,&rdquo; Kaplan adds. When you need help, it&rsquo;s worth giving your HCP a call; if they can&rsquo;t see you right away, they can at least help you determine if you should seek urgent care or visit the ER.

Sources:

MedlinePlus. &ldquo;When to use the emergency room &ndash; adult.&rdquo; Reviewed August 4, 2018. Accessed September 16, 2020. 
Cigna. &ldquo;Urgent Care vs. the Emergency Room.&rdquo; 2020. Accessed September 16, 2020. 
Centers for Disease Control and Prevention. &ldquo;Emergency Department Visits.&rdquo; Reviewed February 21, 2020. Accessed September 16, 2020. 
Mount Sinai. &ldquo;What is Urgent Care and When Should You Use It?&rdquo; 2020. Accessed September 16, 2020. 
N Caldwell, T Srebotnjak, et al. &quot;&rsquo;How much will I get charged for this?&rsquo; Patient charges for top ten diagnoses in the emergency department.&rdquo;&nbsp;PLoS One. 2013;8(2):e55491. 
Medline Plus. &ldquo;Stroke.&rdquo; Reviewed April 30, 2018. 
Mayo Clinic. &ldquo;Suicide: What to do when someone is suicidal.&rdquo; January 31, 2018. Accessed September 16, 2020. 
AdventistHealth. &ldquo;Navigating emergencies during a pandemic: Should I go to the ER or urgent care?&rdquo; April 20, 2020. Accessed September 22, 2020. 
PhysicianOne Urgent Care. &ldquo;COVID-19 FAQs &amp; Important Updates.&rdquo; 2020. Accessed September 22, 2020.

What You Should Know About Urgent Care—and When to Use It

It&rsquo;s Labor Day! One last hurrah of a holiday before autumn, last chance to wear white (or so grandmother says) and&mdash;the #1 holiday for the greatest number of injuries and trips to the ER&mdash;especially for children.

Follow these tips for a safe holiday weekend:

Biking

<ul>
	<li>More kids on bicycles over the last warm-weather holiday of the year plus more cars on the road equals a dangerous set-up for bicycle injuries.</li>
	<li>Keep your children safe by ALWAYS requiring that they wear helmets. In the ER I have truly seen helmets save lives. As kids grow so quickly, it can be tough to make sure the helmet continues to fit well. Every summer, recheck the helmet fit and replace if needed. A poorly fitting helmet will not protect a child&rsquo;s growing brain in case of an accident.</li>
	<li>If there&rsquo;s any chance that kids will be riding bikes when it&rsquo;s dusk or even late afternoon, make sure they wear bright-colored clothing and have appropriate lights and reflectors on their bikes.</li>
	<li>On the high-traffic days such as Labor Day, it&rsquo;s safest to keep kids from biking on driving roads altogether.</li>
</ul>

Driving

<ul>
	<li>Labor Day is one of the highest traffic weekends of the year and one of the deadliest ones as well&mdash;the National Safety Council (NSC) estimates that there will be nearly 400 traffic-related fatalities, with 42,300 people seeking medical care for accidents.</li>
	<li>Buckle up: the NSC also estimates that 144 lives may be saved this weekend because people wore their seatbelts.</li>
	<li>Create a &ldquo;distraction-free zone&rdquo; with no cell phones or other technology to grab the driver&rsquo;s attention when there are so many cars on the road.</li>
	<li>Allow plenty of extra travel time to account for traffic, weather -- and decrease the impulse to speed.</li>
	<li>If your car develops a problem (e.g. a flat tire) -- DO NOT just pull over on the side of a busy highway -- I have treated many people in the ER that were hit doing just this. Pull over in a rest area if you can, and if you must be on the side of the road, pull off the road entirely (into the grass, not just on the shoulder) and use flares.</li>
</ul>

With a little precaution, you can have a safe and happy Labor Day. Here&rsquo;s hoping for a great one for you and your family!&nbsp;

Labor Day: Tips to Stay Out of the ER

Common injuries aren&#39;t treated as they once were.

8 First Aid Mistakes

Carbon monoxide (CO), is the leading cause of poison-related deaths in the United States, responsible for more than 20,000 trips to the emergency room and 400 deaths each year.

Board-Certified Hyperbaric Medicine Specialist, <a href="https://www.sharecare.com/doctor/dr-william-clem">William B. Clem, MD</a> of <a href="https://pslmc.com/service/hyperbaric-medicine-carbon-monoxide-poisoning">Presbyterian/St. Luke&rsquo;s Medical Center</a> in Denver, Colorado shares the dangers of carbon monoxide poisoning, called the <a href="https://www.sharecare.com/health/carbon-monoxide-poisoning/what-is-carbon-monoxide">silent killer</a>, and tips for avoiding exposure.

Get the 4-1-1 on CO 
Carbon monoxide is a colorless, odorless gas, nearly impossible to detect by smell. The poisonous fumes are produced by anything that burns&mdash;oil, charcoal, gasoline, kerosene, propane or wood.

When you breathe it in, the gas has two toxic effects: It takes the place of oxygen in your bloodstream, and even more seriously, it acts as a direct toxin within cells, interrupting the cell&rsquo;s ability to use oxygen.

&ldquo;The carbon monoxide attaches itself to the hemoglobin in your blood, which prevents oxygen transportation to your body&rsquo;s essential organs,&rdquo; Dr. Clem says.

Your body&rsquo;s essential organs, like the brain and heart, need oxygen at all times to survive. At its most extreme, CO poisoning can lead to disability, permanently impaired mental ability, and even death.&nbsp; &nbsp;

While carbon monoxide poisoning can occur at any time of year, your risks increase during the winter months&mdash;December through February&mdash;when doors and windows are typically kept closed.

&ldquo;In the home environment, the most common causes of carbon monoxide poisoning are auto engines running in a closed garage, broken furnaces or the use of open heat sources, like using a grill indoors,&rdquo; Dr. Clem says. Other common sources include gas ranges, stoves, fireplaces and water heaters that use natural gas.

Nausea, headache and other common symptoms 
Early symptoms of carbon monoxide poisoning are easily confuse with the flu, which can makes it difficult to interpret the gravity of the illness. &ldquo;The most common symptoms, those of nausea, headache, dizziness and vomiting, mimic <a href="https://www.sharecare.com/health/cold-and-flu/symptoms-of-influenza">common flu symptoms</a>,&rdquo; Dr. Clem says.

CO poisoning can also cause confusion, fatigue, irritability and muscle weakness. The level of exposure&mdash;the amount of carbon monoxide and the amount of time exposed to the gas&mdash;determines the severity of the symptoms.

High levels of carbon monoxide exposure, or exposure that lasts for a long period of time, may result in fainting, loss of consciousness, seizures, coma or even death. Infants and the elderly may be at a higher risk of CO poisoning, as are people with lung and heart disease and smokers.

Learn to treat CO poisoning 
Knowing the signs of carbon monoxide poisoning is the first step to getting quick and effective treatment. If you believe someone has been exposed to the gas, immediately move the person to fresh air and contact emergency assistance.

&ldquo;Oxygen, in one form or another, is the only known treatment for carbon monoxide poisoning,&rdquo; Dr. Clem says, and quick treatment is important to minimizing permanent damage.

<a href="https://www.sharecare.com/health/managing-your-health-care/article/what-to-expect-in-the-er">Once in the Emergency Department</a>, oxygen may be restored through a face mask, intubation (breathing tube through the mouth) or a ventilator (breathing machine). Hyperbaric oxygen treatment, where high-pressure oxygen is administered in a special chamber, is reserved for only the most serious cases.

Symptoms should dissipate with oxygen treatment, but not everyone is in the clear after this period. Symptoms like memory and concentration problems that don&rsquo;t go away after about two weeks may be permanent, and symptoms can return a week or two after they seem to stop.

About 10 to 32 percent of those recovering from CO poisoning may suffer from delayed neurological problems, including personality changes, incontinence, psychosis and Parkinsonism. Fortunately, up to 75 percent fully recover within a year.

How to prevent exposure 
Keep your family safe this winter with these expert-approved tips:

<ul>
	<li>Install a CO detector in your home, ideally near each bedroom so you&rsquo;ll hear the alarm if it sounds.</li>
	<li>Make sure gas-, oil- and coal-burning appliances are maintained. Have them checked by a qualified technician on a yearly basis.</li>
	<li>Don&rsquo;t run your car in a closed garage, even with the door open. Especially if the garage is attached to the house.</li>
	<li>Use your grill outside only.</li>
	<li>Never use a generator or gasoline-powered tools indoors or in the garage.</li>
	<li>Ensure fuel-burning appliances are well-ventilated.</li>
	<li>Never use a gas range or oven for heating.</li>
</ul>

First Aid and Safety