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home : columns : ask the doctors November 18, 2019

8/14/2019 7:43:00 AM
As temperatures rise, readers should head inside

Hello again, dear readers, and welcome to the oh-yes-it's-summer edition of our monthly letters column. To date, it seems no part of the nation has escaped the unique misery of a heat wave. Please be careful when temperatures spike, and take all local heat advisories seriously. It's easy to underestimate the effects of extreme heat and humidity and to overestimate our ability to withstand it.

Limit outdoor or strenuous activities, particularly during the peak hours of 10 a.m. to 4 p.m. Use air conditioners or fans if you have them; if not, take refuge in an air-conditioned mall or a cooling center. Drink plenty of water and avoid alcohol. Check in with children and the aged, who are particularly susceptible to heat exhaustion and heat stroke.

And now, your letters. We recently answered questions about a study that found the sustained scent of a tempting food had the unexpected effect of actually easing the craving for a snack. Several of you wrote to say you've experienced this phenomenon, including a reader from Grand Island, Nebraska. After two years of working in an ice cream shop, she developed an aversion to the sweet treats she was working with.

"Now, 40 years later, I finally like small servings of ice cream occasionally, but no gooey toppings -- ever!" she wrote. "I would joke that the perfect diet would require me to work full time for two years each for a bakery, a pizza parlor, a steakhouse, etc. Aversion therapy does work! Ice cream may not have much aroma, but the sensory overload did the trick!"

A column about the fairly new idea of creating an advanced care directive specific to a dementia diagnosis rang true for many of you, who said it prompted important conversations and even some decision-making.

We heard from a paramedic in Terre Haute, Indiana, who asked families and caregivers to honor the advanced care directives of their loved ones.

"Too many times I have been called on a respiratory/cardiac arrest, and when I ask if the patient has a DNR (do not resuscitate) or advanced directive, there is one person who says, 'Yes, she has a DNR, but I'm revoking it. Save her!'" he wrote. "I understand that sudden death can cause people to act contrary to people's wishes. However, if a person has taken the time to have their wishes properly documented, family members and caregivers need to understand that this is what the patient wants."

We continue to hear from older readers about their pets and the companionship, joy and sense of purpose they bring. An 87-year-old reader in Simi Valley, California, says her two small dogs get her out of the house for a walk several times a day. "The exercise keeps my legs moving so I don't end up in a wheelchair," she wrote.

Thank you, as ever, for taking the time to write to us. We look forward to hearing from you, and will see you back here next month.

Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.





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