Advice on how to have healthy, safe summer

Being outdoors and active seem to be the hallmarks of a fun summer. But it’s only fun until someone gets (insert your common summer ailment here).

To help keep the fun going all summer long, find out ways to prevent and treat more than 12 common summer ailments, with advice from some local physicians and the Centers for Disease Control and Prevention.

Swimmer’s ear

What it is: An infection of the ear canal caused when water remains in your ear after swimming or showering and the moist environment allows bacterial overgrowth. Aggressive cleaning with a cotton swab can cause skin erosion and increase chances of swimmer’s ear.

Symptoms: Ear pain, especially if the ear is moved or gently pulled; mild hearing loss; and drainage from the ear canal.

Prevention: Keep ears dry and don’t stick things in your ears, including cotton swabs. Dry ears after swimming or showing. Use pliable ear plugs during water activity or use over-the-counter ear drops with acetic acid before and especially after water exposure.

Home treatment: Over-the-counter acetic acid drops help dry out the ear and alter the pH so bacteria and fungus can’t grow. Avoid contact with water until symptoms are significantly better.

When to call the doctor: When there is fever, symptoms lasting longer than three days or if the outer ear and surrounding skin become red or swollen.

Stomach flu/viral gastroenteritis

What it is: Although it’s often called stomach flu, it’s not caused by the influenza virus. It’s a viral inflammation of the stomach and small and large intestines.

Symptoms: Starts as 24-48 hours of nausea and frequent vomiting, followed with watery to loose diarrhea for up to two weeks. There may be fever and headaches.

Prevention: It’s contagious, so practice good hand washing and be sure to avoid touching your eyes or mouth after touching public surfaces.

Home treatment: It’s important to stay hydrated with fluid and electrolytes. Even popsicles count as fluid. When returning to solid foods, stick to bland foods like bread, crackers, bananas, applesauce, rice and chicken broth. Avoid foods that are spicy, greasy or sugary and food and drinks with caffeine, alcohol or milk. Do not take over-the-counter anti-diarrhea medicines, as these can make your illness even worse.

When to call the doctor: If you are not able to urinate at least two to three times in a 24-hour period, which is a sign of severe dehydration. If you have excessive vomiting or notice blood in your vomit or diarrhea, call your doctor or go to the emergency room.

Car sickness or motion sickness

What it is: That queasy feeling you get when riding in a car, being on a boat or being on an amusement ride, because there are mixed signals being sent to the brain by the eyes, which are visualizing the motion, and your inner ear, which is sensing the motion.

Symptoms: A queasy feeling that progresses to dizziness, nausea, vomiting, headache, irritability, tiredness.

Prevention: Some people tend to be more prone to motion sickness than others. Prevention works significantly better than treating once symptoms have already started. Talk to your doctor about a prescription for scopolamine patches that can be worn several days or take over-the-counter Dramamine an hour before the car ride. In a car, sometimes riding closer to the front of the vehicle can reduce symptoms, but age and weight requirements for children should be strictly followed. Children 12 or younger should never sit in the front seat of a car.

Home treatment: Take a break from the motion. Increase the flow of cool air across the affected person’s face and drink cold water. Dramamine not only prevents but can treat motion sickness, but don’t use if planning to operate heavy machinery or to drive. Ginger is still being studied as a nausea aid, but many people report a perceived reduction in symptoms. Avoid greasy, spicy and fatty foods and carbonated drinks such as sodas, as these can increase stomach irritation.

When to call the doctor: Any time vomiting, nausea or dizziness last longer than 24 hours after the motion source has stopped. Fatigue and moodiness can linger up to three days. If the sensation of moving when you are stationary lasts longer than three days, your body’s balance centers may not be functioning correctly, so seek medical attention.

Recreational water illnesses

What it is: A variety of illnesses caused by coming in contact with contaminated bodies of water, including pools and hot tubs. Can range from gastrointestinal to skin to eye conditions.

Prevention: Avoid getting water in your mouth while swimming. Shower with soap before going swimming to keep germs on your body from ending up in the water. Don’t go swimming if you have diarrhea. Check diapers frequently and don’t change them poolside. Take kids on hourly bathroom breaks and wash hands after using the bathroom. Maintain proper chlorine, pH levels and disinfectant levels in home pools and hot tubs.

Symptoms: Diarrhea is one of the most common. Other illnesses include swimmer’s ear, swimmer’s itch with the symptoms of irritated skin, small red bumps or blisters.

Home treatment: See treatments for gastroenteritis and swimmer’s ear. For skin conditions, avoid scratching and use an anti-itch cream.

When to call the doctor: See gastroenteritis and swimmer’s ear; if rash is not clearing up with home treatment.

Food poisoning

What it is: Illness caused by bacteria or their toxins in foods.

Symptoms: Usually start 24 hours after exposure to contaminated food with intense onset of vomiting, diarrhea and abdominal cramping. Mild illnesses usually last about 24 hours and do not produce a fever.

Prevention: Avoid foods containing eggs, unpasteurized milk, cheese or juice, deli meats and seafood that have been sitting out unrefrigerated for prolonged periods of time. Be especially careful during outdoor dining. Take perishable foods home immediately when grocery shopping in the summer. At the store, bag uncooked meats separately in plastic to prevent cross-contamination. Wash fruits and vegetables thoroughly. If eating home-canned items, make sure the seal is not compromised before opening and serving. Also, do not drink from streams, lakes or other open water sources that have not be sanitized.

Home treatment: See recommendations for gastroenteritis.

When to call the doctor: A fever greater than 101 degrees or blood in your stool. If you suspect the illness was caused by a meat dish. If you have very frequent episodes of diarrhea in a 24-hour period or watery diarrhea for more than three days, call your doctor or consider going to the ER.

Common colds

What it is: A viral upper respiratory infection. Sometimes hard to distinguish from seasonal allergies.

Symptoms: Runny nose, sore throat, cough, fatigue, fever, headache. Change from clear and colorless to cloudy or discolored mucus is an indication of a cold, rather than allergies.

Prevention: Practice good hand washing and avoid touching your face after touching public surfaces. Regular exercise and eating healthy can also boost the immune system to minimize the number of colds per year.

Home treatment: Rest, drink plenty of fluids; honey eaten from a spoon or mixed into a warm drink can help with cough, sore throat and boost the immune system. Saltwater gargles can help with sore throats. Sinus rinses can relieve congestion and sinus pressure. Acetaminophen or ibuprofen for fevers and headache. Over-the-counter cough and cold medicines are proven to be of limited help.

When to call the doctor: Fevers lasting longer than five days, runny noses and cough lasting longer than two weeks without any improvement.

Heat exhaustion/stroke

What it is: Both are heat-related illnesses that happen when exposed to high temperatures. Heat stroke is more severe than heat exhaustion and requires immediate medical attention.

Symptoms: Early signs of excessive heat exposure can include deep flushing, prickly heat rash, nausea, muscle cramping, headache, dizziness and fatigue. Heat stroke can happen quickly without sighs of heat exhaustion, with symptoms being more severe including confusion, hallucinations, vomiting and decreased or no sweating. Heat stroke tends to happen as a result of prolonged exposure to heat stress.

Prevention: Avoid intense outdoor exercise when the temperature is greater than 100 degrees. Drink plenty of fluids; drink a mixture of both water and fluids that have some added sugar and salt. Avoid drinking excessive alcohol in hot environments; alcohol increases the risk for dehydration. Keep an eye on the elderly and small children, who can easily overheat. The elderly and those with mental impairment may have a hard time gauging body changes.

Home treatment: Remove any extra layers of clothing. If outdoors, move to shade or indoors. Elevate legs to increase circulation. Rehydrate immediately unless vomiting or disoriented. Cool compresses applied to the neck and face can also be helpful.

When to call the doctor: Seek medical care immediately for heat stroke. If any person who has been out in the heat is suddenly acting confused or is no longer able to sweat, call an ambulance immediately. While waiting for the ambulance, apply cold compresses to their armpits, groin and the top of the head.

Phytophotodermatitis

What it is: A burnlike condition that happens when chemicals from citrus fruits, particularly limes, and vegetables such as celery and the sun mix on your skin. The chemical is also found in plants such as wild parsley, wild dill, cow parsnip and buttercups.

Symptoms: Generally within 24-48 hours, redness and sometimes blisters develop, often in an unusual pattern because it happens only where the chemicals have come in contact with the skin. If caused by plant material flung from a weed eater, it may appear as red dots or bumps on the arms and chest. It may be painful. The redness quickly transitions to darkly colored, or hyper-pigmented, skin, which can last from months to years.

Prevention: Eat or handle citrus fruits and celery indoors and use soap and water to wash hands or other parts of skin that have come in contact with the food item before going outdoors. If handling these food outdoors, wear gloves for extra protection. Wear long pants and long sleeves when hiking.

When mowing lawns or using weed eater, wear gloves and long sleeves. Recognize and avoid common weeds that cause the condition; the flowering portions of most of these plants look like upside-down umbrellas. If you’ve come in contact with the plants, wash affected area with soap and water as soon as possible and avoid exposing skin to the sun.

Home treatment: Apply cool compresses to the affected area. Use over-the-counter analgesics such as acetaminophen. Hydrocortisone cream may also help.

When to call the doctor: If the eyes are affected, call right away; if the skin severely blisters or remains painful after at-home treatments.

Insect bites and stings

What it is: A wound caused by an insect. With increased exposure of skin and activity of insects during warmer weather, the chances of getting bites are greater.

Symptoms: Range from none to extreme itching and even blistering. Some insects carry illnesses that can manifest in a variety of symptoms, from fever, fatigue, weakness, stomach upset, etc.

Prevention: Protective clothing and insect repellants are key. According to the Centers for Disease Control and Prevention, DEET is the best repellant against mosquito bites and many other insects. Read and follow instructions when using insect repellants, particularly on small children. They can be toxic if ingested, so don’t put near mouth and eyes and wash hands after application. Other repellant options include permethrin (used only on clothing, lasts through several wash cycles), oil of lemon eucalyptus (not for use on children under 3), picaridin and IR3535. The CDC website has more information on which repellant is best for you and your circumstances.

Home treatment: Camphor and menthol, found in lotions such as Sarna, can be helpful for itching, as can pramoxine, a topical anesthetic. Cool compresses and hydrocortisone cream may also help.

When to call the doctor: Severe itch not responsive to over-the-counter medication; bites that become painful, have pus or otherwise look infected. Seek emergency attention in cases of difficulty breathing or when swelling of the lips, throat or tongue develops.

Sunburn

What it is: Skin condition caused by overexposure to the sun’s harmful ultraviolet rays.

Symptoms: Redness, pain, swelling and possibly blistering.

Prevention: Use sunscreen liberally at all times when outdoors. Most people apply less than half the optimal amount. Minimize sun exposure between 11 a.m. and 3 p.m., find shade and wear protective clothing as tolerated. Sunscreen should be reapplied every two hours when outdoors for extended periods of time or during water activities. Recently an oral supplement called Heliocare has been touted as possibly helping to prevent UV damage to the skin. It contains an antioxidant derived from ferns, but dermatologists recommend using other sun protection as well.

Home treatment: Cool compresses, calamine, aloe vera gel that’s been cooled in fridge, hydrocortisone cream and over-the-counter pain medications.

When to call the doctor: Extensive burn with blistering, fever and chills, significant pain or lack of improvement with at-home treatments. Also, seek emergency treatment with any symptoms of overheating such as heat cramps, typically in stomach, arms or legs, or heat exhaustion that doesn’t respond to treatment.

Poison ivy rash

What it is: Skin condition caused by an oil found in a poison ivy, poison oak or poison sumac plant. More than 70 percent of Americans are allergic to the oil.

Symptoms: Streaky, red, itchy rash on exposed areas of skin, often with swelling and blisters. With the first exposure, this can take up to three weeks, but with repeated exposures, it can occur in as little as hours after contact. If blisters are present, the fluid isn’t contagious and doesn’t cause the rash to spread. Rash typically lasts two to three weeks.

Prevention: Recognize poison ivy, oak and sumac. A common saying is “leaves of three, leave it be.” If present in your yard, get rid of it without allowing the plant to come into contact with your skin. If exposed, wash all affected areas of skin with soap and water immediately to prevent a reaction. Also wash clothing and pets that come into contact with the plant, as they can be a source of the allergic reaction.

Home treatment: Cool compresses, calamine, aloe vera gel cooled in fridge and over-the-counter hydrocortisone cream and pain medications.

When to call the doctor: Extensive rash area, extreme itch, areas that look infected.

Ankle sprains

What it is: A stretching, tearing or other damage of ligaments in the ankle, with a sudden shift in movement.

Symptoms: Can range from minor to severe. With a minor injury, ankle will feel tender, swollen and stiff, but walking is still possible. With a more serious injury, there will be bruising, more swelling, more tenderness and difficulty walking. With a severe injury that could include a fracture, there will be an obvious deformity.

Prevention: Don’t get too ambitious with summer activities and exercise beyond your norm. Slowly progress into more activity. Wear an ankle brace, particularly if you have a history of sprains. Stretch before doing more physical activities. Wear the appropriate shoes for your summer activity.

Home treatment: For up to 72 hours following a mild injury, use the RICE treatment: rest, icing for about 20 minutes every few hours, compression with an ACE bandage and elevate.

When to call the doctor: If you can’t put weight on your ankle, there is an obvious deformity, if there is tenderness over the ankle bone on both the inside and the outside of the foot and if there is difficulty walking. If there is pain after a couple days of home treatment.

Overuse injuries

What it is: Damage to bones, muscles, ligaments, tendons because of repetitive stress and activity. Often common in individuals training for marathons and kids involved in multiple sports concurrently.

Symptoms: Pain and tenderness in the affected area after activity.

Prevention: Slow progression into an activity, thorough warm-ups and stretching. Stay hydrated. Parents shouldn’t overbook kids into too many summer sports and should ensure coaches understand safe parameters of training for the respective sports, such as pitch counts. Runners should change shoes after 500 miles.

Home treatment: Use RICE treatment, take several days off and then ease back into an activity.

When to call the doctor: If pain persist after a few days of home treatment.

Sources: Amy Seery, pediatrician and faculty member of the Via Christi Family Medicine Residency Program; Mary Boyce, family medicine physician with Wesley Family Medicine Center; Kesha Buster, dermatologist with Via Christi Clinic; Shawn Morrow, orthopedic surgeon with Kansas Orthopaedic Center; Mark Stovak, medical director of Via Christi Sports Medicine; and the Centers for Disease Control and Prevention

This story was originally published May 17, 2014 at 3:22 PM with the headline "Advice on how to have healthy, safe summer."