Until the temps drop back into the 80s (and how strange does that sound?), coping with our extended heat wave becomes more of a task each day. An internist in Tinton Falls tells us that there are some recognizable warning signs of heat stress.

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Dr. Dmitri Cefalu is an internist who tends retirees at Seabrook Village in Tinton Falls. Age, he says, gradually factors into our reactions to extreme weather. But in this kind of heat, certain symptoms are easy to spot.

Dr. Cefalu suggests keeping an eye out for "dizziness, lightheadedness, headache, fatigue, decreased appetite. One of the most telling symptoms is a decrease in the amount of urination. All signs that you may be getting dehydrated or have heat stroke."

At the Ocean County Health Department, spokesperson Leslie Terjesen concurs, and points out some common-sense preventive steps.

"Don't rely on your fan as your primary cooling device during extreme heat," she cautions. "When it's over 90 degrees, a fan just circulates hot air. Drink more water than usual and don't wait 'til you're thirsty. Drink at least two cups of water per hour."

If your medical condition allows, says Dr. Cefalu, it's useful to add a pinch of salt to your cooking. "As you get overheated and perspire, you tend to lose electrolytes. And salt is one of the major components of that. Replacing fluids, though, is the priority."

Leslie and Dr. Cefalu agree that this type of heat is an ideal time to show your neighborly side and check on elderly, homebound or disabled folks who may be struggling.

If you're aging, the doctor says, a lifeline-type network may mean the difference between life and death. "Calling for help, either with a relative or speaking with your physician, are things you might want to consider under those circumstances."

Leslie says that if the beach is just too hot to handle, there are plenty of cooler options around Ocean County. "All 21 branches of the Ocean County Library are air-conditioned," she says. "You can go to a supermarket. You can go to the movies. The Ocean County Mall is open from 10 'til 10 Saturday. It's extremely important to stay cool."

Dr. Cefalu adds that a little common-sense preparation can avert heat-related health issues later. "Try to do strenuous outdoor activity in the early morning or late evening," he recommends. "Drink plenty of fluids while you're doing them. If you're not acclimated to such heat, you'd be surprised how much you have to drink to keep up with your losses."

Nausea, fatigue, headaches, profuse sweating are typical signs of the onset of heat exhaustion. Ignoring them is to invite heat stroke, where the risks are higher - in fact, says Leslie, as high as they get.

"You could die," she states flatly. "When a body is unable to control its temperature, a person develops heat stroke. Your body temperature is usually higher than 103. A person has red, hot and dry skin, a person just can't sweat. A person's pulse might be very fast. A throbbing headache, dizziness, nausea, confusion, unconsciousness."

If you encounter someone with such symptoms, she continues, it's time for an immediate call to 911. "And while you're waiting, try to cool the person by moving them to shade, sponging them with cool water. If you have a hose nearby, put some cold water on the body. Try to get them to cool down as soon as possible."

Hot, windless, humid days also pose problems for people with breathing difficulties, says Dr. Cefalu. "People who have asthma or lung disease sometimes have issues with breathing as well with strenuous outdoor activity. That further complicates the effects of the heat."

The Ocean County Health Department keeps detailed information about symptoms, treatments and prevention on its web page, http://www.ochd.org.

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