How I Handle Extreme Heat Waves Living with Rheumatoid Arthritis

Summer is usually my favorite time of year. Not only do the sunny days, pool outings, and endless supply of seasonal fruits lift my spirits, but the warm weather does wonders for easing the pain caused by my rheumatoid arthritis (RA) and osteoarthritis (OA). In Vancouver, British Columbia, where I live, temperatures rarely rise above 30^oC (86^oF) very often or for that long, which is ideal for soothing my often achy joints.

But there are days when the heat is sweltering, the humidity is high, and I have to find relief — because even though a dry heat can help manage my RA symptoms, too much heat (particularly the wet kind) can intensify them.

Everyone with arthritis is different when it comes to how weather affects them. Some find summer to be the worst season; others say winter is the most unbearable. However, we need to take care of ourselves and stay safe when extreme heat warnings are issued.

Before I was diagnosed with rheumatoid arthritis, I didn’t really think about the way heat could impact my body and mind. During the summer, I could bounce between parties, festivals, and concerts, never feeling fatigued. I could wear flip flops every day, even though I knew they were horrible for my feet and knees. I could drink alcohol and only felt the effects if a drank a little too much.

But RA changed all of that that.

Now I have to spread out those activities or skip them all together because I know my body and mind can’t tolerate them. When I do participate in fun summer activities, I have to plan beforehand and pace myself throughout the day, unless I want to experience discomfort.

And this summer may be one of the toughest yet, as the heat seems to be especially brutal. According to Forbes, Lytton B.C. recorded temperatures of 49^oC (121^oF) on Tuesday, June 29, after record-breaking temperatures of 47.5^oC (117.5^oF) on Monday and 46.6^oC (115.8^oF) on Sunday. Over a four-day period, CNNreports that police in British Columbia responded to more than 230 sudden heat-related deaths. The temperatures were so high that schools were closed for a “sun day,” as they did not have adequate air conditioning to keep the students, teachers, and staff safe.

Exposure to high temperatures can be dangerous for anyone. But there are certain groups — the elderly, children, people who are pregnant, and people with certain chronic illnesses, like RA — who are at an increased risk.

Why Heat Waves Are Dangerous for People with Chronic Illness

According to the World Health Organization, “heat can cause severe dehydration, acute cerebrovascular accidents and contribute to thrombogenesis (blood clots). People with chronic diseases that take daily medications have a greater risk of complications and death during a heatwave, as do older people and children.”

The U.S. Centers for Disease Control and Prevention lists different kinds of medication that can increase the risk of heat-related illness, such as psychiatric medications (which include antidepressants and anti-anxiety drugs) and diuretics.

For arthritis symptoms, high temperatures and humidity can reduce the level or thickness of fluid around your joints, which can cause pain. Similarly, tendons, ligaments, and muscles can expand in humid weather, which puts more pressure on the joints.

I recently noticed firsthand how the heat is making my arthritis worse. I got my biologic infusion a few days before the heat wave broke out. I was expecting a decrease in my RA symptoms, as that’s what usually happens post-infusion. Instead, I experienced:

• Increase in fatigue
• Increase in cognitive dysfunction (brain fog)
• Increase in pain, inflammation, and stiffness
• Skin irritation from sweating
• Trouble sleeping
• Decrease in appetite
• Increase in irritability

And many inflammatory arthritis patients report feeling hot all the time to begin with. It is not uncommon for people with RA or other conditions to run a slight fever regularly or feel like they have one even if the thermometer says otherwise (even though doctors can’t explain why some arthritis patients experience this overheated feeling). This can make us even more uncomfortable and at-risk during heat waves.

How I Manage Heat Waves with Arthritis

Although the heat and humidity can take a toll on your arthritis, that doesn’t mean you have to stay inside all summer. Over the years, I’ve developed a few ways to keep my body cool and my symptoms at bay when the heat strikes.

Dress smart. I dress in light fabrics that won’t feel restrictive on my swelling joints — you’ll usually find me wearing a roomy sundress. I wear comfortable and supportive sneakers or sandals that let my feet breathe. I wear the largest wide-brimmed hat I can find to provide extra shade (and I make sure it’s  lightweight, so it doesn’t aggravate the osteoarthritis in my neck.)

Hydrate. Not only do I increase my water intake during the summer, but I limit my alcohol and caffeine consumption since they can dehydrate you even more. I also try to eat more fresh fruits and veggies and smoothies, which are naturally hydrating.

Eliminate extra sources of heat. Turn off lights, electronics, and appliances that make your rooms warmer. Additionally, try to avoid making meals that require a stove or oven, as those will heat up your home.

Do not exercise in the heat. Motion is lotion for the joints, but exercising in the heat is not safe. Opt for light, early morning exercises before the temperatures reach their peak, or exercise indoors in an air-conditioned room.

Plan your outdoor time. To avoid the strongest UV rays and highest temperatures, try to get outside before 10 a.m. and after 4 p.m.

Take breaks. If you’re going to be outside for a long time, find shady areas or nearby spots with air conditioning so you can cool off when things get too hot.

Circulate air. Have a fan or multiple to circulate air flow throughout your home.

Take cold showers.  Spending all day in a pool would be ideal, but it’s not an option for everyone. Instead, take short, cold showers throughout the day to cool off your body. Even dipping your feet into a tub of cold water can do wonders. Or play with a hose or in the sprinklers with your kids to cool off — my son loves to spray me.

Make your bed cool. Stick towels, pillowcases, or sheets in the freezer at the start of the day and take them out before going to bed. The instant cooling effect can help ease pain and make it easier to fall asleep. You can also stuff ice packs into your pillowcase.

Remember: Having arthritis means you need to be a little more prepared and cautious when hot weather arrives. Stay safe out there.

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