5 Things That Can Go Wrong When You’re Day-Drinking

Photographed by Lauren Perlstein.
This story originally published on May 12, 2016.

Independence Day is coming up, which means the official season for pool parties, beach days, boozy picnics, and the like, is upon us. And with it comes sunburns and other more serious heat-related illnesses, unfortunately. Although these things can happen to anyone spending too much time in the heat, you're even more susceptible to them when you're day-drinking. "When alcohol is involved, all of these environmental illnesses get worse," says Christopher Tedeschi, MD, a professor of emergency medicine at Columbia University Medical Center. "Drinking alcohol takes your mind off what the environment is really like, but it also reduces the amount of perspiration you’re able to do. And perspiration is the way you cool yourself." That's no reason to outright avoid your fair share of fun, boozy summer outings, however. Instead, drinking responsibly (of course), keeping an eye out for these sun-related illnesses, and knowing when to get real medical help are the keys to having your fun and staying safe, Dr. Tedeschi advises. "We also know we can acclimate to the heat, so try taking it easy at the beginning of your Cabo vacation." After a few days, you'll be able to withstand some extra sun. Ahead, we go over some of the more common heat- and sun-related illnesses you should watch out for as we head into spring and summer.
When it comes to day-drinking, dehydration is probably the biggest thing to watch out for. Alcohol is a diuretic, which means it makes you pee enough to affect your fluid balance. When you add sweating to that equation, dehydration really can sneak up on you, causing dizziness, headache, and a bigger risk for overheating. This means, if you're hanging out in the park all day, it's really important to hydrate with something other than alcohol. Make it a goal to alternate grabbing a beer with grabbing a bottled water. (Bonus: You will thank yourself for doing this later when you're less hungover.)
There's a very easy way to tell if you're hydrated enough, Dr. Tedeschi says: how much you're peeing. If you haven't made a bathroom trip all day, or if your urine is really dark when you do go, it's definitely time to give the mojitos a break and grab some water. And if you notice a friend hasn't been drinking enough H20, don't hesitate to go into Mom Mode and encourage them to down a bottle of water.

When alcohol is involved, all of these environmental illnesses get worse.

Dr. Christopher Tedeschi

Heat Exhaustion
"Heat exhaustion" happens when — you guessed it — you've been exposed to a lot of heat, and it causes a wide variety of symptoms, Dr. Tedeschi says. Your actual body temperature will usually still be normal, but you might experience cramps, swelling in your legs, weakness, or even heat syncope (fainting). This can happen any time you're spending a lot of time outside during the summer, but it becomes more likely if you're drinking because people often forget to hydrate properly, and you just might not realize how hot you are until you're not feeling well. If you or a friend starts to feel any weirdness like this, sitting or lying down in a cooler environment out of the sun is super important because your symptoms will only get worse if you don't. Then, rehydrate with cold water or a sports drink. If you don't recover within an hour, or you develop other more serious symptoms (like nausea or vomiting), it's time to get medical attention.
Heat exhaustion can turn into heatstroke, which is a serious medical emergency that can be fatal. Here, your body temperature will be really high (in the area of 103 or 104 degrees), but it's not due to a fever, explains Dr. Tedeschi. "Instead, your body has retained so much heat that it can't dissipate it fast enough," he says. Exposure to hot, humid temperatures is the main cause of heatstroke, but alcohol can make it more likely because it can affect your body's ability to regulate temperature. In addition to having an extremely high body temperature, signs of heatstroke include a rapid heart rate, throbbing headache, mental confusion, and shallow breathing. The longer you're overheated, the worse it gets, so calling 911 for heatstroke as quickly as possible is vital. Serious? Yes. Avoidable? Also yes. "We don't want to see any young, healthy person have heatstroke because it’s almost entirely preventable," Dr. Tedeschi says. Staying cool, staying hydrated, wearing loose clothing, and knowing when to head inside for a break are all things that can help prevent it.

We don't want to see any young, healthy person have heatstroke because it’s almost entirely preventable.

Dr. Christopher Tedeschi
You know you need to wear sunscreen, but after a cocktail or two, you forgot to reapply. And now you're home with a killer burn. We've all been there. The best thing to do to prevent this is doing whatever you have to do to remember to reapply. Put the sunscreen near the cooler or set a timer on your phone, if you must. The good news is most burns heal on their own, and there are things you can do to help with the discomfort. Dr. Tedeschi suggests a mild lotion and aloe, and staying away from anything that's greasy or thick enough to block your pores from sweating. Vaseline is a no-no here. Applying a cool compress can also help. The other thing you should know about sunburn is that when a larger area is burned, like your entire back, "it’s super painful and it reduces your ability to perspire," Dr. Tedeschi explains. "That makes you more at risk for heat exhaustion and stroke." So, if you get a really bad burn early in your Cabo vacation, you'll need to be extra vigilant about staying hydrated and in the shade for the rest of it. It's yet another reason to remember the sunscreen!
Sun Sensitivity
Finally, you should know about a few factors that make you more susceptible to all of the above medical issues. For example, "Lots of medications can make your body worse at dissipating heat," Dr. Tedeschi says. "Some of the most common are antihistamines [e.g., Benadryl] and antidepressants [e.g., Lexapro]." These drugs work by manipulating your body's cholinergic system, causing side effects, like dry mouth, for instance, and making it harder for you to cool yourself down. Other things can make your skin more sensitive. Some antibiotics can make you even more likely to burn, like tetracycline, for example. So, if you're prescribed one, Dr. Tedeschi says it's best to ask your doctor whether it will affect you in that way. Oh, and take extra care if you'll be sipping margaritas. Both lime and lemon juice can cause a chemical reaction on your skin, making you more vulnerable to UV rays, says Dr. Tedeschi. This is also called "margarita dermatitis," and it can cause serious burns in some cases, so if you spill, be sure to rinse off and reapply sunscreen.

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