Dehydration, Heat Exhaustion, and Heat Stroke

As we hit the Dog Days of Summer, it is so important to keep yourself current with ways to stay safe in the heat. Dehydration, Heat Exhaustion, and even Heat Stroke can happen quite easily when the temps soar, or when being active during summer months outdoors. Arm yourself with ways to protect yourself, and what the warning signs are, to make sure your “Fun in the Sun” remains just that.

Effects of Dehydration, Heat Exhaustion, and Heat Stroke!

Effects of Dehydration, Heat Exhaustion, and Heat Stroke!

One way to avoid these heat related maladies is to stay hydrated! The body’s weight is approximately 60% water, and when you become dehydrated, your body is not able to perform vital functions. The old “8 cups of water a day” recommendation is actually found to not be enough, especially if you are in intense heat or doing intense exercise. If you partake in intense exercise, particularly outdoors in the heat, also add sports drunks to your water intake to avoid sodium depletion. Aside from staying hydrated, avoid the hottest time of the middle of the day, wear appropriate clothing, try to stay in the shade, and use all proper sun protection precautions (see our blog on Sun Safety, too!).

If you think you may be experiencing or witnessing a heat related medical situation, look for these symptoms:


– Dark colored urine, or no urination at all.

– Listlessness, Dizziness,  Irritability, Confusion

-Sunken Eyes

-Dry, shriveled skin

-Rapid heartbeat and breathing

Heat Exhaustion:

-Fatigue, Nausea, Headache

-Excessive Thirst

-Slowed heartbeat

-Dizziness, Fainting, Agitation, Weakness

-Muscle Aches and Cramps

-Profuse sweating and cold/clammy skin

Heat Stroke:

-Nausea, Vomiting, Headaches

-Dizziness, Fatigue, Confusion, and even Loss of Consciousness

-Flushed, Hot, Dry skin (Decreased or no sweating /urination)


-Rapid heartbeat

-Heightened body temp (104 F to 106 F)

-Blood in Urine or Stool

If you witness any of these symptoms, seek medical attention! The effects can be fatal. You do not necessarily have to experience Heat Exhaustion before you reach Heat Stroke, and this can happen suddenly. If you are a member of VIP Medical Services, feel free to call Dr. Holt with your symptoms, and he will be happy to advise your next course of action. If you are looking for a new Primary Care Provider, consider making VIP Medical Services your healthcare home! 417-485-4847

Bee Stings and Spider Bites

One of the more feared parts of spending time outdoors as the weather turns warmer are the bites and stings offered by spiders and bees/wasps.  While most of these bites and stings are harmless albeit uncomfortable, it is important to know how to treat them to aid healing and limit discomfort, as well as what symptoms warrant higher care.  We also want you to know some tips for avoiding spider bites and bee stings, and how to detect which bugs are most dangerous.

Yellow Jacket

It is important to note that bee stings can be deadly, depending on whether you are allergic to the stings.  If you find yourself with a sting, it is always a good idea to let someone else know that you have been stung, just in case you have an adverse reaction.  Luckily, for the most part, stings can be avoidable.  When trying to avoid bee/wasp/yellow jacket stings:

  • Avoid wearing strong fragrances or highly scented beauty products, and avoid wearing brightly colored clothing.  Anything that is flower-like such as scent or color will attract them to you.
  • Wear shoes, many stings happen on the ground.
  • Be mindful about what food and beverages you keep outdoors with you, especially at outdoor cookouts and parties. Bees are drawn to sweet beverages and foods, and will put you at a higher risk of stings.
  • If a bee does come near you, try not to swat or make sudden movements.  Be as still as possible until it has passed.  Bees act in defense, so coming too close to a nest or swatting will trigger a defensive sting.

When attempting to avoid spider bites:

  • Use insecticide
  • Avoid wood and rock piles and/or dark, warm, places spiders are likely to populate
  • Be aware of webs, especially low-lying ones that may not catch your eye
  • When inside, shake out bedding or clothing before using, and move beds away from walls
  • Plug or seal any openings to the outdoors
  • Consider having certain areas of home sprayed if prevalent with spiders
Black Widow Female

Black Widow Female


The two most harmful spiders to make yourself familiar with are the Black Widow, and the Brown Recluse.  Both spiders can be found in our area, though the Brown Recluse is much more common.  Black Widow spiders are noted by a glossy black coloring and a red hourglass shaped marking on the underside of the female, whom are often 1.5 inches in length.  Male Black Widows are smaller and exhibit spot marking on their backs.  Black Widows prefer dark, dry, out of the way places.  They hang in their webs only at night, so unless disturbed, bites are rather rare.  Brown Recluse spiders are light brown in color and are recognizable by a darker brown violin shaped marking on their back, behind their eyes.  These spiders are, as their name states, reclusive, and are most active at night.  These spiders place their webs inside structures such as furniture, garages, closets, basements, building structures, etc.  Again, unless touched or provoked, these spiders do not typically attack humans.

If you find yourself with a bite from a Black Widow or a Brown Recluse, call your doctor’s office right away.  If you find yourself with an unknown spider bite, clean with soap and water, elevate if on an arm or leg, use cool compresses, and use over the counter medications such as Benadryl, Ibuprofen, or Tylenol for pain and inflammation.  If you find yourself with a sting, first, remove the stinger.  Scrape the area to extract the stinger rather than pinch – you run the risk of more venom being deposited.  Next, similar to the spider bite, elevate if on an arm or leg and use cool compresses to control swelling.  You can also use over the counter pain and inflammation relief, as well as antihistamines to control itching.

In the event of a sting, call 911 or head to the emergency room if:

  • There is a known history of allergies or severe reactions to stings
  • Swelling occurs in tongue
  • There is trouble breathing, tightness of throat, trouble speaking
  • Hives occur
  • Feelings of dizziness or faintness

In the event of a spider bite, call 911 or head to the emergency room if you have:

  • Trouble breathing or swallowing, or have wheezing and hoarseness
  • Intense stomach pain or cramps
  • Dizziness or loss of consciousness
  • Rash or hives
  • Sever itching, cramping, or even numbness
  • Facial swelling in areas of mouth (lips/tongue/throat) or eyes

If you believe you have received a sting or bite and are experiencing non emergent symptoms and would like a medical opinion, reach out to your primary care provider.  If you are a member of VIP Medical Services, feel free to send Dr. Holt a text or email with your symptoms (if it is outside of office hours), and he will be happy to advise your next course of action.  If you are looking for a new Primary Care Provider, consider making VIP Medical Services your healthcare home! 417-485-4847


Sun Safety & How to Treat Sunburn

Don't make this same mistake this summer, practice sun safety!

Don’t make this same mistake this summer, practice sun safety!

With summer right around the corner, it should come as no surprise that now is the time to step up your sun safety precautions. While sun safety is something that should be practiced year round, now is a great time to brush up on some sun safety tips to get a great practice in place. Even with a solid sun safety regimen in place, accidents can happen. In the case of burns, we also want to arm you with tips on how to treat and relieve sunburns at home, as well as when to see a doctor in severe situations.

Prevention is the best way to keep your skin healthy and youthful, as well as skin cancer free. Great practices on how to protect yourself from the sun include:

  • Avoid direct sun exposure between the hours of 10 AM and 2 PM
  • Wear sunscreen every day, regardless of weather or season. Utilize a broad spectrum sunscreen with a minimum SPF of 30 so you are protected against UVA and UVB rays
  • Reapply sunscreen every 2 hours if you are sweating or swimming
  • Use sunglasses with total UV protection
  • Wear brimmed hats and long sleeves and pants when possible
  • Check skin regularly for developments or changes
  • Don’t use tanning beds!

If you find yourself with a sunburn, immediately get out of the sun! Sunburns often take hours to develop to their full intensity, so be mindful of any feeling of burning or pink/red coloration of skin and seek shade. Once you are out of the sun, the quicker you take action on your burn, the better. You have the ability to lessen your discomfort, as well as possibly lessen the damage done to your skin by taking quick action. Treatment of the burn should include:

  • Take ibuprofen and utilize cold compresses to reduce inflammation. Compresses can utilize cold water, witch hazel, tea bags, milk, or aluminum acetate (found at drugstores)
  • Don’t shower or bathe in hot water, don’t use soap if possible, and only pat dry with a towel. Only take cool showers or baths with soothing add ins such as oatmeal, vinegar, or baking soda
  • Moisturize! This will help the severity of the itching and peeling. Try to use a moisturizer that has both Vitamin C and E, Aloe, or Soy. You can also try Hydrocortisone cream to reduce discomfort and inflammation as well.
  • Drink extra fluids, as the burn will have a dehydrating effect on the rest of your body
  • Do not agitate the healing process by trying to peel skin before it is ready or hurt blisters
Try these househould items to relieve your sunburn

Try these househould items for sunburn relief:

If you develop fever, chills, nausea, faintness, heavy blistering, burns on more than 20% of your body, or intense itchiness or pain, you may have a severe burn that needs medical treatment. If you develop even one of these symptoms with your sunburn, we recommend you call your primary care provider as a precaution. It is important to note that some prescriptions cause photosensitivity and therefore make you more susceptible to burns and skin damage. If you take any medication regularly, we suggest you review with your doctor to ensure you are aware of this potential side effect. Even after your burns have gone, your skin will take months to return to normal. The new skin that surfaced as a result of the burn is extremely sensitive, so be sure to take extra precautions to keep yourself safe. We hope you have a wonderful summer and (safely) get out and enjoy the sunshine!

Rashes from Poison Ivy – Oak – Sumac

After a long winter, it is a welcome sight to see everything blooming and turning green, however, some plants are making a comeback that may not be so welcome. Poison Ivy and Poison Oak are notorious for wreaking havoc on children, campers, and outdoor enthusiasts alike. Arming yourself with the knowledge of what to look out for, and what to do should you have a run in with one of these plants, will set you up for a much more enjoyable time spent outdoors this summer!

First up, Poison Ivy, the most widely known of this rash inducing trio. Some identifying factors of this plant include:

  • Leaves are found in groupings of three and often have pointed ends
  • May have reddish leaves in the Spring
  • Can grow as ground cover, small bushes, and also climb other plants and structures as a vine
  • Leaves are among the first to turn colors in the Fall, often turning vibrant Fall colors

Second most commonly encountered is Poison Oak. Some identifying characteristics of this plant include:

  • Found primarily in the Southeast US and West Coast – Missouri INCLUDED
  • Leaves grow in groups of three
  • Leaves are notched similar to actual Oak leaves
  • Can have yellow/green flowers as well as similar colored or white berries

Last but not least is Poison Sumac:

  • Primarily in the Eastern half of the country, especially prominent around the Mississippi River and boggy areas of the Southeast
  • Shrub like plant with leaves growing in groups of 7-13, arranged in pairs
  • Can have glossy, off white, or light yellow berries
Poison Ivy - Oak - Sumac Leaves

Poison Ivy – Oak – Sumac Leaves

Some ways to avoid the rashes caused by these plants include:

  • Wearing long sleeves and pants when out in overgrown or wooded areas. Consider also using gloves and boots as an extra precaution. Wash all exposed clothing in hot water separate from other laundry.
  • Use rash barrier lotions to protect skin. Follow all product instructions carefully.

How to treat Poison Ivy, Oak or Sumac.

If you find that you have encountered any of these plants, don’t worry, rashes from this poisonous trio are often treatable at home. The Urushiol oil secreted from these plants will typically produce an itchy, blistering rash, though everyone reacts differently to this exposure. Some easy steps to follow are:

  • Wash hands and affected area thoroughly and immediately upon exposure if possible.
  • Wash clothes in hot water, seperate from other laundry.
  • Clean all items that could have been exposed to the plant and it’s oil, including shoes, tools, pets, etc.
  • Avoid scratching rash or disturbing blisters.
  • To ease itching, short, lukewarm oatmeal baths or short, cool showers may help, as well as Calamine Lotion, Hydrocortisone Cream, or cold compresses.

    Example of Poison Ivy Rash

    Example of Poison Ivy Rash

While these treatments typically help ease the symptoms of Poison Ivy, Oak, and Sumac rashes, always feel free to call your primary care provider to ensure you are taking the right course of treatment. If you do not see improvement in your symptoms after a week, or your symptoms are severe, such as:

  • Most of body is covered in rash
  • Multiple areas of rash and blistering
  • Face and/or genitals have rash
  • Swelling
  • Trouble Breathing or Swallowing

Such serious symptoms may require a trip to the Emergency Room. If you are a member of VIP Medical Services, please feel free to call your 24/7 Physician phone number and Dr. Holt and his staff will be happy to consult with you on whether or not your symptoms are treatable in our office, or if they warrant a trip to the ER. Hopefully this information provides you with the “need to know” knowledge to enjoy the outdoors, safely, this summer!

Tick Bites & Lyme Disease Symptoms

As the weather turns warmer and we begin to spend more time outdoors, we inevitably increase the likelihood of encountering ticks. Even as I write this, ticks are already out in full force. Granted, tick bites are unpleasant, however, there are several ways to lessen your likelihood of acquiring such bites. More importantly, from a medical perspective, there are several things you need to know regarding tickborne illnesses, primarily Lyme Disease and Lyme Disease symptoms.

Difference in Deer and Dog Ticks

Difference in Deer and Dog Ticks

Lyme Disease is spread by deer ticks carrying the bacteria B. burgdorferi. Symptoms of Lyme Disease include flu like symptoms such as stiff neck, chills, fever, fatigue, muscle and joint pain, and often the most tell tale sign being a rash. Such rashes can appear at the site of the bite days to weeks after the initial bite. Oftentimes the Lymes Disease rash resembles a “bullseye” with a center on the bite and a ring around it. This bullseye rash can vary from small to spanning several feet across the body. If you experience any of these symptoms and have been in an area that would potentially have deer ticks, or if you suffer a tick bite from what you believe to be a deer tick, don’t hesitate to call your primary care provider. Doctors use physical examination and blood tests to determine whether a patient has contracted Lyme Disease. It is important that you call your doctor as soon as possible if you believe you may have Lyme Disease, as the longer it is left untreated, the greater the likelihood of developing permanent arthritis, nervous system problems, and even heart problems exist. If caught early, standard treatment is simply a round of antibiotics.

Symptoms of Lyme Disease

Bullseye Rash from Deer Tick Bite

Luckily, knowledge is power when it comes to keeping yourself at a lesser risk of tick bites and Lyme Disease. First, know that deer ticks are most plentiful in wooded areas, tall grass areas, or areas where neighborhood/suburban land meets the woods. Such bites are happening now! Peak season happens late Spring through early Fall, so vigilance is key. Follow these easy steps, and if you have any further questions about Lyme Disease or Lyme Disease symptoms, don’t hesitate to call our office at 417-485-4847! We would be happy to talk to you further.

How To Avoid Tick Bites:

– Wear long sleeves and pants when spending time in wooded areas or areas with tall grass.

– Use an insect repellent with DEET

– Inspect yourself, your family, and pets upon coming inside from time spent outdoors – the sooner, the better.

– The easiest way to inspect yourself is to shower and shampoo your hair, this will give you the opportunity to do a thorough check of your scalp.