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Tag: degrees Fahrenheit

  • Everything I Thought I Knew About Nasal Congestion Is Wrong

    Everything I Thought I Knew About Nasal Congestion Is Wrong

    Having caught a cold every month since my kid started day care, I’ve devoted a lot of time recently to the indignity of unclogging my nose. I’m blowing, always. I have also struck up an intimate acquaintance with neti pots and a great variety of decongestants. (Ask for the stuff that actually works, squirreled away behind the counter.) And on sleepless nights, I’ve spent hours turning side to side, trying to clear one nostril and then the other.

    Nasal congestion, I’ve learned in all this, is far weirder than I ever thought. For starters, the nose is actually two noses, which work in an alternating cycle that is somehow connected to our armpits.

    The argument that humans have two noses was first put to me by Ronald Eccles, a nose expert who ran the Common Cold Centre at Cardiff University, in Wales, until his retirement a few years ago. This sounds absurd, I know, but consider what your nose—or noses—looks like on the inside: Each nostril opens into its own nasal cavity, which does not connect with the other directly. They are two separate organs, as separate as your two eyes or your two ears.

    And far from being a passive tube, the nose’s hidden inner anatomy is constantly changing. It’s lined with venous erectile tissue that has a ”similar structure to the erectile tissue in the penis,” Eccles said, and can become engorged with blood. Infection or allergies amplify the swelling, so much so that the nasal passages become completely blocked. This swelling, not mucus, is the primary cause of a stuffy nose, which is why expelling snot never quite fixes congestion entirely. “You can blow your nose until the cows come home and you’re not blowing that swollen tissue out,” says Timothy Smith, an otolaryngologist at the Oregon Health & Science University’s Sinus Center. Gently blowing your nose works fine for any mucus that may be adding to the stuffiness, he told me. But decongestants such as Sudafed and Afrin work by causing blood vessels in the nose to shrink, opening the nasal passages for temporary relief.

    In healthy noses, the swelling and unswelling of nasal tissue usually follows a predictable pattern called the nasal cycle. Every few hours, one side of the nose becomes partially congested while the other opens. Then they switch, going back and forth, back and forth. The exact pattern and duration vary from person to person, but we rarely notice these changes inside our noses. “When I tell people about the nasal cycle, most people are not aware of it at all,” says Guilherme Garcia, a biomedical engineer at the Medical College of Wisconsin. I certainly wasn’t, and I have been breathing through my nose only my entire life. But the idea made sense as soon as I consciously thought about it: When I’m sick, and extra swelling has turned partial congestion into complete congestion, I do tend to feel more blocked on one side than the other.

    Once you’re aware of the nasal cycle, you can control it—to some extent. In fact, when I was turning from side to side during my sleepless nights, I was unknowingly activating receptors under my arm, which open the opposite side of the nose. This could be an age-old survival reflex: When we lie down on our right side, our left nostril is farther from the ground and likely less obstructed. Yogis have learned to take advantage of this, using a small crutch under the arm, called a yoga danda, to direct breathing to one nostril or the other. And an online hack for stuffy noses suggests squeezing a bottle under the opposite arm. The effect is not instantaneous, though. When I tried this recently, my arm got tired before my nose unclogged. And when I tried again with an old crutch I had from a knee injury, it took several minutes, by which time I’d already reached for a tissue out of impatience and habit.

    No one knows exactly why humans have a nasal cycle, but cats, pigs, rabbits, dogs, and rats all have one too, according to Eccles. One hypothesis proposes that this cycle helps guard against pathogens. When the venous erectile tissue shrinks, antibody-rich plasma is squeezed out onto the inner lining of the nose. Each cycle might replenish the nose’s defense. Eccles also pointed out that upper-respiratory viruses seem to prefer temperatures just below body temperature; when one side of the nose becomes partially congested, it might warm up enough to ward off viruses. Or, he said, the cycle allows one half of the nose to rest at time. Unlike our eyes, ears, and mouths, noses have to function 24 hours a day, every day, constantly filtering and warming air for the delicate tissue of our lungs. The nose’s job might not sound that hard, but consider what it has to do: The air we breathe is maybe 70 degrees Fahrenheit and 35 percent humidity, Smith said. “By the time that air goes in my nose and gets back to my nasopharynx—which is, what, maybe three to four inches—it is 98.7 degrees Fahrenheit and 100 percent humidity.” The nose is quite the powerful little HVAC system.

    But it’s fallible, too. Our noses don’t measure airflow directly; instead, they rely on cold receptors that are activated when cool air passes by. These cold receptors can be tricked by, say, menthol. Eccles has found that people given menthol lozenges can hold their breath longer, possibly because the minty coolness fools them into thinking they are still getting air. And it’s why Vicks VapoRub might make congestion feel better, despite having no positive effect on the opening of the nasal passages. The opposite may happen in a baffling condition called empty-nose syndrome, in which a very small proportion of patients who have surgery to improve airflow in their noses end up feeling completely clogged—possibly because of damage to cold receptors and other changes in sensation. The lack of a feeling of airflow can be so disturbing that these patients feel like they’re suffocating, even though their noses are perfectly unobstructed.

    To a lesser extent, we are all unreliable narrators of our nasal congestion. When patients go to be examined, a doctor might see that one side of their nose is clearly more swollen than the other—but it’s not necessarily the same side that the patient feels is more congested. “This still baffles clinicians,” Smith told me. Other factors, such as temperature, must play a role. The inner workings of the nose are complicated and still mysterious. I’ll be thinking about all of this the next time I’m lying awake at night, once again sick, once again congested.

    Sarah Zhang

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  • Living in Phoenix Makes Perfect Sense

    Living in Phoenix Makes Perfect Sense

    In Phoenix, a high of 108 degrees Fahrenheit now somehow counts as a respite. On Monday, America’s hottest major city ended its ominous streak of 31 straight days in which temperatures crested past 110. The toll of this heat—a monthly average of 102.7 degrees in July—has been brutal. One woman was admitted to a hospital’s burn unit after she fell on the pavement outside her home, and towering saguaros have dropped arms and collapsed. Over the past month, hospitals filling up with burn and heat-stroke victims have reached capacities not seen since the height of the pandemic.

    “Why would anyone live in Phoenix?” You might ask that question to the many hundreds of thousands of new residents who have made the Arizona metropolis America’s fastest-growing city. Last year, Maricopa County, where Phoenix sits, gained more residents than any other county in the United States—just as it did in 2021, 2019, 2018, and 2017.

    At its core, the question makes a mystery of something that isn’t a mystery at all. For many people, living in Phoenix makes perfect sense. Pleasant temperatures most of the year, relatively inexpensive housing, and a steady increase in economic opportunities have drawn people for 80 years, turning the city from a small desert outpost of 65,000 into a sprawling metro area of more than 5 million. Along the way, a series of innovations has made the heat seem like a temporary inconvenience rather than an existential threat for many residents. Perhaps not even a heat wave like this one will change anything.

    My first morning in Phoenix, more than 20 years ago, the sun broke the horizon two miles up a trail in South Mountain Park, one of the largest municipal parks in the United States. I had arrived the previous night from Michigan, leaving behind the late-March dreariness that passes for spring in the Midwest for several months of research that would become my book, Power Lines. As the sun turned the mountain golden and I stripped down to short sleeves for the first time in months, I realized the Valley of the Sun’s charms.

    Outside the summer months, the quality of life in Phoenix is really quite high—a fact that city boosters have promoted stretching back to before World War II. They traded the desiccated “Salt River Valley” for the welcoming “Valley of the Sun.” Efforts to downplay the dangers of Phoenix’s climate go back even further. In 1895, when Phoenix was home to a few thousand people, a local newspaper reported that it had been proved “by figures and facts” that the heat is “all a joke,” because the “sensible temperature” that people experienced was far less severe than what the thermometers recorded. “But it’s a dry heat” has a long history, one in which generations of prospective newcomers have been taught to perceive Phoenix’s climate as more beneficial than oppressive.

    Most people surely move to Phoenix not because of the weather, but because of the housing. The Valley of the Sun’s ongoing commitment to new housing development continues to keep housing prices well below those of neighboring California, drawing many emigrants priced out of the Golden State. Subdivisions have popped up in irrigated farm fields seemingly overnight. In 1955, as the home builder John F. Long was constructing Maryvale, then on Phoenix’s western edge, he quickly turned a cantaloupe farm into seven model homes. Five years later, more than 22,000 people lived in the neighborhood; now more than 200,000 do. Even today, the speed of construction can create confusion, as residents puzzle over the location of Heartland Ranch or Copper Falls or other new subdivisions that include most of the 250,000 homes built since 2010.

    Even in the summer, you might not always notice just how harsh of a terrain Phoenix can be. Developers engage in a struggle to secure water rights, tapping groundwater aquifers, drawing water from the Colorado River brought to the city by aqueduct, and purchasing water from local farmers. Air-conditioning is the lifeblood of Phoenix, as much a part of the city as the subway system is in New York. In 1961, Herbert Leggett, a Phoenix banker, spoke of his normal summer day to The Saturday Evening Post: “I awake in my air-conditioned home in the morning … I dress and get into my air-conditioned automobile and drive to the air-conditioned garage in the basement of this building. I work in an air-conditioned office, eat in an air-conditioned restaurant, and perhaps go to an air-conditioned theater.”

    In the kind of air-conditioned bubbles Leggett described, it is actually possible for people like me, who work indoors, to forget the heat and oppression of Phoenix’s summer—that is, until we have to scurry across a parking lot or cross concrete plazas between buildings. Starting in late April, when high temperatures regularly hit over 90, many residents fire up their AC, using it until October, when highs once again drop into the 80s. At the height of summer, Phoenix becomes virtually an indoor city during the day. Remote car starters become valuable amenities for taking the edge off the heat. Runners wake before dawn to exercise, and dogs are banned from hiking trails in city parks on triple-digit days. With air-conditioning, the benefits of Phoenix outweigh the drawbacks for many residents.

    But this lifestyle comes with a cost. Electricity consumption has soared in Phoenix, almost doubling in the average home from 1970 to today. At the height of its operation, Four Corners Power Plant, only one of five such coal-fired power plants built north of Phoenix to help power the region’s growth, emitted 16 million tons of carbon annually, equivalent to the annual emissions of more than 3.4 million cars. Even today, with most coal-fired generation retired, Phoenix relies heavily on carbon-emitting natural gas for its electricity. Both the past and present of Phoenix’s energy worsens the very heat its residents are trying to escape.

    Air-conditioning protects most people, but especially as the heat intensifies, those without it are left incredibly vulnerable. Elderly women living alone, many of whom struggle to maintain and pay for air-conditioning, are particularly susceptible, accounting for the majority of indoor heat-related deaths. Unhoused people, whose population in Phoenix has increased by 70 percent in the past six years, suffer tremendously and make up much of the death toll. One unhoused man recently compared sitting in his wheelchair to “sitting down on hot coals.”

    This heat wave will end, but there will be another. Still, the horror stories of life in 115 degrees is hardly guaranteed to blunt Phoenix’s explosive growth. There are currently building permits for 80,000 new homes in the Phoenix metro area that have not yet commenced construction—homes that will require more water, more AC, and more energy.

    But in a sense, nothing about Phoenix is unusual at all. The movement from air-conditioned space to air-conditioned space that Leggett described—and the massive energy use that makes it all run—is now typical in a country where nearly 90 percent of homes use air-conditioning. Clothing companies such as Land’s End advertise summer sweaters that “will come to your rescue while you’re working hard for those eight hours in your office, which might feel like an icebox at times.” And heat has claimed lives in “temperate” cities such as Omaha, Seattle, and Boston. Indeed, one 2020 study concluded that the Northeast had the highest rate of excess deaths attributable to heat.

    “Why would anyone live in Phoenix?” serves as nothing more than a defensive mechanism. It makes peculiar the choices that huge numbers of Americans have made, often under economic duress—choices to move to the warm climates of the Sun Belt, to move where housing is affordable, to ignore where energy comes from and the inequalities it creates, and, above all, to downplay the threats of climate change. In that way, Phoenix isn’t the exception. It’s the norm.

    Andrew Needham

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  • You Really Don’t Want to Be Thirsty in a Heat Wave

    You Really Don’t Want to Be Thirsty in a Heat Wave

    The heat—miserable and oppressive—is not abating. Today, a third of Americans are under a heat alert as temperatures keep breaking records: Phoenix has hit 110 degrees Fahrenheit for two weeks straight, while this weekend Death Valley in California could surpass the all-time high of 130 degrees.

    Even less extreme heat than that can be dangerous. Recently, in Texas, Louisiana, part of Arizona, and Florida, there have been reports of deaths from heat, and many more hospitalizations. The toll of a heat wave is not always clear in the moment: A new report suggests that last summer’s historic heat wave in Europe killed more than 60,000 people.

    Ideally, you’d stay in the air-conditioned indoors as much as possible. That’s not an option for everyone. The other thing to do is stay hydrated. The importance of getting enough fluid is hard to overstate—and often underappreciated: Last month, the Texas state legislature banned local governments from mandating water breaks for construction workers. In the heat, hydration “impacts everything,” Stavros Kavouras, the director of the Hydration Science Lab at Arizona State University, in Phoenix, told me. And with temperatures continuing to rise, it’s essential to get it right.

    Serious dehydration is really, really bad for you. Your blood volume decreases, which makes your heart work less effectively. “Your ability to thermoregulate declines,” Kavouras told me, “so your body temperature is getting higher and higher.” You might feel weak or dizzy. Your heart rate rises; it gets harder to focus. The worst-case scenario is heatstroke, when your body stops being able to cool itself—a  potentially fatal medical emergency.

    In extreme temperatures, heat injuries can happen quicker than you might think. Given that the human body is mostly water, you might assume that there is some to spare, but inconveniently, this is not the case. “If you lose even 10 percent of [the water] your body has, you are entering the zone of serious clinical dehydration,” Kavouras said. “And if you look at optimal health, even losing just 1 percent of your body weight impacts your ability to function.” There are two basic ways your body cools itself when it gets hot. One is to send more blood to the skin, which releases heat from the core of your body, and is the reason you turn red when you’re overheated. The other is to sweat. It evaporates off your body, and in the process, your body loses excess heat. You can’t cool yourself as effectively if you’re not properly hydrated. At the same time, one of your main cooling mechanisms is actively dehydrating, which means the goal is not just to be hydrated, but to stay that way.

    What that takes depends on many factors rather than a single universal rule, but in general, the danger zone is “high humidity with anything above 90 degrees,” Kavouras said, at which point, “it’s actually dangerous” just to be outside. The more active you are in the heat, and the hotter and more humid it is, the greater the risk—and the more important proper hydration becomes. The standard water target in the U.S. during non-heat-wave times is 3.7 liters a day for men and 2.7 liters for women. When it’s very, very hot out, you need more. Even if you spend most of the day in the bliss of AC, you are almost certainly leaving the house at some point.

    Instead of trying to figure out what that precise amount should be, Kavouras recommends you focus on two things instead. “No. 1, keep water close to you. If you have water close to you, or whatever healthy beverage, you’ll end up drinking more, just because it’s closer,” he said. And second: Keep an eye on how often you pee—pale urine, six to seven times a day, or every two to three hours, is good. You want it to be “basically like a Chablis, a Riesling, Pinot Grigio, or champagne-colored,” John Higgins, a sports cardiologist at McGovern Medical School at UTHealth, in Houston, told me. “If you notice the urine is getting darker, like a Chardonnay- or Sauvignon Blanc–type of thing, that generally means you are dehydrated.”

    Certain groups are especially at risk. Older adults are more prone to dehydration, as are young children, people who are pregnant, and people taking certain medications—blood-pressure medications, for example. None of this requires you to take in extra fluids per se, just that you need to be even more careful that you’re getting enough.

    As for what to drink, as a go-to beverage, straight water is hard to beat. Water with fruit slices floating in it has the benefit of feeling like something from a luxury hotel. Carbonated water is also good—you might not be able to drink quite as much of it, which is a potential drawback, but “there is no mechanism in your GI system that will make sparkling water less effective at hydrating you,” Kavouras said. You probably want to avoid downing giant buckets of coffee—caffeine is a diuretic in large quantities and Higgins warns against sugary drinks for the same reason. (A daily iced coffee is fine.) If you’re doing hours of heavy sweating, then you might work in some (less sugary) sports drinks. But for the majority of people, water remains the ideal. Food can also be a fluid source: “Make sure you’re eating a diet that’s rich in vegetables and fruits that have water content,” William Adams, the director of the University of North Carolina at Greensboro’s Hydration, Environment and Thermal (H.E.A.T) Stress Lab, advised. Alcohol, which causes you to lose fluid, is definitively unhelpful.

    There are lots of water myths out there. Can you go too hard? Technically, it’s possible to over-hydrate, causing an electrolyte imbalance, but all three experts agreed that for most people, this isn’t really a concern. You can find arguments for drinking hot drinks in the summer—the idea being that they increase the amount you sweat, thereby promoting cooling. But Kavouras is emphatic that you’re better off with cold drinks, which cool your body, he said. In the moments before a race, marathon runners will sometimes take it one step further, slurping ice slurries to lower their body temperature. For good old-fashioned drinking water, about 50 degrees Fahrenheit is best—roughly the temperature of cool water from the tap.

    One final key to staying hydrated: Start early. A lot of people, Higgins said, are lightly dehydrated all the time, heat wave or not. “So particularly when you first wake up in the morning, typically you are in a dehydrated state.” Accordingly, he recommends that people drink about a standard water bottle’s worth—roughly 17 ounces—as soon as they wake up. The other thing people forget about, he said, is what happens when they come back inside after enduring the outdoors. “You keep sweating,” he pointed out. In other words: hydrate, and then keep hydrating.

    As crucial as hydration is, it is not a miracle. “It doesn’t mean that you can say, ‘I hydrate well, so I’ll go out for a run in the 120-degree weather, and I’ll be fine because I’m drinking a lot,’” Kavouras said. “It doesn’t work this way.” Still, it is a simple but effective tool. As heat waves like this one become even more frequent, many more people will need to learn how to become attuned to their hydration. And perhaps adequate water can be a perverse sort of comfort: You can’t control the unrelenting heat, but you likely can control your water intake. In a heat wave, it helps to have a glass-half-full attitude—and an emptied glass of water.

    This story is part of the Atlantic Planet series supported by HHMI’s Science and Educational Media Group.

    Rachel Sugar

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