Winter health and safety tips

Winter is a special time for celebration. It should also be a time for added caution if you or someone in your family is an older adult. It is the season for falls, slips on icy streets, and other dangers that can be especially harmful for older adults.

"Something as simple as a fall can be devastating for older men and women," says Dr. Evelyn Granieri, director of the Division of Geriatrics at NewYork-Presbyterian Hospital/The Allen Hospital. "Before the cold weather arrives, it is important to prepare."

Dr. Granieri addresses some of the most pressing concerns mature adults have about their health and safety during the winter:

* The flu. Influenza is a serious illness that can be fatal in older adults, who often have chronic medical conditions. The vaccine offers some, if not complete, protection against the flu and can be administered as early as September. The flu season begins in mid-October and runs through March.

* Hypothermia. Keep your thermostat set to at least 65 degrees to prevent hypothermia. Hypothermia kills about 600 Americans every year, half of whom are 65 or older, according to the Centers for Disease Control and Prevention. Also, keeping the temperature at 65, even when you are not at home, will help prevent freezing pipes by maintaining a high-enough temperature within your walls.

*Icy streets. Navigating through icy streets can be intimidating. Wear comfortable shoes with anti-slip soles. If you use a cane, replace the rubber tip before it is worn smooth and becomes slippery on the wet ice.

*House fires. Make sure your smoke alarms are working. If you live in a house rather than an apartment, you should also have carbon-monoxide alarms.

*Falling in the home. Older people often have difficulty adjusting to changes in light, and high contrasts increase the risk of slip and falls. Make sure there are no great lighting contrasts from one room to another. Also, use night lights, and don't have loose extension cords lying around -- tape them to the floor. Make sure rugs are not wrinkled or torn in a way that can trip you up as you walk.

*Strenuous activities. Try to avoid strenuous activities like shoveling snow. If you must use a shovel this winter, warm up your body with a few stretching exercises before you begin and be sure to take frequent breaks throughout.

*Dehydration. Drink at least four or five glasses of fluid every day. This should not change just because it is winter. While you may not feel as thirsty as you do in the summer months, if you are older than 60 your body can dehydrate quicker, putting you at greater risk for colds, arthritis, kidney stones and even heart disease.

*Winter itch. Wear more protective creams and lotions to prevent the dry and itchy skin commonly experienced in the colder months when humidity levels are lower.

*Home emergencies. For older persons living alone, it is a good idea to have a personal emergency response system -- a device worn around the neck or on a bracelet, that can summon help if needed. Wear this device all the time, and use it.

Important Flu Recommendations for High-Risk Populations

The flu season is fast approaching and the Centers for Disease Control and Prevention recommends immunization to include all people 6 months of age and older. Those at highest risk of complications from the flu are still young children; people 65 and older; pregnant women; and people with health conditions such as heart, lung or kidney disease, or a weakened immune system.

"Adults age 65 and older face the greatest risk of serious complications and even death as a result of influenza. That is why it is so important that they get immunized. Even when older adults contract the flu after immunization, which can happen, those cases tend to be less severe and of shorter duration," says Dr. Mark Lachs, director of geriatrics at NewYork-Presbyterian Hospital.

"It is important that all children get immunized against this illness because children are at greater risk of experiencing complications as a result of influenza," says Dr. Gerald Loughlin, pediatrician-in-chief at the Phyllis and David Komansky Center for Children's Health at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

Dr. Lachs and Dr. Loughlin offer the following guidelines to help parents protect their children and their entire families from catching the flu this winter:

*Get vaccinated early. The flu vaccine is most effective when administered during the fall months, before the onset of flu season, which usually reaches its peak in early December.

*It's never too late. The flu season begins in the fall and can last through the spring, so if you do not get vaccinated in October you can still be immunized in December or January.

*Know your options. A nasal vaccine is available for healthy children from age 2 and over, and for adults up to the age of 49. There are some restrictions so check with your doctor first.

*Get your family members vaccinated. The Centers for Disease Control and Prevention recommends that the following groups get immunized against the flu every year:
o Children beginning at 6 months of age
o Pregnant women
o People 50 years of age and older
o People of any age with certain chronic medical conditions such as asthma, diabetes, cardiovascular disease, and any form of immunosuppressive illness
o People who live in nursing homes and other long-term care facilities
o People who live with or care for those at high risk for complications from flu, including:

*Health care workers
* Household contacts of persons at high risk for complications from the flu
* Household contacts and out-of-home caregivers of children less than 6 months of age (these children are too young to be vaccinated)

Physicians and nurses at the Komansky Center for Children's Health at NewYork-Presbyterian Hospital/Weill Cornell strongly urge parents to have their children immunized early to make sure they have optimal protection during December and January when flu epidemics are at their peak.

Breathe Easier! Preparing Your Family for Winter Allergies

Top Ways Allergy Sufferers Can Get Relief This Winter

Spring and summer are not the only seasons that bring misery to those with allergies.

The end of the pollinating season is good news for everyone with hay fever and similar summer allergies, but those who are sensitive to mold spores may have to wait until the first frost to find relief. Dr. Elizabeth Leef Jacobson, an internist with a specialty in allergy and immunology at the Iris Cantor Women's Health Center at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, says, "The cold season can be especially difficult for those who suffer from a combination of indoor allergies and asthma. During the winter, families spend more time indoors, exposing them to irritants like dust mites, pet dander, smoke, household sprays and chemicals, and gas fumes -- any of which can make their lives miserable."

Dr. David J. Resnick, director of allergy and immunology at NewYork-Presbyterian/Morgan Stanley Children's Hospital, adds, "During the holiday season it is especially important to make sure that Christmas trees and holiday decorations are mold-free. Mold spores can be more of a problem than pollen allergy because mold grows anywhere and needs little more than moisture and oxygen to thrive. Allergy sufferers should contact their family physician or allergist for proper evaluation and treatment."

Drs. Jacobson and Resnick offer these tips to make the winter months more bearable for indoor allergy sufferers:

1. Keep your indoor humidity level below 35 percent to help prevent the growth of mold and mites.

2. Use exhaust fans when showering or cooking to remove excess humidity and odors. Avoid putting rugs in the bedroom, if possible, since wall-to-wall carpeting is an ideal place for dust mites to proliferate. Using a HEPA vacuum may also decrease dust mite and pet allergen levels.

3. Replace your furnace filter every two to three months, use high-efficiency filters that can capture up to 30 times more allergens, and make sure your furnace fan is always on.

4. When outdoors, keep children from playing in areas that promote mold growth, such as dark, wooded areas. Also, ensure both children and adult allergy sufferers wash their hands frequently and avoid touching their face, as this decreases exposure to the common winter viruses.

5. Use dust-proof covers for mattresses, box springs and pillows to decrease exposure to allergens, but consult your allergist before undertaking such an expense.

6. Wash bed linens and nightclothes in hot water (above 130 degrees) to kill dust mites.

7. If you must use a humidifier, keep it clean and change the water frequently to avoid contamination by mold and bacteria. Central humidifiers should be sprayed with an anti-mold agent.

8. Don't put plants in the bedroom, since decaying leaves and increased humidity can stimulate growth of mold.

9. Adults and children allergic to household pets (dogs and cats) should minimize their contact with them. If you cannot remove the pets from the household, keep them out of the bedroom at all times.

10. Do not exercise in the cold air if you have cold-sensitive asthma. Choose indoor exercises like swimming, as warm humid air is easier on the airways.

11. Remove all dust from your holiday decorations and tree. If you buy a real tree, spray it with a garden hose before setting up in the house.

Merry Stressmas:'TIS THE OVERWHELMING SEASON

NewYork-Presbyterian Hospital Psychiatrists Offer Advice for Reducing Holiday Stress

Crowded, bustling malls, repeated trips to the airport to fetch long-lost relatives, and the constant shuffling of cookies and turkey out of your oven can translate into one reaction: stress. Christmas may be the season of love and celebration, but sometimes holiday festivities can become overwhelming.

Dr. Mallay Occhiogrosso, a psychiatrist at the Payne Whitney Clinic at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, says, "Overly high expectations for the holidays -- be it around the food, the gifts, the family relationships -- are a setup for many, and can trigger anxiety and even depression. Prioritizing self-care is important, as well as dialing down those unrealistic 'Hallmark holiday' fantasies."

"During the holidays, our lives become even more stressful as we try to juggle our usual responsibilities with extra holiday preparation and complicated family dynamics," says Dr. Eric Marcus, a psychiatrist at NewYork-Presbyterian Hospital/Columbia University Medical Center.

Drs. Occhiogrosso and Marcus suggest that you try to keep your holiday stress to a minimum this year with the following advice:

* Build self-care into your schedule. If you have family difficulties, try to plan some time with friends. If you feel isolated, you may want to seek out the support of your community, religious or social services. If you feel lonely, you might consider volunteering your time at an organization you support.

* Self-care can be simple. Fifteen minutes of "alone time" may be just what you need to refresh yourself to handle all of your tasks. Try taking a brisk walk around the block or engaging in some other outdoor activity. Exercise is a great stress reliever, and a daily dose of winter sunlight can dramatically improve your mood.

* Don't be a perfectionist. Prioritize the events that matter the most to you and your family. Understand that you can't do everything, so choose the things that you can accomplish and enjoy. Get input from your family and friends about what it is they would really enjoy doing this holiday. You may find that your expectations are higher than everyone around you.

* For gift shopping, it's the thought that counts. Money does not equal love -- don't let competitiveness, guilt and perfectionism send you on too many shopping trips. Create a holiday shopping budget and stick to it, so the holiday bills don't linger after the tinsel is gone.

* Simplify. Don't bake 20 different types of cookies unless you enjoy it. You and your family may enjoy fewer cookies but more time together. You may also try asking for help. Getting your family and friends involved in the holiday preparations may alleviate the stress of doing it all on your own.

* Remember that family time can be both wonderful and anxiety-provoking. Sometimes, expectations for reunions are too high, resulting in disappointment and frustration. Try to be realistic. Accept your family members and friends as they are and set aside grievances for a more appropriate time.

* Celebrate the memories of loved ones no longer here. Holidays can also be stressful as we confront the memories of those who have passed. This can be a normal part of the holiday experience and should be openly discussed and celebrated.

* Plan your time so that you take care of several errands on one trip. You will have more time to spend doing the things that you really want to do. Set aside specific days for shopping, cooking and visiting friends. You may also want to plan your menu in advance and make one big shopping trip.

* Take some time to think about what the holiday really means to you and your family. Time together, religious observance, reflection on your life and future goals -- let these aspects of the holidays keep things in perspective.

* If you find that your depressed mood lingers, consider getting input from a mental health professional. Rates of anxiety and depression peak during the holidays; you don't have to suffer unnecessarily. Help is available.

These tips can help you to reduce stress and make the holidays a pleasure. Doing less may help you to enjoy the season more, and that is really the best stress reliever of all.

Maximize Your Meals and Not Your Waistline: A Guide to Keeping the Holidays Lite and Festive

You cast your eye on the table. Mmm… one after another, great heaping dishes of food -- comfort food and holiday food. You dig in, savoring every bite. Now the meal is over and you are going through that terrible cycle of holiday remorse.

Jessica Miller, a registered dietitian at NewYork-Presbyterian Hospital/Columbia University Medical Center, says you can avoid this psychological turmoil by adopting a more sensible approach to holiday eating and exercise. "You will not gain weight from one meal by itself. Consistency is the key; if you generally follow a healthy diet, it is acceptable to treat yourself to a few seasonal indulgences around the holidays."

Martha McKittrick, a registered dietitian at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, says, "Don't deny yourself the occasional treat. What people need to realize is that everybody can eat something of everything -- it's just a question of how much."

The following is the holiday feast survival guide -- a road map of sorts to keep you and your diet from straying too far this year.

* Never go to a party hungry. Snack on fruit, non-fat yogurt or vegetables before you leave for the party. You will be less tempted to overindulge while you're there.

* Take control of your environment whenever possible. Never engage in conversation while sitting next to a platter of your favorite cookies. Grab a bottle or glass of water as soon as you arrive at a holiday gathering and take a few minutes to survey your food choices.

* Bring a low-fat dish to the party. Share with other guests.

* Fill your plate with vegetables and lean protein foods -- then add small "tastes" of high-fat dishes.

* Eat slowly and savor every bite. It takes 20 minutes for the stomach to signal to your brain that you are full.

* Decide in advance how you will handle gifts of cookies and candy. Don't leave them out in the open so that you will be tempted to binge. Keep one or two and give the rest away.

* Limit alcohol consumption. Not only does alcohol contain many calories, but it can also stimulate your appetite and reduce your willpower. Try a wine spritzer, or, better yet, avoid alcohol completely and drink seltzer or mineral water with a twist of lime, or a non-alcoholic tomato juice cocktail.

* Don't allow holiday activity to slow down your exercise program. Exercise can help burn off extra calories and make you feel good about yourself.

* Moderation is the key to weight maintenance. A forkful of cheesecake will do less damage than a whole piece. Remember, an occasional indulgence will not destroy your weight-loss attempts, and if you don't love something don't eat it.

How to Stop Winter From Weathering Your Skin

All winter flakes are not made of snow. Cold weather with its low relative humidity wreaks havoc on our skin, sometimes making it dry and flaky. Skin dries out if it's deprived of moisture and this dryness often aggravates itchiness, resulting in a condition commonly referred to as "winter itch."

During the winter the air is drier, and indoor heating further depletes your skin of moisture. Fortunately, there are several ways that you can replenish the water content of your skin.

Dr. Monica Halem, a dermatologist and dermatologic surgeon at NewYork-Presbyterian Hospital/Columbia University Medical Center, suggest the following top 10 tips to help turn your alligator skin into suede:

1. Moisturize daily. Cream-based moisturizers are better than lotions for normal to dry skin. If you have sensitive skin, choose a moisturizer without fragrance or lanolin. Apply moisturizer directly to your wet skin after bathing to ensure that the moisturizer can help to trap surface moisture.

2. Cleanse your skin, but don't overdo it. Too much cleansing removes the skin's natural moisturizers. It is enough to wash your face, hands, feet, and between the folds of your skin once a day. While you can rinse your trunk, arms and legs daily, it is not necessary to use soap or cleanser on these areas every day.

3. Limit the use of hot water and soap. If you have "winter itch," take short lukewarm showers or baths with a non-irritating, non-detergent-based cleanser. Immediately afterward, apply a mineral oil or petroleum-jelly-type moisturizer. Gently pat skin dry.

4. Humidify. Room humidifiers can be beneficial. However, be sure to clean the unit according to the manufacturer's instructions to reduce mold and fungi.

5. Protect yourself from the wind. Cover your face and use a petrolatum-based balm for your lips.

6. Avoid extreme cold. Cold temperatures can cause skin disorders or frostbite in some people. See a doctor immediately if you develop color changes in your hands or feet accompanied by pain or ulceration. If you develop extreme pain followed by loss of sensation in a finger or toe, you may have frostbite.

7. Protect your skin from the sun. Remember that winter sun can also be dangerous to the skin. Even in the winter months you should use a sunscreen with a sun-protection factor of 15 or greater if you will be outdoors for prolonged periods. Overexposure to sunlight can lead to premature aging of the skin and skin cancer.

8. Avoid winter tanning. Tanning beds and artificial sunlamps are always damaging to your skin and increase your risk of skin cancer. If you want to keep your summer glow, use self-tanners along with extra moisturizer as self-tanners can also dry out your skin.

9. Take vitamin D supplements. During the summer months your natural vitamin D production increases due to daily sun exposure, but when winter rolls around that exposure decreases. Taking vitamin supplements can ensure that you are getting the recommended amounts of vitamin D all year.

10. See your dermatologist. If you have persistent dry skin, scaling, itching, skin growths that concern you, or other rashes, see your dermatologist -- not only in winter but throughout the year.

The activity and excitement of the holidays tend to make people less careful when they should be more cautious. There are an estimated 47,000 fires every holiday season that claim more than 500 lives a year.

Dr. Roger Yurt, director, and Nicole E. Leahy, R.N., M.P.H., manager of Outreach and Community Education, both of the Hearst Burn Center at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, urge you to take care all of the time, and offer these special tips for the holiday season:

* Trees: One in every 22 home fires caused by a tree results in death. Remember that trees that are cut early in the season quickly dry out to become fire hazards, so make sure to keep them well watered. Never put a tree in front of an exit and always make sure it is placed at least three feet from any heat source such as a fireplace, space heater, candle or radiator.

* Candles: The chance of having a candle fire quadruples during the holiday season. Never leave religious, or any, candles burning unattended. Make sure candles are placed at least three feet from curtains, holiday decorations and Christmas trees.

* Decorations: Never decorate your holiday tree with candles, even if you don't intend to light them. Keep all decorations away from sources of heat such as space heaters, candles, fireplaces and radiators and, when possible, use fire retardant decorations.

* Lights: Only buy holiday lights that have been inspected and approved by the Underwriters Laboratory (UL). Inspect and test lights each year before using them. Unplug the lights when going to sleep or leaving your home.

* Electricity and Electrical Wires: Never leave holiday lights on when you leave the house. If a wire should short, you might return to find your house on fire! Make sure not to overload outlets, limit the use of extension cords to short periods of time, and use a surge protector when plugging in holiday lights and decorations.

* Fireplaces: Never place a Christmas tree near a fireplace. If there is no other place to put it, do not use the fireplace until after the tree has been removed and the needles have been cleaned up. Use of a screen over the fireplace will prevent embers from escaping. Keep small children at least three feet from the fireplace area.

* Holiday Cooking: Create a three-foot zone of safety around the stove, oven and cooking areas to ensure that children and other adults will stay clear of pot handles, oven doors and open burners on the stove. When cooking, wear short sleeves and tight-fitting clothing to prevent it from getting caught in a flame on the stove, and turn pot handles inward on the stove.

Surviving Heart Attack Season

While we may be accustomed to battling frigid temperatures and the inevitable snow storms that arrive every winter, many of us are unaware of the dangers these pose to our hearts.

"When the temperature outside drops, our blood vessels narrow to prevent our bodies from losing heat. This is a natural response that can also put people with heart conditions and those involved in strenuous exercise at greater risk of having a heart attack," says Dr. Holly Andersen, director of education and outreach at the Ronald O. Perelman Heart Institute of NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

Shoveling snow is one of the most strenuous and dangerous winter exercise activities. It can raise blood pressure, and coupled with the effects of colder temperatures, shoveling can increase heart attack risk drastically.

Dr. Andersen offers the following tips for safe shoveling and maintaining a healthy heart this winter:

* Warm up. Warm up with stretching and light activity before shoveling, exercising, or beginning more strenuous physical activities.

* Bundle up. When going out to shovel, always wear a scarf over your mouth and nose to warm the air before you breathe in, and dress in layers. Layering clothes underneath a windproof and waterproof outer shell helps maintain body heat.

* Push the shovel. It is less strenuous to push the snow rather than lifting it, and this reduces the risk of overexerting yourself.

* Take breaks. You should take frequent breaks while shoveling to give your muscles, especially your heart muscle, a chance to relax. You may also consider sharing the work with a friend to make the workload lighter and ensure that you are not alone in the event of an emergency.

* Consult a doctor. If you are over the age of 50, overweight, out of shape or have suffered a heart attack, you should consult a doctor before shoveling snow or starting any exercise routine.

Source: NewYork-Presbyterian Hospital

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