HOLIDAY ILLNESS

In the midst of the holiday season, visits to the doctor and the emergency department usually increase. People frequently ask me what conditions are prevalent in the emergency room at this time of year, so let’s look at what we are seeing on an emergent basis.

Overindulgence can lead to a lengthy examination. During the holiday season, an increase in parties usually means an increase in food and alcohol consumption. As a result, many people experience gastrointestinal complaints. Unfortunately, due to the nature of the symptoms – chest pain, for one – many of these complaints appear to be a cardiac issue. Indigestion, for example, may present with chest pain, shortness of breath, nausea, and vomiting. Thus, a medical professional must order an extensive workup to rule out cardiac distress. One of my rules is, “Any pain within six feet of the heart is cardiac until proven otherwise.”

The diagnostic process takes time and observation – EKGs and laboratory tests are necessary, as well as potential hospitalization. It is not easy to determine if discomfort caused by indigestion and gastrointestinal distress is coming from the heart in this type of situation. For at-risk patients the investigation is exceptionally important. Risk factors for cardiac disease include age, obesity, high blood pressure, high cholesterol, diabetes, and smoking.

Alcohol and an irregular heartbeat. Holiday Heart occurs when individuals consistently drink more alcohol than they are used to. These individuals present with atrial fibrillation – an irregular heart beat. Millions of Americans suffer from atrial fibrillation, such as Vice President Cheney, but it is usually due to structural heart disease and not alcohol consumption.

A patient with Holiday Heart may feel an irregular, rapid heart beat. This condition must be treated, as prolonged atrial fibrillation can lead to a stroke. First, an emergent evaluation must occur. Next, treatment – either medicine or an electrical shock – will be given to get the heart beating normally again.

Weather-related injuries. In the north, winter weather and the tools we use to deal with it contribute to increased visits to the emergency department. Orthopedic injuries are seen more frequently because of slips and falls, and snow blowers can do incredible damage to one’s fingers. I’m impressed to see that new snow blowers on the market include a built-in probe used to unclog the shoot. It may seem foolish that I even have to write this – but never stick your hand in a snow blower shoot, even if it is not running, because the auger may be under tension when jammed and will easily remove fingers when “unjammed”.

Influenza and RSV. Typically, Influenza A or B, as well as Respiratory Syncytial Virus (RSV), are more prevalent in the winter months. These conditions present with upper respiratory complaints such as cough, fever, aches, and respiratory distress. The very young and the elderly usually suffer the most with this condition. Remember, it is not too late to get your flu shot.

Stress and mental health. As can be expected, many people become stressed during the holidays and therefore we see an increase in visits for mental health issues. People can set high personal expectations for the holidays and when not met, disappointment can lead to depression. Over stressed and depressed individuals can be treated on an outpatient basis.

Suicide attempts usually increase at this time of year as well. Any attempt at suicide should be seen for what it is – a cry for help – and measures should be taken to address the person’s concerns. Patients who are deemed a threat to their selves are usually hospitalized for care.

Celebrate with moderation. The holidays should be an enjoyable time – just do everything in moderation. Avoid overindulgence in food or liquor to save your self from added discomfort. A simple tip is to eat some healthy food, like an apple or some low fat cheese, prior to attending a party because this will help curb your appetite. Also make a special attempt to exercise on a daily basis – a good cardiovascular workout and weight training will keep off the pounds and make you feel great. And, finally, don’t put off to tomorrow what you could do today – appreciate family and friends, stay on track with good health and enjoy yourself while keeping your head.

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