Fall/Winter Health Tips

• Back-to-School Health
• Facts and Fictions of Cold and Flu
• Reducing Holiday Stress
• Avoiding Winter Weight Gain
• Pediatric Flu Vaccines
• Holiday Fire Prevention
• Senior Safety
• Tips for Children With Winter Allergies
• Exercising in the Winter
• Fighting Winter Itch

NewYork-Presbyterian Pediatrician's Back-to-School Health Checklist

New York, NY (September 2004) — The first day of school always requires preparations — notebooks, pens, and a new set of clothes. Don't forget to prepare for your child's health, says Dr. Pamela F. Gallin, a pediatrician with the Morgan Stanley Children's Hospital of NewYork-Presbyterian, a mother of four, and the author of The Savvy Mom's Guide to Medical Care. Dr. Gallin provides parents and caregivers with tips to help their kids get a smart start to the academic year.

• Have your child's vision screened. It is important for children to have an annual vision screening because young children, especially, often don't know if they can't see adequately. If your child wears glasses, be sure that the prescription is current.
  
• Have your child's hearing tested. Most states now mandate hearing tests for babies. But many school-age children have not been tested. If your child is listening to the television or music at a very loud volume, or tends to favor one ear over the other when listening to you speak, it may be a sign of hearing loss.
  
• Be equipped for sports. For children who wear glasses, the American Academy of Ophthalmology recommends one-piece wraparound polycarbonate sports frames for all contact sports, including soccer, field hockey, and basketball. All children wearing spectacles need sports frames for gym.
  
• Are your child's immunizations up-to-date? The last thing you want is for your child to be turned away from school on the first day because he or she was not properly immunized. If you have recently moved from one state to another, check to see if your child meets the new state's regulations. In addition, new immunizations, such as Hepatitis B, are now required. Check with your child's pediatrician.
  
• Have you noticed your child scratching his or her scalp since camp ended? It may be a sign that a case of lice was contracted during the summer. It is important that you check your child's head yourself, and, if you are unsure, contact the school nurse or your child's pediatrician. Head lice will not go away by itself, but can be treated with over-the-counter remedies.
  
• Does your child receive medication on a regular basis for diabetes, asthma, or another chronic problem? School nurses and teachers must be made aware of your child's needs, especially if they are the ones who administer the medicine. Be sure to speak with them about these procedures before school begins, and work out an emergency course of action in case of a problem.
  
• Is your child anxious and apprehensive? Most children are naturally anxious about the new school year. It normally takes about a month for children to adjust to new situations. A new school, fear of a class bully, or taking a school bus for the first time may cause anxieties. If after a few weeks, your child continues to be anxious and apprehensive, bring this to the attention of his or her teacher so that you can identify the source of his anxiety and work out a solution.
  
• Do you suspect a learning disability or dyslexia? If you suspect that your child is not processing information as he or she should, speak to the teacher or learning center in your child's school as soon as possible. A professional diagnosis usually requires two days worth of testing.
  
• Does your child eat breakfast? Studies show that children who eat breakfast are more alert in class. Also, be sure that your child has a balanced, nutritious lunch, whether it is one you send or one provided by the school cafeteria. If your child is allowed to bring a snack, try to avoid junk food and focus more on fruits and other healthful food.
  
• Are your up-to-date emergency phone numbers on file? Make sure that the school and your child know how to reach you or another caregiver at all times. The school administration and teachers should always know how to reach you if there is an issue that needs to be discussed.

"Your child will have a great year in school if you make sure that the teacher understands all your child's special needs," says Dr. Gallin. "But remember, just as a child may be overwhelmed by school the first day, often so are the teachers."

Can a Change in Temperature Cause a Cold?

Sorting Out the Facts and Fictions of Cold and Flu

New York, NY (September 2004) — Considering how common they are, colds and flu are the subject of a great many misconceptions. Dr. Seth Feltheimer, an Associate Attending Physician, and Patricia Ciminera, Nurse Practitioner at NewYork-Presbyterian Hospital/Columbia, offer their insights and expertise on these sources of misery.

First of all, the differences: a cold is usually an upper respiratory tract infection with symptoms including a sore throat, head congestion, sinus pain, and low-grade fever. On the other hand, the flu is generally marked by a higher fever, a sore throat, a cough, and body aches. A common cold usually lasts two to three days while the flu can take as long as a week. Unlike colds, the flu can lead to more serious complications and even hospitalization, especially in high-risk individuals like asthmatics and the elderly.

Now, the facts and fictions:

• "The best way to prevent a cold is to wash your hands."
  True. Also, try avoiding people with colds.
  
• "You can catch a cold by staying outside in the cold too long."
  False. Colds are transmitted by touching something that an infected person has touched, or by breathing in moisture that an infected person has coughed out. The reason people get more colds in winter is that they spend more time indoors and have more contact with each other.
  
• "Antibiotics can cure a cold or the flu."
  False. A cold or flu is a virus, and, therefore, cannot be treated with antibiotics. There are medications that can alleviate the symptoms of flu and make you feel better, but the best defense against the flu is to be vaccinated against it. There is no vaccine against the common cold.
  
• "If you have the flu, you shouldn't go to work."
  True. Going to work can expose your colleagues to infection. Sometimes, professional athletes play with the flu, but in those cases it is usually a different virus involved. The best advice is to rest and recover.
  
• "Flu shots can give you the flu."
  False. Flu shots can produce very mild flu-like symptoms for a short period, but this happens very infrequently.
  
• "If you have a flu shot one year, you don't need it the next."
  False. Flu shots do not last for more than a year. And the vaccine is reformulated each year to target the specific kind of virus, which may change from year to year.
  

Merry Stressmas: 'Tis the Overwhelming Season

NewYork-Presbyterian/Weill Cornell Psychiatrist Offers Advice for Reducing Holiday Stress

New York, NY (September 2004) — 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.

According to Dr. Gail Saltz, a psychiatrist at NewYork-Presbyterian Hospital/Weill Cornell, some families feel stress from trying to keep up with the Joneses. For others, family conflicts arise from stress borne out of togetherness. Additionally, mothers often do a tremendous amount of preparation during the holiday season. This excess work and struggle to please everyone can leave them feeling isolated.

"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. Saltz. "This year, try to keep your holiday stress to a minimum by prioritizing what is important to you and then planning how you will get it done."

• Don't wait for the last minute to make plans. If you have family difficulties, try to plan some time with friends.
  
• Don't be a perfectionist about the holidays. 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.
  
• For gift shopping, remember that it's the thought that counts. Don't let competitiveness and perfectionism send you on too many shopping trips.
  
• 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.
  
• 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.
  
• 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.
  
• 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.

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.

Holiday Celebrations and Overeating: Experts Offer Tips on Avoiding Winter Weight Gain

New York, NY (September 2004) — You cast your eye on the table. Mmm... one after another, great heaping dishes of food. Comfort food. Holiday food. You dig in, savoring every bite. Now the meal is over and you are going through that terrible cycle of holiday remorse. Sure, it's great to be able to indulge in some festive food favorites, but there is always that guilt afterward.

Wahida Karmally, DrPH, a registered dietitian at NewYork-Presbyterian Hospital/Columbia, 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 eat healthful meals during the months before the holidays, a splurge or two can be fit in."

Laura Cipullo, a registered dietitian at NewYork-Presbyterian Hospital/Weill Cornell, suggests, "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."

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

• Plan ahead. Remember the "calorie bank" concept. Save calories the week before to give yourself more calories to eat during the holidays.
  
• 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.
  
• 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.
  

A Shot in the Arm Could Save Your Child's Life

New York, NY (September 2004) — Flu season is approaching again, and parents should know that fall is the time to have your children immunized. This is especially important for children with asthma and other high-risk medical problems.

"It is important to get a flu shot early because vaccine shortages can arise," says Dr. Gerald Loughlin, chairman of the department of pediatrics at the Children's Hospital of NewYork-Presbyterian at Weill Cornell.

The flu vaccine is most effective when administered during the fall months, before the onset of flu season, which usually reaches its height in early December. However, it is still appropriate in December or January to have the vaccine administered.

The flu vaccine is reformulated every year. Children, especially those with asthma, should be vaccinated on an annual basis. For most of us, the flu can be a debilitating illness lasting several days. For children with asthma and other high-risk medical problems, it can lead to more serious complications, which, in many cases, require hospitalization.

Other high-risk groups that should have a flu shot include children with chronic lung or cardiovascular disease, diabetes, kidney dysfunction, sickle-cell anemia, or any form of immune suppression. It is estimated that during major flu epidemics, high-risk individuals are two or five times more likely to be hospitalized, depending on the age group.

Physicians and nurses at the Children's Hospital of NewYork-Presbyterian at Weill Cornell strongly urge parents to have their children immunized to provide optimal protection during December and January when flu epidemics are at their peak.

Common Sense and Care: Tips for Holiday Fire Prevention

New York, NY (September 2004) — The activity and excitement of the holidays tend to make people less careful when they should be more cautious. Dr. Roger Yurt, Director and Robert Dembicki, R.N., M.S., Patient Care Director of the Hearst Burn Center at NewYork-Presbyterian Hospital/Weill Cornell, urge you to take care all the time, but especially during the holidays.

Among the Christmas and Hanukkah pointers to bear in mind are:

• Remember that Christmas trees cut early in the season quickly dry out to become fire hazards. Never put a Christmas tree in front of an exit.
  
• Never decorate Christmas trees with candles, even if you do not intend to light them.
  
• Only buy Christmas tree lights that have been inspected by the Underwriters Laboratory (UL). Inspect and test lights each year before putting them on the tree.
  
• Never leave Christmas tree lights on when you leave the house. If a wire should short, you might return to find your house on fire!
  
• 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.
  
• Never leave religious or holiday candles burning unattended.
  

Winter Watch for Senior Citizens: 10 Tips for Having a Safe Season

New York, NY (September 2004) — Winter is a special time for caution if you or someone in your family is an older adult. It is the season for flus, for slips on icy streets, and for other dangers that are especially serious for senior citizens.

"Something as simple as a fall can be devastating for older men and women," says Dr. Rafael Bejarno-Narboma, Medical Director for Geriatric Practice of the Ambulatory Care Network at NewYork-Presbyterian/Columbia. "Before the cold weather arrives, it is important to prepare."

Dr. Bejarano-Narboma offers tips for a healthy and safe winter:

• Get vaccinated annually against the flu. The season for flu runs from mid-October to mid-March, and the illness can be fatal to older adults. The vaccine offers some, if not complete, protection.
  
• Ask your doctor about Pneumovax, the vaccine against pneumococcus, which protects against pneumonia.
  
• Check the lighting in your house. Make sure there are no great contrasts from one room to another, because older people have difficulty adjusting to changes in light and high contrasts increase the risk of slip and falls. Also, use night lights, and don't have loose extension cords lying around — tape them to the floor.
  
• Check your rugs. Make sure they are not wrinkled or torn in a way that can trip you up as you walk. Use padding or special tape underneath them to prevent from sliding.
  
• In the bathroom, have mats inside and outside the tub to keep you from slipping on a wet surface. If you need them, install grab bars inside the tub, and always check the temperature of the water before getting into the tub.
  
• Continue your exercise regimen — indoors if possible. However, avoid strenuous exercise like shoveling snow.
  
• Maintain your diet and a good level of hydration. Drink at least four or five glasses of water every day. This should not change just because it is winter.
  
• Make sure your smoke alarms are working. If you live in your own house rather than an apartment, you should also have carbon monoxide alarms.
  
• Have appropriate footwear. Comfortable shoes with anti-slip soles will help you navigate icy streets.
  
• Have a programmable phone with emergency numbers entered. Another good idea for older persons living alone is a personal emergency response system — a device worn around the neck or on a bracelet, which can summon help if needed. Wear this device all the time, and use it.
  

Breathe Easier! Ten Tips on Improving Life in the Winter for Children With Allergies

Advice for Parents from the Morgan Stanley Children's Hospital of NewYork-Presbyterian

New York, NY (September 2004) — Spring and summer are not the only seasons that bring misery to children with allergies.

"The end of the pollinating season is good news for children 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. Allergy to mold spores is more of a problem than pollen allergy because mold grows anywhere and is not limited to a single pollinating season. It needs little more than moisture and oxygen to thrive," says Dr. William Davis, Director of the Division of Allergy at the Morgan Stanley Children's Hospital of NewYork-Presbyterian.

In winter, children spend more time indoors, which increases their exposure to irritants like dust mites, pet dander, smoke, household sprays and chemicals, and gas fumes — any and all of which can make their lives miserable.

Dr. Davis offers these ten tips to make the winter months more bearable for children with allergies:

• Keep your indoor humidity level below 35 percent to help prevent the growth of mold and mites. Use exhaust fans when showering or cooking to remove excess humidity and odors.
  
• Avoid putting rugs in your child's room, if possible, since wall to wall carpeting is an ideal place for dust mites to proliferate.
  
• When outdoors, keep children from playing in areas that promote mold growth, such as dark, wooded areas.
  
• Use dust-proof covers for mattresses, box springs, and pillows to decrease exposure to allergens, but consult your child's allergist before undertaking such an expense.
  
• Wash bed linens and nightclothes in hot water (above 130 degrees) to kill dust mites.
  
• 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.
  
• Don't put plants in your child's room, since decaying leaves and increased humidity can stimulate growth of mold.
  
• If your child is allergic to household pets (dogs and cats), minimize his or her contact with them. If you cannot remove them from the household, keep them out of your child's bedroom at all times.
  
• Children with asthma should get a flu vaccine in the fall before the onset of cold weather. Also, keep your child well hydrated and protected from cold air with proper attire (i.e. a scarf over the mouth).
  
• Contact your child's physician or allergist for proper evaluation and treatment.
  

Winter Exercise May Exacerbate Asthma Complications

NewYork-Presbyterian/Weill Cornell Specialist Offers Advice for Exercising in the Winter

New York, NY (September 2004) — Whether jogging, skiing, or skating, enthusiastic exercisers don't let the frigid temperatures of winter keep them indoors. But what many people don't realize is that exercising in cold weather can be hazardous for millions of Americans with asthma.

According to Dr. Abraham Sanders, a pulmonologist at NewYork-Presbyterian Hospital/Weill Cornell, "It's crucial that all asthmatics know about possible triggers. For active men and women it means being aware of the potential dangers of cold weather exercise."

"Winter is already a difficult time for asthmatics because of the increased incidence of colds and flu, which can evolve into more serious conditions such as bronchitis or pneumonia. Adding exercise to the mix can mean even more trouble."

Dr. Sanders offers the following tips when exercising in winter:

• Always wear a scarf over your mouth and nose to warm the air before you breathe in.
  
• Warm up with stretching and light activity before exercising, shoveling, or beginning more strenuous physical activities. Also, make sure to cool down.
  
• Take all medication as prescribed, even if you feel fine.
  
• If it's too cold or icy, head inside for mall walking or another activity.
  
• When exercising indoors, be sure that the room is well humidified and ventilated.
  
• Dress in layers. Layering clothes underneath a windproof and waterproof outer shell helps maintain body heat.
  
• Drink plenty of fluids. Your body needs fluids during cold weather, too. Try carrying a water bottle.
  
• If you've been sedentary or have health problems, check with your doctor before starting any exercise program.
  

Tired of Scratching? Dermatologist From the Iris Cantor Women's Health Center Offers Tips On Fighting "Winter Itch"

New York, NY (September 2004) — All winter flakes are not made of snow. Cold weather wreaks havoc on our skin, sometimes making it dry and flaky. Skin dries out if it's deprived of water, resulting in a condition commonly referred to as "winter itch."

"Most of us experience dry and itchy skin from time to time, but you should seek medical attention if discomfort becomes severe," says Dr. Diane Berson, a dermatologist at the Iris Cantor Women's Health Center of NewYork-Presbyterian Hospital/Weill Cornell. "The best thing you can do to relieve the itch is to moisturize your skin because, unfortunately, you can't do anything about the weather."

"Remember, dry skin is due to lack of water, not oil. Apply moisturizers immediately after bathing or showering to trap water in the skin," notes Dr. Berson.

She suggests the following tips to turn your skin from alligator into suede:

• Moisturize daily. Cream moisturizers are best for normal to dry skin. People with sensitive skin should choose a moisturizer without perfume or lanolin.
  
• Cleanse your skin, but don't overdo it. It is enough to wash your face, hands, feet, and between the folds of your skin once a day. The trunk, arms, and legs can be rinsed daily, but do not use soap or cleanser on these areas every day. Too much cleansing removes the skin's natural moisturizers.
  
• 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 "water-in-oil-type" moisturizer. Gently pat skin dry.
  
• Humidify. Humidifiers can be beneficial. However, be sure to clean the unit per manufacturer's instructions to reduce mold and fungi.
  
• Protect yourself from the wind. Cover your face and use a petroleum-based balm for your lips.
  
• 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.
  
• Protect your skin from the sun. Winter sun can be as dangerous for the skin as summer sun. It can lead to premature aging of the skin and skin cancer. When outdoors for prolonged periods, use a sunscreen with a sun-protection factor of 15 or greater.
  
• Exercise. For skin with a healthy glow, 20 to 30 minutes of aerobic exercise three times a week is recommended.
  
• 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.
  

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