Much of the East Coast is in the middle of one of the worst blizzards.  These storms can cause damage to property and cars, but we often forget that they can adversely affect your health.  Already the news reports have stated there have been 9 deaths so far.  Most were from car accidents, but there were also a few heart attacks in people who were shoveling snow.

Here are some tips to keep you and your family safe during the storm.

• Make sure you have enough medications for you and your family’s chronic conditions (e.g. insulin for diabetics) to last for the the next 7 days
• If a medication requires cold storage, make sure to freeze some ice packs that you can place in a cooler
  Collect clean tap water in pots and pans that you can use for drinking should the municipal water system be contaminated by the storm surge/runoff. Continue to drink only boiled water after the storm if needed.
  Make a list of your medical conditions, names of all medications and doses. If you need to evacuate or need to go to a hospital for an injury, this information is important. If you have a heart condition, you should have a copy of your latest EKG (electrocardiogram). Keep these papers in a plastic waterproof sealable bag.
• Print out a list of phone numbers of family and friends. If you lose power, you may not be able to recharge your phone and access those numbers. This is especially important if you need to evacuate.
• Create a small bag filled with water, food (granola bars, nuts, etc), some cash and clean clothes should you need to evacuate. (remember, you may not be able to use ATM’s if the power goes out)
• Check on elderly relatives and neighbors. Elderly people are most vulnerable to dehydration. Make sure they have plenty of bottled water available.
• First aid kit. Have it accessible at all times. Fallen trees and flying debris can cause wounds that need immediate attention.
• Clear any clutter on the floors. If there is no electricity and it is dark, you have a chance of tripping on objects.
• Stock up on food that does not require refrigeration, such as soy milk, cereal, and bottled juices.
• Avoid going outside, even if you think the storm has passed. Be careful, downed power lines and falling tree branches can very dangerous.  Stay off the roads!
• If you have a heart condition or are physically out of shape, do not shovel the snow.  Leave it for someone else to do it.  Snow can get very heavy and shoveling can be very taxing for your heart.
• Dress warmly.  Better yet, put your warm clothes on about 10 minutes before going outdoors.  This will allow your body to trap heat inside your clothing and keep you much warmer.  Make sure all skin is covered with clothing.  Wearing goggles or sunglasses can be helpful to keep sharp snow from scratching your eyes.
• Drink plenty of fluids.  Cold air is dry air.  You lose a lot of fluid just being cold and outdoors.
• Moisturize your skin.  This is best done after showering to lock in moisture.  Don’t forget your lips!  Chapped lips can be feel very uncomfortable.

Stay safe and keep warm!

Holiday gift-giving is a great tradition, but do you need to give or get another scarf or box of chocolate? How about giving gifts that promote health and wellness instead?  Here are my top 8 gifts to give your loved ones a healthy start to the new year!

• Yoga mat–  Yoga is a wonderful low-impact exercise that can improve symptoms of arthritis and reduce stress
• Basket of healthy foods– We all hear about foods that can improve our health.  Why not create a basket with an assortment of all these foods.  I recommend a good bottle of extra virgin olive oil, chia seeds, flax seeds, and walnuts.
• Spice rack– Replace the salt shaker with exotic spices such as curry, basil, mustard, and chili powder.  Food will taste much better and healthier.
• Exercise bands–  Perfect for the person who says they don’t have time for exercise because they travel a lot. These bands can fit easily into any suitcase and do not take up much room.  Speaking from experience, they can give a workout that is comparable to using weights.
• Bottle humidifier–  The cold dry air during the wintertime can lead to increased respiratory infections and dry skin/lips.  By keeping the humidity of the room higher, you will feel much better.
• Live plants– Studies have shown that people feel much better when they are around live plants.  Plants remove toxins and carbon dioxide and release oxygen into the air.  They also add humidity to the air.  I find that lucky bamboo plants are easy to care for and can adapt to even the harshest conditions.
• Pedometer/Fitbit–  Help your loved ones track their steps.  These are great tools to encourage more physical activity and help them stay accountable to their goals.
• Himalayan salt lamp– This is a beautiful source of warm light that can also help to purify the air of chemicals.  I keep one in my office and the air always smells crisp.

Currently, our healthcare system is under stress.  Health care providers are seeing many patients and they may not have the luxury to spend as much time with them as they would like to.  This means you need to make sure you make the most of your appointment.  You need to cooperate with your healthcare provider and work as a team.  I have seen some rude and maladaptive behavior from patients who may not realize they are hindering their healthcare provider with their actions.  Here are some tips based on actual patient encounters.

• Turn the cell phone off.  You may use the cell phone for apps while you are waiting, but do not use or look at the phone while your healthcare provider is talking to you.  Not only is this rude, but you force the healthcare provider to repeat her/himself unnecessarily because you were distracted.
• Place less emphasis on self-diagnoses that you found the internet and more on what your provider says.  Many health websites are not written or verified by experts.  You may discuss what you have found with your physician, but don’t be offended if they do not think that is what you have.  Many conditions can present with the same symptoms.  Your healthcare provider is trained to do a full assessment specifically with you in mind.
• Don’t play “Stump the Doctor”.  I’ve had some patients who have withheld information hoping for the doctor to come to the same diagnosis they found on a website where they put in their symptoms.  Every piece of information is important when it comes to diagnosing diseases.  You should be open and honest with your provider.  You may think that your trip to Brazil last month isn’t an important piece of information, but it can be a very valuable clue to the right diagnosis.
• Write down a list of questions before your see your provider.
• Take notes so that you won’t forget any important information or instructions.  I always recommend bring a pad and paper.
• Bring all your current prescribed medications in their original bottles.  Many pills look the same and most physicians are not trained to know what each pill looks like.  Saying, “I take a small white pill for blood pressure” does not help to identify the medication.
• Write down your home blood pressure (if you have hypertension) or blood sugar (if you are diabetic) readings
• Ask about what signs/symptoms to watch for and what to do if your condition worsens.
• Ask for copies of test results, X-rays, and blood pressure readings for your own records.  We should all be keeping records of our health.
• Before you leave the exam room, let the provider know that you want to summarize the visit and to ask them to comment if everything was summarized correctly.  For example, “I came in today with a runny nose, it is likely due to seasonal allergies to pollen, I’m going to start taking anthistamines and buy an air purifier for my home and keep the windows closed.  If it doesn’t improve in one month, I am going to follow up with an allergist.  Is that all correct, doc?”

Flu season is approaching and you need to protect yourself and your family from the awful flu virus.  Need more reasons to convince you to get the flu shot? Here are 10 of them:

1. Getting the flu means 2 or more weeks of feeling miserable and usually happens at the worst possible time (your long awaited vacation, wedding, Christmas holiday, etc.)
2. The flu shot is widely available right now (October 2015).  In previous years, people waited till January when there was a shortage and a terrible flu season.  You can get your flu shot from your primary care provider, nurse, or local pharmacy.
3. It is covered under all insurances and medicare.  If you don’t have insurance, some community health centers can provide it for free.  Check with your local public hospital.
4. It’s quick!  A typical flu shot takes 30 seconds.  Make sure you wear clothing where you can roll up your sleeves to the deltoid muscle.
5. It hurts for only 1-2 days.  Yes, most flu shots can cause some local pain, but that’s temporary and pales in comparison to the body aches when you are getting the actual flu.
6. The flu shot takes 2 weeks to become effective.  Getting a flu shot now will ensure that you are protected before the holiday season.
7. By getting the flu shot, you are not only protecting yourself but also your family.  If you got the flu you could spread it to your children or elderly relatives.

Sometimes, we must travel on planes when we have a cold or sinus infection.  This can be problematic as the pressure changes during flight can cause ear problems and pain.  We have a tube called the “Eustachian Tube” which connects the ear to the airway (sinuses/throat).  When this tube gets clogged, pressure builds up behind the eardrum (tympanic membrane).  When the pressure changes on the outside, the pressure difference can be so great that the eardrum can burst.  People describe severe pain crescendo-ing (building up of pressure), then a severe pain (eardrum bursting), a sense of relief (pressure is equalized), then a realization that they cannot hear as well out of that ear. I always recommend that you see a health care provider before you fly when you are sick.  If your symptoms are severe, you may want to postpone your flight.  Here are some tips that can reduce your risk.

• Take decongestants at least 1 day before your flight.  These are pills such as psuedephedrine or phenylephrine or nasal decongestant spray called oxymetazoline (Afrin).  (If you have high blood pressure or heart problems, you should not take these.)
• Use a medication called Mucinex to thin out the mucus.  Thick mucus is difficult to clear out of your nose and can block the Eustachian tube.
• Drink plenty of fluids before the flight.  Sip on fluids continuously while the plane is taking off and landing.  I recommend buying a large bottle of water so that you have it at your seat rather than depend on the flight attendants.
• Do NOT fall asleep just before landing.  This is the most dangerous part of the flight.  Instead, make sure you sip fluids.  If you are tired, a cup of coffee can help you stay awake.
• Do a “clearing technique” when you feel pressure start to build.  Cover your nostrils with one hand and keep your mouth closed.  Then gently blow your nose.  You should feel the pressure suddenly release in both ears.  If not, repeat.   If you feel pressure start to build up again, repeat this process.
• Yawn and swallow frequently.  Candies that stimulate salivation are helpful.  Sour candies work the best (lemon flavored or “Sour Patch Kids” are my favorite)
• Blow your nose if you feel mucus starting to accumulate in your nose.
• If you feel like your eardrum has burst, make sure you visit a medical provider immediately for further evaluation.  A burst eardrum makes you more susceptible to inner ear infections.  Avoid getting water in the ear.