HAVE A HEALTHY HOLIDAY: How to Avoid Your Local Emergency Room This Holiday Season
By Irene Tien, MD // December 27, 2017
holiday health • Avoid extreme changes in eating
EDITOR’S NOTE: We are delighted to welcome Dr. Irene Tien, a board-certified emergency medicine and pediatric emergency medicine physician with over 20 years of experience, as a guest contributor to enhance our focus on providing timely, relative healthcare education. Dr. Tien’s website, MyDoctorFriend.com, Facebook page, Instagram and Twitter accounts and Youtube channel provide a plethora of useful information centering around health-literacy and patient advocacy.
For many, the holiday season can be a stressful time of year and unfortunately can present some unique health hazards.
Your normal healthcare resources may well not be immediately available to you, and the hospital emergency room the only option. Dr. Tien provides sage advice on how you can avoid a trip to your local hospital emergency room on a holiday.
— Dr. Jim Palermo, Editor-in-Chief
The holiday season is stressful enough without having to try to fit a visit to the emergency department (ED) in your schedule.
Needless to say, getting medical care on a major holiday can be especially difficult because most, if not all, offices and urgent cares are closed.
People are left with the ED as their sole source of direct medical care.
This can make the ED wait longest around the holidays. How can you avoid being one of the many waiting for medical help in the ED on a holiday?
This is some advice based on working many years of holiday seasons in the ED where I think a visit could have been avoided.
Make sure your medications are refilled.
I can’t tell you how often people discover they have run out of their medications on a holiday. Make sure you look through your medications and that you have enough to get you through the holiday.
If you are traveling, your medications and medical devices should be the FIRST things you pack. If you come to the ED for a refill, it is likely you will have a very long wait while we take care of the most seriously ill people first.
Consult with your doctor before the holiday if you have an illness or injury.
It’s 2 days before Christmas and you feel like you might be coming down with a cold. You have asthma. Now is the time to call your doctor and discuss a “what-if” plan. What if you get worse?
Should you have a prescription medication on hand to start if your breathing gets worse? When should you definitely go to the ED and what can you do to help you stay safely out of the ED? Coming up with your own “what-if” action plan for the holidays can go a long way to avoiding an unnecessary visit to the ED.
Avoid extreme changes in eating.
Many folks feel like holidays and other celebratory occasions are a free pass to eat and drink whatever we want. I am certainly not suggesting you shouldn’t enjoy your holidays, but going way off of your usual eating/drinking habits can make chronic problems much worse.
If you have heart failure, over-indulging in salt can worsen your heart failure to the point of needing a hospital admission to fix the problem. Allowing kids to over-indulge in junk food can lead to severe constipation, one of the most common reasons for a visit to the ED for abdominal pain.
Over-indulging in very large amounts of fibrous foods in one sitting, like cauliflower or Brussel sprouts, can lead to bowel obstructions, from a mass of food stuck in your bowel, called a bezoar (no, this is not meant to be an excuse to avoid eating your vegetables!). Weight gain over the holidays can be very hard to lose or may not be lost at all! So, enjoy your food. Just be mindful of not over-doing it.
Avoid extreme changes in physical activity.
If you have heart disease, high blood pressure, asthma, COPD, or other chronic illnesses, the holidays are not the time to suddenly become a weekend warrior if you are usually a couch potato. I have seen people over do it and have a heart attack or injure themselves because their bodies are not used to overly physical activities. Keep a steady course in your usual physical activities and sleep patterns during the holiday season. Your body likes routine.
Participate in activities safely.
There are a lot of injuries requiring a visit to the ED over the holidays that can be avoided. Make sure you wear the appropriate safety equipment, like helmets, when skiing.
Also make sure that if you are sledding, that you choose a location free of obstructions, like trees, bushes, fences, and away from roads/traffic. Keep your eyes open even if you are not sledding. I have seen bystanders wiped out by people who could not control their sled. I’ve seen children lose control of their sled and ram into a tree.
Make sure winter snow removal equipment is in serviced and in working order before you need it. And, PLEASE don’t use your hand to clear an obstruction in your snow blower. You WILL get injured. You WILL end up in the ER.
If you are sick, be cautious when in a large group or when you are around very young, very old or chronically ill folks.
The cold weather allows for viruses to thrive because they survive on surfaces longer, more people are sick, and we are in close proximity to each other because we’re driven indoors for more activities.
This is a time to think about those around you if you are sick. What is simply a cold for you can turn into a life-threatening illness for the very old, very young, or chronically ill. Avoid close contact and make sure to wash your hands frequently if you are sick and around other people.
Think twice about going to that holiday party if you are coughing a lot, have a fever, have vomiting or diarrhea, or if you think you have the flu.
Conversely, if you have are at higher risk of a minor illness causing serious illness (eg. lung disease requiring you to be on oxygen, poorly-controlled diabetes, young infants or newborns, pregnancy, significant heart disease causing heart failure or angina, or frail and elderly), think twice about going to large gatherings or keeping your distance from folks who are coughing or have a fever. This is also a good time to remind you to get your flu shot!
Utilize other sources of care like telehealth or urgent care for advice.
If you find yourself in need of urgent medical advice, your first call should be to your primary care doctor. If you have trouble getting through (let’s face it, they’re really busy over the holidays as well), investigate any nearby urgent care centers that may be open or telehealth options by using the internet. If you feel you have a life-threatening emergency, please simply come to the ED, holiday or no. That’s what we’re here for!
Investigate where you can get medical care if you are traveling.
If you are traveling for the holidays, do some research as to where the nearest urgent care or hospital is located. If you have special medical needs, for example, children with complex medical problems, make sure you have a quick chat with your doctor at home before leaving for your trip and know which hospitals near your destination has the resources to take care of an urgent problem, should one arise.
It also is extremely helpful for you to prepare a medication and medical history list, a copy of your labs or EKG if you have a history of problems in this area, and a list of your doctors and their phone numbers, as well as advance directive and health care proxy forms to give to the ED staff if you have to come see us.
If you are from out of town, it is extremely unlikely we can access your medical records, especially on a holiday or after business hours. Investigate apps like InfoSage to organize your medical history. There are additional easy ways to manage your medical information using the technology in your hand.
And, I can’t say it enough, please pack your medications and medical devices first!
Watch out for hazards when traveling.
Your home may be safe for your children, but when you are traveling, be aware of unseen hazards. Make sure that other people’s medications and firearms are secured and out of reach of children and adolescents. If you have young children, keep an eye out for small objects on the ground, which can quickly become choking hazards. Be aware of potential allergens like dander from pets or food allergens that those who are allergic can be exposed to. Make sure that those around you are aware of allergens that need to be avoided.
Be aware of how the holidays may affect your mood and stress you out.
Even though the holidays are supposed to be a time of happiness and joy, they are often a time of stress and sadness. Be aware of how the holidays are making you feel. If you have a pattern of becoming depressed or anxious around the holidays, confide in your friends, family or health/mental health providers early.
There is nothing wrong with you if you aren’t in the “spirit” of the holidays and I guarantee you that others feel the same. Checking in with yourself mentally and physically throughout the holidays may avert an emergency. There are some tips you can follow here to help manage stress during the holidays.
The holidays are meant to be enjoyed, but we all know that this is also a stressful time of year. Keep yourself healthy by trying to stick to your routine in eating, physical activity and sleep. Indulge in the pleasures of the season, but plan out how you are going to do this in moderation.
Keep yourself healthy by making sure you get the proper flu and pneumonia immunizations, wash your hand frequently, and avoid hanging out in close proximity in crowds if you or others are sick. Make sure you have all of your medications and medical devices available to you. Most of all, have a happy and healthy holiday season.
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