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Most winter woes can be prevented

November 10, 2012
By C. Paul Martin, M.D. , Marshall Independent

We here in southwest Minnesota are fully aware that, although we haven't had our first snow yet, winter and its characteristic weather are fast approaching. In past discussions about this event in this column, I have emphasized the indoor challenges which we face as the temperature drops, the humidity decreases, and the snows and wind prevail. However, this winter visage has significant and often serious effects on our outdoor winter activities, especially the ones we negotiate every daywalking, driving, shopping, church activities and even shoveling snow.

Previously, we have discussed the perils of winter characteristic of our home environments and indoor activities. By this time, all of us should have our heating systems inspected and operating safely, smoke and carbon monoxide alarms in place, humidifiers working, and our wardrobes appropriately selected for winter use. In addition, be sure your holiday decorations and the Christmas tree will present a safe environment! Plan ahead and safely enjoy the seasons.

Outside activities in the winter require thought, preparation, and execution of common sense knowledge. I often treated patients who had incurred significant morbidity because they had not been vigilant about winter changes. At times, these seemingly minor injuries have led to serious illness and death! For example, the mortality rate of falls in the elderly in all seasons, especially in winter, approaches 15 percent ... so be careful!

Colder temperatures are not the cause of the usual illnesses such as colds, influenza, etc., which we all experience, but recent studies do suggest upper respiratory viruses are enhanced and more easily transmitted by colder, drier air. Thus, the use of face covers and humidification (40 percent) may decrease the frequency of upper respiratory infections.

Obviously, severe cold exposures causing frostbite and hypothermia are to be avoided, usually by careful safety precautions, proper apparel, and being aware of weather reports and precautions from the media. If you have doubts about traveling in the winter, especially in rural areas, DON'T! The prominent "blizzard gates" on the edges of Marshall and other cities remind us to think before traveling. The "winter survival kit" for your car has been discussed in this column and in the media, but its preparation, precautions, and proper usage should be reviewed yearly by you and your family.

While icy road conditions can be avoided or partially treated, those ice-encrusted sidewalks, walkways, and paths around our homes, workplaces, schools, churches, and stores may present continuing problems all winter. Many falls occur due to these icy paths; I remember an instance when one of our local family physicians treated in excess of a dozen patients with ice-related falls and fractures in just one winter evening ice storm! Wear your boots or rubber-surfaced shoes at all times during the winter. Your safety depends upon the amount of surface area of your feet in contact with the walking surface - so no high heels! Occasionally, a cane (rubber-tipped), a walker, and/or a companion may be necessary for older people when walking outside on slippery surfaces.

Most important, outside winter activities requiring exercise merit our specific attention. Snow shoveling is a demanding task, especially when the temperature is low, significant wind is present, and the snow is wet and heavy. Consultation with the cardiac rehabilitation staff at the Avera Marshall Regional Medical Center has informed me that snow shoveling can require 10 METS or more, an exercise level found in the mid-high range in cardiovascular stress tests. People well known to me have died while shoveling snow, and some, but not all, had pre-existing cardiovascular risk factors. However, as everywhere in life, use your common sense to modify your snow shoveling and other winter activities, dress warmly in layers, don't exercise after eating, and use a snow shovel which allows you to push the snow, not lift it, if possible. Your best course may be hiring a local snow removal service. It will result in your health and psyche being preserved and in money well spent!

Enjoy our winters, but be cautious in outdoor activities. Anticipate unsafe and dangerous conditions and act appropriately.



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