December 10, 2018
Clinical Contributors to this Story
Robin Ashinoff, M.D. contributes to topics such as Dermatology.
Shaddy Younan, M.D. contributes to topics such as Cardiac Care.
Sivia Lapidus, M.D., contributes to topics such as Pediatrics.
Tamar Weinberger, M.D contributes to topics such as Pediatrics, Allergies.
Tomasz Grochowalski, M.D. contributes to topics such as Internal Medicine.
By Brianna McCabe
The winter does more than just raise your heating bill and empty your wallet as a result of holiday shopping – it can also impact your physical and mental health. Some experts at Hackensack Meridian Health Medical Group shared just a few of the ways in which the colder months affect some of their patients:
- Your risk of having a heart attack may increase. One study identified up to a 31 percent increase in heart attack cases during the coldest months of the year. “Cold weather forces your heart to work harder,” explains Shaddy Younan, M.D., a board certified cardiologist. “The cold weather can decrease your body’s supply of oxygen-rich blood to your heart, too. When this is coupled with your heart working harder, which in turn requires more oxygen-rich blood, you can see how this is problematic and can lead to a heart attack. Everyone, especially those with preexisting heart conditions, must be cautious during the winter months,” warns Dr. Younan.
- You might feel ‘down.’ Over 15 million Americans are affected each year by seasonal affective disorder (SAD), a type of depression that is related to changes in the seasons. Tomasz Grochowalski, M.D., a board certified internal medicine provider, explains that the darker, colder days can zap your energy and shift your mood. “If you start feeling depressed, lose interest in activities that you typically enjoy, feel sluggish, and have difficulty sleeping – and you notice this is interfering with your normal daily functions – then you might be suffering from SAD. Speak with your primary care provider about any symptoms or severe mood fluctuations.”
- You’re at risk for frost bite or hypothermia. Although you may not live in a notoriously cold area, prolonged exposure to excessively cold temperatures and whipping winds can make you a victim of frostbite or hypothermia. The Centers for Disease Control and Prevention (CDC) defines frostbite as a bodily injury caused by freezing which results in the loss of feeling and color in affected areas. Dr. Grochowalski explains, “In cases of frostbite, all layers of the skin are affected. The skin will become numb, blister, and eventually a patient’s tissue dies and turns black. This can permanently damage the body, and in severe cases, can lead to amputation.” Hypothermia, on the other hand, is a dangerous condition that occurs when you reach an abnormally low body temperature – typically anything below 95 degrees Fahrenheit (with severe cases being below 82 degrees or lower). “As your body begins to ‘cool,’ your organs shut down to preserve heat and protect the brain,” explains Dr. Grochowalski. “In other cases, the brain might shut down, too.” To avoid getting frostbite, it is recommended that individuals wear multiple layers, cover the head neck, and ears, bundle up with insulated gloves, and wear appropriate winter boots. “If you think you have frostbite or hypothermia, resist dunking your body in excruciatingly hot water. Your body is numb and you can burn yourself,” advises Dr. Grochowalski. “Go the emergency room immediately if you suspect frostbite or hypothermia.”
- Your skin can crack and burn – which can lead to infection. “The skin – the body’s largest organ – oftentimes is overlooked, especially in the winter,” says Robin Ashinoff, M.D., chief of the Department of Dermatology and Dermatologic/Moh’s Surgery at Hackensack University Medical Center. If the skin isn’t properly nourished and moisturized throughout the winter months, the skin can crack, blister, and bleed. “Having fissures or cracks in the skin allows bacteria and viruses to enter because that barrier isn’t there,” continues Dr. Ashinoff. “Prolonged dryness can lead to warts, impetigo (sores), and even cellulitis (a skin infection) – especially for those with diabetes.” If you notice that your skin is excessively dry and/or is cracking, Dr. Ashinoff advises that you schedule an appointment with your primary care provider or dermatologist.
- If you’re asthmatic, your risk of having an ‘attack’ may rise. Tamar Weinberger, M.D., a board certified pediatrician with a specialization in allergy and immunology, explains that patients with asthma and allergic rhinitis report having more respiratory-related symptoms with cold temperature than healthy young adults. “In patients with stable asthma, cold exposure at rest causes a significant decrease in lung function,” she says. “Effects are magnified when patient’s asthma was uncontrolled to begin with.” Additionally, Dr. Weinberger discusses the effect of exercising in cold weather and the potential to induce asthma-related attacks. Although exercising in cold air has minimal effect on normal individuals, it can cause bronchoconstriction in patients with asthma. She explains, “Inspired air (the air that we breathe in) is normally warmed and humidified by the nose. When exercising, people often breathe through their mouth, which brings cold, dry air to the lower airways and lungs and can trigger asthma symptoms. It is more important than ever to travel with your inhaler.” Additionally, Dr. Weinberger also mentions that asthmatics should avoid going outside when the temperature drops, cover your nose and mouth with a scarf to help warm inspired air, practice good handwashing, and avoid anyone who is sick. “Get your flu vaccine as soon as possible, too!” she adds.
- You may find that you are battling allergies. Although pollen isn’t an issue in the winter, other indoor triggers such as mold, dust mites, and pet dander can lead to unbearable coughing and sneezing fits. “When you’re inside, allergy sufferers have little chance to circulate fresh air and increase ventilation,” explains Dr. Weinberger. “By breathing in these triggers, you can actually trigger asthma in allergic individuals. If you are allergic to dust mites, make sure to wash your bedding once a week,” recommends Dr. Weinberger. “You can also explore if an air filter would be beneficial to you, too. However, if you find that your allergies are becoming unbearable, speak to your primary care doctor or allergy specialist for possible allergy relief medication.”
- You may experience joint pain – especially if you’re arthritic. Sivia Lapidus, M.D., a board certified pediatrician with a specialization in pediatric rheumatology, explains that although there aren’t many conclusive studies available that definitively establish a link between colder weather and increased joint pain, she does notice that there appears to be more complaints from arthritic patients regarding flares throughout the winter. “Many of my patients express that they feel like human barometers – when the weather dips, their joints ache,” she explains. Some studies suggest that cold weather decreases blood flow to the joints; joints with active arthritis in rheumatoid arthritis patients have been measured as colder and have been shown to increase in stiffness in colder temperatures. Other research has explored the correlation between the lack of Vitamin D exposure in the winter months and increased inflammation in juvenile arthritis patients. “Then there is always the possible link between inflammation and stressors,” explains Dr. Lapidus. “A person’s mood can fluctuate in the shorter, colder days. This, coupled with the tendency to exercise less, can cause a person’s joints to swell more, become more restrictive in motion, and stiffen – ultimately causing pain. I encourage many of my patients to sleep in socks if they have ankle arthritis or to really utilize heating pads for relief,” shares Dr. Lapidus.
Robin Ashinoff, M.D., practices in Hackensack (551-996-8660). Tomasz Grochowalski, M.D., practices in South Amboy (732-721-5511) and South River (732-254-3892). Sivia Lapidus, M.D., practices in Hackensack (551-996-5306). Tamar Weinberger, M.D., practices in Hackensack (551-996-2065). Shaddy Younan, M.D., practices in Parlin (732-727-0400) and in Holmdel (732-888-1115).
To find a provider near you, visit HackensackMeridianHealth.org.
Seasonal Variations of Complete Blood Count and Inflammatory Biomarkers in the U.S. Population
Anxiety and Depression Association of America
Centers for Disease Control and Prevention – Frostbite
Environmental Cold Exposure Increases Blood Flow and Affects Pain Sensitivity in the Knee Joints of CFA-Induced Arthritic Mice in a TRPA1-Dependent Manner
Vitamin D and Juvenile Idiopathic Arthritis
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