Employee Health Systems - February 2010 Newsletter

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EAP Newsletter - February 2010

In This Issue:

When Cold Weather Hurts

Welcoming the New Year With a Positive Attitude!

Can Stress Make You Sick?

Good News About Winter Energy Costs - Really!

Stock Your Emergency Kit

When Cold Weather Hurts

Cold winter weather can be especially hazardous for people who work outside or even for those who just like to spend lots of time outside. Cold exposure injuries, including frostbite, have increased over the past 20 years. But sometimes the cold can cause other ailments, too.

A 40 year old chef was still wearing woolen gloves when she sat down in my office last winter. She said her symptoms - hand pain and numbness - worsened when she was outdoors or reached into the freezer. When her fingers got cold, they turned shades of red, white, and blue. Several fingertips were ashen and one had a small ulcer. She had a severe case of Raynaud's phenomenon, caused by spasm of the arteries of the digits or a nerve sensitivity to cold, which affects 3 to 5 percent of people.

Attacks usually last from a few minutes to several hours. Aside from avoiding the cold and not smoking, treatment is generally not warranted. In more serious cases, calcium-channel blockers such as nifedipine (Procardia and generic) may prevent and reduce episodes. In advanced cases, ulcers can develop on the fingers and may necessitate amputation.

Frostbite is another concern. While it affects feet or hands in 90 percent of cases, it can also involve the face and ears. At first, most people experience a cold numbness, and the body part feels icy to the touch. Go to the emergency room immediately if you are affected, to be warmed (a whirlpool is ideal) and to take steps to avoid infection and gangrene. Two to three days later, the blood supply re-establishes, causing a throbbing pain that can last weeks or months.

Added risks

Other cold-weather ailments include hypothermia - when the body's temperature plummets below 95 F (35 C) - and cold-induced asthma and heart attacks. People with hypothermia first feel cold, shiver, and seem socially withdrawn. As the condition worsens, victims can become confused and sleepy and slur their speech. In the most severe stage, the heart can slow down dangerously.

The risk of hypothermia is highest when people are not prepared for it - when they're at a sporting event on a cold, rainy day, for example, or swimming in a cold lake on a hot spring day.

Exercise-induced cold stress, which can be caused by working outdoors in the winter, can raise blood pressure. Activities involving the upper body seem to be most dangerous, particularly for people with coronary artery disease, who may be susceptible to angina and heart attacks. That is why people with coronary disease shouldn't shovel snow.

My patient was lucky. She responded well to medication and her skin ulcer healed. She has asked her sous-chef to handle the freezer and is thinking of moving to Florida.

To prevent frostbite:

Wear layered, loose-fitting, heat-retaining clothing and avoid constrictive garments, including tight boots.
Wear mittens instead of gloves, and consider a balaclava, a cap that can also cover the ears, nose, and lips.
Stay dry and out of the wind, cold rain, and snow.
Avoid alcohol, which, besides impairing judgment, causes heat loss by dilating the blood vessels and contributes to dehydration, another risk factor.

By Orly Avitzur, MD

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This sounds like a difficult, if not impossible, task given the news of the day. But if one looks beyond the headlines, there are some very good things happening!

A Improving Economy: In a November, 2009 report, The Associated Press reveals that "a flurry of good news - including falling jobless rates, stronger consumer spending and higher new-home sales - suggests that the economic rebound, modest though it may be, might just be here to stay." This view is reinforced by economist Ken Mayland of ClearView Economics who comments: "It is not a gallop. But it is still forward movement."

Cancer Deaths Decline: A 2009 report in the medical journal Cancer Research states that "The number of cancer deaths has declined steadily in the last three decades. Although younger people have experienced the steepest declines, all age groups have shown significant improvement." In a separate report, Dr. Richard Severson, a cancer epidemiologist at Wayne State University Department of Family Medicine, states that "In childhood cancer particularly, we're able to do amazing things with leukemia and lymphoma that used to be a death sentence - but now we are curing many of these cancers."

Life Expectancy Longer Than Ever: According to the Centers for Disease Control, life expectancy in the United States has surged to 77.7 years. The numbers are even better for Canada, where the life expectancy has reached a record 80.4 years, according to Statistics Canada.

The Promise of "Herd Immunity": The nationwide incidence of H1N1 infections and related visits to physicians' offices for influenza-related visits decreased slightly while the production and delivery of H1N1 vaccine accelerated during late 2009. Some researchers are hopeful that a form of "herd immunity" also known as "community immunity" may be occurring. This means that as more people become resistant to the virus via preventive inoculations or from having actually experienced the disease, the lower the threat to the unprotected population. Herd immunity is generally believed to have been the major reason for the eradication of smallpox and diphtheria.

American Savings Rate Surges: According to Bloomberg News, "Americans are building their nest eggs at the fastest pace in 15 years." The household savings rate - which was exactly zero in 2008 - grew to 6.9% of income during 2009. While this may not be the best news for retailers, it is definitely good news for the banking industry, where deposits now exceed $7.5 trillion. The Federal Reserve believes that the increase in personal savings will put the country's finances in better balance and reduce our dependence on overseas investments.

So as we enter 2010, let's make a concerted attempt to maintain a hopeful, optimistic perspective. And always remember that for those times in the New Year when problems or challenges do present themselves, the professionals at your Employee Health Systems are standing by to provide expert help - 24 hours per day!

"The stress at work is sending my blood pressure through the roof," a patient told me. His instinct was good, because experts who study stress are increasingly seeing how it connects to illness. Stress affects your heart, weight, and skin. It's also linked with "poorer wound healing, an increased risk for developing depression, the common cold, and influenza, as well as associated with increased symptoms among those with chronic illnesses," says Dr. Sheldon Cohen, a professor of psychology at Carnegie Mellon University in Pittsburgh.

Confronted by sudden danger, the human body instantly pumps the bloodstream full of adrenaline. This hormone, along with cortisol, raises your blood pressure, heart rate, and blood sugar, temporarily giving you additional strength, speed, and stamina. In emergency situations, stress can save your life.

But ongoing stress - the kind you might face when you're experiencing marital, financial, or work-related problems or are caring for a sick relative - influences your ability to function and may lower your immunity. Even your genes can be affected, says Dr. Elissa Epel, a health psychologist at UC, San Francisco, because stress changes "the protein output of our DNA." That's like saying it affects the core of what we are made of.

Heart. "There is overwhelming evidence that stress creates an environment where heart attacks and even sudden death become more likely," says Dr. Joel Dimsdale of UC, San Diego, in the Journal of the American College of Cardiology. Job stress has been found to increase cardiovascular risk by up to 50%. In addition, stress lowers estrogen production, which reduces protections against heart disease in women, explains Dr. Stephen Manuck, a professor of psychology at the University of Pittsburgh.

Headaches. Stress appears to change the balance of chemicals in the brain in a way that may contribute to the narrowing of blood vessels - one theory for why we get migraines. Stress also is a factor in tension headaches. And physical reactions to stress - such as tensing the neck and shoulders, grinding teeth, or clenching the jaw - may make headaches worse.

Skin. Stress can exacerbate many common skin conditions, such as acne, psoriasis, hives, and rosacea. It may lead to hair loss, brittle nails, herpes outbreaks, and shingles.

Cancer. The evidence linking stress to cancer is limited, but we do know that chronic stress can weaken a person's immune system, which may make him or her more susceptible to certain cancers associated with viruses.

Obviously, you need to address stress that wreaks this sort of havoc. Start by recognizing what stress looks like - it's not always obvious. You might feel tense, have headaches, sweaty palms, a racing heart, or an upset stomach. General aches and pains can be stress-related. The same goes for constant worrying, difficulty focusing, and trouble making decisions.

The good news is that there are various ways to cope with stress, ranging from medications to exercise to calming techniques like meditation and biofeedback. Taking these routes to "chilling out" is well worth the effort.

Yes, it's true. The U.S. Energy Information Administration released its annual winter outlook in mid October and based its prediction on the anticipation of a mild winter coupled with lower fuel costs. The agency says that regardless of the type of fuel used, heating costs are expected to take less of a bite out of your budget in the coming months by an average of about 8%. The nearly 58 million households that use natural gas stand to save about $105 compared with last year and propane users will get an even bigger break - as much as $280. More modest reductions of $20 to $60 are expected for people who use electricity or fuel oil to heat their homes.

In addition, a few minor lifestyle adjustments can drive energy costs even lower. These include:

Simply by implementing a few of these ideas, you will be able to keep warm and know that you are doing yourself, your family, your environment and your wallet a great service!

If a blizzard or other emergency struck this winter, would you be prepared to hole up for two weeks at home?

Eighty-two percent of Americans we surveyed said they'd survive just fine or with only a little difficulty. Yet only 1 percent of them had the 16 items we consider necessary in a home emergency kit. (The average respondent had fewer than 10 of them; that's a D-in our book.)

Renters were the least prepared, followed by adults 29 and younger. Those living in New England and the mid-Atlantic states were a little better but still worse than average. Our telephone survey, conducted by the Consumer Reports National Research Center, polled 1,007 adults at the end of August.