Increase in patients with respiratory, heart ailments
Doctors have seen a 20 to 30% increase in number of patients with respiratory ailments, heart conditions and uncontrolled hypertension in the last fortnight as the temperatures in the capital dropped to a record low.
“Bronchitis cases have gone up. Heart patients also face risks. If the healthy people do not take care of themselves, they may face a condition called hypothermia which results in abnormally low body temperatures,” AIIMS director Dr Randeep Guleria told news agency ANI.
Bronchitis is the inflammation in the lining of bronchial tubes that carry air to and from the lungs. In cases of respiratory ailments, it is not only the numbers but also the severity that has the doctors concerned.
“The cold along with high levels of pollution has resulted in exacerbation of symptoms in asthma patients. The sudden dip in temperature has been especially brutal for people with chronic obstructive pulmonary disease (COPD). We have had to intubate and put several people on ventilators; our ICU is overflowing,” said Dr Sandeep Nayyar, head of department of respiratory medicine, allergy and sleep disorders at BL Kapur Super speciality hospital.
There has been a 20% increase in the number of patients in the intensive care unit at the hospital.
“People who were earlier being managed in the clinics are now coming to us in hypoxic state (a condition where the body is deprived of oxygen) and in need of emergency intubation,” he said.
He suggests that those with weaker immunity – the children, the old, pregnant women, those on steroids or immunosuppressant and those with HIV – should take flu shots at the beginning of the season.
Heart failure and heart attacks also go up when temperatures dip.
“We see more patients with heart failure and heart attacks during the winters. Although we do not have data for this winter, it is a fact. As far as hypertension goes, nearly 30% of people whose blood pressure is under control with medicines need a dose adjustment during the winters,” said Dr HS Isser, professor of cardiology at Safdarjung hospital. “This happens because the cold weather constricts the blood vessels, the sympathetic nervous system also releases more hormones like epinephrine which precipitates heart failure and other heart conditions, coagulation also increases during the cold leading to clot formation and heart attacks. In winters, salt consumption also increases leading to uncontrolled hypertension.”
He suggests that patients with heart disease and hypertension visit their doctors when the temperatures start dipping in November and December to get their doses adjusted. He also encourages monitoring of BP at home.
Apart from that, doctors have been receiving cases of muscle pains and headaches.
“To maintain the body temperatures in severe cold, muscles contract to produce heat. This leads to muscle pains. We have been receiving at least 20% higher than normal the number of people with muscle pains and headaches,” said Dr Srikant Sharma, senior consultant of internal medicine at Moolchand hospital.
The diversion of blood to the skin to keep it warm also results in poor supply to the intestine resulting in indigestion. “During winters, people should eat light easily digestible foods and stop a little before satiation. Otherwise, the undigested food in the intestine can lead to gas, vomiting and other gastric symptoms,” he said.
Not drinking water also leads to dehydration in the winters. “Due to the severe cold people avoid drinking enough water, especially during the night to avoid going to the washroom. Coupled with people using heaters at this time of the year, this can lead to dehydration,” said Dr Nayyar.
Keep yourself warm: Ensure that you keep yourself warm within the house and wear multiple layers before stepping out to protect yourself against the cold.
Stay indoors: Minimise the time you spend outdoors, do not step out unless you have to.
Do not exercise outdoors: People should give up on morning and evening walks outdoors when the temperatures are low. Indoor exercise is the best; outdoor exercise can be done if the sun is out during the afternoons.
Avoid temperature difference: Do not step out of a heated room or car immediately to the cold outside. Switch off heaters a few minutes before you need to step out, acclimatise to a lower temperature before stepping out.
Drink enough water: People tend to drink less water in winters which can lead to dehydration. Drink lukewarm water to ensure you consume enough.
Have a healthy, balanced diet: A good diet can boost immunity. Have lots of seasonal vegetables and fruits. Include jiggery, turmeric and dry fruits in your diet.
Do not overeat: Due to blood flow to the extremities, the digestion slows down in the winters. Ensure that you do not overeat to avoid gastric symptoms.
Take medicines regularly: People living with asthma and other chronic respiratory ailments, hypertension, and heart diseases should check in with the doctors to adjust their doses for the winters and take the medicines regularly.
Flu shots for those with lower immunity: The children, the old, pregnant women, and people with lower immunity like those with asthma who take steroids, those who have undergone a transplant and are on immunosuppressant, and those with HIV should take a flu shot at the start of the winter.