Dangerously Cold? Protect Your Health

A forecast of negative temperatures may make you feel like shuddering. But extreme cold temperatures are more than a nuisance - they could hurt your health.

"The bitter air that accompanies these conditions poses serious health issues of its own," said Mary Raymond, MD, board-certified internal medicine physician at Franciscan Physician Network St. John Health Center in northwest Indiana. "Patients with respiratory problems, such as COPD and asthma, can find this extreme cold can exacerbate this breathing and worsen their conditions.  Patients with arthritis often find this weather to worsen their joint pains and make simple chores more challenging. Patients with peripheral arterial disease can find the bitter cold aggravates their extremity pains, particularly in their hands and feet.” 

Risk For Hypothermia And Frostbite

Hypothermia, the lowering of your body temperature, and frostbite, a cold injury to your skin, are both caused by prolonged exposure to cold temperatures.

Both the very young and older adults are at increased risk of hypothermia. Poor blood circulation and not dressing appropriately for cold temperatures can also increase your chances of developing frostbite.

Before frostbite or hypothermia kicks in, our bodies experience something called frostnip. That's the feeling of numbness in our skin, that tingling that can set in after just a few minutes outside. 

"This could set in anywhere from 10 plus minutes in the wind chill and then the cold," explained Franciscan Health Indianapolis emergency physician Ryan King, DO. "And this could lead to serious issues like digit amputations, gangrene, really could be life-threatening if it is more advanced. So it's a pretty serious situation that we want to take all actions to avoid." 

Heat Your Home Safely

At home, set the thermostat to at least 68 degrees Fahrenheit. Even homes set to 65 degrees can trigger hypothermia in older adults, who often have slower circulation. Keeping layers on, including long underwear, socks and a hat, or using a blanket can also keep your body warm.

Have a plan for possible power outages, as well. Charge cell phones and check the batteries in flashlights. It's important to call seniors periodically to check up on them if they live independently as a well check.

Low temperatures may tax your heating system. The CDC offers these tips for safely heating your home:

• Use fireplaces, wood stoves, or other combustion heaters only if they are properly vented to the outside and do not leak flue gas into the indoor air space.
• Ensure adequate ventilation if you must use a kerosene heater.
• Use only the type of fuel your heater is designed to use - don't substitute.
• Never use an electric generator indoors, in the basement, inside the garage, or near open windows or the air intake of your house because of the risk of carbon monoxide poisoning.
• Protect yourself from carbon monoxide (CO) poisoning by installing a battery-operated CO detector and never using generators, grills, camp stoves, or similar devices inside the house, in basements, in garages, or near windows.

"Avoid bad exposures, trying to heat your home with things like your stove or with gasoline powered space heaters," said Franciscan Health Indianapolis emergency physician Chris Hartman, MD. "We're seeing lots and lots every year: house fires and carbon monoxide exposure."

Bundle Babies And Small Children

Babies sleeping in cold bedrooms are at an increased risk of hypothermia. Try to maintain a warm indoor temperature and realize that your young child may need more clothing than you to stay comfortable.

Generally, infants should wear one more layer than adults. If you have a hat and a coat on, your infant will probably need a hat, coat, and blanket. Start with close-fitting layers on the bottom, like tights, leggings and long-sleeved bodysuits. Add pants and a warmer top, like a sweater or thermal-knit shirt. Avoid puffer coats or other bulky materials that may compress and allow your child to slip out of a car seat. Get more tips on bundling your baby or toddler.

Chronic Conditions And Cold Temperatures

Cold and Lung Conditions

Extreme temperatures can make breathing difficult, whether your lungs are healthy or if you have a lung disease. The cold, dry air can irritate airways, especially for people with asthma, COPD or bronchitis, and wood-burning fireplaces may seem cozy, the smoke can cause irritations.

Bronchospasms, or shortness of breath, tightness in the chest or coughing, can be triggered by the sudden onset of cold weather, said Faisal Khan, MD, medical director, endoscopy, respiratory and pulmonary rehabilitation services at Franciscan Health Indianapolis.

"The more cold the temperature, the more rapidly bronchospasms flare up," Dr. Khan said. "It may be a few minutes or seconds.

"With mild bronchospasms, you might come inside and get better, or if you're more sensitive, you may need a puff or two on a rescue inhaler," he said. "The key is if you're sending that something's building up compared to with normal weather, don't tough it out based on past experiences. If it's -20 out there, you might not be able to shake it off. If it's not better after an inhaler, seek help soon."

Even if you don't venture outdoors, the winter weather and dry indoor air may put added pressures on the respiratory system. Dr. Khan recommended the following steps for persons with chronic lung conditions:

• Avoid using a fireplace if possible.
• Take medications and inhalers as prescribed.
• If you must go outside, cover your nose, mouth and neck to help retain the moisture within your nasal passages and lungs as you breathe.
• Hydrate. "In general, people don’t keep up the hydration, but increasing the water and using the old grandma's tale of warm soup does help," Dr. Khan said.
• Ensure you have a supply of all your medications in stock in case you are unable to get out on the roads.
• Have an emergency action plan in order.

Learn more about indoor air quality in the winter months.

Cold and Your Heart

Cold weather makes your heart work harder to help your body stay warm, and that can spell trouble for people who have underlying cardiovascular disease.  The winter months – in part due to the outside temperatures - are associated with a significant increase in blood pressure.

"In extreme cold weather, blood vessels constrict as a response to maintaining core body temperature," explains Mark Booth, cardiac rehabilitation manager for Franciscan Health Dyer and Hammond. "As the blood vessels constrict, the blood pressure raises, the heart rate increases, and it forces the heart to work substantially harder than in times of normal weather."

Additionally, the cold winter temperatures may increase your risk of heart attacks, or even stroke.

"Extreme cold weather can put stress on patients with heart disease," said cardiologist Ryan Daly, MD, of Franciscan Physician Network Indiana Heart Physicians. "Try and stay inside. Walk in the mall to avoid falls and get your exercise. Falls may be dangerous in patient on blood thinners, so take extra precautions.”

That upward swing of temperatures promised by our meterologists feels welcome, but extreme temperature swings creates stress on our body as well, according to a study presented at the American College of Cardiology last year.

If You Must Go Outside

If you must go outside, layer up! Wear a hat, scarf and gloves. Wear several layers of clothing to trap warm air between the layers. Stay dry to keep your body warmer.

If you have small children, keep the infant carrier inside your home to keep it warmer when not in use. Get an early start to warm up your vehicle and allow enough time to dress your baby or toddler in layers.

But before you leave, ask yourself whether venturing out is even necessary during cold temperatures.

"I advise our patients to exercise extreme caution when choosing whether or not to venture out in these conditions," Dr. Raymond said. "They should ask themselves if their plans can be postponed until the weather conditions are more amicable to leaving their home. If you chose to leave home, please allow extra time for travel, wear appropriate winter clothing, and take your time."