Doctors’ orders for surviving the winter holidays

While the holidays can be a wonderful time, full of warmth and merriment, the days can easily fill up with distractions, stress, and unwise choices. The result may be a trip to the doctor’s office—or even the emergency room. Doctors’ advice: Be careful, maintain your regular health routines, don’t try to be perfect, take breaks from computers and other electronic devices, and make your teenagers do the same.

Here are more tips for enjoying a healthy holiday season:

Prepare kids for ice and snow

Karen Santucci, MD, Medical Director, Yale Pediatric Emergency Medicine

Winter holidays bring cold weather, ice and snow—and an increase in visits to the emergency room to treat ice skating and sledding injuries. Children should have warm coats, gloves and appropriate footwear, as well as the proper protective gear. One piece of gear that may be gathering dust on a shelf in the winter is a bicycle helmet. Not only will a helmet keep a child’s head warm, it will also help keep a child safe on slippery slopes and icy surfaces where dangerous spills can be unpredictable.

Stay alert on the road

Federico Vaca, MD, MPH, Director of the Yale Center for Injury Prevention and Control Research

Data consistently shows that the winter holiday season is a particularly deadly time to travel by car. The primary reason is the increase in drunk drivers. Just one glass of spirits can dull a driver’s judgment; certain medications, including antidepressants or pain killers, can further impair function. Even drivers who don’t use any of these substances can take the additional precaution of staying off the roads between 10 p.m. and 5 to 6 a.m., when some roads are poorly lit, and when there is more drinking, drug abuse, sleepiness, speeding and poor night vision.

Take control of the stress

Rajita Sinha, PhD, Director, Yale Stress Center

We all have so much to do: the meals, the gifts, getting relatives together. A helpful approach is to focus on one thing at a time. I tell my kids to think of the brain as a ball. If you have five different things going on at the same time, you’re dividing that ball into five pieces and breaking up your resources. Sometimes you need to stop and focus on one activity at a time, and commit to doing that for the next 10 minutes or whatever it takes. Then take a break and recoup before you tackle the next item on the to-do list. It’s one way to stay calm, safe and healthy. When stress becomes overwhelming, it may be important to seek help. Yale Stress Center services include acupuncture, biofeedback, meditation instruction, nutritional counseling, psychotherapy, psychiatric care, weight management and yoga. Call 203-737-3398.

Get good-quality sleep

Craig Canapari, MD, Medical Director, Yale Pediatric Sleep Program

This tip is especially important if your family is traveling or facing other disruptions to the usual routine. Small children need a dark, quiet place to sleep at night and during regular nap times. Teenagers and adults should avoid shifting to a schedule of late nights and late mornings because this change can result in difficulty reentering school or work once the break is over. The latter group should get up in the morning no later than two hours later than they usually do on school or work days. In addition:

• Plan for jet lag: Traveling westward is especially challenging for parents of young children. In this scenario, plan for early morning awakenings.
• If you are visiting friends or relatives, be creative with sleeping arrangements for children. Don't be afraid to bunk kids of similar ages together.
• Adults: Be aware that overindulging in heavy food, alcohol, and caffeine can result in poor-quality sleep.

Keep kids away from medications

Carl Baum, MD, Emergency Medicine, Director, Yale Center for Children’s Environmental Toxicology

Here's a common scenario: Grandma and grandpa come to visit for the holidays and bring along all of their prescription medications: blood pressure pills, pain killers, etc., in an easy-open Monday-Tuesday-Wednesday container. It takes five seconds for a toddler to open the container and ingest a week's worth of potentially dangerous meds—and nearly one-third of all calls to poison centers are about toddlers. How do you prevent an unwelcome trip to the hospital?

• Interrogate (yes—interrogate!) any guests about prescription medications they have brought along, and insist that everything be stored in original containers with child-resistant closures.
• Offer to help dispense medications to older relatives who might have trouble opening the original containers.
• Offer to store all medications in an out-of-reach, preferably locked, cabinet.
• Never leave loose medications on tables or countertops.

Parents who suspect their child has ingested a poisonous substance should call the state or regional poison control center at 1-800-222-1222.

Keep your body moving

Lisa Freed, MD, Director, Women’s Heart and Vascular Program

Stress and poor lifestyle choices are incredibly common during the holidays. The average weight gain from Thanksgiving to the New Year is one to two pounds, sometimes as many as five pounds. This extra weight may contribute to high blood pressure, high cholesterol, and diabetes, which all lead to an increased risk of coronary artery disease. Here are some ways to take charge of your diet and exercise during the holidays:

• Prepare for parties by eating a high-protein snack before you leave home, such as nonfat yogurt, perhaps with a piece of fruit to make you feel full.
• Allow yourself to taste what looks appetizing at the parties, but take only small portions, and opt for more fruit and vegetable dishes.
• If sweets are your downfall, go for a small piece of dark chocolate.
• Don’t go overboard with alcohol, which contains extra calories. Start with bubbly water, perhaps with a splash of lemon or lime.
• Maintain your exercise regimen both to burn extra calories and relieve stress. This exercise includes parking far away from stores and taking the stairs whenever possible. Fit in your usual exercise whenever you are able, aiming for 30 minutes a day.
• Don’t beat yourself up if you do splurge—just try to resume all your heart-healthy habits as soon as you can.

Keep up with health maintenance

Geralyn Spollett, APRN, Associate Director, Yale Diabetes Clinic

It’s especially important for those with chronic diseases to pay attention to medications and self-care during the holidays. For example, persons with diabetes have many challenges: diet, insulin administration, blood glucose testing. When the routine of care is disrupted by holiday parties and activities, blood glucose levels become more difficult to control. I encourage my patients to take the time to de-stress through exercise; even a quick 10 minute walk will help reduce stress and keep glucose levels more stable. Although the tendency to skip medication or glucose testing is greatest when people are pressed for time, it can lead to bigger problems with glucose control including illness and hospitalization. No matter how busy the holidays get, paying attention to medications and self-monitoring is time well spent.

Quit smoking once and for all

Benjamin Toll, PhD, Program Director, Smoking Cessation Service at Smilow Cancer Hospital at Yale-New Haven

If you quit recently you can make freedom from tobacco a New Year’s resolution; if you haven’t, don’t let the holidays get in your way. Here are some tips that may help:

• Use friends and family as a support system to keep you occupied at parties.
• As often as possible, put yourself in environments where you can’t smoke.
• Acknowledge that the holidays can be a time of stress, and teach yourself to walk away from stressful situations, take a few deep breaths and reset.
• Avoid alcohol at holiday parties, because it can contribute to smoking urges. Recent research shows that cutting down on heavy alcohol use can help with quitting smoking.
• Aim to eat smaller meals more often throughout the day as opposed to one or two big meals. Choose healthy snacks like carrot sticks to satisfy a craving for crunchy foods, and choose nuts in shells so that you can keep your hands busy cracking them.

Get your flu shot if you haven’t already

Peter Ellis, MD, Yale Internal Medicine Associates

There’s still time—the flu season runs until May. But the holidays are an especially high-risk period, with parties, travel and exposure to crowds in general creating more opportunities for cold and flu germs to spread. The Centers for Disease Control (CDC) recommends the flu vaccine for all persons aged 6 months and older, with rare exceptions. The CDC reported that last year’s flu season hit working-age adults especially hard. Because the immune system weakens with age, adults age 65 years and older are always more susceptible, and people with a chronic or serious illness are at high risk of complications from the flu. So if you haven’t gotten the shot, call your doctor right away, or visit the CDC's HealthMap Vaccine Finder to find flu shot locations.