Health and Wellbeing: Many health problems get worse in cold weather

THE welly boot industry has never had it so good, and you can't buy a sledge for love nor money.

But for many of us, the recent cold snap has spelled bitterly bad news, causing everything from travel chaos to nose-bleedingly high gas bills, not to mention extreme health problems ranging from chilblains and dry skin to broken bones or hypothermia.

Falls

The number of admissions to Scotland's accident and emergency units for slips and falls has increased threefold over the recent period of cold weather, according to Ken Lawton, chair of the Royal College of GPs Scotland. "It's things like broken wrists – which are very common because people stretch their hands out to save themselves. Broken hips too, if someone goes down with a thump on their bottom. Then there was that chap who died two days before Christmas after simply slipping and hitting his head at Waverley station."

Lawton's advice is to wear shoes with good soles. "Not all shoes that would appear to have good grips actually do. I bought a pair I thought would be fantastic but they were a disaster. You now get strap-on spikes for your shoes so it might be worthwhile thinking about that."

And make sure the area around your home is safe by putting down salt or grit. "If you have an old biddy next door, put some down for them as well," he adds.

In the end, if you do find yourself taking a tumble, follow your instincts and put your hands out to cushion the blow. "It's a reflex," he says. "And if you don't put your hands out, you fall and thump your face and you land up with a broken nose or, worse, a fractured skull."

Colds and flu

The publicity surrounding swine flu may have begun to abate but it remains a very real threat.

"The vaccine take-up among pregnant women has not been as good as we would have liked," says Lawton, "and we started the under-five campaign last month, so anyone who is in an at-risk group, pregnant or under five should, if they haven't heard from their GP's surgery, be contacting them to find out what's happening."

As for the more common cold and flu bugs, these can happen at any time year. "In fact," says Lawton, "there is some evidence that in the colder weather some of the bugs get knocked off. There's the old wives' tale – 'Ach, we need a good winter to kill off all the viruses.'

"I'm not sure how true that is but certainly, when we've had a good cold snap, it has seemed as though there were fewer colds and flus around."

However, the colder weather does make us more vulnerable to infection so if you already have the sniffles, always cover your mouth when you cough or sneeze – "using a paper hanky," cautions Lawton, "rather than a green-coloured piece of cotton".

Other strategies include common sense moves such as staying warm. "Wrap up, in the house as well, because temperatures do drop inside.

And if you're going out, rather than one big sweater, put on several layers, which will allow you to alter your clothing depending on how hot or cold you're feeling.

"But there's no magic wand that will help you avoid colds and flu. Some people say vitamin C and zinc help, but the evidence is that they don't really make that much difference."

Pre-existing health issues

Conditions such as asthma, bronchitis, heart disease and arthritis can be exacerbated in the cold weather. And while it might be wisest to simply stay indoors, that becomes impractical for long periods.

"Sufferers need good neighbours, friends or relatives, to help them with their shopping, because they will be temporarily frail and more vulnerable to slips and slides on pavements," advises Lawton.

Otherwise, they should try to stay warm and not over-exert themselves. "People with heart and respiratory problems should not be out there with a shovel clearing the path," says Lawton.

"I've had two or three people in the surgery since the snow who have come in saying, 'I was clearing the path this morning and now I've got a pain in my chest that won't go away,' and they've needed to go to hospital to check whether they've had a heart attack."

Arthritis sufferers, meanwhile, always say they know when a cold snap is on the horizon, because their joints start seizing up in advance. And, as well as being excruciatingly painful, it also makes them more vulnerable to nasty falls.

"They will probably feel a bit stiffer and find it a bit more difficult to get going," says Lawton. "Warm gloves and clothing will help ease the discomfort. And they should make sure they're feeling limber or warmed up before they go out, because if they go on slippy pavements and their joints are feeling stiff, they're not going to be as able to respond as quickly to correcting the slip."

Chilblains

The warning from our mothers as we rested our frozen hands above the bar heater still rings in our ears. But does anyone even get chilblains any more? An inflammation of small blood vessels causing tingly, red, uncomfortable patches in the joints of the knuckles or the toes, they result from a rapid change in temperature.

Prevention in this case is better than cure, says Lawton. "Wear a good pair of thick gloves with silk liners, though mitts are even better because the exposed surface area is smaller. Also, avoid the temptation to stick your hands on the radiator, in front of the fire or in hot water when you come in from the cold.

"I haven't seen chilblains for a few years because of the milder winters we've been having," he adds, "but I'm sure we'll see them after all the recent extreme weather."

Poor circulation

Otherwise known as Raynaud's disease, it causes the blood vessels in the hands and feet to be particularly sensitive to changes in temperature.

"You go out in the cold and your fingers will turn white then blue," says Lawton. Again, prevention is better than cure, so try to keep your hands warm.

"Then again, the people I know with Raynaud's come in with liner gloves and gloves on top and still the cold gets through. There are some medications you can get that open up the blood vessels in the fingers, but they have the side-effect of a headache."

The danger coming in from the cold with numb fingers is that serious burns can result from trying to warm your hands up too quickly. "Be aware if your fingers are white and you're going to do the washing up, for instance, as it may not be until your hands have been in the water for two or three minutes that you realise it has been too hot," says Lawton.

Hot-water bottles, too, can be a risk. And not just for people with Raynaud's. "What people tend to do is boil the kettle, fill the hot water bottle and stick it in the bed, put their feet on it and fall asleep. Particularly older folk. I've seen several really nasty burns from hot water bottles.

"So if you have one, don't fill it straight from the kettle, fill it from the tap. Or add some cold water to it. Then put it in a cover as well."

Dry skin

How many of us are turning up at the office looking as though we're auditioning for the lead role in The Singing Detective? The cold weather means there is less moisture in the air, which results in dry, cracked skin, especially for those already suffering from eczema or dermatitis.

"Plenty of moisturiser is your preventative measure," says Lawton, "because it puts moisture in and is a barrier to losing it. Also, the greater the area you can cover while you're out and about, the less drying it will be." So, balaclavas all round, then.

Cold sores

The bright, clear skies are a welcome relief from our traditional dreich winters, but all that sunlight is bad news for cold sore sufferers. It's even worse if you're already feeling under the weather.

"One of the triggers for cold sores is UV light," says Lawton. "The important thing is, as soon as you feel a tingle, put your cream on to try and abort the attack before it becomes too well established.

"They are infectious, so if they're blistering and discharging, don't pick them then touch someone else. Also, look after your general health – they do happen when you're run down, though some people are just prone to them."

Frostbite

A more common complaint in Scotland is frostnip, rather than frostbite – less serious but still painful. Causing a discolouration of the tissue – usually fingers or a toe – it is best treated by heating up the affected area with warm blankets or towels to get the circulation back slowly.

Hypothermia

Elderly people are seriously at risk from hypothermia for several reasons. "One is that older folk are scared of heating their house because they can't afford it," says Lawton. "My advice would be, if you don't want to heat the whole house, keep one room warm, shut the door, shut the curtains and stay cosy.

"Also, older folk don't have the ability to adapt as rapidly to changes in temperature. They don't have as much subcutaneous fat so they lose the heat much faster, and their metabolism tends to be slower as well.

"I can think of a couple of cases in my own experience of an old person getting up at night to go to the loo, falling and been unable to get back to bed. They've been hypothermic in the morning."

He urges us all to be more aware of our neighbours and elderly relatives, and to make contact to ensure they are surviving the cold weather. The signs of hypothermia to be looking out for include confusion and sluggishness that is out of character.

"If they're not engaging in conversation as they would normally be, if they're cold to touch, be suspicious of hypothermia." If you're at all suspicious, call their GP or NHS24. "We need to be looking after each other. Let's become a caring society again."

For advice on health issues and how to stay warm, contact NHS24 (08454 242424, www.nhs24.com)

• This article was first published in Scotland on Sunday, January 17, 2010