ER Doctor: Listen To Your Body During The Holidays

Hospital emergency rooms don't take off for the holidays. As a matter of fact, it can be their busiest time of the year.

Dr. Steven Polevoi, medical director of the University of California San Francisco (UCSF) has done everything from treat traumatic injuries to deliver babies during his 23-year career. While medical emergencies occur throughout the year, Polevoi sees the winter season and its related overindulgence as a pivotal time for preventing emergencies by listening to our bodies.

Ignoring symptoms

“People tend to delay care around the holidays,” said Polevoi, whose emergency medicine team treats about 3,000 patients every month. “They may have symptoms of cardiovascular disease such as abdominal or chest discomfort which they interpret as indigestion or overeating, but in fact it could be cardiac ischemia.”

Cardiac ischemia -- which could lead to a heart attack -- occurs when blood flow and oxygen to the heart are dramatically reduced by narrowing of the coronary arteries. Symptoms include discomfort in the upper abdomen or chest that is often described as a heavy sensation or pressure, like “an elephant sitting on my chest.”

Excuses

“You meet the patient and they tell you their story,” Polevoi said. “You say, ‘Why didn’t you come sooner?’ and they say, ‘Well, I was traveling or I was having a party.’ These can be subtle symptoms patients interpret as something other than a serious condition.”

People can sometimes confuse a serious heart condition with acid reflux or heartburn – especially around the time of holiday feasting -- because the symptoms are similar. But consider this: heart-related deaths increase by five percent during the holidayt season. In fact, fatal heart attacks peak on Christmas, the day after Christmas, and New Year’s Day, according to a national Circulation study published in 2004.

The message Polevoi tries to drive home is that anyone suffering from coronary symptoms should act immediately and not put it off. The longer blood flow to the heart is reduced, he says, the more likely a heart attack is on its way. Insufficient blood flow to the heart muscle can lead to congestive heart failure, end-stage heart disease and even death. Overeating and stress typically associated with the holiday season could exacerbate existing conditions.

Don't overdo it

People with heart conditions should also watch what they eat and drink during this season of over-indulging. Foods high in salt and fat can easily push someone with heart trouble over the edge.

Another excess that fills the emergency room during the winter holidays involves binge alcohol consumption. Last New Year’s Eve, the UCSF emergency department experienced a 50 percent jump in the number of ER visits from the year before. Of that, 70 percent were for alcohol intoxication. That number has steadily risen over the past few years.

Typically these patients are so intoxicated that they aren’t able to walk or talk. They can lapse into unconsciousness, have trouble breathing and sometimes even die.

“People ought to have a good time on New Year’s Eve but drinking responsibly means a lot not only to yourself but to other individuals as well,” Polevoi said. “If you become so intoxicated that you lose consciousness and need to be transported to an emergency department, that has an impact on other patients. As with most things, know your limits and listen to your body.”