Important Flu Recommendations for High-Risk Populations

NEW YORK (September 2012) -- While it is important to get vaccinated against the flu virus as early as possible, it is never too late to reap the benefits of this vaccine. According to The Centers for Disease Control and Prevention, the peak months for the spread of the flu virus are January and February and the season can last into mid-May.

Those at highest risk of complications from the flu are young children; people 65 and older; pregnant women; and people with health conditions such as heart, lung or kidney disease, or a weakened immune system.

"Adults age 65 and older face the greatest risk of serious complications and even death as a result of influenza. That is why it is so important that they get immunized. Even when older adults contract the flu after immunization, which can happen, those cases tend to be less severe and of shorter duration," says Dr. Mark Lachs, director of geriatrics at NewYork-Presbyterian Hospital.

"It is important that all children get immunized against this illness," says Dr. Gerald Loughlin, pediatrician-in-chief at the Phyllis and David Komansky Center for Children's Health at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

Dr. Lachs and Dr. Loughlin offer the following guidelines to help protect these most vulnerable populations from catching the flu this winter:

• Get vaccinated early. The flu vaccine is most effective when administered during the fall months, before the onset of flu season.

• It's never too late. The flu season begins in the fall and can last through the spring, so if you do not get vaccinated in October you can still be immunized in December or January.

• Know your options. A nasal vaccine is available for healthy children from age two and over, and for adults up to the age of 49. There are some restrictions so check with your doctor first.

• Get your family members vaccinated. The Centers for Disease Control and Prevention recommends that the following groups get immunized against the flu every year:o Children beginning at six months of ageo Pregnant womeno People 50 years of age and oldero People of any age with certain chronic medical conditions such as asthma, diabetes, cardiovascular disease, and any form of immunosuppressive illnesso People who live in nursing homes and other long-term care facilitieso People who live with or care for those at high risk for complications from flu, including:* Health care workers* Household contacts of persons at high risk for complications from the flu* Household contacts and out-of-home caregivers of children less than 6 months of age (these children are too young to be vaccinated)

Physicians and nurses at the Komansky Center for Children's Health at NewYork-Presbyterian Hospital/Weill Cornell strongly urge parents to have their children immunized early to make sure they have optimal protection during December and January when flu epidemics are at their peak.

# # # How to Stop Winter From Weathering Your Skin

Top Ten Tips for Preventing "Winter Itch"

NEW YORK (September 2012) -- All winter flakes are not made of snow. Cold weather, with its low relative humidity, wreaks havoc on our skin, making it dry and flaky. Skin dries out if it's deprived of moisture and this dryness often aggravates itchiness, resulting in a condition commonly referred to as "winter itch."

During the winter the air is drier, and indoor heating further depletes your skin of moisture. Fortunately, there are several ways that you can replenish the water content of your skin.

Dr. Robyn Gmyrek, a dermatologist and director of the Skin and Laser Center at NewYork-Presbyterian Hospital/Columbia University Medical Center, suggests the following ten tips to help turn your alligator skin into suede:

1. Moisturize daily. Petrolateum or cream-based moisturizers are far better than lotions for normal to dry skin. If you have sensitive skin, choose a moisturizer without fragrance or lanolin. Apply moisturizer directly to your wet skin after bathing to ensure that the moisturizer can help to trap surface moisture.

2. Cleanse your skin, but don't overdo it. Too much cleansing removes the skin's natural moisturizers. It is enough to wash your face, hands, feet, and between the folds of your skin once a day. While you can rinse your trunk, arms and legs daily, it is not necessary to use soap or cleanser on these areas every day.

3. Limit the use of hot water and soap. If you have "winter itch," take short lukewarm showers or baths with a non-irritating, non-detergent-based cleanser. Immediately afterward, apply a thick cream or a petroleum-jelly-type moisturizer. Gently pat skin dry.

4. Humidify. Dry air can pull the moisture from your skin. Room humidifiers can be very beneficial. However, be sure to clean the unit and change the water according to the manufacturer's instructions to reduce mold and fungi.

5. Protect yourself from the wind. Cover your face and use a petrolatum-based balm for your lips.

6. Avoid extreme cold. Cold temperatures can cause skin disorders or frostbite in some people. See a doctor immediately if you develop color changes in your hands or feet accompanied by pain or ulceration. If you develop extreme pain followed by loss of sensation in a finger or toe, you may have frostbite.

7. Protect your skin from the sun. Remember that winter sun can also be dangerous to the skin. Even in the winter months you should use a sunscreen with a sun-protection factor of 15 or greater if you will be outdoors for prolonged periods. Overexposure to sunlight can lead to premature aging of the skin and skin cancer.

8. Avoid winter tanning. Tanning beds and artificial sunlamps are always damaging to your skin and increase your risk of skin cancer. If you want to keep your summer glow, use self-tanners along with extra moisturizer as self-tanners can also dry out your skin.

9. Take vitamin D supplements. During the summer months your natural vitamin D production increases due to daily sun exposure, but when winter rolls around that exposure decreases. Taking vitamin supplements can ensure that you are getting the recommended amounts of vitamin D all year.

10. See your dermatologist. If you have persistent dry skin, scaling, itching, skin growths that concern you or other rashes, see your dermatologist -- not only in winter but throughout the year.

# # # Ten Tricks to Combat Winter Allergies

NEW YORK (September 2012) -- Spring and summer are not the only seasons that bring misery to those with allergies. The winter months can be brutal for people sensitive to mold spores and dust mites.

Dr. William Reisacher, director of The Allergy Center in the Department of Otolaryngology (head and neck surgery) at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, says, "During the winter, families spend more time indoors, exposing allergic individuals to allergens and irritants like dust mites, pet dander, smoke, household sprays and chemicals, and gas fumes -- any of which can make their lives miserable."

Dr. Rachel Miller, director of allergy and immunology at NewYork-Presbyterian/Morgan Stanley Children's Hospital, adds, "Mold spores can cause additional problems compared to pollen allergy because mold grows anywhere and needs little more than moisture and oxygen to thrive. During the holiday season it is especially important to make sure that Christmas trees and holiday decorations are mold-free."

Drs. Reisacher and Miller offer these simple tricks to keep mold and dust mites at bay and make the winter months more bearable for indoor allergy sufferers:

• Turn on the exhaust fan when showering or cooking to remove excess humidity and odors.

• Clean your carpets with a HEPA vacuum to decrease dust mites and pet allergen levels.

• Wash your hands after playing with the family pet and avoid touching your face to decrease exposure to common winter viruses.

• Launder your bed linens and pajamas in hot water (above 130 degrees) to kill dust mites.

• Treat your bedroom as the allergy "safe haven" of your home because this is where you may spend most of your time. Your bedroom should have the fewest allergy triggers so keep pets, carpets, rugs and plants out of this room to avoid dust mites and mold from decaying plants. You may also want to place an allergenic barrier around your pillows and mattress to create a barrier between dust mites and your nose.

• Spray your live Christmas tree with a garden hose before setting it up and remove all dust from your holiday decorations.

• Install high-efficiency furnace filters: they capture 30 times more allergens, and make sure your furnace fan is always on.

• Keep your indoor humidity level between 30-40%, with the help of a humidifier or dehumidifier, to help prevent the growth of mold and mites.

• Change the water and filters in your humidifier according to manufacturer recommendations to avoid contamination by mold and bacteria.

• Perform an indoor and outdoor survey of the house every month to look for visible mold and identify areas that are at high-risk for mold formation, such as a pile of firewood close to the house or an area of the basement with a musty odor.

# # # Surviving Heart Attack Season

Learn How to Keep Your Heart Healthy During the Winter Months

NEW YORK (September 2012) -- While we may be accustomed to battling frigid temperatures and the inevitable snow storms that arrive every winter, many of us are unaware of the dangers these pose to our hearts.

"When the temperature outside drops, our blood vessels narrow to prevent our bodies from losing heat. This is a natural response that can also put people with heart conditions and those involved in strenuous exercise at greater risk of having a heart attack," says Dr. Holly Andersen, director of education and outreach at the Ronald O. Perelman Heart Institute of NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

Shoveling snow is one of the most strenuous and dangerous winter exercise activities. It can raise blood pressure, and coupled with the effects of colder temperatures, shoveling can increase heart attack risk drastically.

Dr. Andersen offers the following tips for safe shoveling and maintaining a healthy heart this winter:

• Warm up. Warm up with stretching and light activity before shoveling, exercising or beginning more strenuous physical activities.

• Bundle up. When going out to shovel, always wear a scarf over your mouth and nose to warm the air before you breathe in, and dress in layers. Layering clothes underneath a windproof and waterproof outer shell helps maintain body heat.

• Push the shovel. It is less strenuous to push the snow rather than lifting it, and this reduces the risk of overexerting yourself.

• Take breaks. You should take frequent breaks while shoveling to give your muscles, especially your heart muscle, a chance to relax. You may also consider sharing the work with a friend to make the workload lighter and ensure that you are not alone in the event of an emergency.

• Consult a doctor. If you are over the age of 50, overweight, out of shape or have suffered a heart attack, you should consult a doctor before shoveling snow or starting any exercise routine.

# # #

'TIS THE OVERWHELMING SEASON

NewYork-Presbyterian Psychiatrists Offer Advice for Reducing Holiday Stress

NEW YORK (September 2012) -- Crowded shopping centers, visits from long-lost relatives, and the pressure of preparing holiday meals can all summon one universal reaction: stress. The holidays may be the season of love and celebration, but sometimes festivities can become overwhelming.

Dr. Mallay Occhiogrosso, a psychiatrist at the Payne Whitney Clinic at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, says, "Overly high expectations for the holidays -- be it around the food, the gifts, or the family relationships -- can trigger anxiety and even depression. Prioritizing self-care is important, as well as dialing down those unrealistic 'Hallmark holiday' fantasies."

"During the holidays, our lives become even more stressful as we try to juggle our usual responsibilities with extra holiday preparation and complicated family dynamics," says Dr. Maria A. Oquendo, a psychiatrist at NewYork-Presbyterian Hospital/Columbia University Medical Center.

Drs. Occhiogrosso and Oquendo suggest that you try to keep your holiday stress to a minimum this year with the following advice:

• Seek out emotional support. If you have family difficulties, try to plan some time with friends. If you feel isolated, you may want to seek out the support of your community, religious or social services. If you feel lonely, you might consider volunteering your time at an organization you support.

• Take a 15 minute break. Fifteen minutes of "alone time" may be just what you need to refresh yourself. Try taking a brisk walk around the block. Exercise is a great stress reliever, and a daily dose of winter sunlight can dramatically improve your mood.

• Prioritize your time. Understand that you can't do everything, so choose the things that you can accomplish and enjoy. Get input from your family and friends about what it is they would really enjoy doing this holiday.

• Shop without anxiety. Remember that it's the thought that counts. Don't let competitiveness, guilt and perfectionism send you on too many shopping trips. Create a holiday shopping budget and stick to it, so the holiday bills don't linger after the tinsel is gone.

• Ask for help. Getting your family and friends involved in the holiday preparations may alleviate the stress of doing it all on your own.

• Set realistic expectations. Sometimes, expectations for family get-togethers are too high and result in disappointment and frustration. Accept your family members and friends as they are and set aside grievances for a more appropriate time.

• Celebrate the memories of loved ones no longer here. Holidays can also be stressful as we confront the memories of those who have passed. This can be a normal part of the holiday experience and should be openly discussed and celebrated.

• Plan ahead. You will have more time to spend doing the things that you really want to do if you set aside specific days for shopping, cooking and visiting friends. You may also want to plan your menu in advance and make one big shopping trip.

• Put it all in perspective. Think about what the holiday really means to you and your family: time together, religious observance, reflection on your life and future goals -- let these aspects of the holidays keep things in perspective.

• If you find that your depressed mood lingers, consider getting input from a mental health professional. Rates of anxiety and depression peak during the holidays; you don't have to suffer unnecessarily. Help is available.

These tips can help you to reduce stress and make the holidays a pleasure. Doing less may help you to enjoy the season more, and that is really the best stress reliever of all.

# # #

When a Winter Wonderland Becomes a Nightmare: Best Ways Older Adults Can Avoid the Hazards of Winter

NEW YORK (September 2012) -- Winter is a special time for celebration. It should also be a time for added caution if you or someone in your family is an older adult. It is the season for falls, slips on icy streets and other dangers that can be especially harmful for older adults.

"Something as simple as a fall can be devastating for older men and women," says Dr. Evelyn Granieri, director of the Division of Geriatrics at NewYork-Presbyterian Hospital/The Allen Hospital. "Before the cold weather arrives, it is important to prepare."

Dr. Granieri addresses some of the most pressing concerns mature adults have about their health and safety during the winter:

• The flu. Influenza is a serious illness that can be fatal in older adults, who often have chronic medical conditions. The vaccine offers some, if not complete, protection against the flu and can be administered as early as September. The flu season begins in mid-October and runs through March.

• Hypothermia. Keep your thermostat set to at least 65 degrees to prevent hypothermia. Hypothermia kills about 600 Americans every year, half of whom are 65 or older, according to the Centers for Disease Control and Prevention. Also, keeping the temperature at 65, even when you are not at home, will help prevent pipes from freezing by maintaining a high enough temperature within your walls.

• Icy streets. Navigating through icy streets can be intimidating. Wear comfortable shoes with anti-slip soles. If you use a cane, replace the rubber tip before it is worn smooth and becomes slippery on the wet ice.

• House fires. Make sure your smoke alarms are working. You should also have working carbon monoxide alarms.

• Falling in the home. Winter means fewer hours of daylight. Older people often have the need for a higher level of illumination in the home. You may also have difficulty adjusting to changes in light, and different levels of lighting may increase the risk of slip and falls. Make sure there are no great lighting contrasts from one room to another. Also, use night lights, and don't have loose extension cords lying around -- tape them to the floor. Make sure rugs are not wrinkled or torn in a way that can trip you up as you walk.

• Strenuous activities. Try to avoid strenuous activities like shoveling snow. You should ask your doctor if this level of activity is advisable. If you must use a shovel this winter, warm up your body with a few stretching exercises before you begin and be sure to take frequent breaks throughout.

• Dehydration. Drink at least four or five glasses of fluid every day. This should not change just because it is winter. You may not feel as thirsty as you do in the summer months, but as you get older your body can dehydrate more quickly, putting you at greater risk for complications from a number of illnesses; and also changing the way in which your body responds to some medications.

• Winter itch. This usually occurs because of dry skin. Wear more protective creams and lotions to prevent the dry and itchy skin commonly experienced in the colder months when humidity levels are lower.

• Home emergencies. For older persons living alone, it is a good idea to have a way to communicate quickly with other persons or medical personnel. If you have a cell phone, keep it handy. Another option is a personal emergency response system -- a device worn around the neck or on a bracelet that can summon help if needed.

# # # The Diet-Proof Holiday Meal: Seven Ways to Stay on Track this Season

NEW YORK (September 2012) -- Holiday dinners are filled with heaping dishes of comfort foods, fattening favorites and savory treats. It is no wonder these meals often leave us feeling stuffed with guilt and holiday remorse.

Patricia Nicholas, a registered dietitian at NewYork-Presbyterian Hospital/Columbia University Medical Center, says you can avoid this psychological turmoil by adding "new favorites" to the traditional dishes. "Healthy meals can be festive as well and hopefully, you have been making healthy changes to your diet all year."Michelle Morgan, a registered dietitian at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, says, "Stay in tune with your hunger during holiday meals. If you feel satiated and comfortable – stop eating!"

The following is the holiday feast survival guide -- a road map of sorts to keep you and your diet from straying too far this year.

• Re-think your appetizers. Incorporate healthier pre-meal snack options. Swap the bread bowl for whole-wheat pita with a low-fat bean dip!

• Add some color to your holiday dinner spread with a bowl of fruit or a vegetable salad.

• Choose smaller portions. You can still taste all the foods in your holiday spread without overeating. Remember, an occasional indulgence will not destroy your weight-loss attempts, and if you don't love something don't eat it.

• The only thing that should be stuffed during the holidays is the turkey! Just because there is more food sitting around, does not mean you need to eat more. A forkful of pie will do less damage than a whole piece.

• No need for second helpings; have a calorie-free chat instead. The holidays are a great time to engage in conversation with your loved ones – and this will not add inches to your waistline. Just be sure to move the conversation away from the food!

• Don't skip meals prior to a holiday party or dinner. You are less likely to overeat if you have eaten well throughout the day.

• Don't allow holiday activity to slow down your exercise program. Bundle up and take a walk after your holiday meal – this not only can prevent you from overeating and picking at leftovers, but is also a great way to burn off some of the extra calories you may have consumed.

For more information, patients may call (866) NYP-NEWS.

NewYork-Presbyterian HospitalNewYork-Presbyterian Hospital, based in New York City, is the nation's largest not-for-profit, non-sectarian hospital, with 2,409 beds. The Hospital has nearly 2 million inpatient and outpatient visits in a year, including 12,797 deliveries and 195,294 visits to its emergency departments. NewYork-Presbyterian's 6,144 affiliated physicians and 19,376 staff provide state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian/Morgan Stanley Children's Hospital, NewYork-Presbyterian/The Allen Hospital and NewYork-Presbyterian Hospital/Westchester Division. One of the most comprehensive health care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. The Hospital has academic affiliations with two of the nation's leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons. For more information, visit www.nyp.org.