Autumn is Coming - Have a Healthy Fall

Hopefully, you avoided the more prevalent health issues of summertime:

• Insect bites and stings

• Sunburn

• Heat-related illnesses

• Dehydration

• Food poisoning (from picnics, road trips, hiking)

Autumn is upon us, with its more moderate temperatures, drier air, increased allergens in the air, less sunlight, and circumstances that promote the spread of viruses. Here’s some information to help you plan to limit health issues associated with the season.

• Seasonal Allergies: Itchy eyes, sneezing, coughing, and runny nose can be triggered by increased allergens like pollen and mold spores. Nasal steroids (e.g., fluticasone, mometasone, and triamcinolone) tend to be more effective than oral antihistamines. Not all oral anti-histamines are the same. A rough rule of thumb is the sleepier it might make you, the more histamine it blocks. Non-drowsy loratidine is a good first-line drug for milder allergies. Cetirizine is more likely to cause tiredness (usually mild and tolerable if present) and can be more effective if loratidine fails.

• Norovirus (Stomach Infection): This highly contagious virus that causes nausea, vomiting, diarrhea, and stomach pain for 1-3 days spreads easily in cooler months. Wash your hands…and don’t forget your thumbs.

• Common Cold or Bronchitis: Weather changes can weaken the immune system, making people more susceptible to viruses that cause colds. Cooler weather and close indoor contact contribute to cold outbreaks. Use good hygiene–wash your hands, cough into the inside fold of your elbow, and be polite and wear a mask to protect others if you are sick for a few days.

• Flu: Viruses that cause flu (fever, cough, severe body aches, fatigue) are more prevalent in the fall and peak during the winter months. An ounce of prevention is worth a pound of cure. Get your annual flu shot. Nothing is as good at preventing the flu. Most people who die do not die from influenza, they die from the pneumonia that follows or the stress on the heart infections can cause. People with heart disease who get the flu shot are less likely to die than those who do not.

• Asthma Attacks: Cold air and increased respiratory infections can trigger asthma symptoms. Get your flu shot. Travel with your inhaler. If you have moderate to severe asthma not well-controlled by a low- or medium-dose daily inhaled corticosteroid alone, discuss SMART (Single Maintenance and Reliever Therapy) with your family doctor. It is a newer approach to asthma therapy.

• Seasonal Depression: Shorter days and decreased sunlight can lead to general mood change or even seasonal affective disorder (SAD).

Regular exercise, healthy eating, and social connections can help. These things often decrease in the fall. Being active can boost mood and energy; aim for 150 minutes of exercise weekly. Keep your diet full of vegetables, fruits, and whole grains. Light therapy can also help prevent SAD. The studies on vitamin D to prevent SAD are

Stay proactive with good hygiene, vaccinations, and a healthy lifestyle. In summary:

1. Wash your hands.

2. Cough into the inside of your elbow.

3. Get your shots.

4. Sleep at least 7 hours daily.

5. Exercise 150 minutes weekly.

6. Stay hydrated.

7. Eat a diet rich in fruits, vegetables, and grains.

8. Get a periodic health evaluation, also called annual check-up or physical.

9. Stay socially connected.

10. Part of overall health is spiritual health— read your Bible, pray, and attend church regularly; the latter doubles as good for your social connection.

Lastly, enjoy the present. Prepare your heart for the Incarnation, but leave Christmas alone until after Halloween, and better yet, after Thanksgiving. These practices can help nurture your physical, mental, social, and spiritual well-being.

Dr. Stephen A. Wilson, MD, MPH, FAAFP, is Chair of Family Medicine at Boston University Chobanian and Avedisian School of Medicine and Chief of Family Medicine for Boston Medical Center.