Winter advice for patients with chronic conditions

Managing chronic disease during winter

Asthma

Take your asthma medication as prescribed by your GP. It will help you control your asthma better and hopefully prevent an asthma attack.

Always carry your blue reliever inhaler. Having this with you ensures that in an asthma emergency you have a tool which will help ease and relieve your symptoms.

Have an up-to-date asthma action plan as this helps you manage your asthma. It can help you identify if your symptoms mean you need a check-up. You can download and Asthma Action Plan on www.asthma.ie.

COPD

Patients with chronic obstructive pulmonary disease (COPD) are vulnerable during the winter season. The prevalence of winter viruses, particularly the flu virus, make these patients particularly susceptible to exacerbations or ‘flare ups’. These exacerbations may predispose the patient to requiring emergency attendance at the GP or emergency department and may require admission to hospital.

Some preparation for the winter may help these patients get through the season safe.

All COPD patients should receive flu and pneumonia vaccines. They should use the opportunity to check with the pharmacist or healthcare provider that they are on the correct medication and most particularly that they can use inhalers properly. Many patients with COPD have difficulty with their inhalers and this is a good time to have a refresher instruction.

Patients with COPD should be on the lookout for warning signs of an impending exacerbation. These warning signs include increasing phlegm production, discoloured phlegm, or increasing breathlessness.

Patient should have a self-management plan or action plan to deal with an exacerbation. This would usually involve a course of antibiotics and steroids.

Carers should check with their elderly relatives with COPD to see can they assist with any of this advice.

Cancer Treatment: Avoiding Infection

If you have cancer and you are treated with chemotherapy, you are more likely to get infections because you have a weakened immune system. Chemotherapy drugs are used to treat cancer by killing the fastest growing cells in the body, that is, the cancer cells themselves. But some good cells are killed too, unfortunately.

Cancer chemotherapy can damage the immune system by reducing the number of white blood cells. White blood cells fight infection. Neutropenia (low white cells) is a side effect of chemotherapy that means your body is less able to fight infection.

Infections are usually caused by viruses and bacteria. Bacteria can come from the air, water, soil, or food. Common bacterial infections include pneumonia, bronchitis, and urinary infections. Viruses are passed from one person to another. Common viral infections include and the flu.

3 simple steps to prevent infection during your chemotherapy treatment

Prepare:

  • Ensure you have enough medication at home during bad weather
  • Watch out for a temperature. Take your temperature at same time every day
  • Know when your white cells are at their lowest. This is when you are most at risk of infection
  • If you get a temperature, it is an emergency. Phone your medical oncology team.

Prevent:

  • Wash your hands OFTEN and especially before eating and after going to the toilet
  • Ensure everyone washes their hands

Protect:

  • Get the flu vaccine. Check with your oncologist first
  • Ask you family / carers / close contacts to get the flu vaccine
  • Here are the guidelines for flu vaccination
  • Politely decline to have visitors if they might have a cold / flu
  • Know the signs / symptoms of infection
  • Ask you medical team who you should contact if you feel sick
  • Write down the chemotherapy day ward phone number
  • Know the hospital number to call at night and at weekends

Read our guide to help patients who are receiving chemotherapy to prepare, prevent and protect themselves from infection.

Diabetes

  • Get the flu jab and Pneumovax.
  • Take your medicine as prescribed.
  • Get in touch with the Diabetes Specialist Nurse team if you are experiencing illness or out of range blood sugars.
  • Monitor for ketones during sick days if you have Type 1 diabetes and contact the DSN team if necessary.

Heart failure

If you have heart failure you are at increased risk during cold weather. Cold weather makes the heart work harder to keep the body warm. So the heart rate and blood pressure may increase and those changes can lead to difficulties, particularly for people who already have heart conditions such as heart failure.

If you have heart failure you need to be extra vigilant during winter. It is important to stay warm, avoid going out unnecessarily particularly in fog or low cloud. Keep warm and wear layers of clothing, a hat and scarf if you do go out. Also as best as is possible keep active and develop a routine of exercise which is possible in cold weather, such as walking in covered areas or using treadmills or stationary bikes

If you feel you may be coming down with a cough or cold, don’t wait for it to get worse, go to your GP or pharmacist immediately. Ask them about the flu vaccine and pneumococcal vaccine - to protect against pneumonia.

Take your medicines regularly as prescribed and monitor your heart failure symptoms every day, take action immediately when you notice any deterioration. Your doctors can then adjust your treatment to improve or stabilize your symptoms.

Check list:

  • Avoid fog / low cloud
  • Stay warm
  • Get the flu-vaccine and pneumococcal vaccine
  • Take your medicines as prescribed
  • Monitor your symptoms i.e. record weight daily, check for swollen ankles, measure your breathing.
  • Contact a health professional without delay if your symptoms deteriorate. Keep the number of your heart failure nurse specialist and/ or GP beside the phone. Also keep your eircode beside the phone.

Advice for patients with chronic kidney disease and their families

In winter it can be difficult for everyone to get about and conduct day to day activities. It is even more difficult for vulnerable people such as patients with Chronic Kidney Disease. Patients should remember to take extra care and be prepared during a cold spell.

Health advice:

  • Patients with chronic Kidney Disease should get the flu vaccination as this is the best protection against the flu for at risk groups
  • Haemodialysis patients should not miss dialysis sessions regardless of weather conditions. You should have alternative travel arrangements or backup travel plans in case of local road disruptions
  • Make contact with your hospital/facility for any change in operating times or deferrals/ change of services due to severe weather conditions
  • Ensure you have sufficient supplies of any prescription medicine and of food you may need
  • Renal Transplant patients should keep several days’ supply of anti-rejection medication in case of emergency or unable to get to the GP/Pharmacy

Keeping well and warm:

  • Keep warm, eat well and avoid unnecessary travel. You should eat regular hot meals and drink plenty of fluids, this will keep you warm and will give you energy to keep active
  • Keep active indoors
  • Have sufficient fuel supplies to maintain adequate heating in your home
  • Ask your relatives and neighbors for help if you need it
  • Keep emergency contact details in close proximity to your phone

Personal safety - staying safe:

  • Ensure that you are registered as a vulnerable patient with Irish water / electrical supplier/ gas supplier
  • Keep details of Meter point numbers and your Eircode close to your phone
  • In icy weather, wear well-fitted shoes with non-slip soles if you have to go out but try to limit walking outside during the cold weather
  • Consider wearing a personal alarm so that family or neighbors are alerted if you fall
  • If you have a fall, even a minor one, make sure you visit your doctor for a checkup

Fall prevention in your home:

  • Leave a low energy light on at night time, preferably one with a high light output
  • Use a non-slip shower or bath mat
  • Make sure wires or cords from lamps, telephones etc. do not trail where you walk
  • Arrange furniture so that you can easily move around all your rooms
  • Remove rugs or use non-slip tape or backing so rugs will not slip
  • Consider installing hand rails on both sides of the stairs

Checklist for patients with chronic disease

Winter ready checklist for patients with chronic disease like COPD, asthma, heart disease, or diabetes.