obody wants to spend the holidays in the emergency room, but sometime it’s better than the alternative.

Dr. Marianne Smalley, a doctor in the emergency room at Lehigh Valley Hospital Carbon, said it is because people don’t want to take time out from their busy holiday schedules or disrupt visiting with family and friends that health issues become so dangerous.

“Nobody wants to be hospitalized. Nobody wants to spend half of their day on Christmas Eve sitting in the ER or the days leading up to it, but often if people would come in a little bit sooner the outcomes would be better,” she said. “We end up putting people on ventilators quite a bit, and having major heart attacks with pretty catastrophic results.”

Smalley said hospitals typically see an upswing in heart attacks over the holidays. It’s a phenomenon that is pretty well-documented.

The American Heart Association has actually put out a paper about it recently, she said. The weeks between Thanksgiving and New Year’s are the highest for heart attacks in the country.

“Christmas Eve, we start seeing fatal heart attacks and quite a few of them,” she said.

Why is there an increase in heart attacks?

Smalley said there are several reasons why heart attacks increase this time of year.

Stress can be a factor. Stress in seeing family; stress in getting everything ready for the big day. People’s routines are different. They’re busy running around and squeezing in meals where they can. Those on strict diets cave in to convenience, and people traveling miss taking their medications.

“All of that can lead to stress and strain on the heart. It can lead to congestive heart failure with pretty severe breathing difficulties,” she said.

What to look for

The symptoms of a heart attack are different from indigestion from the rich foods of the holidays.

“If you’re sweating, feeling lightheaded like you’re going to pass out or dizzy, ‘I just need to sit for a minute,’ those are not symptoms of indigestion. They’re concerning symptoms,” she said. “Something like that would warrant a call to 911. That’s a visit to the emergency department.”

Smalley said often people sense that what they are feeling is something different, something alarming, something serious. When they come in, she asks where they are feeling pain. Is it in the neck? Is it going down the arm? Is it in the chest?

Heart attacks are most common in people between the ages of 40 to 60, and the risk increases with age. Smalley said people come into the emergency room apologizing for making a fuss out of nothing.

“Those are the people going to get a catheterization, because their EKG (electrocardiogram) or their blood test clearly shows that they have had a cardiac event. Something clearly happened to their heart, likely a heart attack,” she said.

Smalley encourages people to seek medical attention if something feels wrong. It’s much better to spend Christmas Day in the hospital, than it is to end up in the ICU for weeks at a time or maybe not survive at all.

More than just heart attacks

Although heart attacks are prevalent during the holidays. There are other types of emergencies to try to avoid.

“We see a lot of people falling off ladders trying to put up Christmas lights, which is unfortunate. In people on blood thinners, it can be devastating,” said Smalley.

Falls result in a lot of broken arms and legs and other breaks. Fingers getting cut during food preparation is another common injury during the holidays, and then there are more vehicle crashes caused by increases in traffic.

“They’re all exacerbated when you add alcohol, which is something that is also common during the holidays,” she said.

Another common occurrence in the ER is accidental ingestion by children of things they shouldn’t be eating. This can happen when children are visiting a house that isn’t childproof or are at a party where there are lots of people, and parents are distracted.

If a child gets ahold of someone’s medication, it can be devastating.

“A 3-year-old takes a blood pressure pill and it can be fatal, especially if it goes unrecognized,” she said.

It’s important to be aware of surroundings and keep an eye on the kids.

Smalley advises to do things in moderation. Eat in moderation. Drink in moderation. Don’t overdo physical activity.

“One thing leads to another, and suddenly you’re not feeling well,” she said. “Try to stick to your diet.”

Is it the flu or COVID?

Influenza is also on the rise in the area. Smalley said the doctors have seen several cases and they have had to admit some people.

“People seem to be much sicker with it,” she said.

The doctors are testing everyone now for both COVID-19 and the flu. They expect cases of both to increase after the holidays, because people are getting together now. She knows everyone is fatigued with wearing masks, and following recommendations like social distancing, but she said it is really important to keep it up.

Anyone who thinks they could have come in contact with someone with COVID should wear a face mask when they get together with elderly relatives, because young unvaccinated people often don’t have any symptoms, but can still have a large viral load that they can spread.

“As much as it is exhausting for me to constantly be the person wearing the mask coming from the emergency department, I sleep well at night knowing that I’m protecting my family, I’m protecting the people around me,” she said.