The last place you want to be in during the most anticipated time of the year is in an emergency room. Yet hospitals, according to Makati Medical Center (MakatiMed) Cardiologist Paul Quetua, MD are at their busiest in December, and often for conditions that could have been prevented, had people practiced merrymaking in moderation.
Data gathered by the Department of Health (DOH) from eight (8) hospitals around the country in December 2024 confirms it. According to the DOH, stroke cases rose from 12 on December 23 to 103 a week later. Incidence of acute coronary syndrome (from heart attack or unstable chest pains due to poor blood flow to the heart) also went up, from two a few days before Christmas to 62 just before year’s end. Of the stroke patients, two (2) died, while one (1) who suffered a heart attack passed away.
Chalk it up to Filipinos’ “fiesta mentality,” or the rationale that it is perfectly acceptable to eat and drink excessively in a season that happens once a year.
“In our culture, the holidays are the longest cheat day. It is not uncommon for people to attend 10 to 20 parties in one month during December,” says the MakatiMed Cardiologist. “It is really the calling of the season that we can go out and eat and indulge. We need to change that mindset.”
Planning ahead, making conscious food choices, and pacing yourself spare you from the possibility of landing at the ER following days of unabashed eating and drinking.
Heart Attack and Stroke
The number one and number three causes of mortality among Filipinos in 2024 just don’t happen after stuffing yourself silly at Noche Buena. Rather, they are the result of years of unhealthy eating habits, obesity, sedentary living, constant exposure to stress, tobacco use, and uncontrolled cholesterol, blood pressure, and blood sugar. Over time, as cholesterol accumulates in our arteries and sugar turns our blood vessels sticky and narrow, this impedes blood flow to our various organs, including the heart and brain.
“[After a Christmas party], the patient might be sleeping soundly, but their heart and stomach are working hard to digest all that food and alcohol. And that can really stress the heart,” says Dr. Quetua. “In a patient who isn’t healthy, the additional stress can really push them to the brink and maybe cause a heart attack or stroke the following day.”
As such, it is best to err on the safe side as soon as you feel the classic symptoms of a heart attack (chest pains and shortness of breath) or stroke (numbness on one side of the body, slurring speech, drooping face, severe headache).
Time is of the essence when it comes to these life-threatening conditions. “Better safe than sorry,” says the doctor. “Most of the time, we rely on symptoms, but there is no better way to diagnose than through an examination and tests. If it is a false alarm, then at least you have peace of mind, and you can face the next day with confidence.”
Attending all the parties you are invited to? Drink a glass of water or focus on appetizers like sliced veggies so you feel full before the main course. If you still want to eat, use a small plate to pick samples of dishes; a bite or two of lechon, a spoonful of fruit salad, a sliver of Queso de bola, and the like.
Undergoing an executive checkup or annual physical exam just before the holidays can be an effective way to lay low on the salty, sweet, and fatty staples of Christmas. “If your cholesterol and blood sugar are already high, maybe you need to take maintenance medicines, or need not overindulge,” says Dr. Quetua.
“It is like going to battle. You need to know your strengths and weaknesses. If you don’t come prepared during the holidays, then you might lose the battle and end up in the hospital.”
Holiday Heart Syndrome
A night of binge drinking does not just leave you with a nasty hangover. It sets you up for Holiday Heart Syndrome—irregular and rapid heart rate at rest (or atrial fibrillation in medical terms) following the excessive consumption of alcohol.
“It can last for hours, sometimes even days,” says Dr. Quetua. “Imagine if your heartbeat is racing at 140, 160 beats per minute: It is like running for the whole day. It can tire your heart out, and it might cause a heart attack or heart failure.”
Alcohol irritates the heart and messes with its electrical activity, affecting its regular rhythm and manifesting through palpitations, shortness of breath, and dizziness.
Notice how you keep peeing when you drink? Alcohol is also a diuretic, and with each toilet break, you eliminate not just fluid but sodium, potassium, magnesium, and other electrolytes, which directly impact heart function.
“We always tell our patients if they go to a party to drink something on the side like water or a sports drink. It will help them to feel full earlier so that they will not imbibe,” says the cardiologist. “We also tell them ‘Eat ahead of time,’ so when they go to their event and start drinking alcohol, they are already full and won’t drink as much.”
Anaphylactic Shock
One minute you are swapping stories with the gang over dinner and laughing over a friend’s joke; the next thing you know, someone is wheezing, experiencing tightness in the throat, tongue, or chest, turning red, and feeling faint.
They are likely experiencing anaphylactic shock, or “the most dangerous form of allergy,” says Maria Socorro Agcaoili de Jesus, MD, an Allergology and Immunology specialist at MakatiMed. “It is rapid in onset, and it can end up with a person’s death.”
While insect bites and certain medications can prompt an allergic reaction, food (particularly peanuts, eggs, milk, and seafood) is the most common trigger of allergy. Contact with an allergen can set off a severe reaction in minutes; or the symptoms of allergy can worsen as the day progresses. Either way, it should be treated as an emergency case that requires immediate medical attention.
Because there are no tests to confirm if you are experiencing anaphylaxis, allergologists like Dr. de Jesus diagnoses the condition based on what the patient is presenting at the time of the consult, how the patient was just before the symptoms appeared, and two criteria.
The first is the acute onset of symptoms involving the skin and mucosa; so, a rash and swelling of the lips or eyes. The second is at least one of these: respiratory compromise or difficulty breathing; a drop in blood pressure or signs that show low blood pressure, like dizziness or the tips of their fingers turning black; or issues with the gastrointestinal tract, like vomiting or diarrhea,” she says.
In the holiday traffic, it is next to impossible to get someone with anaphylactic shock to the ER immediately. Dr. de Jesus recommends keeping epinephrine at home. The drug of choice for addressing anaphylaxis, it is administered via injection under the skin or into the muscle of the outer thigh and provides relief in seconds.
Pre-filled auto-injectors are available in e-commerce platforms, but you can also secure a prescription from your doctor to purchase 1 mg ampoules of epinephrine that you can inject using disposable syringes.
“It is not true that you should feed sugar to someone who is having an allergic reaction,” she says. “There is no basis for that, and you are just delaying management.”
The holidays are meant to be a happy occasion spent with people near and dear to us. Let’s keep it that way by thinking of those whose lives will change when we don’t watch what and how we eat and drink.
“A lot of people depend on us. I always tell my patients, ‘Your health does not just end with you. You need to take care of your health because you want to see your granddaughters or grandsons. When we’re living for someone else, it actually makes us more responsible,” says Dr. Quetua.
“So, plan ahead, simplify your life, and be responsible. This includes seeing your doctor even before the holiday break so that we can prepare you and give you more advice on how to better manage yourself and your health. The peace of mind that comes from a clean bill of health is priceless.”
Article based on “Healthline with MakatiMed hosted by Nicole Jacinto” guesting of Paul Quetua, MD, last December 23, 2024, and “Anaphylactic shock: A critical emergency and how to react quickly” guesting of Maria Socorro Agcaoili de Jesus, MD, last 2023.
Go to the MakatiMed Emergency Department at the Ground Floor, Tower 1 for rapid assistance. You may also call (+632) 8888 8910 to request for a MakatiMed ambulance.
Got questions/concerns? Reach us via MakatiMed On-Call at (+632) 8888 8999 or at [email protected] [email protected].
Follow our social media pages for more health-related content and for the latest updates: https://www.makatimed.net.ph/social-media-pages/
