This week has brought some pretty wild winter weather to Bradford. Between avoiding the flu, shoveling snow and adjusting to changing temperatures, how is one to stay healthy?

The week brought nearly a foot of snow, temperatures dropping to below zero then rising to snow-melting numbers. Rain fell on the whole mess, which will then be freezing when frigid temperatures return.

Bradford Regional Medical Center doctor Jakub Wojcik, MD, internal medicine, and Anne M. Hardy, RN, BSN, CEN, offered suggestions to stay safe and healthy this winter.

Hardy sees many weather-related injuries and illnesses as director of the emergency department at Bradford Regional Medical Center.

“We see a variety of injuries or conditions from heavy snowfall including everything from back-related injuries from muscle strains to head and extremity injuries from falls due to slippery conditions,” said Hardy.

“Of course there is also cardiac issues related to folks shoveling snow,” she added. “Per the National Safety Council, both the sudden exertion of moving heavy snow after being sedentary for several months as well as pushing heavy snowblowers can cause a strain on the heart or other injuries.”

Hardy referred to further explanation from the National Safety Council on why the cold is hard on the heart: It can increase heart rate and blood pressure, make blood clot more easily and constrict arteries.

While even healthy people can be affected, it is people who are relatively inactive or over age 40 who are at greater risk, she said.

Hardy shared these tips from the council on safe shoveling: When shoveling, push snow instead of lifting it if possible; when lifting snow, using a small shovel or don’t fill the shovel all the way. Shovelers should always lift with their legs. Don’t smoke while shoveling or eat right before shoveling. Take breaks and learn the signs of a heart attack. People with a history of heart disease should not shovel without talking to their doctor.

Signs of heart attack can include chest pain and shortness of breath, according to the American Academy of Orthopaedic Surgeons. Anyone who believes they are having a heart attack should stop immediately and seek emergency medical care.

Hardy shared tips from AAOS, which recommends that shovelers warm up their muscles with about 10 minutes of light exercise before beginning. Also, they should be sure to stay hydrated. Use a shovel that is not too heavy or too long, also.

To lift snow, “Squat with your legs apart, knees bent, and back straight,” the AAOS states. “Lift with your legs. Do not bend at the waist.”

Do not remove wet, heavy snow all at once, and walk the snow to where it is to be dumped; people should not throw snow over their shoulder or to the side. If rest and over-the-counter pain medications do not relieve the pain of musculoskeletal injuries in a day or two, call the doctor.

Regarding snowblower use, Hardy passed this advice from the AAOS: “never clean a jammed snowblower without turning it off and keeping your hands away from moving parts.”

Wojcik talked about the risk of the common cold, influenza and frostbite.

“A rapid change in weather can make you sick,” he said. “Despite popular belief, it has less to do with the actual temperature change, and more to do with environmental effects associated with those changes. Some of those changes include changes in pollen, dust, mold and mildew levels which may aggravate severe and chronic sinus and throat issues.”

He suggested routinely changing home filters to minimize allergen risks.

Being exposed to the cold, however, does not necessarily put someone at risk for catching the common cold. Wojcik referenced recent research indicating that simply being in the cold does not directly make one more likely to become sick.

He offered a simple, tried-and-true approach to warding off illness.

“Studies demonstrate that the best method to avoid getting sick is washing your hands with soap and water frequently,” said Wojcik. “This is especially important before and after preparing food, before eating and after using the toilet.”

The doctor listed vaccines as another tools for fighting of sickness and recommended people stay up-to-date on recommended vaccinations.

“Also, please use antibiotics sensibly,” he added. “Take antibiotics only when prescribed. Unless otherwise directed, take all prescribed doses of your antibiotic, even if you begin to feel better before you have completed the medication.”

His final advice when it comes to avoiding illness is to “stay at home if you have signs and symptoms of an infection. Don’t go to work or class if you’re vomiting, have diarrhea or are running a fever as you may be contagious to others.”

While being in the cold is not the cold- and flu-causing action many believe, exposure to cold does put one at risk of frostbite.

In fact, “It can take as little as 5 to 10 minutes for frostbite to set in, especially during the recent cold snap,” Wojcik said.

To avoid frostbite, limit time outdoors when the weather is cold, wet or windy, he said.

When you have to be outdoors, dress to protect vulnerable areas such as the ears, nose, cheeks, chin, fingers and toes.

“Make sure to dress in several layers of loose, warm clothing,” Wojcik explained. “Protect the extremities as they are most susceptible. Wear a hat or headband that fully covers your ears, mittens rather than gloves, socks and sock liners that fit well, dispel moisture and provide insulation.”

Be on the lookout for areas in which the person is experiencing cold, numbness, clumsiness or a tingling sensation.

In the case of frostbite, “The skin may be white or grayish-yellow in color, and hard or waxy to touch,” he said. “Blisters containing clear or bloody fluid may form after thawing.”

If the skin is cold, numb and white, and possibly tingly, “This stage of frostbite is known as frostnip.” He advises people experiencing frostnip symptoms to warm the area in warm — but not hot — water until the skin becomes red and warm.

“When anything more severe occurs (bluish discoloration to the skin), transport the person to a warm environment as soon as possible,” Wojcik said. “Whenever possible, pad or splint the affected area to minimize injury en route.”

He said to remove wet clothing and advised, “Do not rewarm frostbitten tissue if there is a possibility of refreezing before reaching medical care. This would result in worse tissue damage.

“Rubbing frostbitten areas can also cause additional tissue damage,” he added.

“Avoid the use of stoves or fires to rewarm frostbitten tissue,” the doctor warned. “Such tissue may be insensitive and burns can result. Get to the emergency room immediately if this occurs.”