Winter Is Gushing: My Nose Always Knows When the Seasons Change

It's time to be wary of disease symptoms, especially during a 'tripledemic'

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by Mike Naple |

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The weekend after Thanksgiving, I had a gusher of a bloody nose and one thought: Winter is coming.

When the seasons change, I get bloody noses. I feel them coming on like a dog sensing a forthcoming storm before we mere humans feel a drop of rain. During the worst episodes, these nosebleeds can mimic Mount Vesuvius. Other times they’re a series of drip, drip, drips that feel more manageable.

For better or worse, they’re usually the first bodily indicator that the temperature is about to change. That meteorological shift reminds me to pay attention to how my body responds to cold weather because of pulmonary hypertension (PH).

Winter can be tough for people with PH and other respiratory and pulmonary chronic illnesses. Our bodies already struggle with breathing issues, among other PH-related side effects. Blasts of cold weather can not only exacerbate these side effects, they can also bring with them viruses and other infections that can inflict more harm on our already compromised and inflamed systems.

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Managing My Health Through the Holidays

Reading through the “Winter-time difficulties?” thread on the Pulmonary Hypertension News Forums, one individual asked about chest-tightening and changes in their breathing during the winter months. I could relate and empathize with the conversation among other folks in the community.

I notice similar seasonal symptoms, beyond those pesky nosebleeds. My breathing can feel more labored, especially if I’m out walking around, and I don’t always move as quickly as I might in the spring and summer seasons. When I spend time outside in the cold weather, I’m making a deliberate choice, knowing full well that my body will use more of my minimal energy reserves to keep me warm.

The post-pandemic ‘soup of viruses’

It’s hard to fathom that this winter season could be more harsh than the last three of the pandemic era. Yet staying healthy might feel more worrisome to the PH and broader rare disease community given recent reports about a “tripledemic” of surges in RSV, COVID-19, and the flu. Reporting in The Washington Post described this tripledemic as “the post-pandemic soup of viruses,” and the U.S. Centers for Disease Control and Prevention is once again advising mask-wearing in certain communities where COVID-19 cases and hospitalizations have increased.

A soup of viruses is not a specialty I want to see on my winter 2023 menu, that’s for sure. As somebody with PH and compromised lungs, I try to stay alert and adopt some preventive measures. Still, we sometimes get viruses and germs despite doing our darnedest to stay clear.

In February 2020, I was on a gurney in a hospital hall, waiting to get an answer for why I couldn’t walk more than a few yards without experiencing massive shortness of breath. Patients were packed into the emergency room. It felt like the system was near or at capacity a mere few weeks before shutdowns began in March to halt the coronavirus spread.

Tests indicated that I had community-acquired pneumonia, requiring a few days of monitoring in the hospital. Eight months later, I’d be back in that same hospital hall to address some PH-related fluid retention. A chronic pulmonary disease can feel like its own “soup of viruses,” which is why it’s important to take precautions and adopt preventive measures.

Covering the basics

Before I received a formal PH diagnosis, I didn’t always anticipate bloody noses, nor did I fortify my body with the basic defenses to ward off or take the punch out of winter illnesses. I felt relatively healthy on a daily basis, rarely remembered to get a flu shot, and powered through any minor symptoms.

The behavior change began post-diagnosis, mostly at the urging of my doctor, and getting a flu shot is an annual priority now. I also assess my personal health risks related to different activities depending on how much they’ll lead to exhaustion, shortness of breath, dizziness, and other PH-related side effects.

I’m also curious how different disability groups and disease communities might be influencing a broader conversation about redefining what it means to cover the bases, as well as how normalized public health measures could help keep all of us healthy each winter.

Spending time in colder weather this year

I usually spend the holidays in warmer San Diego. This year, I’m in upstate New York attempting to trade the beach for some snowflake-dotted scenery. Spending time in a much colder climate, though, requires forethought and planning — especially during a “tripledemic” when flu shots and COVID-19 boosters are essential.

If I remember to cover the basics for any PH flare-ups, listen to my body, and pack enough tissues for any unexpected crimson nostril ruptures, I’ll be prepared to enjoy a healthy and relaxing winter season.

Follow Mike Naple on Twitter: @mnaple.

Note: Pulmonary Hypertension News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Hypertension News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to pulmonary hypertension.


Scott Olitsky avatar

Scott Olitsky

Many PAH medications can increase the risk of bleeding. The use of oxygen can dry the nasal mucosa and increase the risk of bleeding too as can dry heat and low humidity during the winter season. However, nosebleeds are the most common problem for people with Hereditary Hemorrhagic Telangiectasia (HHT). HHT is a genetic disease that runs in families and leads to the development of abnormal blood vessels that bleed. These abnormal blood vessels can grow in the lungs and brain which can lead to stroke. These problems need to be found and treated which is why it is so important to make the diagnosis in people with HHT (only 10% of people with HHT know they have it). A small percentage of people with HHT develop PAH. A family history of nosebleeds should raise the suspicion of HHT in a person with PAH.


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