Happy Black Friday! We seem to have divided ourselves into two groups: those who are stretched out on the couch eating leftover turkey sandwiches, and those who are up at the crack of dawn hitting the malls for the best shopping deals of the year. Either way, there are some surprising medical issues related to this particular day of the year.

Plumbers call this day Brown Friday, because it is the single busiest day of the year for plumbers. Searches on Yelp for “emergency plumber” spiked 27% nationwide last year on the day after Thanksgiving. Emergency calls are at an all-time high, and plumbers know to expect to work all day. Granted, some of their calls are for stopped up garbage disposals, because some silly folks tried to stuff a whole turkey carcass down the in-sink-erator. But a significant percentage of calls are for clogged toilets. Apparently, big families congregating at Grandma’s, eating unprecedented amounts of food can overwhelm Grandma’s turn-of-the-century plumbing, resulting in, shall we say, bathroom disasters. Interestingly, Salt Lake City was America’s most clogged up city last year, with data showing their Google searches on Black Friday for “plumbers near me” were up 180%, and searches for “septic services” were up 60% over baseline. I was relieved to see Atlanta (my hometown) didn’t make the top twenty list of Brown Friday clogged up cities!

Jimmy Kimmel spoke about Brown Friday on his late-night television show earlier this week. “I, for one, choose to embrace Brown Friday,” Kimmel said. “Is it repulsive? Yes, it is. But it reminds me of what we have in common. One nation, under God, living in a country with such a plentiful bounty we can eat to the point where our toilets are so full professionals need to be called in.”

So, maybe one of the things I am thankful for this year is plumbers!

There’s always an uptick in cases of Salmonella and E. coli infections, related to food preparation. Turkeys get left sitting out at room temperature too long, utensils get shared, and hands don’t get washed after raw bird preparation. Big-hearted people not used to cooking try to do too much, and disaster can ensue.

Emergency Room physicians can tell you that overindulgence on Thanksgiving Day leads to a Black Friday surge in ER visit for indigestion, diarrhea, and heartburn. People with preexisting heart problems can trigger heart failure or arrhythmias with excessive salt and alcohol intake. Diabetics who consume too much sugary food can negatively impact their blood sugar levels. Lots of chopping mushrooms, celery, carrots, and potatoes leads to ER visits for finger lacerations that need stitches. Many hot pots on the stove inevitably end up in an influx of burns that need treatment.

And it’s not just food-related problems that land people in the ER on Black Friday. Many people travel to be with family, so there are lots of households with multiple generations crammed into one house. This leads to busy adults, Grandma’s purse unattended on the floor, with her beta blockers, pain pills, and digitalis within reach. Just a terrible attraction for an unattended toddler. We all know that child-proof pill containers are anything but. Those curious toddlers will taste everything, and many host houses for Thanksgiving aren’t child-proof. Cleaning products under the kitchen sink, Uncle Bill’s nicotine gum left on the counter, Aunt Suzie’s martini on the dining table- all of these are fair game when a small child is around, and can result in ER visits.

And those travelers who have driven to be with loved ones? There’s always an increase in traffic accidents during this long holiday weekend. Much of the country has snow and sleet in November, which can further exacerbate travel dangers.

Most people are thrilled to get to spend time with their extended family. But for some, it is a time of added stress and anxiety, as old hurts are revisited and difficult relationships must be confronted or endured. Mental health can take a hit on this day. Have you heard of Takotsubo cardiomyopathy? Also called “broken heart syndrome”, this is a heart condition brought on by sudden release of stress hormones like adrenaline after a stressful situation or extreme emotions. It mimics a heart attack, with chest pain and shortness of breath. The way the heart pumps blood is briefly interrupted, and abnormal heart rhythms can develop. Eighty-nine percent of cases are in women, usually over 50 years of age. The theory is that estrogen has a protective effect on heart muscle and as menopause occurs and estrogen levels wane, the heart becomes more susceptible. There is no cure for Takotsubo cardiomyopathy, but most people make a full recovery within a few weeks. Treatment with aspirin, beta blockers, ACE inhibitors, and other heart medications helps.

What about those Black Friday shoppers and workers? In 2008, a mob of unruly shoppers broke down the doors and trampled a temporary Wal-Mart worker and two shoppers to death on Black Friday in Valley Stream, N.Y. In 2011, a woman at a Porter Ranch, Calif. Wal-Mart used pepper spray on shoppers battling for Xbox 360 video game units. Twenty people were injured. In 2012, two people in Tallahassee, Florida, were shot while fighting over a parking spot. Adding insult to injury, the victims never even made it into the mall for Black Friday savings! And these are not isolated incidents. It’s a day of maximum shoppers, inexperienced newly hired workers, high-intensity physical demands (restocking shelves, carrying heavy boxes), and long shifts. People are wrenching their backs from picking up new big-screen TVs, slipping on wet floors or icy patches, getting hurt from falling store displays, and getting injured in parking lot fender benders. While researching this article, I Googled “Black Friday shopping accidents”. I was amazed to find page after page of law firms ready to represent you in your Black Friday personal injury case! So, be careful out there.

Then there are those folks up on tippy ladders, hanging Christmas lights outside and playing with electricity. Those people who played touch football in the backyard yesterday and now realize that ankle sprain isn’t going away by Friday. Those people who overindulged in holiday spirits of a different kind and are now nursing a hangover. The list seems endless.

If you think this is enough to make me a curmudgeon about holidays, think again. I love being with my family, enjoying cooking together in the kitchen, thinking of all the things I have to be grateful for again this year, and basking in the relative calm of Black Friday at home, before the whirlwind of the Christmas season. Happy Black Friday!!