Parents’ questions about the everlasting flu season of 2017-2018

by Dr. Kevin Benson, Board Certified in Pediatrics, ProCare Healthy Kids Clinic

As seen in the Odessa American’s Medical Matters:

http://www.oaoa.com/people/health/medical_matters/article_8d4cb80c-142c-11e8-89ec-0f7e6ed22b8c.html

There is endless information about the flu available to anyone with a smartphone. Rather than reprint information that is available elsewhere, I would like to answer a few questions that parents ask every day at my office.

Can you get the flu twice?

I chuckled seeing a report on one of those sensational nightly news shows that highlighted “This boy has had the flu TWICE!” I didn’t realize that any of the many patients I have seen with the flu twice this season could make national news. Unfortunately, catching one strain of the flu does not protect a person from catching one of the many other strains. Flu just doesn’t play fair … you can even have multiple strains at the same time! It is unlikely that you would get the same strain more than once though … if that makes you feel better.

The flu test was negative, does that mean my child doesn’t have the flu? 

Unfortunately, no. They still might have the flu. The flu test is very specific. So, if you have a positive, it is extremely accurate. However, the sensitivity of the test varies with the quality of the specimen (yes, we need boogers) and the length of illness. I have had families where every child is positive but one, but they are all symptomatic. A child can be diagnosed clinically with the flu.

Is Tamiflu (osteltamivir) good?  Is it bad?  What if they can’t finish it? 

This medication decreases the flu virus’ ability to reproduce. It does not “kill the flu” like an antibiotic might kill a bacteria. It is supposed to shorten the course of the illness. It is best started within the first 48 hours of illness.

Like every medication, Tamiflu (osteltamivir) has side effects. Most commonly, the side effects include stomach issues, but there are many more. I tell parents, if the side effects are worse than the illness, stop the medicine. The clear majority of us will still make it through the flu. Before the introduction of this medication, humans still survived the flu, and probably continue to.

Is it too late to get a flu vaccine?

Flu season, as a rule, is from October to April. So we give vaccines through March. Remember – the vaccine takes at least two weeks to be effective. This year’s effectiveness rate has been about 30 percent, which sounds low. However, remember that according to the Centers for Disease Control and Prevention, 85 percent of children who have died this flu season were unvaccinated.

 

 

RSV and the Nose Goblins

By Dr. Bonnie Carter, Board Certified in Family Medicine

 

As seen in OA Medical Matters:

http://www.oaoa.com/people/health/medical_matters/article_24b41b36-f344-11e7-9bdf-5304c112ea19.html

 

RSV … three simple letters that strike fear into the hearts of parents everywhere. Probably everyone knows someone whose child has been hospitalized due to the respiratory syncytial virus (RSV). We’ve all heard the horror stories and, if diseases had a Most Wanted List, RSV would definitely be on it. According to the CDC, RSV accounts for approximately 2.1 million office visits, 57,000 hospitalizations in children under five, 177,000 hospitalizations for adults over 65 and 14,000 deaths in adults over 65.

The peak season for RSV is late fall to early spring, with January and February seeing the highest numbers. It is estimated that by the age of two, 90 percent of children will have had RSV at least once. RSV is the leading cause of bronchiolitis and pneumonia in children under the age of one. There are multiple strains of the virus, which means you can get it more than once. At this time, there is no vaccine available.

The symptoms of RSV are similar to the common cold: fever, cough, congestion and runny nose. What distinguishes RSV from other upper respiratory infections is the diffuse wheezing and difficulty breathing. For most healthy children over the age of two and healthy adults, RSV is just a bad cold. While uncomfortable, it does not present a danger to most in this age group. However, for children under the age of two, and especially those under six months, RSV can be a ticket to the hospital.

So why is RSV so bad for babies? One of the main reasons babies have so much trouble with RSV is that they don’t know how to breathe out of their mouth until they are older. When a baby’s nose is congested, they can’t breathe. This is why it’s important to use the bulb syringe and suck out any of those nasty nose goblins and boogies that get in there. And there are a lot of nose goblins with RSV! It creates an excessive amount of nasal drainage and secretions. It also causes inflammation of the air tubes, or bronchioles, causing bronchiolitis.

Signs that are concerning for respiratory distress in an infant or small child are tachypnea (rapid breathing), nasal flaring, retractions (caving in between the ribs with inspirations), use of accessory muscles (arm muscles and abdominal muscles) to breathe and perioral cyanosis (turning blue around the mouth).

One question I’m often asked is, “How do I know whether to take my baby to the doctor’s office or the emergency room?” Obviously, our goal is to keep you out of the ER as much as possible. They are busy and don’t need to be bogged down with non-emergent visits. But if your child is having respiratory distress with any of the signs listed above, that is where they need to be. If your kiddo has a runny nose, cough, fever, sore throat or earache, then call your physician and bring them into the office.

Treatment of RSV is symptomatic and it requires the tincture of time to resolve. RSV is a virus and therefore does not respond to antibiotics. Likewise, antibiotics do not prevent the illness from worsening. Like the commercial says, “That’s not how this works…that’s not how any of this works!” Parents often pressure physicians to prescribe antibiotics, especially when the child appears moderately ill. When we tell you antibiotics are not necessary, it’s not that we don’t believe your child is sick, or that we want your child to suffer longer. Trust me, if I had the magic wand to wave and make it all better, I would do it in an instant. Unfortunately, I never got my letter to Hogwarts, so I went to medical school instead. Also, we do not recommend cold medication such as cough medicine, decongestants and antihistamines for small children because studies have not shown an improvement of symptoms with their use and they often cause adverse side effects. The one therapy that has shown any consistent improvement is bronchodilator therapy (nebulized breathing treatments). I do recommend frequent nasal suctioning to help keep their nose clear and Tylenol to help fever. On average, an infection with RSV lasts about a week, with the worst symptoms being in the first three to four days.

As the old saying goes, “An ounce of prevention is equal to a pound of cure.” Preventing RSV infection is always the best plan, but sometimes the best laid plans go astray. Do not take your baby out to stores, church or anywhere there is a group of people who could be sick. If you do have to take your baby out, keep their carrier covered with a blanket to protect them from respiratory droplets. I know that everyone wants to see and hold the new baby, but it is safer to keep away from Grandpa Bill and his germs if he is sick. If someone in the house gets sick, try to keep them isolated in a separate room, especially at night. Cover your mouth and nose when you cough or sneeze and wash your hands. You can use Lysol to spray surfaces such as countertops, door knobs, or toys that might be contaminated with respiratory droplets. As tempting as it is, don’t Lysol the baby (or the dog, or your sibling, or your husband …)!

Winter Weather Safety

by Amanda Everett, MCHS Emergency Management Coordinator

Vehicle Preparedness and Safety:

  • Plan your travel and check the latest forecasts.
  • If you encounter snow, sleet or freezing rain, drive extremely cautiously. Even four-wheel drive vehicles will have difficulty on icy roads.

Dressing for the Weather:

  • Wear loose-fitting, lightweight clothing in several layers.
  • Outer garments should be tightly-woven and water-repellant.
  • Wear a hat. Nearly half of your body heat loss is from the top of your head.
  • Wear gloves or mittens. Mittens snug at the wrist are better than gloves.

Preparing Your Home:

  • Bring your pets inside.
  • Have a flashlight and extra batteries available. Do not use candles if the electricity goes out.
  • Use a battery-powered NOAA Weather Radio and a portable radio to receive emergency information.
  • Be sure to wrap any exposed pipes.

Special Requests during Holiday Meals

by Mia Gibson RDN, LD, CDE

Dietitian at Cardiac and Pulmonary Rehab, Center for Health and Wellness

The holidays are a time to gather for meals with our families and friends. If you are the host or attendee, there are things to consider so the meals will go smoothly to accommodate special requests.

For some, it is just dietary preferences. For others, it may be a life-threatening food allergy to be concerned about.

If you are the host, always ask your guests ahead of time for any special requests. They may have medications that need to be adjusted with meal timing. Providing your guest with the menu and what time the meal will be served will allow them to plan accordingly.

If you have a guest with food allergies:

  • Snap a picture of the label from food items with ingredients listed.
  • Prepare items separately to avoid cross contamination.
  • Be careful with serving utensils and let guests with allergies serve themselves first.

To serve healthy options that will help guests with special requests, try these ideas:

  • Keep food simple by serving dishes that have fewer ingredients.
  • Serve sauces and dressings on the side.
  • Reduce salt as much as possible by not adding salt and by using low sodium options.
  • Provide non-starchy vegetable items. A nice, green salad is a festive healthy option to the buffet.
  • By serving a variety of foods, most guests will be able to select foods that work well for their needs.
  • Always offer non-alcoholic beverages. Sparkling water and water infused with vegetables or fruit offers a nice alternative to plain water.

As a guest, please let you hosts know ahead for special requests. If possible, offer to bring a dish to share.

A little preparation can be the key to a happy healthy holiday gathering!

Source: Tufts University Health and Nutrition Letter, Nov 2017.

 

 

Pumpkin – More than just decoration!

by Christina Salina, MS, TTU Dietetic Intern

 

Few people think of pumpkins besides Halloween decorations and carvings or the traditional Thanksgiving pumpkin pie. However, it might be time to rethink this nutritious and delicious orange plant.

Pumpkin is considered a fruit that is rich in nutrients and has a wide range of fantastic health benefits. Beta-carotene is powerful antioxidant that is found in abundance with pumpkins and is also responsible for giving fruits their vibrant orange color. This antioxidant is converted into Vitamin A within the body. Consuming foods rich in beta carotene may prevent the development of certain types of cancer and protect against heart disease.

Another wonderful nutrient found in pumpkins is fiber! On average, an American diet includes about 15 grams of fiber while the daily recommendation is between 25 – 30 grams. Fiber can slow down the rate of sugar being absorbed in the blood and regulate bowel movements.

Here is the complete nutritional breakdown of one cup of cooked pumpkin:

  • 2 g of protein
  • 3 g of fiber
  • 49 calories
  • 200% of vitamin A
  • 19% vitamin C
  • 10% or more of vitamin E, riboflavin, potassium, copper and manganese

 

Preparing your own pumpkin will deliver most of these health benefits. However, canned pumpkin does retain nutrition well. Steer away from pumpkin pie mix as it contains added sugars and syrups.

REMEMBER: Canned pumpkin should contain only one ingredient: PUMPKIN.

 

Here are a few creative ways to include pumpkin in your diet:

  • Dice pumpkin into cubes and roast it with other veggies such as Brussel sprouts, red onion, winter squashes etc.
  • Mash boiled pumpkin into puree instead of mashed potatoes
  • Mix pureed pumpkin into oatmeal or smoothies
  • Roast pumpkin seeds for snacking
  • Add cubed pumpkin to chili or soups
  • Stuff mini pumpkins with a veggie rice mix

 

 

TRY this easy recipe for a yummy

Pumpkin Breakfast Bowl

that was created by Christina Salina, MS, TTU Dietetic Intern.

Some Like It Hot

by Dr. Bonnie Carter

As seen in the Odessa American Medical Matters:

http://www.oaoa.com/people/health/medical_matters/article_e4a67b46-8ab7-11e7-a364-833e575d9cdb.html

 

Well, it’s that time of year again … time for two-a-days, marching practice and heat illness. Heat illness is a very real threat, even in cooler climates than the Permian Basin. There are several risk factors for heat illness which I will discuss below. Heat illness actually occurs on a spectrum that ranges from heat cramps to heat exhaustion, and then to heat stroke. The physiology behind heat illness and heat regulation are very complex, and I won’t go into a lot of details here.

 

Risk factors for heat illness can be broken down into three main categories: medical conditions, environmental and drugs.

  • Medical conditions that can put you at risk of heat injury are obesity, heart disease, high blood pressure, diabetes, hyperthyroidism, gastroenteritis or a febrile illness to name a few.
  • Environmental factors include exercise in a hot environment, inappropriate clothing, decreased fluid intake, lack of acclimatization, enclosed hot environments such as a hot car or sauna and lack of air conditioning or proper ventilation.
  • Some common medications or drugs that make you more susceptible to heat injury include: beta blockers (Atenolol, Metoprolol), diuretics, antihistamines (Benadryl, Claritin, Zyrtec), alcohol, cocaine, amphetamines (including Adderall) and aspirin. Basically, what these risk factors boil down to is impaired heat regulation.

So, what is the body’s normal response to heat stress? The first thing the body does is dilate the blood vessels and increase blood flow to the skin, which increases heat transfer to the environment. When this happens, the heart has to increase the heart rate to increase cardiac output. There is also release of catecholamines that causes you to sweat to dissipate heat by evaporation. The body also decreases heat-producing processes. Where you get into trouble and things start breaking down is when the body reaches its cardiac output limits in the face of water and electrolyte loss. This leads to the inability to regulate heat which causes damage to the cells and organs. If not stopped, this leads to multisystem organ failure and ultimately death.

The first stage of heat injury is heat cramps. This actually occurs with adequate hydration with water. When you are sweating, you lose electrolytes as well as water. If you are only replacing those losses with water, you actually will dilute your electrolytes, leading to involuntary muscle cramps. These cramps are usually treated with an oral salt solution or, sometimes in worse cases, with IV normal saline.

 

The next stage of heat illness is heat syncope. This is caused by a drop in blood pressure from a loss of fluids, dilation of the blood vessels and decreased vagal tone that leads to a lower heart rate. This most commonly occurs in elderly and people not acclimated to an environment. Symptoms include lightheadedness, nausea, yawning and restlessness. After the patient is flat on the ground, consciousness returns because blood flow has been restored. People who suffer heat syncope are generally not very dehydrated or hyperthermic. Treatment for this stage of heat illness includes moving the patient to a cool area out of direct sunlight, lying flat and elevating the feet.

 

Heat exhaustion is the next stage in the progression of heat injury. For heat exhaustion to occur, there is a significant heat stress, loss of fluid and salt depletion. Symptoms of heat exhaustion are weakness, fatigue, lightheadedness, headache, nausea and thirst. Signs of heat exhaustion include a rapid heart rate, rapid breathing rate, profuse sweating, low blood pressure and elevated body temperature. Treatment of heat exhaustion entails immediate cessation of activities, removal to a cool area out of direct sunlight, removal of restrictive clothing, aggressive fluid and electrolyte resuscitation and active cooling measures if the body temperature is above 100.4 degrees Fahrenheit. The best method to cool the body is to use room temperature water to soak the patient, and then fan him or her to cool by evaporation. You do not want to use ice and cold water because this causes shivering which actually raises body temperature.

 

Heat stroke is a life-threatening medical emergency. It is differentiated from heat exhaustion by the presence of central nervous system dysfunction such as ataxia, irritability, confusion, hallucinations, seizures and ultimately coma. The core body temperature is greater than 104 degrees Fahrenheit for heat stroke. A late sign of heat stroke is the lack of sweating (anhidrosis). In addition to the treatment measures listed for heat exhaustion, rapid cooling measures should be employed. The most effective way is ice packs to the areas where large blood vessels are located such as arm pits, groin, neck and scalp. A patient with heat stroke needs emergency medical care and evacuation to a medical facility. They need constant vital sign monitoring and support. The important thing to remember is that heat injury is not independent disease processes, but one continuum (i.e., a patient can progress).

 

Preventing heat stroke:

Preventing heat stroke involves adequate hydration, acclimation and heat dissipation. You should drink enough fluid to have clear urine. This is a better goal than an amount of fluid to take in. If you are exercising in heat for more than two to three hours and are only drinking water, you should add salt to the fluid (¼ to ½ teaspoon per liter) or eat salt-containing foods. You can drink sports drinks such as Gatorade if you dilute it 50/50 with water. Otherwise there is too much sugar. Wear loose-fitting, light clothing to allow air circulation. Frequently spray or douse your skin with tepid water to allow evaporation. To acclimate to an environment, you should slowly increase activity levels over seven to 10 days. Children and elderly may need 10 to 14 days to acclimate.

Heat stroke can carry a mortality rate approaching 75 percent. Every year, about 200 people die of heat stroke. Often, they are young, healthy athletes with no prior issues. So, if someone is lagging behind, don’t tell them to “just suck it up” and keep going. The main thing is to be smart and be aware.

Summer Colds

Summer Colds
by Charlotte A. Carr, BSN, RN, CIC – MCHS Director of Infection Prevention and Control

Colds can happen any time of the year. Although they are not as common in warmer months as they are in the colder months, this is not the result of the weather. Rather, colds are caused by viruses.

Here are a few simple things that we can all do to help prevent summer colds from occurring. After all, preventing a cold is definitely the preferred option to having to suffer through the unwelcome symptoms.

 

Heat Stroke – Tips for Surviving the Summer

Heat Stroke – Tips for Surviving the Summer
by Amanda Everett, RN, Emergency Management Coordinator

Heat stroke is very prevalent in West Texas due to the fact that we, as West Texans, “think we can handle it”. As we all know, the summers in West Texas can be brutal. So here are a few things to keep in mind this summer:

  • Be aware of your body – if you are out in the heat, wear light colored and light weight clothing.
  • Have a wet bandana or a cloth to keep around your neck. Re-wet it often.
  • Hydration is a big part of this. If you are thirsty, then you have already started to dehydrate. Try to have a bottle of water prior to going out in the heat, have a drink every 20 to 30 minutes and have two to three bottles of water after being out in the heat.
  • You can alternate sports drinks and water to allow electrolyte levels to stay up. However, most sports drinks have a lot of sugar in them and that will dehydrate you even faster.
  • In the event of a heat exhaustion or heat stroke, get out of the heat immediately and try to lower the body temperature in any way possible. Ways to do this include a cold shower, cold drinks or ice packs.
  • If the person is having slurred speak or difficulty answering questions, dial 911 immediately.

A couple of other things to remember in the hot months include:

  • Make sure that no pets or children are left in cars. The temperate in a vehicle rises exponentially and can cause great harm to those inside the cars.
  • Surfaces may be extremely hot as well. So, make sure that surfaces are checked before children or animals are allowed to walk or play on them.

Be safe this summer. Take care of yourself and your loved ones!

The Deadliest Days

The Deadliest Days

by Brenda Myers, RN, BSN
Divisional Director of the Center for Heart Disease at Medical Center Hospital

 

Each year around the holidays, the media contacts the local cardiac experts about “Holiday Heart Attacks.”  It’s easy to dismiss the story as, “well, it must be a slow news day,” and perhaps it is a slow news day … but the reality is that around the holidays, there is a spike in heart attacks and heart problems. In fact, Christmas Day, the day after Christmas and January 1 are identified as the deadliest days of the year for heart disease. There are fifty percent (50%) more heart attacks in the winter months than in the summer months. Cold weather is hard on your heart and arteries … and when those arteries constrict the chance of having a heart attack increases. Stress, disruption in our normal routines and overeating and overdrinking all pre-dispose us to coronary events – and we do all of those things during the holidays. Many people do not seek treatment right away because they attribute their symptoms to indigestion or don’t want to be a bother. In the cardiac world, we have a saying – “time is muscle”. The longer a patient waits to seek treatment, the worse the outcome.

In addition to heart attacks, otherwise normal patients can develop abnormal fast heart rhythms after indulging in too much alcohol. And more recent studies also name marijuana as a contributor to fast heart rhythms. All of this creates an environment where anyone can end up in the hospital …and nobody really wants to spend the holidays in the hospital.

A few key things to avoiding the hospital:

Keep your heart healthy all year, not just during the holidays. Exercise at least thirty (30) minutes three to five times a week—and don’t miss just because it’s the holidays.

Don’t forget your medications. If you travel during the holidays, make sure you have your medications before you head out.

Eat and drink in moderation. Focus on spending time with friends and family, not on food and drink. All of the holiday foods that we love are high in fats, sugar and salt.  It’s the perfect storm for a heart event. No one expects that you won’t have a piece of fudge, but there’s a big difference between a piece of fudge and a plate of fudge.

Don’t stress out. We overload our plates literally (with food) and figuratively (with activities) during the holiday season. Set a schedule and stick to it. Don’t spend more or do more than you can during the holiday season.

***

Consider getting your Heart Health Checkup. For only $75 you will receive the following screenings so you will know your numbers!

  • Calcium Score, a fast, non-invasive, CT screen of your heart
  • Blood Pressure
  • Weight
  • Body Mass Index
  • Cholesterol and Triglycerides

No physician’s order required for this test and no insurance will be filed.

Call 432-640-2255 to make your appointment today!

Holiday Shopping Safety Tips

Holiday Shopping Safety Tips
from the ECHD Police Department

  • Do not have purchased items visible in your vehicle. Place them in the trunk or cover them with another object such as a blanket.
  • When shopping during evening hours, park in a well-lit and heavily traveled area.
  • When possible, avoid shopping alone.
  • Carry a minimal amount of cash. Instead use checks or debit/credit cards to make purchases.
  • Notify the credit card issuer immediately if your credit card is lost, stolen or misused. Keep a record of all of your credit card numbers in a safe place at home.
  • Be aware of strangers approaching you for any reason. At this time of year, people try various methods of distracting you with the intention of taking money or belongings.
  • Be aware of your surroundings. If you see any suspicious activity, notify the police, security or appropriate store personnel.
  • Do not leave your purse/wallet unattended for any amount of time.
  • Avoid overloading yourself with packages. Instead make frequent trips to you vehicle to lessen your load.
  • Be extra cautious using ATMs. Use machines located in highly populated areas and be aware of your surroundings.