DR SUGAR 's Medical Inspiration: Influenza

Influenza part I
HELLO I AM DR. SUGAR, YOUR INTERNET DOCTOR, HERE TO GIVE YOU YOUR DOSE OF MEDICAL INSPIRATION FOR THE DAY. OUR TOPIC IS INFLUENZA – THE FLU - - SO LETS GET STARTED SHALL WE.
Influenza - the dreaded flu. It seems that just when one flu season is over, the next one begins. Just what is the flu? Why is everyone so concerned about it? And why oh why do you need to have a flu shot EVERY single year?
The flu is a viral illness cause by the influenza virus. Life would be much simpler if the influenza virus was one little virus but in reality there are many types and strains of influenza and they can make you sick to varying degrees. The two main types are influenza A and B (though there is also a C). Influenza A has many types and can infect many different animals besides humans. Influenza B only infects humans, does not have any subtypes but does have many strains. Why is this important? Well it is important because each year a decision is made as to which types of influenza should be guarded against in this year’s vaccine. Given the sheer number of types it is unreasonable to include vaccines against every type of influenza, every year. Having said that though, some types ARE included every year such as influenza B and two of the more dangerous types of influenza A. After that, the decision as to which subtypes to include is made based on the subtypes that are reported. Unfortunately the virus can mutate and even though you have had the flu in the past and perhaps even gotten your flu shot this year, you may get infected with another subtype next time and then all bets are off.
Why all the fuss? Well, it may be hard to believe but not too long ago influenza was a killer on a global scale. The major epidemic of influenza that does not stray too far from the minds of epidemiologists and infectious disease specialists is the influenza epidemic of 1918. According to the National Archives and Records Administration, less than a century ago an estimated 50 million people around the world lost their lives to an outbreak of the flu. There were two phases of the epidemic. The first phase, occurring in late spring of 1918 appeared without warning and very few deaths were reported. Later, in fall of that year, the illness presented itself again, this time with a vengeance. Over 25 percent of the US population was infected and millions died. It did not discriminate between urban and rural, every region of the country had numerous cases. All ages got the flu but children and the elderly were by far the hardest hit. According to the National Archives, the influenza epidemic of 1918 caused the average life expectancy in the United States to drop by 12 years.
I am Doctor Sugar and I want to invite you to join me for part 2 of my blog series on Influenza. In the next section, I will go into a lot more detail on the flu vaccine, who should get it and who should definitely get it. Make sure to check it out. I’ll see you there!!

Giving You Your Dose of MEDICAL INSPIRATION,
Dr. Sugar
TO YOUR TOTAL WELLNESS!!

Resources:
National Archives and Records Administration
Centers for Disease Control
http://www.cdc.gov/flu/
http://www.archives.gov/exhibits/influenza-epidemic/

The information contained in this blog is not medical advice.
Please consult your medical doctor before making any decisions
or taking any actions on your health or the health of your family.

INFLUENZA part II
HELLO I AM DR. SUGAR, YOUR INTERNET DOCTOR, here to continue our discussion on influenza. I will go into a lot more detail on the types of flu vaccine and who should get it and who should definitely get it - - so if you are ready, let’s get started with a dose of MEDICAL INSPIRATION.

Who should get vaccinated? Anyone and everyone should at least strongly consider a flu vaccine - at least if you are like me and don’t have time to be sick for two weeks. While some groups of people are strongly encouraged to get a flu shot each season, it is not a bad idea for just about everyone.

According to the Centers for Disease Control the groups that should consider the flu shot to be essentially mandatory are children from six months to 19 years old, pregnant women, and all people over age 50. So these 3 groups should consider the flu shot to be mandatory but if there is such a thing as even more important than mandatory it is the following group of folks who without a doubt DEFINITELY should get the flu shot – that would be any person with a chronic medical condition, those living in an nursing home or other group living environment and those who come in close contact with any of the above groups should absolutely get the flu shot. It is also important for every member of a household that has a new baby in it to be vaccinated since babies less than 6 months old are too young for the flu shot, therefore it is important to protect them by immunizing parents, siblings, and any other household members.

While I just said that everyone should be vaccinated, there are some rare exceptions. Anyone who is allergic to chicken or egg, ever had a severe reaction to the vaccine, has had Guillain-Barré syndrome, as well as those who are sick at the time of the vaccination or children less than 6 months old should not get a flu shot.

Many people have misconceptions about the flu vaccine. You have probably heard someone swear up and down that the flu vaccine gave him or her the flu. This is simply impossible. The flu that is administered during an influenza vaccination is dead – yes dead as a doorknob. It is not coming back any more than Elvis is (conspiracy theorists that believe Elvis is alive probably won’t get the flu shot no matter what I say, so I can use Elvis as a safe comparison). While I am not saying that your acquaintance is misinformed, I am saying that she is wrong. There is at least one good reason for what happened. The first possibility, and most likely, is that the person experienced a mild reaction to the vaccine. This is normal and is just your body mounting its immune attack against the dead invader. The second possibility is that the vaccinated party was already infected at the time of the injection. Influenza has a rather long incubation period, which is one of the reasons that it is so darn good at spreading. We may have the flu virus for days before we start feeling sick.

The nasal spray vaccine is a bit different. That preparation is made from a weakened virus, not a dead one. There is a small but real possibility that this vaccine can cause mild flu-like symptoms; however, the symptoms are much less severe than those caused by the full blown influenza virus. There are greater restrictions on who can get a nasal spray vaccination because the virus in it is not dead. For example people over 50 and under 2 should not get the nasal vaccine. Also those with long term health problems and weakened immune systems should get the dead virus shot instead. Consult your physician to determine which influenza vaccination is right for you.

I am Doctor Sugar - - Be sure to check out part 3 of our blog series on influenza. In the next section, I will go into a lot more detail on what the symptoms of the flu are and what kind of complications can arise from the flu. I’ll see you there!!

Giving You Your Dose of MEDICAL INSPIRATION,
Dr. Sugar
TO YOUR TOTAL WELLNESS!!


Resources:
National Archives and Records Administration
Centers for Disease Control
http://www.cdc.gov/flu/
http://www.archives.gov/exhibits/influenza-epidemic/

The information contained in this blog is not medical advice.
Please consult your medical doctor before making any decisions
or taking any actions on your health or the health of your family.

Influenza part III
HELLO I AM DR. SUGAR, YOUR INTERNET DOCTOR, here to continue our discussion on influenza. I will go into a lot more detail on what the symptoms of flu are and what kind of complications can arise from the flu - - so if you are ready, let’s get started with a dose of MEDICAL INSPIRATION.

So you feel crummy and you think you might have the flu – lets talk about some of the symptoms that we commonly associate with the flu. First and foremost expect to see Fever (usually very high) – along with this may come chills, coughing, fatigue, headaches, eye pain, sore throat, body aches and occasionally a runny nose and nasal congestion. Often times these symptoms start very suddenly – many of my patients will describe a shaking chill that started at a very specific time – the symptoms often hit hard and hit fast.

Diarrhea and vomiting while occasionally seen in children is not often seen in adults – this is a common misconception that we should just briefly discuss before moving on – a lot of times people think that the flu is a gastrointestinal illness or a stomach problem that involves vomiting and diarrhea – I think this got started because sometimes people call gastroenteritis - “the stomach flu” – this is NOT the real flu caused by the influenza virus that we are talking about today – so just be aware of that – if you haven’t already done so be sure to check out the entire series on stomach flu a.k.a. gastroenteritis you can catch this as well as many other medical topics if you click on my picture and go to my profile where all my blogs will be listed. Be sure to check it out.

Ok back to the real flu – influenza. So you have a fever, you have a runny nose, sore throat, cough, body aches – does this mean you have the flu?

Some people think they have the flu but in reality they have a cold. Truth be told it is very difficult to tell the difference, even for doctors. This ambiguity arises from the fact that both cold and flu share many of the same symptoms. They both cause respiratory illness, fever, chills, aches, fatigue and a general crummy feeling. In general, though, the symptoms of influenza are much more severe and last a bit longer than a cold. Muscle aches and fevers are more intense in flu than during a cold. Also colds typically cause a runny or stuffy nose while the main features of the flu are generally more respiratory with more intense coughing and chest congestion.

Finally, it is important to be aware that very serious health complications like pneumonia or hospitalizations are much more likely to occur with influenza than the common cold. In some people, the flu can cause serious complications, including bacterial pneumonia, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma or diabetes. Children and adults may also develop sinus problems and ear infections.

The flu most often is mild in healthy people but can cause severe illness and can even lead to death. Although most healthy people recover from the flu without complications, some people, such as older people, young children, and people with certain health conditions like asthma, diabetes, or heart disease, are at high risk for serious complications from the flu.

I am Doctor Sugar - - Be sure to check out part 4 of our blog series on influenza. In the next section, I will go into a lot more detail on what the treatments (both traditional and alternative) for the flu are, how influenza is spread, and how you can avoid catching the flu. I’ll see you there!!

Giving You Your Dose of MEDICAL INSPIRATION,
Dr. Sugar
TO YOUR TOTAL WELLNESS!!


Resources:
National Archives and Records Administration
Centers for Disease Control
http://www.cdc.gov/flu/
http://www.archives.gov/exhibits/influenza-epidemic/

The information contained in this blog is not medical advice.
Please consult your medical doctor before making any decisions
or taking any actions on your health or the health of your family.

Influenza part IV
HELLO I AM DR. SUGAR, YOUR INTERNET DOCTOR, here to continue our discussion on influenza. I will go into a lot more detail on what the treatments for the flu are, how influenza is spread, and how you can avoid catching the flu- - so if you are ready, let’s get started with a dose of MEDICAL INSPIRATION.

We are in the midst of Flu season, which usually starts in the late Fall and ends in the early Spring. If you begin having severe respiratory symptoms that started suddenly such as cough, chest congestion and along with these high Fevers, severe body aches, chills, fatigue, headaches, and a sore throat it is important to get in and see your doctor quickly as the rapid flu swab should be done at the earliest symptoms. Diagnosis of the flu involves a quick and painless nasal swab - - - In my clinic the results are back within 20 minutes so we can make a decision on treatment.

If the flu is strongly suspected or conclusively diagnosed, your doctor may prescribe an ANTIVIRAL medication (not an antibiotic) that works against influenza. Remember ANTIBIOTICS only work for BACTERIAL illnesses and INFLUENZA is a VIRUS. These antiviral medications are only effective if started within 48 hours of the first symptoms – so if you wait too long to get in to the doctor, even if you have the flu, medication will probably not be given.

And of course if your illness is more likely to be a cold then don’t be surprised to leave the office without a prescription. We still don’t have a treatment for the common cold! Remember colds generally affect the upper respiratory tract giving mostly symptoms in the nose and throat where as the flu virus can wreak havoc on the entire respiratory system, going down into the lungs and causing more coughing and chest congestion. This difference is what makes influenza a much more serious and even occasionally lethal illness. So if you have a cold or if you have had the flu for longer than 48 hours it is likely that your doctor will recommend “supportive care.” This means things like good old chicken noodle soup, drinking lots of fluids, especially water and juices, getting extra rest, and taking ibuprofen (Motrin, Advil, etc) or acetaminophen (Tylenol) which may help with fever and generalized aches and pains.

Some alternative or complementary herbs and supplements that are currently being studied for their effectiveness with flu and colds include ginseng root, elderberry, spirulina, lactobacillus acidophilus oscillococcinum, peppermint, golden seal, golden rod, eucalyptus, celery seed, astragalus, and Echinacea. Remember that herbs and supplements can all have side effects and drug interactions so it is best to consult with your doctor or a practitioner knowledgeable in herbal medicine and get their advice before taking these. Recent studies have shown Echinacea can help shorten a cold by a day or two. And while the studies are not conclusive on this, I always take some zinc and mega dose on Vitamin C whenever I start coming down with a viral illness and I believe that it helps me.

The flu is very contagious and spreads easily from person to person. Healthy adults may be able to infect others 1 day before they even start to feel bad and then up to 5 days after getting sick. Therefore, it is possible to give someone the flu before you know you are sick as well as while you are sick. The flu is usually spread from person to person when someone coughs or sneezes. Touching something with influenza virus on it and then touching your mouth, nose or eyes can also occasionally infect people. Three of the best ways to avoid catching the flu is to wash your hands, wash your hands, and wash your hands. Just kidding – washing your hands is very important yes – but in addition, a couple of other things I recommend is that if you do start feeling like you may be coming down with something STAY HOME, go to bed, and if you are coughing or sneezing – cover that up – don’t cough and sneeze on people or things. A few ideas for preventing the flu would be keep your body in a healthy state - so get regular exercise, drink lots of water, eat plenty of fruits and veggies, stay away from sweet carbonated beverages, relax, don’t stress and finally, the absolute best way to protect yourself and others against influenza is to get a flu vaccination each year.

Be aware that if you get the flu it may take several days for your fever to return to normal, during which time you are definitely contagious and will often feel pretty crummy. And even after your fever goes away, it may take another week before you are feeling completely back to your old self again.

I am Doctor Sugar - - If you have symptoms of the flu, it is important to get in to see your healthcare provider as soon as possible, stay home don’t spread the virus, and a little TLC and mom’s good old chicken noodle soup go a long way. If you haven’t already done so be sure to read all of the medical inspiration blogs on INFLUENZA. Thank you for your interest in Total Wellness. Simply click on my picture and go to my profile to see the latest medical blogs on a wide variety of topics. I’ll see you there.

Giving You Your Dose of MEDICAL INSPIRATION,
Dr. Sugar
TO YOUR TOTAL WELLNESS!!


Resources:
National Archives and Records Administration
Centers for Disease Control
http://www.cdc.gov/flu/
http://www.archives.gov/exhibits/influenza-epidemic/
http://www.umm.edu/altmed/articles/influenza-000062.htm

The information contained in this blog is not medical advice.
Please consult your medical doctor before making any decisions
or taking any actions on your health or the health of your family.

The Common Cold part I
HELLO I AM DR. SUGAR, YOUR INTERNET DOCTOR, HERE TO GIVE YOU YOUR DOSE OF MEDICAL INPIRATION FOR THE DAY. OUR TOPIC IS the Common Cold - - SO LETS GET STARTED SHALL WE... If you ask ten different people what to do to overcome a cold or flu, you’ll get 10 different answers. Grandmas will say chicken soup. Moms will say get some rest and don’t go out into the cold if your hair is wet. Friends will say take some over-the-counter medication. In the old days some doctors might have said take an antibiotic to prevent complications from setting in. Researchers will say why didn’t you wash your hands and change your toothbrush? And the FDA says only time is a sure cure.

What we refer to as the “common cold” is an illness that is caused by a virus – well I say A virus but to be more accurate it can actually be caused by any one of over 200 different viruses that all can lead to a “cold.” These viruses cause over one billion colds in the United States each year. Most of the time when you get sick it is likely that you have a cold, as this is one of the most common illnesses around for both adults and children. Kids can get as many as 3 to 8 colds every year throughout their childhood. And adults who are around children can catch these colds as well. So if you have kids or if you work with kids, you are likely to continue to get more colds even in adulthood. Colds are the most common reason that children miss school and parents miss work. It’s true that viral infections that cause the cold and flu are often self-limiting which means that they die out on their own. But getting the cold or flu every month or so can lead to some 15 million days lost from work, and that may mean less income for that person’s family since most of us have limited sick days.

How do you tell the difference between the cold and the flu? A cold usually starts slowly with a scratchy sore throat. The next symptom is sneezing and then a runny nose follows. Sometimes you will also experience coughing, headache, muscle aches, decreased appetite, or other symptoms, but for the common cold, the most severe symptoms will be in the nose. Body temperature is normal or slightly elevated in a cold, although infants and young children can run a temp up to 102 degrees Fahrenheit.

The flu signs are different. Flu symptoms occur suddenly and often there is a headache, cough and chills that are more severe than what you experience with a cold. You may feel severe muscle aches in your legs and back, and a fever is usually higher, sometimes as high as 104 degrees. That fever seems to dwindle away by the second or third day and the fever is soon replaced by a stuffy nose and sore throat. The fatigue and weakness goes on for longer than a week and sometimes it’s still there weeks later. If you haven’t already seen it be sure to read the entire blog series on influenza for much more in depth information on the flu.

These signs and symptoms don’t always mean it’s a cold or the flu. These signs and symptoms are also common with measles, chickenpox, allergies and strep throat so if you have unusual or severe symptoms it is a good idea to get in and see your healthcare provider.

I am Doctor Sugar - - Be sure to catch part 2 of our blog series on the common cold. In the next section, I will go into a lot more detail on how you catch a cold and what can be done to prevent it. I’ll see you there!!
Giving You Your Dose of MEDICAL INSPIRATION,
Dr. Sugar
TO YOUR TOTAL WELLNESS!!

References:
http://www.nlm.nih.gov
Long, SS, Pickering, LK, and Prober, CG, eds. Principles and Practice of Pediatric Infectious Diseases. 2nd ed. New York, NY: Elsevier; 2003.
Mandell GL, Bennett JE, Dolin R, eds. Principles of Infectious Diseases. 5th ed. New York, NY: Churchill Livingstone; 2000.
Noble J, ed. Textbook of Primary Care Medicine. 3rd ed. St. Louis, Mo: Mosby; 2001.

The information contained in this blog is not medical advice.
Please consult your medical doctor before making any decisions
or taking any actions on your health or the health of your family.

Swine Flu - - why all the panic in the media. Is it really that big of a deal and what can I do to protect myself anyways? I am Dr. Sugar, your internet doctor bringing you your dose of medical inspiration for the day so let's hear all about the swine flu shall we...

Influenza viruses are genetically very simple yet they are great at mutating which is what can make them very deadly. Swine Flu is concerning because of the 1918 Swine flu outbreak which killed nearly 50 million people. It was one of the deadliest outbreaks in human history. The swine flu that is currently in the news is - at the present time - much less lethal than the 1918 swine flu. What we know at this point - is it is spreading very fast and new information is coming out hour to hour - so as the days proceed - we will be able to make better recommendations.

I would consider a few things at this point:
1) Rest
2) Relax - - stress lowers immunity
3) Drink Lots of Fluids - to keep mucus membranes moist
4) Vitamin C
5) Vitamin D
6) Echinacea
7) Garlic
8) Omega 3's
9) Wash Your Hands - Wash Your Hands - Wash Your Hands
10) Stay home if you feel ill
11) If you have to go to a doctors office or urgent care or hospital - - consider wearing a mask to protect yourself - - probably overkill - - but until more is known in the days to come - just better to be safe.

There are several recent videos which I did on INLFUENZA in the educational video section of BHWGC.

These two are the most relevant.
Influenza signs and symptoms

Influenza - Prevention and treatment


I would like to copy and paste the latest update on swine flu I received this morning - will send along in entirety -
Swine Flu: Information for Patients from the Urgent Care Association of America and JUCM, The Journal of Urgent Care Medicine

Swine Influenza is a respiratory disease caused by type A Influenza virus that commonly infects pigs, causing seasonal outbreaks of disease among swine. Due to the ability of the virus to mutate, or change, sporadic human infections can occur. The symptoms of Swine Influenza are similar to seasonal influenza and typically include fever, cough, sore throat, nasal congestion and runny nose.
All of the confirmed cases of Swine Flu in the United States have thus far been mild and have resolved without complication.

The management of Swine Flu is essentially no different than the management of Seasonal Flu, and there is currently no evidence that it is more dangerous.

Persons with Swine Influenza are contagious for up to seven days after the onset of illness and possibly longer if still symptomatic.
Travel to areas where outbreaks have been reported is a key risk factor. Health personnel should be notified immediately if you have a respiratory illness and have a travel history to any of the following areas within the last 7 days:
o Mexico
o San Diego or Imperial County, CA
o Guadalupe County or San Antonio, TX
o Dickinson County or Wichita, KS
o New York City, NY
o Lorain, OH


This information may change daily, so it is important to watch for updates from the CDC (http://www.cdc.gov/swineflu). You should also notify health personnel if you have had direct contact with a person or animal with a known case of Swine Flu.

Just as with any respiratory infection, one should always cover their mouth when coughing and wash hands frequently.

Testing protocols for Swine Flu vary from state to state. Patients should contact their personal doctor, local urgent care center, local hospital, or local health department to determine whether they are an appropriate candidate for testing and where such testing can be done.
It is important to know that we are still experiencing regional cases of the seasonal form of Influenza A. If one tests positive for Influenza A, a confirmatory test will need to be sent to identify whether it is the Swine Flu strain. Currently, the number of seasonal influenza cases far outnumbers Swine Influenza cases.

Patients with confirmed cases of Swine Flu will be asked to stay at home while they recover unless they are very ill. They will be asked to stay in one room of their house to limit unnecessary exposure to others.

Regular antibiotics are NOT effective against any strain of influenza.
The antiviral medications Oseltamivir (Tamiflu®) and Zanamivir (Relenza®) have both been shown to be effective at lessening the severity and symptoms of Swine Flu.

These medications should be used ONLY for confirmed cases of influenza or for high risk cases while awaiting confirmation.
If you have had contact with someone with a known case of Swine Flu, but have no symptoms of disease, you should notify your healthcare provider so that you may be evaluated for a medication shown to help prevent illness in those exposed.

Please do not ask for Oseltamivir (Tamiflu®) or Zanamivir (Relenza®) “just in case.” Your healthcare provider will not be able to dispense these medications for that reason.

By far the best prevention is frequent hand washing. It is also advisable to keep your hands away from your eyes, nose and mouth.

Lee A. Resnick, M.D.
Immediate Past President, Urgent Care Association of America (UCAOA)
Editor-In-Chief, JUCM, The Journal of Urgent Care Medicine
Chief Medical Officer, NextCare Urgent Care


I am Dr. Sugar - Thanks for checking in and if you haven’t already done so be sure to check out all of the medical inspiration blogs and videos on influenza. Thank you for your interest in Total Wellness. And when you have a medical question, click on my picture and go to my site to see many more blog topics and some great video's. I’ll join you soon for your next dose of medical inspiration.

The information contained in this blog is not medical advice.
Please consult your medical doctor before making any decisions
or taking any actions on your health or the health of your family.

Sources:

The Urgent Care Association of America
(UCAOA; www.ucaoa.org)
http://www.cdc.gov/swineflu/
http://pandemicflu.gov/faq/swineflu/