We are now entering a season with the beginning of changing weather we are starting to see more and more colds even though it's still Summer. If you are having a common cold below is some advice that can help with the common symptoms. This is a virus that DOES NOT respond to antibiotics. In the past many doctors prescribed antibiotics for any cold "just in case." This has lead to many people getting antibiotic resistant infections even if they only have taken an antibiotic once a year or less. The common cold will start to show improvement in a couple of days with or without treatment. The only thing that we do is help with the symptoms. For everybody I recommend:
1) Rest.
2) Drink plenty of fluids.
3) Wash your hands.
Common colds are easily spread from one person to another through coughing but also through the sick person touching something that a healthy person then touches. To help protect your family and friends I recommend keeping a bottle of alcohol based hand cleaner around so that you can sanitize your hands after touching your face or blowing your nose even when a sick in not around to wash.
Sore Throats
If you have a sore throat as part of your cold symptoms there are a variety of over the counter products that can help. I personally recommend the cough drops that contain benzocaine. This is a topical anesthetic that is a sister to Novocaine used by the dentist. These drops will numb your throat to help with pain relief but be warned they will also numb your mouth. But if they help the pain most folks don't mind numbing the mouth.
Stuffed Up Noses
When noses run easily it is easy to get the junk out given that you can't really stop it from coming out. Sometimes in this very dry environment that we live in our nasal mucus gets dehydrated and we need something to loosen it up so that we can blow our nose and get it out. My two favorite products are nasal saline sprays and the Sinus Rinse Bottle. The first is a little squirt bottle that sprays a mist into your nose. The second is a bottle that you mix water in a salt packet and squirt a larger amount of water up your nose. I personally use the second for my allergy symptoms. Use these and then in a few minutes you can blow some of the mucus out and repeat if needed.
Pain In Your Ears
Often time if you have a cold or allergies pain in your ears is not an ear infection and you do not need antibiotics. Our middle ears produce a small amount of fluid all the time and we have a tube "the Eustation tube" that connects our middle ear to the back of our throat. This tube drains the fluid. If the tube gets stopped up, possibly by mucus blocking it, we get pain in our ears. If we can loosen up that mucus blocking the tube we can get rid of the pain and will not have any infection to treat. To do that you can:
1) Chew gum - This moves the muscles around the tube and helps to jar the mucus loose.
2) Drink everything through a straw - The sucking helps suck the mucus loose.
3) Eustation tube massage - You place a finger under your ear and behind your jaw in that ridge between your jaw and your neck. Then using medium force against your skin move your finger along that ridge to the center of your throat. Do this on both sides 5-6 times every few hours to help massage the mucus loose.
Muscle Aches
The best thing to help these is to take Tylenol or ibuprofen. The store brand is just as effective but cheaper. Take them according to the directions on the bottle.
Fever
We medically define a fever as any temperature of 100.3 deg F or higher as a fever. Take Tylenol or ibuprofen as above. We used to tell people to alternate them every few hours of one by itself was not working. Recent research shows this to not be effective and only leads to more side effects. Just use one and use it consistently. If this is not working let us know and we can give you advice on what to do next.
Sinus Pain/Infection
Pain in the front of the face, usually beside the nose or in the for head, is considered to be sinus pain. Many people come to see me with two days of sinus pain and feel it's a sinus infection. Sinus infections start with plugging up the nose and blocking the drainage from your sinuses. It takes at least 7-10 days to get a real sinus infection. If it's been less than that you probably just have plugged up sinuses. If you have a real infection you will need to see us for a prescription for antibiotics which we can only prescribe after seeing you. If you have sinus pain from pressure we can often relieve some or all of it by getting the mucus out of the most. Follow the directions for a stuffed up nose above. Then when the sinuses drain the pressure will be relieved and you should feel better.
Cough
Unfortunately nothing works very well for coughs. Robitussin (dextromethorphan) is the only over the counter cough suppressant but it has not been shown to be effective. It was placed on the market before the FDA was created so it was grandfathered in and has never been FDA approved. It is just as effective as an 8oz glass of water. We do have various things we sometimes recommend including codeine based cough syrups and Tessalon Pearls but they all have minimal effectiveness. Also, the cough can persist for up to a month or even a little more after the rest of your cold symptoms have resolved. So if you had a cold and the cough is sticking around don't worry it will just take time.
Friday, August 24, 2007
Tuesday, August 21, 2007
West Nile Virus
By now most of the community has been hearing about West Nile virus as this has become a bigger and bigger problem in this community and all of us in the clinic are seeing folks with West Nile-like symptoms.
West Nile virus is transmitted to humans from mosquitoes. Usually the mosquitoes get the virus from birds who bring it up from tropical areas as they migrate North in the Spring. It is possible to spread the virus from person to person but this will only happen with exposure to body fluids such as blood exposure, sharing needles and possibly through breast milk.
The majority of people who carry the disease never get any symptoms. Only about 1 in 5 will even feel symptoms. After contracting the virus there is an average incubation period of 2-14 days. There is a wide range of symptoms and most people will have:
1) F0ever
2) Headache
3) Malaise
4) Back pain
5) Myalgias (muscle aches)
6) Loss of appetite
These tend to last 3-10 days. Other known symptoms include eye pain, pharyngitis, nausea, vomiting, diarrhea, rash, and abdominal pain. Some of the symptoms especially fatigue and muscle aches can persist for a month or longer.
The diagnosis is made based on symptoms but we can do a blood test to confirm that diagnosis. Currently there have been so many cases of West Nile virus in this area that we do not test everybody that we think has the disease. Especially since treatment is symptomatic meaning that we just do what we can to help you feel better as your body fights the disease itself. So often we do not test because if a positive test will not help us treat you then there is no value in doing the test other than just to know for sure. The test shows us if you have had West Nile in the last six months so if you had the disease a few months prior the test will be positive even though you do not have it anymore.
Because we have no treatment to get rid of the disease faster the main treatment is Tylenol or ibuprofen. I recommend these to help with fevers and muscle aches but nothing has been proven to shorten the course of the disease. The most important thing is to avoid mosquitoes. The key ways to do that are to:
1) Use insect repellents containing DEET (for people greater than 6 months old)
2) Avoid the outdoors from dusk to dawn.
3) Wear long sleeve shirts and long pants when outdoors.
4) Drain standing water sources on your property.
On occasion the disease can spread into the brain and cause meningitis and more severe disease. In these cases we often will have to send patients to the hospital in Billings and will consider using experimental treatments. In such times the disease is much more serious and can possible lead to death. Fortunately it is not common for the disease to become this severe.
If you think you may have the virus please schedule a visit with your doctor. For more information on West Nile virus you can visit http://www.patients.uptodate.com/topic.asp?file=inf_immu/2199&title=West+Nile+virus+infection
West Nile virus is transmitted to humans from mosquitoes. Usually the mosquitoes get the virus from birds who bring it up from tropical areas as they migrate North in the Spring. It is possible to spread the virus from person to person but this will only happen with exposure to body fluids such as blood exposure, sharing needles and possibly through breast milk.
The majority of people who carry the disease never get any symptoms. Only about 1 in 5 will even feel symptoms. After contracting the virus there is an average incubation period of 2-14 days. There is a wide range of symptoms and most people will have:
1) F0ever
2) Headache
3) Malaise
4) Back pain
5) Myalgias (muscle aches)
6) Loss of appetite
These tend to last 3-10 days. Other known symptoms include eye pain, pharyngitis, nausea, vomiting, diarrhea, rash, and abdominal pain. Some of the symptoms especially fatigue and muscle aches can persist for a month or longer.
The diagnosis is made based on symptoms but we can do a blood test to confirm that diagnosis. Currently there have been so many cases of West Nile virus in this area that we do not test everybody that we think has the disease. Especially since treatment is symptomatic meaning that we just do what we can to help you feel better as your body fights the disease itself. So often we do not test because if a positive test will not help us treat you then there is no value in doing the test other than just to know for sure. The test shows us if you have had West Nile in the last six months so if you had the disease a few months prior the test will be positive even though you do not have it anymore.
Because we have no treatment to get rid of the disease faster the main treatment is Tylenol or ibuprofen. I recommend these to help with fevers and muscle aches but nothing has been proven to shorten the course of the disease. The most important thing is to avoid mosquitoes. The key ways to do that are to:
1) Use insect repellents containing DEET (for people greater than 6 months old)
2) Avoid the outdoors from dusk to dawn.
3) Wear long sleeve shirts and long pants when outdoors.
4) Drain standing water sources on your property.
On occasion the disease can spread into the brain and cause meningitis and more severe disease. In these cases we often will have to send patients to the hospital in Billings and will consider using experimental treatments. In such times the disease is much more serious and can possible lead to death. Fortunately it is not common for the disease to become this severe.
If you think you may have the virus please schedule a visit with your doctor. For more information on West Nile virus you can visit http://www.patients.uptodate.com/topic.asp?file=inf_immu/2199&title=West+Nile+virus+infection
Sunday, August 12, 2007
We are in Glasgow now
A week ago my wife, Jen, and I made it to Glasgow. We are excited to be here and I will be starting to see patients tomorrow (Monday). We had a wonderful road trip across the country to get here stopping to see family in Ohio, Nashville, St. Louis and also doing tourist things in Mark Twain's hometown, visiting pioneer stuff in Southern Nebraska and seeing national parks across Kentucky, Nebraska, South Dakota and Wyoming.
But our adventures only started as we ended our 4100 mile road trip here in Glasgow. We were not in our house more than 2.5hrs when we decided to go out and get dinner before everything closed on a Sat night. But after locking the front door we dropped our only house key and it fell through our front porch. Having no idea how to even get a locksmith at 9pm on a Sat night we decided to get dinner and ultimately had to use some of my tools from the still unlocked garage to cut a piece out of the floorboard to get it. Then the next day we had to return our rental car in Williston and were planning to take the train back to Glasgow. But we forgot that Williston is in a different time zone. Thankfully Amtrak was running 90 mins behind schedule so we were saved.
But in our first week Jen has already finished repainting our master bedroom, we have all of the large items where they need to be and are just sick of unpacking the little stuff. But we are enjoying being back and this time to stay. It was great to get out this morning to the Evangelical Church and nice to start hospital orientation this past Thursday. We do want to thank the many folks who helped us with various parts of our move and those that have been so very welcoming since we have gotten here.
But our adventures only started as we ended our 4100 mile road trip here in Glasgow. We were not in our house more than 2.5hrs when we decided to go out and get dinner before everything closed on a Sat night. But after locking the front door we dropped our only house key and it fell through our front porch. Having no idea how to even get a locksmith at 9pm on a Sat night we decided to get dinner and ultimately had to use some of my tools from the still unlocked garage to cut a piece out of the floorboard to get it. Then the next day we had to return our rental car in Williston and were planning to take the train back to Glasgow. But we forgot that Williston is in a different time zone. Thankfully Amtrak was running 90 mins behind schedule so we were saved.
But in our first week Jen has already finished repainting our master bedroom, we have all of the large items where they need to be and are just sick of unpacking the little stuff. But we are enjoying being back and this time to stay. It was great to get out this morning to the Evangelical Church and nice to start hospital orientation this past Thursday. We do want to thank the many folks who helped us with various parts of our move and those that have been so very welcoming since we have gotten here.
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