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Daily Dose

Do Essential Oils Boost Immune System?

1:30 to read

Although it is still hot and officially summer, soon everyone will be heading back to school  and coughs and colds (and eventually flu, another topic) will be just around the corner. I had a patient ask me about the use of essential oils. Her 2 1/2 year old daughter is heading to preschool for the first time and she “had heard from her friends that essential oils help a child’s immunity during cold season”.

Unfortunately, there is very little data at all to confirm that statement. I only wish that rubbing a bit of lavender oil on would help prevent the common cold. While it may smell great and be relaxing....there is no data that I can find to show that there is any reproducible science to the claims that essential oils boost the immune system.  

While I was researching I found many sites stating that “eucalyptus oil is an anti-viral” and “peppermint oil is an anti-pyretic (fever reducer)”.  Tea tree oil is touted as being “both anti -bacterial and anti-fungal” (I don’t know of other drugs that can claim both!).  But, I just don’t see any data to support all of this. 

The word essential refers to the essence of the plant the oil is derived from, rather than being “essential” to your health. While in most cases essential oils (which are highly concentrated) used as aromatherapy are not harmful for adults, it may be a different story in children, especially those under the age of 6. While labels may say  “natural” it may not always mean safe.  Many oils are poisonous if ingested and there have been reports of accidental overdoses in children with several different oils. In one report tea tree oil and lavender oil applied topically have been shown to cause breast enlargement in boys.  Oil of eucalyptus and peppermint are high in menthol and cineole.  These substances may cause children to become drowsy have decreased respirations.  While there are articles stating that the use of menthol (Vicks) on a child’s feet may be helpful during a cold for reducing a cough, do not use this if child is young enough to put their feet in their mouths. 

I must say that I sometime use a few drops of eucalyptus oil in the shower when I have a cold as I think it smells great and seems to help “open up” my head. Whether this is in “my mind” or a response from my olfactory centers which sends calming messages to respiratory center is not clear. But, I am not ingesting it or using it topically. 

 

Daily Dose

Do Essential Oils Boost Immune System?

1.30 to read

Although it is still hot and officially summer, soon everyone will be heading back to school  and coughs and colds (and eventually flu, another topic) will be just around the corner. I had a patient ask me about the use of essential oils. Her 2 1/2 year old daughter is heading to preschool for the first time and she “had heard from her friends that essential oils help a child’s immunity during cold season”.

Unfortunately, there is very little data at all to confirm that statement. I only wish that rubbing a bit of lavender oil on would help prevent the common cold. While it may smell great and be relaxing....there is no data that I can find to show that there is any reproducible science to the claims that essential oils boost the immune system.  

While I was researching I found many sites stating that “eucalyptus oil is an anti-viral” and “peppermint oil is an anti-pyretic (fever reducer)”.  Tea tree oil is touted as being “both anti -bacterial and anti-fungal” (I don’t know of other drugs that can claim both!).  But, I just don’t see any data to support all of this. 

The word essential refers to the essence of the plant the oil is derived from, rather than being “essential” to your health. While in most cases essential oils (which are highly concentrated) used as aromatherapy are not harmful for adults, it may be a different story in children, especially those under the age of 6. While labels may say  “natural” it may not always mean safe.  Many oils are poisonous if ingested and there have been reports of accidental overdoses in children with several different oils. In one report tea tree oil and lavender oil applied topically have been shown to cause breast enlargement in boys.  Oil of eucalyptus and peppermint are high in menthol and cineole.  These substances may cause children to become drowsy have decreased respirations.  While there are articles stating that the use of menthol (Vicks) on a child’s feet may be helpful during a cold for reducing a cough, do not use this if child is young enough to put their feet in their mouths. 

I must say that I sometime use a few drops of eucalyptus oil in the shower when I have a cold as I think it smells great and seems to help “open up” my head. Whether this is in “my mind” or a response from my olfactory centers which sends calming messages to respiratory center is not clear. But, I am not ingesting it or using it topically. 

 

 

Daily Dose

Does the Color of Mucus Really Matter?

1.30 to read

It is that time of year and everyone seems to have a cold, including me!! I am actually “on” my second cold of the month, so I am feeling like a toddler who gets sick every two to three weeks.  

This is really a good time to talk about mucus. I wonder how many people will keep reading now? But I do get lots of questions and comments from parents who are worried about the color of their child’s mucus. Runny noses and mucus color are discussed as often as color of poop. And just like poop, the color of your nasal mucus is usually not terribly significant. 

If you happen to have a cold yourself, you probably notice that your nasal discharge changes throughout the day, that is unless you are a teenager, and they swear they never look at mucus or stool color!! I think we notice “green snotty noses” among children between the ages of six months and four years, when they typically don’t blow their noses and many times the mucus is either wiped off of their face or they wipe it themselves on their shirt sleeve, (which then leaves a telltale sign of the color of the mucus). Once a child can blow their nose and dispose of the Kleenex, the color of the mucus does not seem to be a hot topic of discussion.

So, what does color of mucus mean? When you have a cold, the nasal discharge associated with that viral infection typically begins as a clear discharge, that changes over several days into a thicker and more purulent (green) discharge. The color may be due to the white cells that are in the mucus that are producing antibodies to fight the cold. 

As a cold progresses the green mucus then changes back into a more clear discharge and eventually goes away, but that is usually after a seven to 10 day course. It is also common to see thicker “booggers” in the nose in the morning or after your child’s nap as the dry air they are breathing makes the mucus thicker and they are not wiping or blowing their noses so the mucus is thicker. Same for us, we also usually have thicker greener nasal discharge in the morning, while the “snot’ has been sitting overnight. The best way to clear out any color mucus is by using saline nasal irrigation. It works great for all ages. By clearing the nasal passages, it will prevent a secondary bacterial infection which and cause a sinus infection.   

Most doctors use length of time of nasal discharge as more indicative of an infection than color of mucus. Typically in a pediatric patient an antibiotic for a “presumed” sinus infection is not even considered until a child has had over 14 days of a “gunky” green nasal discharge. Remember too, that the nose can clear up and the cold can go away, only to be followed in another week or two by another cold. It is the season. With that being said I am off to blow my nose again and wash my hands! 

That’s your daily dose, we’ll chat again tomorrow.

Daily Dose

Upper Respiratory Viruses

Why does it seem that our kids continue to get sick this time of year.I have been on call over the last weekend and I am beyond sounding like a broken record as I explain to parent after parent, “we are at the height of upper respiratory season”.

When you take weekend call in our practice you see patients in the office, you make hospital rounds at several hospitals and you also are taking phone calls from the answering service.  With that being said, parents are having a hard time understanding “how is it possible that my child is sick AGAIN?”  Said child was sick 2-3 weeks ago with something that seemed like the SAME thing, and here we are AGAIN.  You don’t even have to see their faces, you can hear the concern, disbelief and exhaustion in their voices! So, after finishing up hospital rounds and seeing all sorts of sick kids (these were not the hundreds seen in the office mind you, but the few that were sick enough to be hospitalized) it seemed like a great time to review respiratory illnesses. There are literally hundreds if not thousands of upper respiratory viruses that cause many similar symptoms, which are typically congestion, cough, scratchy throat, fever and just feeling “cruddy”.  A typical young child (under the age of 5 yrs) will get 7–10 of these viruses during a season which means at least one a month.  Unfortunately, this often means that parents with young children are also sick and it is even harder to take care of your child when you are sick and feeling terribly yourself.  Double whammy for sure! When discussing the frequency of upper respiratory infections parents wants to know “which virus is causing this?”  Surely you can name the virus, or do a test to confirm the virus or SOMETHING!!   Well, we can often name the viruses that are in the community, but again, naming the virus often does little good in diminishing the symptoms or expediting the length of the illness. Today was a good example of that as I was seeing our hospitalized patients. I saw a 6 month old with parainfluenza virus (this has nothing to do with flu either, so confusing), who had been admitted with croup and cough and needed oxygen.  Both of her parents are sick with colds too (probably due to the same parainfluenza virus). The next room was a 18 month old with wheezing who needed oxygen and bronchodilator treatments,  and he was found to have metapneumovirus.  Yet again, his 3 year old sibling and mother were coughing away and blowing their noses, somehow the father was yet to be sick and he felt quite smug! Several more rooms and 2 more children who had RSV and they too were coughing, having a hard time breathing and needed oxygen. Lastly was a child with rhinovirus who had developed a viral pneumonia and also required oxygen.  The point of this is that despite the fact that we “named” their viruses it really did not help very much in their overall care. All of these patients were under the age of 4 years, were otherwise healthy children and needed to be admitted to the hospital for a viral upper respiratory infection which required supportive care in order to maintain their oxygen levels.  In just one morning, I saw 4 documented different viruses, all causing similar symptoms and definitely lots of concern, exhaustion and frustration for their parents.  The best news is that they were all improving and would be going home over the next several days. Unfortunately, there will be new cases to fill their rooms. The list of respiratory illnesses seems just endless and by this time of year everyone, including children, parents and their doctors are “over it”.  In other words, when is this going to end?  We probably have 6 - 8 more weeks of this and then the viruses will diminish as the weather gets warmer and more humid. Viruses like cold dry temperatures like we have during the winter months .With warmer temperatures we will all spend a l more time outdoors and germs are not so easily spread. I too am hopeful for the end of upper respiratory season, as I was innocently sneezed on today by the little 6 month old with croup, and her mother said, “Dr. Sue, guess you will be the next one to be sick.”  Washing hands, and praying that I am immune. That’s your daily dose. We’ll chat again tomorrow.

Daily Dose

Colds & Nosebleeds

1.15 to read

The cold weather is gripping a good portion of the country......and that means the heat is now on your house. With the dry air in the house, and lots of sniffles and colds, before you know it I am hearing from parents concerned about nosebleeds.   

Kids get tons of nosebleeds (not just from trauma) and even small noses will look like they are bleeding a lot.  For some reason a lot of children’s noses bleed during the night. That means lots of blood on sheets.  A little bit of blood on sheets, hankies, or Kleenex looks like a lot more blood than it really is, so don’t freak out. 

If your child has a bloody nose try to have them tip their head forward, breath through their mouths and pinch the nose halfway between the tip and the base of the nose. Don’t stick anything inside their nose at that may irritate the nostril even more. Don’t let your child sniff the clot or rub it during the pinching.  

In order to prevent nosebleeds during the dry cold months, it is often necessary to use a lubricant in your child’s nose There are several saline nasal sprays that help, some of which have lubricants like aloe in them as well. A minimal amount of Vaseline can also keep the inner nasal mucosa moist so that the clot that forms after the nose has bled can have time to heal.  Think of the clot inside the nose, just like a scab on your child’s knee. If it gets bumped before it is healed it will bleed all over again.   

Remember, if your child rubs their nose, “God forbid” picks their nose, or even blows their nose, once the nose has bled it is going to bleed again! If nosebleeds become recurrent, check with your doctor about taking a look inside your child's nose.

 

 

Daily Dose

Got a Virus? Treat it with TLC

1.30 to read

I was on call this week and I think I saw “a million” kids with colds!

Everyone, from 3 months – 20 years, seemed to have runny/congested noses and coughs.  Interspersed with all of these colds were a lot of wheezing kids too, as these winter viral upper respiratory infections will trigger a lot of wheezing in very young children or those with asthma. Thankfully, none of them were “very” sick.

We have all been fortunate this year as most of the country is not seeing much flu, and I have my fingers crossed that this trend will continue!  Flu will usually make children (as well as adults) much sicker than these upper respiratory viruses.

Parent after parent kept asking me, “what is causing all of this?” “ If not flu, then what?”  Well, I can tell you that we are seeing RSV, rhinoviruses, para-influenza virus and metapneumovirus, just to name a few.

Unfortunately, there is not “a magic treatment” to cure these viral infections. With that being said, the treatment is entirely symptomatic. In other words, treat the symptoms with fluids, fever reducing meds if needed, rest, cool mist humidifiers, hot steamy showers, chicken noodle soup, and anything else that makes the symptoms seem to improve. (I am currently into ginger tea for my sore throat.)

So, after explaining viral infections and treatments, I often end the discussion with, “your child just needs some TLC”.  Well, I know I have said before that many of my “young” parents were not quite clear what TLC stood for. But this weekend I really had to laugh!

As I explained colds and symptomatic treatment to a mother with a 2 year old I told her to try a little TLC.  She looked at me slightly puzzled and said, “I have to go to THE LEARNING CHANNEL to find out what to do for this cold?”  “Do they have shows about treating colds?”

Just another reminder that not everyone knows the same acronyms! I just laughed (LOL) and told her that I meant Tender Loving Care and that she did not have to search her TV guide for treatment of colds!

I’m on call again next weekend, so be prepared for a few more funny stories as I tend to get a bit slap happy after being sleep deprived.

That’s your daily dose for today.  We’ll chat again tomorrow.

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Treat Your Child's Cough & Cold!

Daily Dose

The Best Cold Treatment

1.30 to read

Alright, enough is enough! How could I possible have another cold?  I routinely tell patients with children that it is not unusual for kids to get 8-10 colds a year which seems like once a month from September through April!

If you also think that the average cold lasts anywhere from 7–14 days, then it seems like a child has a cold that lasts most of the year. That is how I am feeling right now.

A cold usually starts off with a little “sniffles” and maybe a sore throat, and you pray that it is just your imagination, and then over several days you  realize that you now feel “yucky”, have more congestion, the sore throat is still there and you are coughing. That is a cold!!!! That is not allergies, nor is it flu. It is that pesky cold virus of which there are an infinitesimal number, and you have succumbed once again. That is my story!

So, with those symptoms AGAIN, and a day in the media research office, I went back to the literature to see if I could find ANYTHING that might lead me to preventing  a cold, curing a cold or making this nasty thing go away any faster. I mean, I am a busy woman and like everyone else, “I really don’t have time for this!” There have been thousands of studies done over the years looking at cold symptoms and their prevention. Studies on Vitamin C from the days of Linus Pauling, to more recent studies for prevention and treatment of upper respiratory infections have really found no benefits to taking vitamin C.

There was one study that showed taking vitamin C might reduce the duration of cold symptoms if taken before a cold begins.  My question is, how do you know that you need to start Vitamin C in anticipation of a cold?  Also, too much vitamin C may cause an upset stomach and diarrhea.

How about Echinacea?  I have been taking Echinacea for years in hopes of “warding off colds”, but the review of the data  showed that Echinacea had no effect in preventing the common cold, studies did show that it might reduce cold symptoms in adults, but studies in children did not produce the same results.  It was also found to increase rashes in those who had eczema (atopy), and allergies to ragweed. I am still taking it, but personally “can’t tell a difference”. You do realize that my opinion alone is not statistically significant. Then there was the whole zinc movement and there are numerous studies that show conflicting results. Some studies did show that those who took 15 mg of zinc daily had a lower mean number of colds and also a shorter duration of cold symptoms.

Other studies did not find a statistical significance for either reducing the number of colds or decreasing symptoms. I have tried all sorts of zinc preparations over the years (even when it was such a hot item I had to order lozenges off of QVC-should I admit that?) and besides tasting horribly I think my cold lasted the same number of days.  Another study of one (not significant), and most would say that the data is still inconclusive.

The hottest new topic is vitamin D.  A study published in the Archives of Internal Medicine in early 2009, analyzed information on vitamin D levels in adult and adolescents.  The results showed that those people with the lowest vitamin D levels (less than 10 ng/ml) were 36% more likely to report having upper respiratory infections that those with higher vitamin D levels (above 30 ng/ml).

Vitamin D is also important for bone and general health, so it is a good idea to be making sure that you are getting adequate vitamin D. The AAP increased the recommended daily intake of vitamin D to 400 IU. I am currently taking a vitamin D supplement in hopes of boosting my immunity as well as keeping my bones healthy.

If you have any ideas or PROVEN remedies, potions, concoctions please send them my way. In the meantime, I continue to drink lots of herbal tea, take hot showers and baths to help the congestion, go to bed earlier than usual, suck on my honey throat lozenges and pray. I also wash  my hands incessantly and even resorted to wearing a mask over the last several days in hopes of warding off germs. My patients think I am playing dress up!

That's your daily dose for today.  We'll chat again tomorrow (cough)! 

Daily Dose

Dealing With Runny Noses

With the combination of back to school germs and fall allergies, every child I see seems to have some sort of nose or throat symptom.

Cooler weather is here and with fall it seems runny noses begin to abound. With the combination of back to school germs and fall allergies, every child I see seems to have some sort of nose or throat symptom. Unfortunately there isn’t much to do for those first fall colds except to push fluids, encourage a good nights rest and lots of Kleenex.

Fortunately, fall viral respiratory infections don’t seem to be as miserable or last as long as the ones that are lurking around the corner for the winter. But, allergies are treatable and there are more and more over the counter medications available. Children under 2 typically don’t have a runny nose caused by allergies, but older kids may. It may be worth trying a product like Claritin or Zyrtec for several days to see if the itchy eyes, runny nose and intermittent sore throat improve. Benadryl is still an excellent antihistamine to use, although it may cause drowsiness, so try taking at bedtime. Nasal irrigation is also a good idea and there are many products available or make your own salt water solution at home (be thrifty). Lastly, although you can’t prevent the common cold, it is already time to be thinking about flu shots, so get yours scheduled. That’s your daily dose. We’ll chat tomorrow!

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