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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. 

 

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Fight the Flu

Fight the Flu

Daily Dose

Alert: Flu is Here!

Flu is here! I just saw 3 patients from 1 family who has tested positive. Go out and get a flu shot today!I am writing this with trepidation as I have just seen my first 3 cases of Influenza A! Does this mean that we have a long winter flu season ahead, or does it mean it will come early and leave early?  

I only wish that I had the crystal ball that would/could predict this, but what I do know for a fact, flu is not fun!! These first 3 patients, all from the same family, really did not “look like the typical influenza” that I think of when we start seeing flu.  In this family of five, only the father had already received the flu vaccine, and as of now, he is the only one in the family not to get sick.  (I am happy to report that I too got my flu shot about 2 weeks ago, hooray!) When this 5 year old girl came to the office with a 2 day history of a fever and a headache, she really looked no different than numerous other children I had been seeing with a fall viral syndrome.  She definitely looked like she didn’t feel well but was sitting on her mom’s lap, did not have a cough or congestion and had no other real symptoms.  She did complain about a “scratchy throat” and her strep test was negative. It is not unusual to see a few days of fever with any virus, so she was sent home with instructions to treat her fever, and to return if the fever persisted more than another 24 – 48 hours or if she had new symptoms etc. She improved over the next 24 hours and returned to school the day after. The following day her 3 year old sibling began running a fever, again complained of a headache and was brought to the office.  Her mother requested that a flu test be done, as “there is a lot of flu at her school”.  That was an interesting comment as the Dallas County health Dept. had reported “little to no” influenza activity to date, and our office sends flu samples to the health department for epidemiology. But, knowing that “mother knows best” a flu test was performed and low and behold, it was positive for influenza A.  I was shocked!!! How could they have flu with essentially just a fever and headache?   It was after the fever was gone that they developed the classic congestion and cough that we doctors typically associate with the flu. This is really early in the season to typically see flu and if the Health Dept. is correct based on other samples this was probably H3N2 flu.  Now we are wondering if we are going to see more similar cases or if this is just a fluke?  In talking with other docs in the community, they too did not think they had yet seen influenza, or had they “missed cases” with kids who just had a fever. Take home message for all of this is GO GET YOUR FLU SHOT or FLU MIST , as I like to say “run don’t walk” because a virus has a mind of its own and trying to predict what course it will take  is often an exercise in futility. But this I know to be true, there will be more flu cases over the next 4 months, but when the “true season” begins is still an unknown. That’s your daily dose for today.  We’ll chat again tomorrow. Send your question or comment to Dr. Sue!

Daily Dose

Colds & Suctioning Your Child's Nose

1:30 to read

I am beginning to sound like a broken record, but we are in the throes of cold and flu season and unfortunately there are a few more months of this.  As every parent knows, colds (aka upper respiratory infections) are “age neutral”. 

In other words, there is not an age group that is immune to getting a cold and for every age child (and adult for that matter), the symptoms are the same. Congested nostrils, scratchy sore throat, cough, and just plain old feeling “yucky”. When an infant gets a stuffy nose, whether it is from “normal” newborn congestion, or from a cold, they often have a difficult time eating as an infant is a nose breather.  When they are nursing and their nose is “stopped  up”, they cannot breath or even eat, so it is sometimes necessary to clear their nasal passage to allow them to “suck” on the bottle or breast. 

Of course it is self evident that an infant cannot blow their nose, or rub or pick their nose so they must either be fortunate enough to sneeze those” boogers” out or have another means to clear the nose.  This is typically accomplished by using that wonderful “bulb syringe”. In our area they are called “blue bulb syringes” and every baby leaves the hospital with one tucked into their discharge pack.  As a new parent the blue bulb syringe looked daunting as the tip of the syringe appeared to be bigger than the baby’s nose.  But, if you have ever watched a seasoned nurse suck out a newborn’s nose, they can somehow manage to get the entire tip inside a baby’s nose. For the rest of us the tip just seemed to get inside the nostril and despite my best efforts at suctioning nothing came out. Once a nurse showed me the right “technique” I got to be a pretty good “suctioner”.  With the addition of a little nasal saline, which you can buy in pre made spray bottles, or which may be made at home with table salt and warm water, the suctioning gets a little easier as the nose drops helped to suction the mucous.

Now, I have become a firm believer that there is a place for suctioning a baby’s nose, but once a child is over about 6 months of age they KNOW  what you are getting ready to do. I am convinced that a 6 month baby with a cold sees the “blue bulb syringe” approaching their face and their eyes become dilated in fear of being suctioned!!  Then they begin to wail, and I know that when I cry I just make more mucous and the more I cry the more I make. So a baby with an already stuffy nose gets even more congested and “snotty” and the bulb syringe is only on an approach to their nose. It also takes at least two people to suction out a 6 – 12 month old baby’s nose as they can now purposely move away , and hit out to you to keep you away from their face and nose. It is like they are saying, “ I am not going to give in to the bulb syringe” without a fight! I swore I would not have a child with a “green runny nose” that was not suctioned.

As most parents know, don’t swear about anything, or you will be forever breaking unreasonable promises to yourself!  I think bulb suctioning is best for young infant’s and once they start to cry and put up a fight I would use other methods to help clear those congested noses.  Go back to the age old sitting in a bathroom which has been steamed up with hot water from a the shower. Or try a cool mist humidifier with some vapor rub in the mist (aroma therapy).  Those noses will ultimately run and the Kleenex will come out for perpetual wiping. Unfortunately, it takes most children many years before they learn to blow their nose, but what an accomplishment that is!!!  An important milestone for sure.

That's your daily dose for today. We'll chat again tomorrow. Send your question or comment to Dr. Sue!

Daily Dose

Let's Talk Flu

1:30 to read

Summer is not even officially over, but it is time to discuss flu vaccines.  This years flu vaccine is now being shipped and our office has already started giving the vaccine.  If you somehow missed the biggest news you need to know that there is not an intranasal flu vaccine (Flumist) available this year…in other words, everyone gets a shot!

The flu vaccine is recommended for everyone over the age of 6 months. Because circulating flu strains change, the flu vaccine is “new” every year..in other words, the flu shot you may have received last year is not the same shot that will be given this year.  I have had several adults  (friends) already say to me, “  got my flu vaccine in January….so I don’t need one now, right?” WRONG..that was “last years vaccine”…put your arm out for the new one.

While many children had gotten used to “sniffing” their flu vaccine and were thrilled not to have a shot, recent studies found that the intranasal flu vaccine was not as effective as the injectable flu vaccine.  In fact, for the 2015-2016 flu season the intranasal vaccine effectiveness among children 2 through 17 years was 3 percent as compared with 63 percent for the injected vaccine (quite a significant difference).

Actually, the fact that studies are done to look at flu vaccine effectiveness each year should be reassuring. By having the data available adjustments and new recommendations can be made, providing children with the best possible protection from getting the flu, and this year that means a shot.

The flu vaccines available this year may be either a trivalent vaccine ( containing 2 influenza A strains and 1 B )  or a quadrivalent vaccine (2 influenza A strains and 2 B).  I would ask my doctor which vaccine they are offering and if given a choice I would pick the quadrivalent…but most importantly just get your vaccine, sooner rather than later.

While I am already seeing sad little faces when they hear they will have a “shot rather than a mist”,  the good news that should bring smiles to their faces (and their parents) is that they will have better protection against the flu.  

Even though temperatures may still be on the warm side without any hint of flu “in the air”, it is time to get your vaccine…and yes, the protection will last throughout the flu season. It is best to be vaccinated and protected ahead of flu season.

 

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Daily Dose

Fight The Flu

1:30 to read

It is National Influenza Immunization Week, and I am hopeful that most everyone reading this has already had their flu vaccine….but if not, it is NOT too late! Just like the after Thanksgiving sales being extended…..your opportunity to be vaccinated has not passed!  Lucky for you, there are still vaccines available. If you act quickly there may be some places having a two for one sale, a coupon for shopping after getting vaccinate or even free vaccines…no excuses, everyone in the family ( over 6 months) may be vaccinated.

All kidding aside, this is an important time to remind people that it is not too late to get your flu vaccine and as of the first week of December there has not been a significant amount of flu in the country. But with that being said, influenza typically circulates December thru February but some years flu may even last into April or May.  But one thing is sure, flu is coming!!

No one is immune from the flu and the best protection is to get a flu vaccine!!  I hear people tell me, “they have never had the flu before so why should I get a vaccine?”, or “ I got sick after I had the flu vaccine, so I am not getting it again”.   Both of those are myths and are just a few of the anecdotes that I hear from patients and their families.

It is recommended that everyone over the age of 6 months receive a flu vaccine as it is the best protection against getting sick from the flu, and by vaccinating everyone we are also protecting those infants under 6 months that cannot yet get a flu vaccine.  Infants have a higher incidence of complications from the flu ( as do children with asthma and other underlying health issues ), and those precious babies born during the late summer and into the winter depend on the community to help keep them healthy. This is especially important for infants and children in day care, as influenza is a respiratory virus that is spread when someone in close proximity has coughed or sneezed. So, check to make sure that everyone in your daycare center is vaccinated, including the parents.

Statistics show that flu vaccination activity drops off after the end of November, but it is never too late to get the vaccine.  Remember,  it does take about two weeks to develop immunity after being vaccinated.  People also tell me, “I think I have already had the flu this year”, but even if you have, you have not had all of the strains of influenza that are in the vaccine and yes…you could get sick again. This years flu vaccine is available as a trivalent vaccine (which contains 2 type A, flu and 1flu B) and a quadrivalent vaccine ( with 2 type A and 2 B strains), and either vaccine is fine….get whatever your doctor, health department, pharmacy, grocery store, or employer has.  Most children over the age of 2 years may also take the live attenuated intranasal flu vaccine ( because how many kids want a shot -right?) and it is a quadrivalent vaccine.

So now is the time to run…not walk to get your flu vaccine!!  Don’t delay, put it on the top of the holiday “to do list”.

Daily Dose

Flu Season Continues

Another Monday in the office and Influenza B is here in full force. Seeing all of the kids (and many of their parents) who have succumbed to flu B this season reminded me that the FDA has already recommended that the flu vaccine for next year contain a different B virus strain than this year's vaccine. The Influenza B virus that is circulating in our area right now is not a good match for this year's vaccine. Fortunately, Influenza B is typically not as serious and as lengthy as Influenza A.

It seems that the flu vaccine this year was right on the mark for the Influenza A viruses that we have been seeing and provides good protection against flu A. The flu vaccine that will be made over the next months for distribution next fall will only vary slightly from this year's vaccine. The two Influenza A strains in this year's vaccine will remain the same while the B component will change from type B/Florida to type B/Brisbane, which is the strain that we have been seeing this winter. Determining the viruses to target in flu vaccine is always based on the epidemiology of flu strains that are circulating throughout the world. The strains must be chosen early in the year in order that manufacturers have a long enough time to ensure that vaccine will be available in the six to seven months ahead. Funny to already be discussing flu for 2009 - 2010 when we are still in the thick of the season for the current flu strain. Hopefully the season will soon be winding down. That's your daily dose, we'll chat again tomorrow.

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What's Going Around?

Daily Dose

Too Many Antibiotics Prescribed!

1.45 to read

What are the sounds of the season in my pediatric office? Coughing, sneezing and wheezing.  It's upper respiratory season and I'm seeing a lot of viral illnesses.  

With the winter season in full throttle, no one wants to be sick, so parents and patients still “want” me to prescribe antibiotics for a plethora of viral illnesses “because it is a busy time of year, we are traveling and can’t be sick."  

According to a recent article in issue of Pediatrics, pediatricians write more than 10 million antibiotic prescriptions unnecessarily every year. Antibiotics won’t help a viral upper respiratory infection and in many instances might be causing more harm than good. That is sometimes a hard concept to explain to parents. 

Everyone wants to be well sooner than later. Parents don’t want to be sick and never want their children to be sick or feeling cruddy, yucky, pathetic or pitiful. We are the parents so we can "fix it” right?

Unfortunately, a virus is bigger than any concerned parent, and even an antibiotic won’t “fix it”.  In many cases the only cure is “tincture of time” and that is often bitter medicine to swallow.

An antibiotic that is prescribed for a cough or cold is typically broad spectrum and will kill good bacteria that are beneficial to our bodies. An antibiotic is not very specific and by hitting everything in your body it may upset the normal bacteria and lead to symptoms such as diarrhea or abdominal cramping.  

In many cases of a viral illness it may be more appropriate to avoid an unnecessary antibiotic and to “wait and see” how the illness progresses.  If a child has worsening of symptoms or a change in symptoms it is better to re-examine the child than to just prescribe an antibiotic.   

Unfortunately, fall/winter URIs do not go away quickly. In most cases, it takes 7-14 days to get over the congestion, cough, and sore throat no matter what you do.   

I have patients who are seen at outside clinics with a negative strep test, then given antibiotics and do not get any better. That good old Z-pack just doesn’t do the trick!  By the time I see them the sore throat has developed into a classic upper respiratory infection and the antibiotic has not helped at all.  Good rule of thumb: if you are told you have a viral infection, you should not be getting and antibiotic. 

Viruses are also quite contagious so it is not uncommon for the entire family to succumb to the cold. Keep up hand washing and good cough hygiene and don’t assume and antibiotic will help, it may do more harm than good!

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

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