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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

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.

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.

Daily Dose

Dog Flu Is Going Around

1:15 to read

Funny time of year for me to be blogging about flu?  Well, now it is “dog flu” that has been spreading across the United States.  Dog flu is caused by an influenza virus and is a contagious respiratory disease in dogs. There have not been any reported human infections with either of the viruses that cause dog flu.  The viruses are also of the Influenza A variety and cause symptoms similar to those seen in humans including cough, runny nose, fever, lethargy and at times severe respiratory symptoms including pneumonia. Sadly, there have been dog deaths reported due to this infection. 

Because dog flu is a fairly new virus now being seen in the United States, most dogs have never been exposed to this virus.  Due to this, just like new influenza types in humans, most dogs that are exposed (about 80%) may develop dog flu but remember most will have mild symptoms and just require supportive care including extra fluids and rest.

If you are concerned that your dog may be showing signs of dog flu there is a test that your vet may administer ( just like we do flu tests for kids!). Extremely ill dogs, especially young puppies or pregnant dogs may have a harder time handing the virus ( again, does this sound familiar?).

But, the main thing to know is that this flu is not being seen in humans.  There is a vaccine for one of the types of dog flu and the veterinary community it working on other vaccines.

So, no need to worry about the kids and their pet dog!!  Just like your children make sure your dog is up to date on their vaccines, gets a healthy diet, exercises daily, has enough sleep and enjoys lots of family time too. But,  this is a good time to remember that human flu vaccine will begin to be available by the end of the summer. But don’t worry, I will remind you! 

Daily Dose

Travel Healthy During The Holidays

1:30 to read

With all of the viruses and illnesses popping up, I am getting a lot of questions about travel plans. Many parents are asking "should I travel with a sick child?"

In my opinion, we all must continue our lives, even in the face of flu fear, and a trip for a toddler to see his/her grandparents is important for everyone. We should all make our plans for trips to the visit family. While traveling, everyone needs to practice good hand washing and cough hygiene and be prepared to change plans if a family member is ill. Traveling while being acutely ill and running a fever is only exposing everyone else to you or your child’s illness and seems somewhat selfish.

None of us should be traveling within 24 hours of having a fever (that means without the benefit of fever reducing medications), and isolating a child or parent for several days will be better for everyone, than traveling while sick. Think of the greater good! With that being said, I am not a proponent of a newborn under the age of 2 months traveling, unless out of necessity.  I have always been fairly conservative about exposing a baby to crowds and closed in spaces (malls, movies, restaurants) and airplanes certainly fit that description.  With the uncertainty of this year’s flu season it seems like a really good year to stay put. A newborn’s immune system is still fragile, and the more often a newborn is exposed to large groups of people,  the better chance they have of getting sick in the first 6 – 12 weeks of life. This must have been what was called “confinement” in the olden days.

Staying home and enjoying the simplicity of life, with the excuse, “I have a newborn baby” gets you out of so many invitations and situations.  This is probably the only time that you can get away with that line, as after several months the realities of work, family commitments, and day to day living return and often that means with baby in tow. We all do what we have to do, but if you don’t have to take your newborn baby on a flight this holiday season, I would not. I also know that not everyone will abide by the “Do Not Travel While Sick” mantra, and exposure to illness is not uncommon during airline travel. There is not a way to sit 3 – 6 feet from another person on a plane! This is probably the time to have family come to you, and to make sure that they have all had their seasonal flu vaccines, and when available, the swine flu vaccine.

I don’t have a crystal ball to see how this winter season is going to unfold, but I do know that a sick infant has a better chance of ending up in the hospital if they develop a flu like illness.  The holidays will be a happier for all, if infants stay close to home and leave the travel to those with older children.

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

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Fight The Flu

Daily Dose

Plenty of Colds Going Around

1.30 to read

I have been looking at the data from the Center for Disease Control and Prevention and it looks like flu season has made an early exit from many parts of the country. That would be a welcome blessing. But cold season is still in full swing and so many of the parents I am seeing in the office continue to say, “it just seems impossible that my child can have this many colds in one year!”.  If you have a child between the ages of 6 months and 3 years of age, and they go to school, you are probably one of these parents.

The first several winters that you child starts day care or pre-school are pretty tough....not only in terms of “being away from your child”, but also for the number of viral illnesses they get. Many a parent has called me “CRAZY” when I tell them that it is not unusual at all for your child to get 7-10 viral infections during the first fall/winter season that their child is around other children. In fact, I know that there have been several families over the years that changed pediatricians just because the parent felt certain that their child had an “immune problem” due to their frequent coughs and colds. True problems with immunity do exist in pediatrics but they don’t typically present with recurrent coughs and colds, but rather with far more serious illnesses.  Thankfully these are rare.

Parents with younger children know their pediatrician far better than they really want to during those first several years. That is another reason that you want to find a pediatrician that is not only close to your house but that you really get along with!

So with all of that being said, hang in there for about another 6-8 weeks and the winter viral season truly will be exiting and children (and their parents) will all start to be healthier for the rest of spring.  I promise once your youngest child reaches 3 years of age your visits to the pediatrician during the winter months become less and less frequent.

Daily Dose

Many Parents Still Confused About the Flu

Here we go again, but I found myself repeating this over and over again today to many parents who are still confused about the flu this year.

  1. Influenza is not the same thing as "tummy flu" where you have vomiting and diarrhea. Unfortunately the flu vaccine does not prevent gastro intestinal disorders which are usually due to other viruses. People just call this a stomach flu and it is a misnomer. Winter is the time of year for MANY viral infections, so you are being bombarded with exposure to many things, not only influenza. The only good thing (if that adjective is appropriate at all) about the stomach bug is that it doesn't last as long as influenza and you usually get over it in 12 - 48 hours.
  2. Influenza, which is a viral infection, is just beginning to rear its angry head around the country. This is the typical time of year for this and influenza infections will most likely continue to rise over the next four to six weeks. There are two different types of influenza, A and B. It is important to distinguish which type you have as the antiviral medications that we had previously used to help treat influenza A and to prevent its spread in household contacts is resistant to the oral medication Tamiflu. I have seen more than several parents who have spoken with a physician by phone and started Tamiflu for "presumed influenza". If you think you have influenza, "the real flu" you need to have a test to see whether it is A or B and then be put on the appropriate antiviral. I would not use Tamiflu alone in Influenza A infections.
  3. Flu vaccine will not "give you the flu" The shot is a killed virus and will not give you flu. You may still get a cold or a stomach flu, but hopefully not the climb in your bed, have chills and fever, cough out your lungs influenza that makes you wish you had gotten the vaccine. The kids I am already seeing look sick, like they have the flu, and if they are old enough already say they don't want to be this sick again.

I know this is repetitive information but people keep asking. Stay tuned for further developments as we get further into this flu season.

Daily Dose

Flu Frenzy Across The Country

1.30 to read

“Flu Frenzy” is rampant in Dallas and across the country.  It is a very busy flu season and it did start earlier than usual in the southern part of the country. Texas has been hit especially hard.  I started seeing flu cases in my office at the end of October.  

But, with that being said, if you look at flu statistics over the past few years, January and February are typically the peaks of the flu season.  I know that these are usually the busiest months in the office and it  seems like there is not a child who doesn’t have a cough or cold and many have a fever lasting a few days.  Don’t panic! 

We have been lucky for several years to have had a light flu season, so this year’s flu season does seem worse. Fortunately, the majority of children we are seeing with flu symptoms are handling the virus very well (like many childhood viruses) and actually do not appear to be too sick. 

The children I am seeing are running 2-4 days of fever, many as high as 102 or 103 degrees, which is not unusual with the flu.  They have coughs, congestion and scratchy throats and the older kids are complaining of feeling “achy” as well. But they are also still drinking fluids, appear well hydrated, and when their temps come down with the help of acetaminophen or ibuprofen, they play, watch a movie, or even run around our waiting room. With a practice of 13 pediatricians we have literally seen hundreds of kids with the flu (both types A and B) but we have not had to hospitalize anyone! 

Parents always want to watch their children for respiratory distress or for prolonged fever, but most of the children may be treated symptomatically. Remember fever is your friend, and higher temps do not necessarily mean a sicker child. 

While there have been 29 pediatric deaths to date reported secondary to complications from the flu (1 death is too many), the majority of people who are having complications from the flu are the elderly.  The CDC confirms that this year is “is shaping up to be a worse than average season and is especially bad for the elderly”. 

The best way to prevent the flu is to make sure that any child over the age of 6 months of age gets a flu vaccine. With the early start of flu season and many people now heading to get vaccinated, the flu vaccine that is given to children between the ages of 6 months and 2 years is hard to find. The live flumist vaccine which is given to healthy children over 2 years of age seems to be more readily available. Call to check if your doctor still has availability. 

Historically we still have 6-8 weeks of flu season to go, so if your child is not yet vaccinated, call your doctor and get that vaccine! While it is not guaranteed to prevent the flu, it is definitely the best protection there is. 

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


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