Dr. Deb

I love my Pilates class, not just for how I feel, but the relationships I’ve made with people in the class. There is a certain intimacy and trust when you sweat and contort with a small group of people. I also love to share new things, so when I was updating this blog with a cold remedy that I was asked to support, it was only the resounding endorsement of the class that convinced me to promote Cold Eeze. They actually have good data supporting that it shortens the duration of a cold by nearly half, but data can be manipulated. Personal testimony of friends cannot. It’s finally cold and people are getting sick. Here are some tips to keep you healthy!
Dr. Deb’s Tips on how NOT to get Sick!

1. Wash Hands and Nose.

We all know to wash hands but doing it regularly is the problem. Flu virus may live on hard surfaces for 24 -48 hours so we need to keep certain zones in our surroundings free of germs. Think of these zones as an automatics hand wash times, in addition to any other times when you have been exposed to germs.

Entering your car

Entering your house

Sitting at your desk

Before food prep

After the bathroom

Before eating

If you automatically wash every time you enter the zone, you will greatly decrease your risk of infection. Remember effective hand washing takes about 15 seconds so do what I tell the kids, “Sing your ABCs or Happy Birthday” while you wash up.

Hand sanitizer and wipes are also convenient ways to clean up especially in your car when water is not available. Put one in your car and in your kids back pack so they can always keep clean.

Just as important it is to wash your nasal passages. This will greatly reduce the risk of sinus infections as it washes the allergens before your body causes an inflammation response. 5 squirts of normal saline in the morning, night and after exercising outdoors is a great prevention strategy. A nettie pot is a power wash if you have a lot of congestion but recently there were infections with tap water. You may want to use distilled or boil the water and cool before using.

2. Don’t Touch your Face

Many infections are transmitted through hand to face contact through the mouth, eyes and nose. A study in 2009 videotaped people and observed that they touched their face an average of 16 times an hour.  Every time you touch your face you are allowing bacteria to enter your body. You may also be spreading virus as the nose has the second highest concentration of bacteria on the body surface. (bet you can guess the first and it’s not the mouth!)

3. Clean Common Germ Collectors

I am forever telling the kids, “Don’t put your shoes on my food prep area!” They love to plop down book bags and shoes on the counter where I make dinner. Wipe down daily Keyboard, phones, remotes, door handles, microwave ovens handles, pens and put toothbrushes in the dishwasher if you are sick or replace them. Avoid teller machines, vending machines, escalators handrails and elevator buttons and wash after you do.

Desks have 400 times more germs than toilet seat so it is important to keep it a clean zone where you work.  Don’t forget to clean the toilet handle. My kids recently proved that the urinal handle had more germs that the wrestling mats and vending machine button in their science fair experiment.

4. Cold Eeze

A study from the Cleveland clinic showed taking Cold Eeze at the first sign of a cold reduced the duration of the cold by nearly half. It must be taken at the first sign of a cold as it is theorized that the zinc gluconate binds to the cold virus receptor blocking them from replicating, Cold Eeze comes in lozenges and now a new oral spray that is convenient. Just two sprays and you are good to go!

5. Start Spring Allergy Prevention Now

Our unseasonably warm winter may result in an earlier spring allergy season.  My daffodils are already 5 inches high! In addition to flushing with normal saline, if you get recurring allergies every year, you may want to think about starting prevention medications earlier than usual. Nasal steroid medications such as Flonase are most effective when taken at least 2 weeks before the allergy exposure.  A late freeze would stop early allergies. You can track pollen counts in your area and receive alerts at pollen.com. 

6. Probiotics

Probiotics are various forms of “good bacteria” that can be taken as a pill or liquid supplement.  They really help with gastrointestinal infections, like diarrhea but a recent study in Pediatrics showed that children given daily probiotic supplements had reduced colds, fever, cough and need for antibiotics.

7. Exercise

A recent study showed that exercising 5 times a week decreased risk of infection by almost 50% and regular exercisers that did catch a cold had a shorter duration and decreased severity.

8. Listen to Mom: Sleep and fluids

A study published in the Archives of Internal Medicine confirms you need more sleep.

After exposing healthy volunteers to a cold virus, researchers found that those who slept fewer than seven hours a night were about three times as likely to become ill as those who, on average who slept at least eight hours.

Fluids and good nutrition are also critical to prevent and shorten cold duration.

9. Flu vaccine

The flu vaccine is the surest way to prevent the flu. It is very safe and the most certain way to avoid influenza. It is not to late to get a flu shot this year.

Prevention really is worth a pound of cure so eat right, exercise and listen to your friends.

Dr. Deb

Preventing Annoying Back to School Infections

There’s peace in my house as all the kids are back to school but the return to school also means the return of annoying school infections such as pink eye and lice. I want to share my tips to keep those infections out of your house this year.

1. ABCs: Allergies, Bacteria and Colds

These three account for the most common infections in children and can all be prevented with hand washing, covering mouths while coughing and not sharing drinks and utensils.

Just one lesson on hand hygiene where students ages 5-15 learned to clean hands 3xs during the school day decreased 4 or more sick days by 66 percent according to the American Journal of Infection Control.

Most importantly have kids wash their hands when they come home from school to keep germs out of the house. They should also wash their noses with normal saline spray to prevent allergy outbreaks. If they do become ill then wash their toothbrush in the dishwasher or replace it to prevent reinfection.

2. Pink Eye

Pink eye is conjunctivitis or inflammation (swelling) of the conjunctiva—the thin layer that lines the inside of the eyelid and covers the white part of the eye.

The most common causes of conjunctivitis are viruses, bacteria, and allergens.

Symptoms include red eyes, crusty eyelids in the morning, itchy eyes, tearing and blurred vision.

Is typically mild, with symptoms being the worst on days 3–5 of infection. The condition usually clears up in 7-14 days without treatment but may take 2-3 weeks.

Many cases improve without treatment but topical antibiotics are often prescribed.

Prevention:

Wash your hands often with soap and warm water or an alcohol-based hand gel, especially after applying eye ointment.

Avoid touching or rubbing your eyes.

Wash any discharge from around the eyes several times a day but use different cloths on each eye.

Wash pillowcases, sheets, washcloths, and towels in hot water and detergent.

Don’t share tissues, towels, washcloths, eye makeup or eye drops with other people.

When treating allergic conjunctivitis dust and vacuum often to reduce allergens in your home and close windows when the pollen count is high.

3. Head Lice

6 to 12 million cases of head lice infestation occur each year in the United States in children ages, 3 to 11 years, according to the Centers for Disease Control and Prevention. They are tiny parasitic bugs that don’t spread disease and spread mainly by direct head-to-head contact with a person who already has head lice. Lice don’t fly or jump; they move by crawling.

Every parent should check regularly for lice by parting the hair in several spots. Lice can move fast so use a magnifying glass and a bright light. Nits can look like dandruff, but stay firmly attached to the hair if you pull your fingernail across the hair while dandruff will come off easily.

Most important for lice treatment is to use a fine-toothed comb or special “nit comb” to remove dead lice and nits that can be used with or without chemical treatment.

Prevention:

Don’t share hairbrushes, combs, hair ornaments, scarves, bandanas, towels, or helmets.  Girls with long hair should keep their hair braided and pulled back. Avoid head-to-head contact during play or slumber parties

When your child returns from a sleep over put everything in the dryer on high heat for 10 minutes. This treatment will also kill bedbugs.

Treatment:

Machine wash and dry clothing, bed linens, and other items using hot water (130°F) and dry on high heat. Clothing and items that are not washable can be dry-cleaned or sealed in a plastic bag and stored for two weeks. Head lice survive less than one or two days if they fall off the scalp and cannot feed.

Vacuum the floor and furniture, particularly where the person with lice sat or lay.

Disinfest combs and brushes used by a person with head lice by soaking them in hot water (at least 130°F) for 5–10 minutes. After finishing treatment with lice medication, check everyone in your family for lice after one week.

4. Molluscum Contagiosum

MC are pink, white or flesh-colored bumps caused by a type of poxvirus. It is common in kids ages 1 to 10 but many parents have never heard of it. Molluscum contagiosum is very contagious, mainly through skin-to-skin contact or contact with contaminated objects, such as clothing, towels or toys.

Once someone has the virus, the bumps can spread to other parts of their body by touching or scratching a bump and then touching another part of the body. Molluscum can also be spread by sexual contact. There has been a relationship of catching molluscum by shared swimming pools, baths, saunas, or other wet and warm environments, this has not been proven. Most likely sharing towels and other items around a pool or sauna than through the water spread the virus.

Prevention: Hand hygiene and not sharing personal items, including towels are the best ways to avoid this skin infection, which typically clears up without treatment in 6 to 12 months. Do not shave or have electrolysis on areas with bumps. If you have bumps in the genital area, avoid sexual activities until you see a health care provider.

To prevent the spread of molluscum to other areas of your body or to other people, it is important to keep every blister or bump covered either with clothing or with a watertight bandage

Treatment

There are many treatment options including Cryotherapy (freezing), Curettage (removes the fluid inside the bumps), Lasers and Creams that include certain chemicals (i.e., salicylic acid, podophyllin, tretinoin, and cantharidin). There is also a newer cream (imiquimod) that helps strengthen the skin’s immune system.

Mollusscum is tough to treat when it spreads and I have used imiquimod on my own children with great success.  It needs to be used every night, is expensive, may cause irritation but is safe.

A home remedy that may be worth trying is apple cider vinegar or ACV. There are several options but one is to soak a cotton ball with ACV and tape it to the MC overnight. There can be some irritation and stinging. Some have reported just soaking in a bath nightly with ½ cup of ACV will work too. Others advocate popping the MC with a sterilized needle then applying the ACV that is very similar to the curettage that we do in the office. I do not recommend popping at home as you may spread the infection or cause a bacterial infection but I would try the ACV nightly bandage option.

Being a parent is never easy. Here is hoping for a Happy Healthy School Year!

Dr. Deb

Last week a parent told me that her son knew me as not just Dr. Deb, but the Diarrhea Doctor. No surprise to me because I taught his class how they get diarrhea and that is something they won’t soon forget.  I usually give a germ talk to first graders at the start of cold season.  We discuss germs and how to fight infection, but they always remember one point in particular. You see, I ask them, “Have you ever had diarrhea?” When most raise their hands I tell them, “Well, that means that you have probably eaten someone else’s poop!” Sure it may be a crude way to explain oral-fecal contamination, but it sure gets them washing their hands!

We are in an Indian summer now but colds and infections abound so here are:
Dr. Deb’s Tips on how NOT to get Sick!

1. Wash your Hands in Zones

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I have to be honest. I was never one to get the flu shot. We really never got sick nor had any health problems in my family. I did encourage my husband who has more patient contact but never thought about it for my 4 kids or me.  I knew that sometimes the vaccine was right on and protected against the flu that was going around. I also knew that sometimes it missed and wasn’t even effective in certain years. I just didn’t think it necessary and worth possible down time from the vaccine.

I am not alone. Less than 40% of all health care workers received the H1N1 vaccine last year when it was a pandemic.  It is actually the pandemic that has changed my mind about flu shots. We did all get the H1N1 vaccine in my family and none of us had any side effects. Now, it turns out the H1N1 was not as severe as they first thought but plenty of young healthy people died from it. In fact, it is the youngest and the oldest that are most at risk from the flu. It comes down to the fact that if my child died or was hospitalized over something that I could have prevented, I could never forgive myself. The flu vaccine has a very long safety record so I feel that I should give it to my whole family now.

October marks the official start of flu season, which lasts all the way until May.

5-20% of all people (15-62 million people) will get the flu and more than 200,000 people are hospitalized each year for influenza-related complications. (more…)