Winter is coming
Every year from October through April, we see a rise in infectious diseases from the common cold to flu symptoms to pneumonia. Hopefully you either have or are planning to get your flu vaccinations soon. Getting the flu is a significant contributor to lost time, productivity, and health. The flu vaccine is our best way of minimizing that lost time. However, when you do get sick, other than resting, staying hydrated, and taking over-the-counter muscle ache and fever medication, there are several other things you can do to help get you back to yourself as quick as possible.
Simple vs Serious
The healthcare providers at Care on Location can help evaluate you to determine if it might be something more serious that would require further testing and treatment. Examples of this include pneumonia, blood clots in the lungs, bacterial infections in your blood stream, or evaluating the possibility of meningitis. While these situations are relatively uncommon compared to cold and flu symptoms during the winter months, they are possibilities and things that you and our providers at least need to consider.
The Live Online Exam
You can help us in gathering the best information to make good medical decisions. This starts with three things:
- Vital signs – Use any medical devices you may own. Take your temperature, check your pulse(count your heart rate for 6 seconds and multiply by 10, or use a heart rate monitor), check your blood pressure, and oxygen level with a pulse oximeter. We can still see you if you have none of these devices, but they are particularly helpful in certain circumstances.
- History – Being able to provide a good account of what is going on is very important, particularly in telemedicine where obtaining a good history gets us 90% of the way to making a diagnosis. There is an anonymous quote that says: “A doctor who cannot take a good history and a patient who cannot give one are in danger of giving and receiving bad treatment.” Let’s not have that happen. It may be helpful for you to write down the first symptom you notice and when it started. Then create a timeline from there, including anything that you think may have had an influence on your condition. Also, having an accurate list of the self-treatments you have tried and the medications you take is important.
- Physical – This part is often interesting and sometimes fun for patients with no medical training. Except in the circumstances where we have an assistant at your side helping with the physical exam, we depend on you, the patient, to help us provide an honest assessment of your physical self. This actually is not as hard as you might think. To start with, you know your body better than we do. So once we start directing you to look, listen, and feel for certain things on yourself that we would be looking for during an old-school office visit, it is amazing how good of a physical exam can actually be done. Plus, you often get to learn a bit about anatomy and physiology as part of the deal when we explain what we are looking for and why.
Multiple Treatment Options
Some may think that as long as it is not a bacterial infection, there is not much that can be done. Well, that is only partially true. There is value alone in getting a professional opinion about how likely something is to be serious and whether or not further evaluation and testing is needed. But, there are also several options beyond rest, fluids, and over-the-counter fever and pain relievers that we can consider and help you with.
- The Flu – Certain individuals considered high-risk for complications from the influenza virus may benefit from receiving anti-viral medications. These are best started as soon as possible after the onset of the flu symptoms and provide little to no benefit if started more than 48 hours after the symptoms have started. So getting seen sooner rather than later is important here. In general, these medications have been shown to reduce hospitalizations and death in high-risk groups and reduce how long the illness lasts too. This is a prescription only and something that we could prescribe if deemed medically necessary for your condition.
- Congestion/Sinus Pressure – Over-the-counter and home remedies are really the mainstay of symptomstreatment for congestion. Other than anti-inflammatories like ibuprofen or naproxen to help decrease the pain and inflammation, there are other options to help with this discomfort. Keeping the nasal passages as clear as possible helps the discomfort but blowing out the mucous is not always possible. Using saline rinses and decongestants like pseudoephedrine may be helpful for some. For others, prescription or over-the-counter nasal steroids can relief some of the congestion or taking medications like guaifenesin which is intended to take thick mucous and make it thinner so it can be blown out. Humidification of the nasal passages using room or personal humidifiers is another additional item that can be considered as trying to blow out dried sinus mucous can be quite difficult, so keeping those passages humidified may help prevent this issue.
- Sore Throat – Painful throat may make eating and drinking more difficult, but is really important when your body is run down. Using a throat lozenge, film, or spray shortly before eating or drinking may make is more tolerable and help keep you hydrated. A simple home concoction that is sometimes used for mouth sores that is worth considering is to mix equal parts benadryl and maalox. This can be swished and gargled to help with discomfort. Be aware though that there has not been much evidence that this mixture provides significant benefit but it has been a common treatment for decades. Similar to congestion, keeping the back of the throat from drying out by staying hydrated and using a humidifier is helpful, as may be gargling with salt water. For a prescription pain reliever for more severe cases, gargling small doses of liquid lidocaine(an anesthetic like novocaine most associate with the dentist).
- Cough – There are a lot of different cough medications on the shelves. Many are combinations of some of the medications listed above. These cough remedies help some but not others. There are a few prescription liquid cough medications available. Several contain narcotics and are considered a controlled substance, which we do not prescribe through a telemedicine exam. One, phenergan DM, may be considered in those that have tried all the regular over the counter once without any relief and who would like to try something different. For those with that little tickle in the back of the throat that triggers that non-stop coughing fit, prescription Tessalon Perles could be the answer to decreasing that annoying cough reflex. Albuterol inhalers can be prescribed for those with asthma or wheezing to help open up the airways. Some symptoms here include obvious wheezing but also a cough triggered by attempts to breath in deeply.
- Vomiting – Sometimes nausea and vomiting is a component of the overall illness. Breaks in the nausea, usually after vomiting, may make you feel like you can drink. It is generally recommended to take small frequent sips rather than drinking a large amount. Given that little bit of fluid time to absorb before challenging the stomach more rather than throwing down a larger amount that may just come right back up. To help with the nausea and vomiting, we can prescribe one of the several versions of nausea medications. Again, staying hydrated is important. If you are vomiting, it may be impossible to do. We can help with that.
- Muscle Aches – Taking a soothing bath is a great way to help take some of the discomfort out of the muscles. Taking over the counter pain medication can help too. Muscle spasms could be a sign of low potassium(possibly from vomiting or diarrhea) and making sure your diet includes potassium containing foods and liquids is wise. For muscle spasm, often related to strain or injury, a prescription medication like cyclobenzaprine can help too.
- Bacterial Infection – If one of our medical providers determines that your symptoms are likely from bacteria, antibiotics can be prescribed and sent to the nearest or preferred pharmacy.
As you can see, there are a multitude of options to help get you feeling better. Some are at-home remedies, some require a prescription. Let us help guide you to what makes the most sense for your specific situation as some of these treatments are not suggested under all circumstances and could even be harmful in certain scenarios. Each person is different and recommendations may differ too. Sometimes it is not so easy for you to decide what to do. We can help.
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