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When Are Antibiotics Appropriate and When Should I Avoid Using Them?

When Are Antibiotics Appropriate and When Should I Avoid Using Them?

People are becoming increasingly aware of the dangers that can result from the overuse of antibiotics. When antibiotics were first discovered in the early 20th century, researchers believed that they had found the key to conquering many deadly diseases. Since that time, antibiotics have certainly helped to cure diseases that once wiped out large parts of the population. However, there is growing evidence that antibiotics are now being used too frequently, and that they are often being used in inappropriate circumstances. This has led to many previously curable diseases becoming antibiotic-resistant, which means that a cure now requires the use far stronger antibiotics. In fact, some diseases have now become resistant to nearly all antibiotics. It is obvious that if antibiotic use continues in this way, we may have a major health crisis on our hands.

The first thing to be aware of is that antibiotics are not effective in the treatment of viruses. They only treat bacterial infections, certain fungal infections and parasites. For diseases such as the common cold, flu or bronchitis, antibiotics are completely ineffective and their use in cases such as these will only contribute to the development of antibiotic-resistant bacteria. You should not ask your doctor to prescribe antibiotics if you have a sore throat or the stomach flu, for instance. According to the Centers for Disease Control and Prevention (CDC), antibiotics were prescribed for an acute respiratory infection in 68% of visits to the doctor. However, 80% of those prescriptions were unnecessary.

Antibiotics are often an appropriate treatment for conditions such as severe sinus infections that last longer than two weeks, ear infections, bladder infections and skin infections. These are frequently due to a bacterial or fungal infection, and treating them with antibiotics is effective.

If you have been prescribed an antibiotic, it is very important that you take it exactly as directed by your physician. If your symptoms happen to clear up before the entire course of antibiotics is completed, you must still continue to take them as prescribed. This is because there may still be a few lingering bacteria in your system, and—if they are not all killed—the strongest ones may survive to produce new generations of ever stronger bacteria that might make current antibiotics less effective.

Some doctors feel pressured by their patients to prescribe something, whether it’s really going to be helpful or not. A study published in the journal Pediatrics found that pediatricians will prescribe antibiotics for children 62% of the time if parents expect them to, and only 7% of the time if the parents do not expect an antibiotic prescription. Do not put pressure on your doctor to prescribe antibiotics for your condition. He or she is the best judge as to whether antibiotics are appropriate.

Also, keeping adjusted helps keep your immune system at its best. To avoid catching colds and other viruses, be sure to keep you and your family adjusted! Call our office at 406-652-3553 if you need to schedule an appointment with Dr. Oblander!

For Many Kids, Back to School Means Back to the Doctor. Here’s How Parents Can Help

For Many Kids, Back to School Means Back to the Doctor. Here’s How Parents Can Help

school-bus-200-300With Halloween two weeks behind us and Thanksgiving less than two weeks away, most school-age children are back in the classroom and (hopefully) have adapted to the fall routine. For some kids, though, the fall routine includes lots of sick days and doctor visits.

According to the U.S. Centers for Disease Control and Prevention (CDC), there’s a good reason for this. “Schools inherently foster the transmission of infections from person to person because they are a group setting in which people are in close contact and share supplies and equipment.”

The CDC also provides some statistics that puts this issue in perspective: “Infectious diseases account for millions of school days lost each year for kindergarten through 12th-grade public school students in the United States:

  • 40% of children aged 5–17 years missed 3 or more school days in the past year because of illness or injury.
  • Nearly 22 million school days are lost each year due to colds alone.
  • 38 million school days are lost each year due to the influenza virus.”

Naturally, schoolchildren aren’t the only ones who are affected when even common illnesses are passed from child-to-child in the classroom environment. Those same illnesses (or the microorganisms that cause them) ride home with kids on the bus or in the neighborhood carpool. And when they do, the whole family is at risk. Plus, parents are left to cope with the inconveniences and costs that come with sick days and doctor visits.

Communicable diseases that spike at the beginning of the school year are numerous and include the common cold (aka rhinovirus), the flu, strep throat, Fifth disease (a viral infection caused by the parvovirus), pinkeye, whooping cough (aka pertussis), mono, chicken pox, meningitis, lice, scabies, pinworm, ringworm, jock itch, and athlete’s foot.

Some areas of the country are also concerned with two other viral infections that thrive in crowded areas such as schools. According to Indiana news station WTHR.com, “The first is a viral infection called ‘hand, foot and mouth disease.’ ”

Noted pediatrician Dr. Michael McKenna from the Riley Hospital for Children at IU Health says in regard to hand, foot, and mouth disease, “The rash looks ugly, kids feel uncomfortable, and they can have fevers. The one concern is if they have so many ulcers in their mouth that they refuse to eat or drink, that they can become dehydrated. This year, it’s much more prominent and the rash is much more severe.”

The article continues: “Doctors are also seeing many more cases of shigellosis, a bacterial infection spread when people do not wash their hands after using the bathroom. It can cause diarrhea, nausea and vomiting.”

Children aren’t the only ones at risk for transmittable infections and diseases in and around the classroom—teachers and administrators are also susceptible to many viruses and bacterial infections, which range from simply annoying to very serious. In fact, many teachers quickly get sick upon the arrival of a new school year. For these people, it is important to practice prevention. Minimize contact with students, urge them to cough and sneeze into their elbow, and send them to the nurse if they look as if they may be coming down with something.

So else can parents do to try to keep their kids healthy and at school during the fall and winter months? Here are a few thoughts we’d like to share:

  • Teach your children good hand-washing habits that follow them from home to school and be sure that they wash their hands when they return from school in the afternoon.
  • Explain to your children the importance of keeping their hands away from their eyes, nose and mouth throughout the school day and discourage them from sharing cups, utensils, etc.
  • Encourage your children to eat a healthy, balanced diet that will support their immune system.
  • Make sure your children get plenty of fresh air and exercise. Spending time outside and away from crowded, enclosed areas can help reduce the likelihood of sickness.
  • Set a reasonable bedtime for your children and stick to it. Not only are well-rested kids likely to perform better at school, they’re also more likely to stay healthy.
  • If your children are sick, please keep them home until they are well. This is for the benefit of classmates and teachers, but it’s also for the benefit of your own kids. Children who have not yet completely recovered and return to school to early may be more likely to pick up additional illnesses in the classroom.
Cold-Weather Risks to Your Health: What You Should Know

Cold-Weather Risks to Your Health: What You Should Know

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Last winter was a particularly tough one across much of North America, given the combination of the freakish “Polar Vortex” winds and snowstorms possibly brought about as a result of climate change. Hundreds of people died, either in transportation-related accidents or from exposure to the cold temperatures. But did you know that your health is at greater risk any time the weather gets cold, not just when near-blizzard conditions strike?

The most obvious health risks from low temperature are hypothermia and frostbite. Hypothermia occurs when you allow your body temperature to drop below 95°F (35°C) and can be very dangerous—it can result in disorientation and can actually stop your heart. About 700 Americans per year die from hypothermia. Frostbite—when your nose, ears, cheeks, fingers or toes are exposed to extreme cold—is not usually fatal, but can result in gangrene and the loss of the frostbitten limbs. To protect against both, “layer up” with warm clothing, keep dry, and don’t stay outside too long.

There are other cold weather health risks that are even more common:

  • Colds and flu. Although they can occur in warm weather too, your risk of contracting these viral diseases goes way up during the winter months. To prevent them, wash your hands often, avoid work or family environments where others have colds or the flu, and if you get sick yourself, stay home. Don’t “tough it out” and go to work and spread the virus.
  • Sore throats. These symptoms are more prevalent in cold weather, and there is some evidence that they are triggered by sharp changes in temperature, such as going in and out from warm, heated homes and offices to cold weather outside. If you feel that scratchy sensation in your throat, treat it immediately by gargling with salt water.
  • Asthma. If you already suffer from symptoms of asthma, cold weather may trigger more attacks than usual, including wheezing and shortness of breath. So try to stay indoors on cold, windy days and keep your rescue inhalers handy.
  • Norovirus. Otherwise known as the “winter vomiting bug.” It’s not fatal, but if you catch it you may wish you were dead. This is an infectious disease that is transmitted via contact, so avoid public places if you’re susceptible to it.
  • Arthritis and joint pain. Yes, your mother and grandmother were correct that you can “feel the effects of cold weather in your bones.” Maintaining your daily exercise regimen can help to prevent outbreaks of joint pain when the weather gets cold.
  • Cold hands and feet. No, it’s not just your imagination. Cold weather affects your circulation, and your fingers and toes can literally “turn blue” in cold weather. To limit this, try to avoid caffeine, smoking, and drinking alcohol, all of which restrict circulation.
  • Depression. Although technically not a transmittable disease per se, about 5% of Americans (75% of them women) experience seasonal affective disorder (SAD), which causes them to become clinically depressed, socially withdrawn, fatigued and sleepy, to crave carbohydrates, and gain weight. An additional 15% of the public has a milder form of the condition. Spending more time in sunlight or using full-spectrum light bulbs in your house and office can help to stave off depression.
  • Dry skin. It’s even more important to stay hydrated and keep your skin moisturized during the winter months than it is during the hot summer months. A tip to be aware of is that “moisturizers” and skin lotions aren’t really absorbed through your skin. What they do is act as a sealant to keep moisture from evaporating, so the best time to apply them is right after a bath or shower.
  • Heart attacks and stroke. We’ve saved this one for last, because it’s the most important winter health risk that you should be aware of. Your blood vessels constrict in cold weather, which can raise your blood pressure and trigger stress reactions that place additional burdens on your heart and circulatory system. Numerous studies have shown that the incidence of heart attacks and stroke go up dramatically during cold weather, and that the greatest periods of risk may be when the temperature changes rapidly during the day. One recent study showed that each 5-degree fluctuation in temperature increased stroke hospitalizations by 6%, and that each additional fluctuation increased the risk by an additional 2%. So don’t over-exercise when the temperatures get cold, or are fluctuating wildly. Take it easy while shoveling snow (one of the biggest winter weather sources of heart attacks) and while performing winter sports such as skiing, snowboarding, and cross-country skiing.

 

Additional Resources

Winter fitness: Safety tips for exercising outdoors. http://www.mayoclinic.org/healthy-living/fitness/in-depth/fitness/art-20045626

Everyday Preventive Actions That Can Help Fight Germs, Like Flu. http://www.cdc.gov/flu/pdf/freeresources/updated/everyday_preventive.pdf

Are You SAD This Winter? Coping with Seasonal Affective Disorder. http://psychcentral.com/lib/are-you-sad-this-winter-coping-with-seasonal-affective-disorder/00010241

 

Do We Really Get Sick More Often During the Winter?

Do We Really Get Sick More Often During the Winter?

i`m ill seriesAlthough your mother may have admonished you when you to bundle up when you went outside during the winter to avoid getting a cold, science shows that this advice is actually pretty ineffective. While it seems to be true that people tend to get sick more often during winter, it has nothing to do with getting a chill. Scientists do have a few alternative explanations for this phenomenon.

First of all, we tend to spend a lot more time indoors when it’s cold outside. Germs are spread far more easily in a crowd or within enclosed spaces. The more people in an enclosed space with a sick person, the more people with an opportunity to become infected. However, this doesn’t explain why children in crowded classrooms get sick more often during winter months, even when the number of students present in the classroom may not change much (or at all) from season to season.

One aspect of winter conditions is that the air is colder and drier. Dry air dehydrates our nasal passages and makes it more difficult for the mucus membranes in our respiratory system to trap and sweep away pathogens, which it typically does more effectively in a warmer, more humid environment. This is one reason why travelers often become ill after enduring a long plane flight– the atmosphere of the cabin is very dry. Add this to the combination we talked about before (lots of people in an enclosed space for a prolonged period of time), and it’s easy to see why a cold virus or flu virus would have a much easier time infecting more individuals in this sort of situation.

In addition, a study has shown that the flu virus in particular survives far longer in cool, dry conditions than in warm ones. Peter Palese and colleagues at the Mount Sinai School of Medicine in New York conducted an experiment on guinea pigs. They found that when guinea pigs were exposed to the flu virus they infected each other quite easily in cool, dry air, but when the temperature was 86°F the guinea pigs could not infect one another at all.

Another theory advanced by some scientists is that in winter our bodies are often low in stores of vitamin D due to a lack of sunlight. Vitamin D deficiency has been shown to cause a reduction in immunity. Given that much of the population in the developed world lives at latitudes where even direct sun is often weak in winter and that these same people are more likely to use sunscreen, it’s not surprising that many don’t have enough vitamin D. Studies show that flu season in different parts of the world correlates with cold weather and short hours of daylight. In the northern hemisphere, cold and flu season runs from November to March, and in the southern hemisphere from May to September. Meanwhile, the tropics have no cold and flu season at all.

Another contributor to a lowered immune system is sugar intake. Around the holidays, people not only find themselves gathering in large groups more frequently (think about office festivities, family celebrations, crowded shopping malls, etc.), but there are also more sweets to be had, which also works to suppress our immune system.

According to health experts, the best thing you can do to avoid winter colds and flu is to wash your hands frequently, since germ-covered hands are the most common way we infect ourselves. It’s not necessary to keep your house at tropical temperatures, but a humidifier may help reduce the drying out of your respiratory passages. Finally, taking a vitamin D supplement and keeping the sweets to a minimum may help reduce the number of times you get sick each year.

Have a Cold? Top Ten Tips for Getting Better Faster

Have a Cold? Top Ten Tips for Getting Better Faster

Oh No! Sick Man Checking for a FeverThe common cold: Even though Americans have over a billion colds per year, there’s nothing “common” about it when you’ve got one. The sneezing, the scratchy throat, the runny nose, the nasal congestion, and the watery eyes can make your life miserable. Even though most colds go away within three to seven days, there are steps you can take to boost your body’s immune system and help get rid of your cold sooner than that. Read on for our “Top 10 Tips” on getting over your cold quickly, consolidated from healthcare experts all over the world.

  1. First, make sure you’ve really got a cold. The symptoms listed above are those of the common cold, which is a disease of the upper respiratory tract caused by a number of different viruses. But if these symptoms are accompanied by more severe ones such as muscle aches, high fever, chills, headache, and fatigue, chances may be that it’s not a cold at all, but the flu instead. This is important to find out, because if you have a serious case of the flu, you may need to see a doctor and take an antiviral medication like Tamiflu, which can shorten the length of the outbreak. However, if you’ve got a cold, not only will the antiviral medication be ineffective, it can even weaken your immune system in the long run.
  2. Don’t “tough it out”—stay at home and get some rest. Going to work will only make your cold last longer, and you can expose all your coworkers to the virus as well. So take a few days off and give your body the rest it needs to recover and heal faster.
  3. Drink lots and lots of liquids, including—yes, really—chicken soup. Your mother’s advice to drink lots of fluids was correct, as it turns out. Research has shown that drinking warm fluids helps to relieve the most common cold symptoms and also loosens sinus secretions that cause a buildup of mucus. Hot tea or broth is a good choice, as is coffee, which has been shown to increase alertness in people with colds. And interestingly enough, the centuries-old prescription to “Have a nice bowl of chicken soup.” is also correct—it has been shown to be more hydrating and thus more beneficial than other liquids.
  4. Gargle with salt water. Gargling with 1/2 teaspoon of salt dissolved in 8 ounces of water can help to relieve your sore or scratchy throat.
  5. Use over-the-counter medications (very selectively) to deal with runny nose and coughs. A pharmacy has reliable saline nose drops or sprays and cough syrups that can help to make these cold symptoms more bearable, although they won’t make the cold go away any faster.
  6. Steam the cold away. If you have access to a steam bath, take one—or many. If you don’t, you can improvise by leaning your head over a bowl of hot water or by taking a long, steamy shower. Inhaling warm, moist air helps to loosen and thin out mucus.
  7. Boost your immune system with supplements. Research has shown that taking zinc supplements during the first couple of days may help shorten the duration of your cold and perhaps reduce its severity. But don’t take zinc on an empty stomach, and don’t use intranasal zinc nose drops or sprays; the FDA has warned that they can permanently impair your sense of smell. Vitamin C can also help to shorten colds, whether in supplement form or in fruits and vegetables. Echinacea, elderberry syrup, and raw honey have also been shown to shorten colds.
  8. Avoid smoke and polluted air. Anything that affects your ability to breathe properly is going to extend your cold.
  9. Don’t reinfect yourself or others. Practice “safe sneezing and coughing” by covering your nose and mouth and carefully discarding any tissues you use. Wash your hands often and consider using hand sanitizers to keep from infecting family, friends, coworkers, and yes, even yourself. If you contracted the cold at work and others there still have their colds, avoid the place for a few days if you can until people get better.
  1. Use over-the-counter pain relievers to reduce inflammation. Used in moderation, aspirin, acetaminophen, ibuprofen, and naproxen can all help relieve minor bodily aches that may accompany your cold, but they also act as anti-inflammatories and can reduce a fever and speed up the healing process.
Starve a Cold and Feed a Fever

Starve a Cold and Feed a Fever

???????????????????????????????????????????????????????????????????????????????Most of us have probably heard the old adage “starve a cold and feed a fever” (with some believing that it’s the other way around…), but does this saying hold up in the face of scientific research?  The short answer is “no.”  The best thing you can do is probably to feed both.

We would all like to believe there’s some easy way of reducing the length or severity of our suffering as we sniffle and cough our way through the aches, pains and lack of energy brought on by a cold or flu.  However, there are not really very many things that can be done about it, apart from getting plenty of rest and drinking lots of fluids.  But what role does eating-or not eating-actually play?

There was one study in 2002 performed by Dutch researchers and published in the journal Clinical and Diagnostic Laboratory Immunology that tested the validity of the concept.  They found that fasting was better at fighting the infections that caused fevers, and eating a meal better fought off viruses associated with colds.  However, it used a very small sample of subjects and its results were not reproducible in further studies.

Most people do not feel particularly hungry when they are sick with a cold or fever anyway, as the body naturally regulates the amount of food we eat when ill.  Certainly, eating a large heavy meal will use some reserves of energy that would be better used in fighting off pathogens.  However, keeping a steady stream of nutrients flowing through your system is a good idea and provides your body with the tools it needs to kill invading viruses.

Concentrate on getting nutrient- and antioxidant-rich foods in your diet as best you can, along with plenty of sugar-free fluids.  Many people drink a lot of juice, thinking it will provide them with vitamin C, but you would be better off eating strawberries or red peppers (both of which are high in vitamin C) or taking a supplement, as juice comes with a lot of sugar.  Sugar has been proven to suppress the immune system, which is exactly the opposite of what you need when you are ill.

Warm broths are also excellent when you are sick.  The prescription of chicken soup for upper respiratory symptoms has been around since the time of the ancient Greeks, and the practice was adopted by the Jewish physician and philosopher Maimonides.  There’s a reason your mother brought you chicken soup when you had a cold or flu.  Far from being an old wives’ tale, a study performed by Dr. Stephen Rennard from the University of Nebraska Medical Center showed that chicken soup inhibited the movement of neutrophils (a type of white blood cell) in the body so they could not travel to the upper respiratory area and induce inflammation.

Chicken soup is only effective as a treatment if it is prepared using both chicken and a variety of vegetables such as onions, celery, carrots, parsnips, sweet potatoes, turnips and parsley (and then filtered).  Whatever its activity against pathogens, at the very least it provides your body with plenty of nutrients and warm liquids that will help get you feeling well again soon.