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Prakash Chandran: You know the saying when life gives you lemons, make lemonade, we all face a healthcare or wellness challenge. At some point in our lives, the lemonade family medicine podcast offers practical guidance from the medical professionals at Mitchell County Regional Health Center, about how to live your best life when your health or the health of a family member takes a twist. I'm your host Prakash Chandran and I'm joined by Dr. Megan Peterson, medicine specialist at Mitchell County Regional Health Center. Today, we're gonna be discussing how to manage health at home in the upcoming flu season. Dr. Peterson, thanks so much for joining me today. I really appreciate your time. I'd love to get started by maybe you sharing a little bit about the most common things that you see people come in with or experience during flu season?

Dr. Megan Peterson: Yeah. During flu season. That's a great question. So a lot of people will come in with some different symptoms, such as sneezing, runny nose, feeling congested in the nose, some facial pressure, like they feel like their sinuses are blocked. Maybe they'll say their throat hurts or that they're having a cough. The cough might be dry. It might be bringing some mucus up. Though, maybe have some low grade fevers or headaches, or they'll even complain that man, I just feel really tired or fatigued or I'm starting to have some body aches.

Prakash Chandran: Yeah. I've definitely experienced a lot of those things and it always seems to come around the same time of year. As a layperson, I'd love to just understand what exactly causes these symptoms to come up at this time of year?

Dr. Megan Peterson: Yeah. So this time of year, we typically see our viruses start to come out. We'll have seasons where kids will get RSV and it is typically is a little bit later in the season, but over the last few years we've been seeing it sooner. Here in Iowa, we tend to see these things as we get into the fall and winter months with the weather changing. And some theories is it's that the viruses don't survive as well in the summer, but we all also get our summer colds. So depending on the virus or what's causing your illness, it can come time of the year, but they tend to get worse in the winter typically because of the colder weather.

Prakash Chandran: Yeah. Now talk to us about how people can distinguish between allergies and when they're actually getting sick?

Dr. Megan Peterson: Yeah, so allergies, it's a tough one here in the state of Iowa. We get a lot of allergies out there, but typically allergies you'll get a runny nose. It's generally clear. You'll get some red itchy, watery eyes. You'll get a lot of sneezing involved. And typically when sneezing involved, it's a little less viral related and that's usually more allergy related.

Prakash Chandran: I see. And as opposed to, for example, like when you're getting a cold, I know there's like a fever and a cough. There are other things to tell you that it's a cold, right?

Dr. Megan Peterson: Yep. So typically if you're getting a fever, that's not gonna be allergy related, body aches are not gonna be allergy related. That's gonna be more related to a cough or a cold syndrome from a virus. With allergies, if you get a lot of drainage down the back of the throat, that can happen with your runny nose. So that can cause a sore throat. So sore throat can be a few different things.

Prakash Chandran: I see, and you know, we're talking about flu season, but just because it's flu season doesn't mean that what you're getting is flu related. It's just, as you mentioned, because it's colder, it's just the onset of a lot of different things, cold and other diseases that may be around. Is that correct?

Dr. Megan Peterson: Yeah. And it's a common misnomer. When we talk about the flu the flu people say, man, I got the flu and it's, they're talking about my body hurts and headaches and different things. And flu actually is talking about a specific virus called influenza. So there's an influenza, A and B, and that's one type of virus. And we do have an antiviral for that. There are other viruses though, that can cause these same symptoms that we don't necessarily have medicines to treat them specifically such as adenovirus, rhinovirus, and antivirus, many different ones.

There's ones that are more common in kids such as RSV. And the other one that we all talk about is COVID and COVID thankfully we have a new antiviral that's come out for that, that can help, like we can with the flu. And so even though it's flu season, it really, what we mean is that there's a lot of viruses out there that can cause illness and they all cause a similar illness with these different symptoms.

Prakash Chandran: Okay, thanks for that clarification. Now, you know, when we're talking about some of these viral illnesses, today we're. managing your health at home. Do you have best practices just around if you're experiencing some of the symptoms that we discuss, how to take care of yourself?

Dr. Megan Peterson: Absolutely. So a tough part of this is it's really symptom management. We can treat COVID and we can treat flu with antivirals being influenza A or B, but the rest of these, we don't have treatments for specifically. So we treat the symptoms. So depending on what symptoms are bothering you, the most, we treat specifically one of the most common things is people come and say, I just keep coughing. I can't stop coughing.

Unfortunately, the cough can linger for over two weeks. It can linger up to three to four weeks after one of these illnesses. And so one of the best treatments and it's actually the safest it's locally grown honey, we've found that if you do a half a teaspoon for kids, age one to five and anybody over the age of six, one teaspoons three to four times a day, actually treats cough and congestion the best. Just a reminder. Under 12 months old, so anyone under the age of one, it is not safe for them to have honey. So we can't give it to our little baby kiddos, but everyone else over the age of one, the best thing you can actually do is some locally grown honey.

Prakash Chandran: Yeah, that's amazing. I actually gave it to my two year old daughter when she was experiencing a cough. And it's amazing what a, like a miracle it is. It's just a little tablespoon of honey before she went to bed. And the previous night she was coughing throughout the night and she just completely stopped. It was amazing.

Dr. Megan Peterson: Yeah, it can work really well. Other things that can help is you put a cool mist humidifier in the bedroom. You don't wanna do warm mist. Cause when you do warm mist that's a area where bacteria like to grow. So that's why we recommend cool mist humidifiers that can help with the cough at night. Other things that can actually help decrease costs as using a topical vapor rub, such as VIX, anyone really over the age of Three months, you can use this on. There is a baby version for kids under the age of two, but you can put a little bit on your chest and actually putting some on the bottom of your feet can help decrease cough in congestion as well.

Prakash Chandran: What about some of the over the counter medications, such as cough and cold medicines. Tylenol, ibuprofen, stuff like that?

Dr. Megan Peterson: Absolutely. So Tylenol works great. Tylenol is really good for fever reduction. If it's more, you're having body aches and you're just really achy, ibuprofen or Motrin things that are what we call NSAIDs, non-steroidal anti-inflammatories work better for that. They help with that anti-inflammatory. To help with the body aches. And those can bring your fevers down too. I'll have people pair them together. As long as the person is over six months old, otherwise there are different things that can help as well.

So if someone's having like a really run nose and that's not getting better, your allergy medicine such as antihistamine, so your Zyrtec or your Claratin, one of those a day can help clear some of those symptoms. Another thing is, is if you're having a lot of nasal congestion where you feel like you're having a really hard time breathing for adults, you can use a spray called Afrin. Afrin will help decrease the congestion, but you do not wanna use it for more than three days at a time. Because it can then make the congestion worse after that.

And Flonase. Again, we use for allergies. It's a no spray, but starting that one, you. The onset of these symptoms and you're having a hard time breathing. That'll help decrease the inflammation in the nose so that you have an easier time bleeding and it can really help when you're sleeping.

Prakash Chandran: Yeah, absolutely. What about like a Netty pot? Like sometimes I've heard people say that that can clear up some of the congestion. do you recommend using a Netty pot at all?

Dr. Megan Peterson: We do so Netty pots, as long as you're clean and sterile with them and follow the instructions. Other thing is just nasal saline irrigation. So getting some of that nasal saline and spraying it up in the nose and letting. It clear out and run down the other side, and then you can even use nasal sectioning, especially when it's a kid. And so for adults, we can spray that up into our nose and everything gets loosened up and we can blow our nose.

But kiddos, it's hard to tell certain age of kids to blow their nose. And so that's when you use those suction bulbs or many people now start to use those noses or things to help kids get their nose cleared up.

Prakash Chandran: So I wanna talk about like the duration of a viral illness, like a cold. I know that there is a certain amount of time where you're viral and you'll have some symptoms, but after like a couple days might still have a cough or a color of your nasal drainage might change. Can you talk like broadly about what people should be aware of? Around that Duration when it's viral and how things change over time?

Dr. Megan Peterson: Yeah. So that's the tough part is viruses, unfortunately can last quite a while. So viruses tend to last up to 10 to 14 days. And so most people will start to notice symptoms in between day three to five, and even up to day seven, depending on the virus. There's symptoms that will be at the peak. And that's when you feel the worst, that's when these medicines become really important. And then typically the sore throats and the headaches start to get better. First that congestion running nose cough can last up to two weeks and even up to three weeks.

And so, as long as the symptoms get worse and start to get better and continue to improve, it still suggests that it's a viral illness, but if you have this situation where you get better and you're doing better and all of a sudden you're two weeks out or so, and you're getting worse, that's when we worry, are you starting to have a bacteria and need an antibiotic? And a common misnomer is, oh, doc, I came in and I had clear drainage and then all of a sudden now it's yucky colors. It's yellow, it's green it's changed.

And that can actually be normal. That's part of the process of the body trying to get rid of the bad toxins and the foreign things that it's recognized. And so the body tries to bring this out through your mucus or your sputum or your boogers. If we wanna call them that. And it makes them change colors. So that doesn't necessarily mean that it's turned into a bacteria at that point. And that generally happens after about three to four days. And that can be normal.

Prakash Chandran: Now you mentioned kind of the nasal mucus or boogers. And one thing that I was actually asked by my daughter the other day is if you have a lot of nasal mucus, is that something that you should pick or do you leave that there because that's your body trying to like cleanse itself? Do you have an opinion on that?

Dr. Megan Peterson: Yep. So we recommend that if people start to build up a lot of that mucus and they're having a lot of that, that you blow it out, you get it out. Some people, especially kids, or if you don't have a Kleenex, you'll start to snort it in and swallow it. Some say that can make it linger. That's not necessarily true, but I tend to recommend to people that you blow it and make sure you have some Kleenex. You don't wanna blow it on your hands, but after you blow it into your Kleenex and even shirts, people use their shirt.

If you can try to, you don't wanna do that cause it'll stay with you. Blow it into a Kleenex, throw those Kleenex away and then make sure you wash your hands. Good hand washing. It's how we avoid spreading this to other people.

Prakash Chandran: Yeah, that makes sense. say that let's say you're sick at home you've been experiencing symptoms for a while. At what point should you consider seeing a doctor?

Dr. Megan Peterson: Yes. So if you have that kind of bimodal experience where what that means is you get sick and you get better. And all of a sudden you're getting sick again, that's a concern. We worry. You have a bacterial infection developing. If you start to get short of breath where you can't catch your breath, if you have chest pain, if you have fingers that are lasting for more than four days, All of those are concerning signs and symptoms. We need to see you.

And the other thing is, if you're trying to figure out if this is COVID or influenza, there are the home COVID tests that you can take. And if you find out it's COVID come on in and we can talk about the antiviral medicine to help with symptoms and influenza there, isn't generally a home test people can take. So if we start to talk about influenza season, people have to come in for that. But influenza generally doesn't start showing up until November-ish into February and even up into March. So we generally don't start seeing influenza as early in the season yet.

Prakash Chandran: Now just before we close. There's one question that I always like to ask all of your experience, what's one thing that you wish more people knew before they came in to see you, whether that be regarding managing their health at home or otherwise?

Dr. Megan Peterson: Yeah, one thing I wish people would know is that there are different medicines you can use at home to help with these symptoms. And so I know you don't feel good when this happens and really it is symptom management and the reason we want you to help manage your symptoms at home is because antibiotics, if we use those and it's not actually something bacterial that creates a resistance. And in the end that actually damages us down the road, because antibiotics will stop working for different things.

Bacteria gets smart and they learn to work away and work around all these things. And so when we're saying that we don't think you need an antibiotic, it's not because we're trying to be mean or harmful it's because we truly don't think it's gonna work for your symptoms. And so, we just hope that with these symptom management, people can use these tools at home to try them first. And if you're not feeling well, we're happy to see you, please come in and see us at that time.

Prakash Chandran: Dr. Peterson, that's the perfect place to end. Thank you so much for your time today.

Dr. Megan Peterson: Absolutely. Thank you so much.

Prakash Chandran: That was Dr. Megan Peterson, a family medicine specialist at Mitchell County Regional Health Center. For more information about this topic, you can visit mcrhc.com. Thanks for listening to this episode of Lemonade, the Family Medicine Podcast from Mitchell County Regional Health Center, your trusted healthcare partner for life. If you found this podcast to be helpful, please tell a friend subscribe and rate this podcast. I'm your host Prakah Chandran. Thanks again for listening and be well.