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Prakash Chandran: There's a lot of sickness going around RSV, the common cold covid, and the flu. All of these have very similar symptoms early on, and it's hard to know which one you might have. Let's find out more with Dr. Greg Faughnan. He's a primary care physician and faculty at St. Joseph's Family Medicine residency. This is St. Joseph's Health Med Cast, the podcast from St. Joseph's Health. My name is Prakash Chandran. So Dr. Faughnan, I really appreciate your time. Thank you so much for joining us today. Generally I talked about these different viruses. What exactly are you seeing at St. Joseph's?

Dr. Greg Faughnan: Yeah, absolutely. thanks for having me. At the hospital lately, we've certainly seen an uptick in the amount of patients coming in with fairly severe cases of the influenza or the flu. There are still some lingering covid cases and actually this year RSV has been particularly bad in affecting more older children and, younger adults who typically, you know, you'd expect to see that more, in young kids under two months old and, the elderly. But for whatever reason, the RSV virus has been behaving a little bit differently this year.

Prakash Chandran: Yeah. And so you mentioned that RSV affects the very old and the very young. Can you talk in a little bit more detail about the concerns surrounding RSV?

Dr. Greg Faughnan: Yeah, absolutely. So, R SV unlike some of the other viruses we'll be talking about, tends to be a more lower respiratory tract infection, and it leads to a condition called bronchiolitis which is, inflammation of your lower airways, which can lead to respiratory distress, trouble breathing, and wheezing. Classically, it affects infants under two months old or primarily people over 65. As far as, kind of things to look out for because of where the virus is active or respiratory symptoms, trouble breathing getting out of breath easily more than normal. And, as we'll get into, I'm sure in a little bit, but a lot of these viral infections can look fairly similar in the beginning. can be kind of difficult to sort out what's what, initially.

Prakash Chandran: Yeah, so let's talk a little bit about that, because you know, as a parent, especially like my child's been sick a lot, If a child is sick, how do they know if it's RSV, the cold, covid or the flu? Is it just a matter of elimination?

Dr. Greg Faughnan: to some degree, it definitely is. The short answer is the best way to know are with either a rapid or a PCR test. That can be done through your doctors. There are home covid tests, but there are some subtle differences between the flu, RSV, the common called. And the big things with Covid, compared to the others, it can cause this sudden loss of smell and taste that you don't really see with the others. And then as far as both covid and the flu tend to cause more body aches and headaches, where the common cold and RSV tend to not do that so much. That said there can be a lot of overlap between the two. And especially early on, it can be really difficult to say which is which.

Prakash Chandran: Yeah, that makes a lot of sense. And so, you kind of look for these subtle differences and that sudden cause of loss and smell and taste that might be covid. There's obviously the tests that can confirm that, but what can be done if it's identified that someone has RSV?

Dr. Greg Faughnan: Sure. So, for most people, RSV is gonna be treated the same as the cold flu, even mild covid. It's really supportive care. It's a viral infection that your body will get rid of on its own, and you just need to monitor for certain things. And this is true for all the virus. It's not necessarily just RSV. But you know, if your child or a loved one or even you are developing shortness of breath, trouble breathing, chest pain, trouble eating and drinking to the point where you feel like you may be getting dehydrated, which can be tough to figure out sometimes, yourself.

But, these are all things that would warrant further testing and, to be seen at least by your primary doctor, if not the ER. And what's difficult is we don't want everyone that, has upper respiratory symptoms to go right to the ER, because they'll be overwhelmed. And it's not, I don't wanna discourage people from accessing healthcare. It's more to point them in the right direction of. Who should you see and when? So for mild symptoms, more often than not, this is you're gonna feel bad for about a week or so when you'll get better.

Staying hydrated, just over the counter cold medicine, ibuprofen, Tylenol on, things like that will help you get through the vast majority of these cases. Now, if you are someone who has other health conditions like, preexisting lung issues or heart issues. If you're immunosuppressed, then I would definitely get ahold of your primary doctor sooner rather than later because one, it's a good idea to get in for testing and just to check your vital signs, have someone take a listen to your lungs, things like that, to ensure, this is mild.

It'll continue getting. And the other thing that kind of goes with that is both the flu and covid have directed treatments. Now you've probably seen them advertised on TV for like what's called pax livid, which is a covid treatment to, kind of shorten symptoms a little bit. And there's similar medications for the flu as well. Now the common cold and RSV don't have specific antiviral treatments like that, that are widely used. But there are options for, some of them. So sorting that out early on in the process can be important for those people with those risk factors.

Prakash Chandran: So what about fevers? They're typically very concerning, especially to parents. What should be done in the case where someone is expressing a fever as well?

Dr. Greg Faughnan: Yeah, absolutely. So, getting ahold of your primary care doctor when your kid has a fever is a good idea. Most fevers will come down with just Tylenol or ibuprofen, depending on the child's age. Sometimes we only recommend Tylenol, but if you have a fever that does not come down with Tylenol, that's concerning. And that child needs to be seen by a doctor that day, either like I said at their primary office, pediatrician, family doctor, or even in urgent care. But it's common to get a fever with all of these viruses, and you can feel really bad from the viral infection, but it doesn't necessarily mean it's out of the ordinary or still won't get better on its own. And because they are viruses, antibiotics really don't help. And a lot of it's just kinda watch and wait and, rest, hydrate, and recover at home until you feel better.

Prakash Chandran: Now, one thing that I've been hearing a lot, especially this season is parents seeing a lingering cough in their child. So if it's not covid, and maybe it's a cold that's just lingered on and on, but that cough just doesn't go away. Is this something that you've heard and what can parents do about that?

Dr. Greg Faughnan: Yeah, absolutely. It's common after an infection like this to have that lingering cough. can be super annoying, keeps you up at night and really a pain. It's just residual inflammation after the virus is cleared itself. And so what can you do about it? Well, there are some just over the counter cough medicine's, not a bad idea, but most often the treatment is honestly, just time, for things to kind of get back to normal and let the body heal itself.

Prakash Chandran: Now, you kind of talked about this before, but obviously people and parents have that natural tendency to rush off to the emergency room. So do you have a framework or way they should think about the times they should stay at home versus the times they should go to the emergency room?

Dr. Greg Faughnan: Yeah, absolutely. So definitely, times to go to the emergency department are chest pain, trouble breathing, a fever that does not come down with Tylenol. Kinda of like we mentioned earlier, especially in kids decreased fluid intake or urine output are all kind of indications that this kid's a little bit more sick than we would expect with with a, mild virus to stay at home and recover. And those people should be seen in the ER. The vast majority of these cases don't necessarily get there, though. And a good place to start is to call your doctor's office and say, Hey, this is what's going on.

Do you have any advice? Should I come in and be seen? And normally that'll start with kind of a triage nurse. They'll tell you that you can talk to your doctor, figure out yeah, you know, everything sounds fine. Keep doing what you're doing. Stay home, feel better. Take these medicines and rest. Or, I'd like to have you come in for an appointment. And sometimes they may say, go to the emergency room, depending on what you're seeing. But that first line of communication's really important to make sure that everyone that has, a cough, runny nose sneezing doesn't go right to the emergency room.

Because if that happens and we're already seeing some degree of this where The wait time to be seen goes way, way up. And that's for everyone, not just with these respiratory issues, people having real emergencies. It takes longer to be seen and have those treated appropriately because the system just gets overwhelmed. So to prevent that, I would always say start by talking with your doctor. Call the office and get some advice from them first before you just run right to the er, unless you're having one of those other things that I talked about that are a true emergency.

Prakash Chandran: Right. Yeah, that makes a lot of sense. but of course a lot of these things happen in the evening when the offices of the primary care physician might be closed. So do you have any recommendations around first line communication that parents or people can reach out to in the later hours of the evening before going into the emergency department?

Dr. Greg Faughnan: Yeah, absolutely. All of our primary care offices at St. Joe's have an on-call provider that's available after hours. And, this will start by a triage nurse if you call the office. You'll get them to talk to and then they'll pass the message along to whoever's on call that night and we'll be able to kind of advise what to do next.

Prakash Chandran: Well, Dr. Faughnan, this has been really informative. I really appreciate your time today. Any final thoughts you wanna leave with our audience?

Dr. Greg Faughnan: I guess the final thoughts are we have vaccines for some of these things, particularly covid and the flu and like anything you want to do, what you can to protect yourself, getting vaccinated, washing your hands and staying home when you're sick are all great things to do to prevent these from spreading and from you and others, from getting sick.

Prakash Chandran: Well, Dr. Faughnan, really appreciate your time today. Thank you so much.

Dr. Greg Faughnan: Yeah. Thanks for having me. I appreciate it.

Prakash Chandran: That was Dr. Greg Faughnan from St. Joseph's Family Medicine. For more information, please visit SJhsyr.org. That's sjhsyr.org. If you found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to. This has been St. Joseph's Health Med Cast from St. Joseph's Health. My name is Prakash Chandran. Thank you so much and be well.