• Advice on Flu
  • We got in ahead of the crowd and asked Dr. Petty for his advice for those of you who were not able to get that all-important flu shot as yet. We got additional information from the official CDC government website. 

  • Symptoms of flu include:
    • fever (usually high), 
    • headache, 
    • extreme tiredness, 
    • dry cough, 
    • sore throat, 
    • runny or stuffy nose, and 
    • muscle aches. 
    • Gastro-intestinal symptoms, such as nausea, vomiting, and diarrhea, are much more common among children than adults. 
  • How Flu Spreads 
  • The main way that flu is spread is from person to person through coughs and sneezes and respiratory droplets. Occasionally a person may become infected by touching something with a virus on it, and then touching their mouth or nose. Avoid unnecessary contact with children! The little darlings are not too good about hand washing which leads us to one of the most important things you need to do also; don't forget to WASH YOUR HANDS!

    The incubation period for influenza is 1-4 days, with an average of 2 days. Adults may be able to infect others beginning 1 day before getting symptoms and up to 7 days after getting sick. That means that you can give someone the flu before you know you're sick as well as while you are sick. Children can be infectious for 10 days

  • Good Health Habits to Prevent the Flu
    • Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
    • Stay home when you are sick. If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.
    • Cover your mouth and nose. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
    • Clean your hands. Washing your hands often, or using alcohol-based hand rubs, will help protect you from germs. Sometimes flu can be spread when a person touches droplets, nose drainage or saliva from an infected person, or a soiled object, and then touches one's own (or someone else's) nose or mouth before washing hands.
    • Avoid touching your eyes, nose or mouth. 
  • Complications
  • Influenza illness typically resolves after a limited number of days for the majority of persons, although cough and malaise can persist for more than two weeks. Some of the complications caused by flu include a secondary bacterial pneumonia or primary influenza viral pneumonia, or a co-infection with other viral or bacterial pathogens. Also possible are dehydration, and worsening of chronic medical conditions, such as congestive heart failure, COPD. asthma, or diabetes. Children may get sinus problems and ear infections. (Please consult PeaceHealth.org for further details - click here)

  • Remedies
  • We hope, and assume, that you have had your "pneumonia shot" which offers protection against the most serious bacterial pneumonias!

    If you haven't yet gotten your flu vaccine make sure you are on you doctor's top priority list so that you can be called should your physician get in more vaccine. If you don't call, the office personnel may think you got your vaccine down at the local grocery store or rehab program. 

    We are already being bombarded by health food store recommendations to take mega doses of Vitamin E or other health supplements. That can be expensive with no research demonstrating any benefits. Do continue to take your multi vitamin every day. 

  • FluMist
  • You may also have heard of the nose spay vaccine. Sounds like a great idea, doesn't it? Unfortunately, is not appropriate for most of our readers. FluMist, the nasal spray influenza vaccine that contains the weakened live virus, should be used only for healthy children and adults between 5 and 49 years of age. It is recommended for those around high-risk individuals. The nasal spray vaccine can cause you to develop symptoms similar to a cold, but it does not cause the flu. If you become infected with the flu despite having been immunized with the nasal spray vaccine, symptoms will usually be mild, and you will have a decreased risk for developing flu complications.

    People who are at risk for severe complications from the flu should not receive the nasal spray vaccine. This high risk group includes:

    • Children younger than 5 and adults older than 50. 
    • Pregnant women. 
    • People of any age with certain medical conditions, such as chronic heart or lung disorders, diabetes and other metabolic diseases, kidney problems, or blood conditions. 
    • People who have an impaired immune system or who are receiving medications that affect immunity, as well as their close contacts, such as caregivers or family members. 
      • Anyone younger than age 20 who is on long-term aspirin therapy because of their increased risk for developing Reye's Syndrome.  Anyone who is allergic to eggs or any component of the vaccine. 
      • People with a history of Guillain-BarrĂ© syndrome (GBS).
      • Anyone who has a high fever. The vaccine can still be given if an otherwise healthy person has a minor illness, such as a cold.3 
  • Relenza 
  • Additional words of wisdom from Dr. Tom are to warn you that Relenza (zanamivir) is not popular as an inhaled antiviral agent because it can cause significant bronchospasm. Who needs more of that! 

  • Tamiflu 
  • The best antiviral at this time is Tamiflu, or oseltamivir. A 75 mg dose is taken once a day for prophylaxis (prevention), and twice a day to abort an attack if you have been exposed, or think you are coming down with the flu. It is a neuraminadase inhibitor, i.e., it stops one mechanism of viral replication. It works on all A and B strains. It is very effective with few side effects and essentially no drug interactions. That's what we all like. But, it is expensive, which we don't like. The prices probably vary a lot according to the pharmacy you use but can be as much as $6.00 per pill. But, dear friends, consider the costs of the possible alternatives. It is better than risking influenza, which is lethal to older people with chronic illnesses and to the very young. Dr. Petty says it is worth it to him. He intends to take Tamiflu this year during attendance at the ACCP in Seattle, mid October. Of course, he'll take it sooner if he thinks he is coming down with the flu with the symptoms of cough, fever and severe muscle aching. Diarrhea alone, wrongly called the "stomach flu", has nothing to do with the influenza viruses. Neither does the sneezing and runny nose of a common cold. These symptoms are very annoying, but will NOT be helped by these antivirals. 

  • Amantadine (symmetrel) and Ramitidine
  • Getting back to antivirals, you should know that there are some that are much cheaper than Tamiflu. They are Amantadine (symmetrel) and Ramitidine. Both work on all A strains, but not on B. The good news is that the B strains almost never cause epidemics. The not-so-good news is that these drugs can cause Central Nervous System (CNS) side effects such as insomnia, anxiety, etc. They are not too bad, compared to the real flu, and the symptoms are reversible. 

    So there you have the latest information. You may want to take one of these antivirals if you are exposed to large crowds, such as those Dr. Petty expects in Washington. You definitely should take antivirals the very first day you come down with symptoms of fever, cough and severe muscle aches, or the second day at the latest, to get the full benefits. Good luck and Gesundheit! 


  • Do you have a question about respiratory disease that has been bothering you? If so, feel free to write and ask us, either through our web site or by mail. We answer all of your letters.