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Posts Tagged ‘treatment’

headcold

Acute bronchitis is an infection causing inflammation of the lung’s airways and is one of the most common of human ailments.

It usually begins with head cold symptoms such as a runny nose, sinus congestion, or a sore throat. It is almost always caused by a virus and rarely by bacteria. If a cough is not due to pneumonia, influenza, or asthma, it is most likely what we call bronchitis.

Most people actually feel fairly well with bronchitis, except for having a persistent, nagging cough. Fever is rare and mucus production may or may not be present.

A very common misperception is that colored mucus — especially green — indicates a bacterial infection and therefore the need for antibiotics. Recent scientific evidence supports that virus infections also produce green mucus.

Those who smoke are much more susceptible to bronchitis because of the damage done by the smoke to the lining of the breathing tubes of the lungs. This allows germs to enter the lungs more easily, causing an infection.

Many patients request antibiotics in hopes of quickly ridding themselves of the cough and therefore visit their doctor as soon as symptoms begin so that they may “nip it in the bud.”

Some think that antibiotics helped them on previous occasions, but there is no proven benefit for these drugs in the treatment of bronchitis.

Inappropriate antibiotic use can cause unnecessary side effects — diarrhea and yeast infections to mention a few — increase the cost of medical care, and lead to the development of resistant germs.

This means that many of our commonly used antibiotics are no longer effective against many germs and there are very few new and extremely expensive antibiotics being developed. That’s a scary situation.

Treatment for bronchitis is directed towards relieving the symptoms. For the head cold symptoms that come with bronchitis, an oral decongestant pill such as Sudafed (pseudoephedrine) as well as a decongestant nasal spray, such as Afrin (oxymetazoline hydrochloride), can be used to combat nasal and sinus congestion.

Afrin spray works well to open up clogged nasal passages but should not be used for more than one week to avoid rebound (worsening) congestion. Tylenol (acetaminophen) or Advil (ibuprofen) can be used for the relief of aches and pains. Drinking plenty of liquids has proven to loosen mucus.

For cough symptoms, over-the-counter cough medicines with dextromethorphan, such as Robitussin DM or Vicks 44 may be helpful.

A recent study has recommended the use of a natural cough remedy using a mixture of 5 parts honey and one part instant coffee crystals. Take one tablespoon of the mixture in about 6 ounces of water every 6 hours for cough.

Also, for a cough that makes the lungs feel tight or wheezy, a doctor may prescribe a brief course of an inhaled medication commonly used for asthmatics.

In summary, most coughs that we call bronchitis can last at least 3 weeks, are almost always caused by a virus, and antibiotic treatment is not helpful. However, if at any time you have a cough with a fever, you should see your doctor.

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CancerTreatment

In previous articles (February 28 and March 14) I described cancer in general terms and then discussed specific common cancers. Now I would like to describe various cancer treatments available and methods of cancer prevention.

There are a variety of treatments available today for treating cancer, including:

– Surgery. This can remove the cancer or as much of it as possible.

– Radiation. This uses X-rays to kill cancer cells.

– Chemotherapy. This uses potent drugs to kill the cancer cells.

– Stem cell transplant. This is also commonly called bone marrow transplant. This uses stem cells which are found in the bone marrow and are the precursors to all other blood cells. The cells are collected from the patient, or less commonly from a donor, and then placed back into the patient after receiving a large dose of chemotherapy or radiation. This allows for the creation of a new healthy bone marrow and immune system.

– Hormone therapy. Some cancers such as breast cancer and prostate cancer are worsened due to the effects of certain hormones in our bodies. Blocking these effects is the goal of hormone therapy.

– Targeted drug therapy. This method allows an anti-cancer drug to specifically attack a specified cancer cell.

– Biological therapy. Helps your own immune system to better recognize and fight off cancer cells.

– Alternative medicine. Not scientifically proven, yet found to be quite helpful for many patients. Such therapies include meditation, acupuncture, yoga, massage, and hypnosis.

– Vitamins and food supplements. Also unproven, but widely used with some success.

Although there is no way as of yet to prevent cancer, there are ways to reduce the risk of having cancer including:

– Stop smoking. Smoking has been associated with many types of cancer, not just lung cancer.

– Eat a healthy diet. Concentrate on fruits and vegetables and select whole grains and non-fatty proteins.

– Avoiding excessive sun exposure. Avoid mid-day sun, use sun screen liberally and avoid tanning booths.

– Get plenty of exercise. At least 30 minutes of exercise daily is a good goal.

– Avoid obesity. Maintain a healthy weight.

– Drink alcohol in moderation if you choose to drink. One dink per day for women, two drinks per day for men.

– Schedule routine screening exams. Talk to your doctor about what exams you may need depending on your risk factors.

The bad news about cancer is that it is still so very prevalent in our society. As I have personally found out, anyone can experience it. The good news is that through early detection and rapidly improving treatments, cancer patients in general have a much improved survival rate. I think that if researchers can somehow find methods to mobilize our immune systems to better recognize cancer and to successfully overwhelm it in its early stages, we may then be close to a cure for many cancers.

From my own personal experience with cancer and from many patients I have treated, my advice is that if something about your health just doesn’t seem right, don’t assume it’s nothing to worry about. Listen to your body as only you can do. Don’t take a chance. Being checked out by your doctor sooner rather than later could save your life.

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Acute bronchitis, an infection causing inflammations of the lung’s airways, is one of the most common of human ailments.

It usually begins with head cold symptoms, such as a runny nose, sinus congestion or a sore throat. It is almost always caused by a virus and rarely by bacteria. If a cough is not caused by pneumonia, influenza or asthma, it is most likely a symptom of bronchitis.

Most people actually feel fairly well with bronchitis, except for having a persistent cough. Fever is rare with bronchitis, and mucus production may or may not be present.

A very common misperception is that colored mucus, especially green, indicates a bacterial infection and therefore the need for antibiotics. Recent scientific evidence overwhelmingly supports that virus infections also produce green mucus, and viruses are treated not with antibiotics, but rather by one’s own immune system.

Those who smoke are much more susceptible to bronchitis, because of the damage done by the smoke to the lining of the breathing tubes; therefore, germs can enter the lungs more easily, causing an infection.

Many patients request antibiotics in hopes of quickly ridding themselves of the cough and therefore visit their doctor as soon as symptoms begin so that they may “nip it in the bud.” Some think that antibiotics helped them on previous occasions, but there is no proven benefit for these drugs in the treatment of bronchitis. Inappropriate antibiotic use can cause unnecessary side effects, increase the cost of medical care and lead to the development of resistant germs.

Treatment for bronchitis should be directed toward relieving the symptoms.

For the head cold symptoms that go with bronchitis, Tylenol (acetaminophen) or Advil (ibuprofen) can be used for the relief of aches and pains. An oral decongestant pill, such as Sudafed (pseudoephrine), as well as a decongestant nasal spray, such as Afrin (oxymetazoline hydrochloride), can be used to combat nasal and sinus congestion. Afrin spray is usually very effective, but it should not be used for more than a week to avoid rebound (worsening) congestion.

Drinking plenty of liquids has proven to be very effective to keep the mucus loose. For cough symptoms, over-the-counter cough medicines with dextromethorphan, such as Robitussin DM or Vicks 44, may be helpful.

If one ends up at the doctor’s office, a prescription cough medication may be prescribed. A cough suppressant, especially if taken at bedtime, will not interfere with the healing process. Also, for a cough associated with wheezing, a doctor may prescribe a brief course of an inhaled medication commonly used for asthmatics.

In summary:

**Bronchitis is caused by a virus, and antibiotics are almost never necessary

**The cough of bronchitis often lasts 10 to 20 days.

**For aches and pains, Tylenol or Advil

**For nasal or sinus congestion, Sudafed or Afrin nasal spray

**For cough relief, Robitussin DM or Vicks 44

See your doctor if you have any significant worries regarding your symptoms, but especially if your cough is associated with a fever of greater than 38 degrees Celsius or 100½ degrees Fahrenheit, or if you have chest pain or trouble breathing.

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Over-the-counter cough and cold medications to alleviate cold symptoms in young children are being largely withdrawn from pharmacy shelves. This is because of unintentional misuse or overdose of these medications causing harm and, rarely, death, especially in children younger than 2.

These medications are frequently used in good faith, even though there is no scientific proof that these drugs are actually effective. This is a case in which the risks outweigh the benefits.

Health care providers are now asked not to advise the use of such drugs for children younger than 6. Some of the most common are PediaCare, Triaminic and Dimetapp.

I know this may sound discouraging when caring for a sick child, but there are useful non-drug treatments for cold and cough symptoms. Try the following, for example:

• Encourage the drinking of fluids to prevent dehydration and to help thin out mucus. Contrary to popular opinion, milk has not been proven to increase mucus formation.

• Control high fever or pain with either acetaminophen (Tylenol) or ibuprofen (Advil), giving doses once every six hours.

• Saline irrigation can be helpful for a congested or drippy nose. For infants, use rubber bulb suction to remove nasal secretions after applying saline nose drops or spray, or try sinus rinsing for older children.

• Use a cool-mist humidifier or vaporizer in the child’s room. To prevent contamination, the water inside should be replaced daily and the machine should be cleansed regularly according to the manufacturer’s recommendations. If possible, maintain indoor relative humidity between 40 percent and 50 percent.

• If a medication such as Tylenol or Advil is given, I do not advise the use of household kitchen spoons to measure doses of medication. Measuring devices that use units of milliliters (mLs,) usually are packaged with the medicine or can be obtained from a pharmacist.

• Honey can relieve coughs by increasing saliva, which coats the throat and relieves irritation. Suggested doses are half a teaspoon for children between 1 and 5 years, one teaspoon for children 6 to 11 years, and two teaspoons for children 12 and older. Do not give honey to a child younger than 1.

Sometimes, a visit to a doctor is called for. See your health care provider immediately for the following cases:

• A child younger than 2 months of age with any fever

• A child younger than 2 years of age with a fever lasting more than two or three days

• A child who complains of an earache or a severe sore throat

• Thick green nasal discharge that continues for more than seven to 10 days

• Mild symptoms that do not improve after 10 to 14 days

• A child who seems very ill to you

By the way, for children who have appropriately been prescribed antibiotics, I am frequently asked whether the drug needs to be refrigerated.

The two most commonly prescribed antibiotics — amoxicillin, which tastes like bubble gum or occasionally is fruit-flavored, and azithromycin (Zithromax), which has a cherry/vanilla/banana taste — can be kept at room temperature for up to 10 days. Refrigeration may improve the taste, but it isn’t needed to maintain potency.

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In my two prior swine flu columns, I advised everyone to be prepared for the flu season by getting vaccinated when the vaccine is available. I also talked about being prepared to stay at home for the duration of one’s flu symptoms.

Now I would like to give advice according to the Centers for Disease Control and Prevention for medical treatment of swine flu.

There are two antiviral drugs available for treatment, Tamiflu (an oral medication) and Relenza (an inhaled medication). Antiviral treatment is recommended for the following groups of patients who display the typical symptoms of H1N1 infection, or swine flu, including fever, cough, aches, sore throat and occasionally vomiting and diarrhea:

  • All hospitalized patients with swine flu
  • Children younger than 5 years old, and especially those younger than 2
  • Adults 65 years or older
  • Pregnant women — treatment is thought to be safe and extremely important in this high-risk group
  • Those with chronic conditions, such as diabetes, asthma, heart-related conditions, cancer, and diseases of the liver, kidney or bloodIn addition to the above recommendations for antiviral treatment, anyone who shows the following symptoms needs urgent medical attention:
  • Difficult or rapid breathing
  • Altered consciousness
  • Persistent vomiting.
  • A return of flu-like symptoms, including fever and a worse cough, after a period of improvement
  • In children, not taking enough liquids, difficulty awakening or extreme irritability.

If an epidemic of swine flu does not materialize this year, there will be adequate treatment facilities available at doctor’s offices, clinics and hospitals to care for those who become ill. But if a truly major epidemic occurs, receiving adequate treatment may prove difficult.

In this scenario, health care facilities may be overwhelmed with sick patients. Medical personnel, including doctors, nurses and technicians, may be in short supply because of being too sick themselves to provide care.

We at the Palo Alto Foundation Medical Group Santa Cruz, like other local medical organizations, are making plans to deal with a worst-case scenario. In such a case, patients arriving at a facility for medical care might be screened and treated outdoors in their cars or in tents. Some clinic buildings might be designated to care for only swine flu patients. More care might be provided over the phone or by e-mail.

We are all exploring novel ideas to deal with a surge of sick patients, while at the same time remaining hopeful that such a situation will not occur.

If we find ourselves with an epidemic, it will be very important for everyone to rely on the media for up-to-date information on what could be a fluid and rapidly changing situation.

In conclusion, I repeat what I said in the beginning of this series regarding swine flu: We must be prepared, not scared.

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