Flu Prevention and Cold vs. Flu

Intro: This is Weekly Dose of Wellness, brought to you by MemorialCare Health System. Here’s Deborah Howell.

Deborah Howell (Host): Hello and welcome to the show. You’re listening to the Weekly Dose of Wellness, brought to you by MemorialCare Health System. I’m Deborah Howell, and today’s guest is Dr. Adam Wass, who has a strong desire to keep the whole family healthy and to do that, he likes to treat the whole person physically and emotionally, not just the ailments and the symptoms. He is board certified in family medicine and is looking forward to being the team physician for the University High School football team in Irvine next season. Alright, that sounds like a fun job, Dr. Wass.

Adam Wass, MD: It is. We have a great time. We’ve been doing that the last four or five years.

Deborah Howell (Host): How’s the team look this year?

Adam Wass, MD: They did okay, but every year we, you know, keep going and move along. Got a great coaching staff and it’s a great academic team, academic school and they do great with football as well.

Deborah Howell (Host): Wonderful. What’s the nickname?

Adam Wass, MD: The Trojans.

Deborah Howell (Host): Alright. Go Trojans. Of course, we have to keep our Trojans well. So let’s talk about the flu because we are deep into flu season, and I’m wondering if you can tell me some of the best ways to prevent the flu.

Adam Wass, MD: I can. Actually, the best way to prevent the flu, as hopefully most people know, is to be vaccinated. We can get vaccinated through your local physicians as well as many pharmacies do it as well. And the best way to prevent the flu is the vaccine ahead of time. It takes two weeks for the vaccine to take effect.

Deborah Howell (Host): Oh, I didn’t know that.

Adam Wass, MD: It does. And now is the time. It looks like this year is going to be an early year for the flu. It’s coming; we’ve already seen some cases through the South and the Southwest.

Deborah Howell (Host): I didn’t realize the two-week period. What happens within those two weeks?

Adam Wass, MD: Well, the way the vaccine works, as the way most vaccines work, is we inject a piece of protein that looks like the virus to the body, and your body’s immune system then develops both antibodies and special cells called memory cells that then the next time your body is exposed to the virus, it responds very quickly and you’re able to fight off the virus prior to infection. Where if you were not immune, your body’s doing the same thing, but it takes a while for that to happen and usually you get sick in the meantime.

Deborah Howell (Host): Sure. That’s pretty cool when you really think about it, what your body can do to exactly remember.

Adam Wass, MD: It is. It’s pretty amazing.

Deborah Howell (Host): So what exactly are the symptoms of the flu? We all think we know, but let’s make sure we’ve got the clinical version of what the symptoms are.

Adam Wass, MD: Okay. What I usually tell my patients, a lot of people think when they get their cold symptoms or their yearly illness that this time of year a lot of people get kids going back to school and the winter season, you get sniffles and runny nose, that that’s the flu, but it’s actually not. The flu symptoms most commonly come with a high fever, fever over 101, a severe headache. You may or may not have a cough, but it’s usually a minimal cough and dry. And then severe muscle and body aches. I think the way I like to describe it is you feel like you got run over by a truck. And you’ll feel sick for about a good week before getting better. So most of the time if you’ve actually had the flu, you never forget it and it’s pretty bad, much worse than the typical colds and coughs.

Deborah Howell (Host): What about the chills?

Adam Wass, MD: Chills as well. Chills and fevers typically will go together, so you may get what we call rigors when you get shakes because you’ve had the chills are so bad. But frequently that comes as well.

Deborah Howell (Host): And what about clammy skin?

Adam Wass, MD: That you may or may not get that as well. That tends to be an immune reaction related to the fever as well.

Deborah Howell (Host): Okay. Let’s talk about some medications. Do antiviral medications really work and if so, when should they be taken?

Adam Wass, MD: The antivirals do work, however their effect is minimal. So still the best treatment for the flu is prevention with a flu shot. But there are two antiviral medicines that are on the market, and for them to be effective, you need to get them into your system within 24 to 48 hours of flu symptoms happening. And frequently when I see patients in the office it’s later than that. So even at that time, you may not get a whole lot of effect from the antiviral medicine. And even if you do get the antivirals, typically the evidence shows it decreases symptoms only by a day or two as well in length. So it’s not a cure-all, it’s not a magic pill, still much better to get the vaccine.

Deborah Howell (Host): There’s always the thing right, oh, I feel so bad, I can’t get in a car and drive myself to the doctor, you know, so then you lose that period of effectiveness for the antivirals.

Adam Wass, MD: Mm-hmm.

Deborah Howell (Host): So maybe it’s just best to stay home and gut it out for that extra day or two.

Adam Wass, MD: It is true, you know, the antivirals, they’re not a panacea and most people if they’re healthy, they don’t have any other medical illnesses or other compromise to the immune system, just hanging through it and doing okay at home is probably almost as good.

Deborah Howell (Host): Lots of chicken soup and fluids.

Adam Wass, MD: Exactly.

Deborah Howell (Host): Alright. Now, the flu can sometimes turn into an emergency situation. So what are the things to really watch for before it becomes an emergency?

Adam Wass, MD: That’s a great question, and the biggest thing we worry about with the flu is developing a secondary - we call it secondary bacterial pneumonia, or a pneumonia that will come related to the fact that your immune system has been knocked down so far by the flu. And that can become extremely dangerous. So that would be a change in breathing, where a patient after having the flu for three or four days then becomes very short of breath. The cough changes from being a slight dry, barking cough to a productive cough bringing up a lot of phlegm. And worsening symptoms in general, where you may feel like from the flu you’re getting a little bit better each day and then all of a sudden things get worse, worse, especially related to your lungs. If that were to happen, that would need to be evaluated. The patient would need to come in right away to make sure there's no signs of pneumonia.

Deborah Howell (Host): Right, no matter how you feel, you’ve got to get in that car or get someone to drive you to the doctor because at that point it becomes really dangerous.

Adam Wass, MD: It does. It does. And people die from the flu every year. We don’t think about it that often because it’s so... we don’t think of the flu as being a life-threatening illness, but it is.

Deborah Howell (Host): I remember reading in history, I don’t know what grade, third, fourth, that George Washington died from the flu.

Adam Wass, MD: Yeah. I, I, that could be, I don’t know for sure if that was the case or not, but he did get sick. I remember him riding around on his horse and got bad flu. And through that river. Not good.

Deborah Howell (Host): So, I guess that’s another thing, people always say, well, it’s not a cold snap and you go outside and you get a chill that causes a cold or flu. But you know what, I got to think that if you’re out there and it’s cold and you’re exposed for a long time and you’re not used to it, that can’t help you.

Adam Wass, MD: Right, probably not, but there is good evidence to show that it’s not the weather. It is viruses, we know it’s not some exposure to an element but exposure to these specific viruses or bacteria that lead to the illness.

Deborah Howell (Host): Is medicine the only treatment for flu?

Adam Wass, MD: In regards to what other things would you be thinking of?

Deborah Howell (Host): Well, you know, I don’t know, there’s so many new treatments out there, there’s, you know…

Adam Wass, MD: Like you mean some kind of alternative treatments?

Deborah Howell (Host): Absolutely.

Adam Wass, MD: Yeah. Nothing that we know of that’s effective. And as I like to tell my patients, there may be other things out there that are new that are still being developed and some of the alternative treatments may work, but if we don’t have evidence for it, I don’t like to suggest or recommend things that I don’t know has the tried-and-true scientific evidence behind it.

Deborah Howell (Host): What is the deal with chicken soup? Everybody does seem to do better after... Is there something in that broth?

Adam Wass, MD: You know what, if you can find out what it is, we can separate it out, you’ll probably be famous. So nothing that I know of.

Deborah Howell (Host): Mothers... mothers for hundreds and hundreds of years have sworn by it, and so have grandmothers, and we are believers in our family, because it really does seem to work. But of course the best thing to do certainly is get into your doctor. Now as a doctor, you’re exposed continually to these flu viruses. How do you keep yourself from getting it?

Adam Wass, MD: The flu shot, just as anyone else would. We here at MemorialCare recommend for all of our employees and all the doctors to get them. And in our office, all of our doctors and employees are vaccinated. Every year, there are new strains of the vaccines that come out. Then actually the Centers for Disease Control and the manufacturers make a determination on which flus they think are going to be the most likely active that year, and those are the ones we put into the vaccine. And so the best way that I stay free from it is to get the vaccine as well. So I do get sick with colds and coughs, but have never gotten the flu even though I’ve been exposed because of the vaccine.

Deborah Howell (Host): Which leads me to another question: is the flu airborne? Can I get it from someone coughing on me?

Adam Wass, MD: You can. It’s droplets. Small droplets can come from sneezing, coughing or, you know, coughing, wiping your hands and then touching somebody else who then touches their mouth or however it would be. So those are... washing your hands is the most important way as well if you’ve been around anybody.

Deborah Howell (Host): And Purell, if you’re on an airplane and can’t get to the washroom.

Adam Wass, MD: Sounds great.

Deborah Howell (Host): Alright. Very good. Well, thank you so much, we learned a lot. Get your flu shot. I did it this year at CVS Pharmacy. It took about two minutes. It was painless. It was like a mosquito bite. So, you know, there’s really no fear. We’ve been speaking with Dr. Adam Wass about flu prevention and treatment, and I hope you’ve learned something that you can share with your family members who may have a concern or may have the flu already. Join us again next time as we explore another Weekly Dose of Wellness brought to you by MemorialCare Health System. And thank you very much for being here, Dr. Wass.