Tips to stay healthy and keep the doctor away. Brought to you by Righttime Medical Care. Visit www.MyRighttime.com for appointments and to learn more about our care.
In this Special Edition of Apple Per Day, Dr. Graw will answer many common questions about the H1N1 Vaccine. Is it safe? Is the mist safe? Who should get it first? Who is at risk? Where can I get it? Why are some doctors not offering it? Should I get the seasonal flu vaccine too and can I get them simultaneously? How did they make the H1N1 vaccine and why has it taken so long? Will Nighttime Care Centers offer it?
Do you have more questions? Leave a comment. We will look at every single one and do our best to get you an answer. Stay Healthy!
Today's Apple Per Day is about Ear Infection. Dr. Graw discusses causes, symptoms, home remedies and relief, when to see a doctor, and what to do if you can't get to your doctor. Stay tuned for our next video where we answer many questions and concerns about the H1N1 vaccine. Stay Healthy!
Ear Infections are called Otitis Media in clinical terminology. Sometimes this can be confused Otitis externa, or swimmer’s ear, when it burns and itches on the outside of the ear. Otitis Media is an infection in the middle ear, the chamber connecting the outer ear and the throat through the Eustachian tube.
The symptoms are: pain associated with irritability in small infants. Children may also find it difficult to eat and swallow and they may poke at the ear. If you elevate the head, you may find the symptoms improve.
In older patients, people complain of "fullness" in the ear, an inability to clear the Eustachian tube, and a stuffiness that results from the upper respiratory congestion in the nose and around the Eustachian tube. Most of the symptoms in older folks are related to inflammation in the adenoids and tonsils or because of an infection in the Eustachian tube. The Eustachian tube being closed creates negative pressure in the middle ear. The ear drum gets sucked in. When the air can pass through the Eustachian tube, the ear drum will pop back to a neutral position and you will feel relieved. As the Eustachian tube remains closed, the air is absorbed into the soft tissues, the ear drum will be sucked in and you will feel like you have to clear the space again. Many people will hold their nose and try to blow air to pop their ear drum out. That is only a temporarily resolution and probably will not permanently open up the Eustachian tube.
Ear infections are commonly cause by secondary complication of upper respiratory tract infections. The number one invader is a virus and requires no special treatment. Secondary complications of bacteria are far less frequent and will require an antibiotic. Other organisms like fungi do not invade the middle ear space.
When there is negative pressure on the middle ear, fluid will be drawn into the middle ear space like a warm bowl of broth, waiting to be infected. It takes one swallow with an infected Eustachian tube and a hundred germs will pass from the throat up into the middle ear space. That warm bowl of broth will be a welcoming environment to perpetuate the growth of those bacteria or viruses.
There are some home remedies to relieve the symptoms. Over the counter medicine like Tylenol and Motrin can relive the pain. Suctioning the mucus from the nose, particularly in small infants, allows the pressure to equilibrate around the Eustachian tube which allows them to swallow and eat better. Keeping the upper airway soft and open using saline and suctioning following the saline will help relieve the symptoms and pressure. In older patients, the use of short courses of neosynephrine or afrin will help relieve the pressure around the Eustachian tube. Gargling hot salt water may decrease the swelling in the throat, allowing you to swallow easier and freeing the Eustachian tube opening so that the pressure can be equilibrtated more easily.
In years past, it was not uncommon that people believed that every ear infection required antibiotic treatement. It is now known that the majority of ear infections will respond to time. That means that if I look at an infected ear today it might be perfect tomorrow whether they get an antibiotic or not. Providers are now counseled to be very reserved with the use of broad spectrum antibiotics to treat middle ear infections if they are not caused by bacteria. Speak with your provider, understand if it’s a virus or bacteria causing the ear infection, find out what you can do to clear the virus or bacteria. Once the mechanical fluid blocking the passage ways to the Eustachian tube is removed, the ear symptoms may resolve.
It is possible for a viral ear infection to become complicated by a secondary bacterial infection. You may have a secondary infection if the symptoms progress, particularly in young children, or if they are associated with a high fever or a thick pussy nose and drainage from the throat.
For symptoms that are progressive of middle ear pain or upper respiratory tract infection, you should see your primary care provider. When you can't see your primary care provider, reach out for Righttime Medical Care at www.myRighttime.com
In this Apple Per Day, Dr. Graw talks about Sore Throat, various causes, symptoms, treatment options, home care, prevention techniques, and when to see a doctor. Subscribe for an update when the next video on Ear Infections is available. Stay Healthy!
Sore throat is a common clinical presentation for many illnesses. It can come from dry air while your sleeping, it can be caused by a viral infection, or by that dreaded worry – strep. Most viral infections are not associated with the symptoms of Strep – high fever, chills, headache, stomach ache, lethargy. Instead, most sore throats are associated with an irritating dryness and burning, particularly when you wake up in the morning. These symptoms can be treated with over-the-counter medications and gargling hot salt water.
The complications of strep include: cardiac disease, heart murmurs, heart failure, rheumatoid arthritis, and kidney infection can be prevented if Strep is treated within the first nine days of its appearance.
The symptoms most associated with sore throat are burning, dryness, and aches in the pharynx (hence the name Pharyngitis). These symptoms are usually easily remedied by Tylenol or Motrin, gargling hot salt water, and keeping your nasal airway open. Try opening your airway through the night and sleeping with your head elevated while running a cool mist humidifier in the room.
Families, particularly on the East Coast, are likely to have several bouts of sore throat and upper respiratory infections through the year. It’s estimated that %20 of children are incubating viral infections at any one time. When you have a sore throat, you want to ensure that there are no secondary infections – streptococcal, otitis media ear infection, or post nasal drip leading to bronchitis. If those don’t occur, it is safe to return to work and school, however, be cautious sneeze into a tissue, dispose of the tissues properly, cough into your elbow, wash your hands, don’t touch your face, do not share water bottles and cups, and avoid direct contact with those who have a sore throat.
When you see your doctor, he/she will likely take a strep culture. If that strep culture is positive, he/she will choose an antibiotic and course of treatment, which he/she thinks is best for you. If your strep test is negative, don’t plead with your doctor for an antibiotic. There is no antibiotic that will improve a viral sore throat infection. In some cases, patients may be treated with an antibiotic for a secondary complication. Although your mother may have told you “you always get better with penicillin”, that is not the case with viral infections – you would have gotten better without the penicillin.
Be sure not to ignore those symptoms of progression – difficulty swallowing, high fever, severe pain. Be sure to reach out for your primary care provider if you are worried. You will never go to the doctor’s office too many times but you may miss the one critical time if you deny the symptoms. If you can’t see your primary care provider, look for Righttime Medical Care at www.MyRighttime.com or call 888-808-6483 for an appointment.
Dr. Robert Graw Jr M.D., founder of Righttime Medical Care, discusses pink eye symptoms, causes, treatment and homecare options, prevention, and when you should see your doctor. Check back regularly for apple per day videos.
Pink Eye is a common name for conjunctivitis. The symptoms and signs of pink eye are redness, itching, burning, sensitivity to light, and often a pussy drainage from the corner of the eye. Any of these symptoms should direct you to your provider if you don’t respond easily to cool compresses or flushing of the eye.
Pink Eye is named for its appearance. We all have seen patients or friends who have a red/pink swollen appearance to their eye. Some people are confused by what pink eye really represents. Pink eye refers to viral conjunctivitis. A virus is a non-bacterial infection that does not respond to antibiotics, such as those used for strep and pneumonia. Viral conjunctivitis is the kind of infection that spreads rapidly in school and work. Is conjunctivitis contagious? Yes it is. How do you prevent it? You prevent it by not exposing yourself and your saliva to others.
Many patients who have pink eye will also have a clear runny nose and be sniffing. This usually indicates that allergens from the air have entered through the nasal passage and the conjunctiva of the eye to cause itchiness and be irritation. This is cause allergic pink eye and there is no specific treatment or worry when you have this type of pink eye.
If your pink eye does not clear up in a day or two, your physician may prescribe eye drops for the itching. They may also may prescribe an antibiotic to prevent secondary infection when you have viral conjunctivitis.
Most schools have a policy that students can not return to school until they have seen a doctor and have received medication to treat the pink eye. As we’ve discussed, viral and allergic conjunctivitis do not require special treatment. As long as the conjunctivitis is not contagious, the student should be able to return to school.
Pink eye is no more contagious that a runny nose or a cough. Its important that you don’t touch your face and then touch others. When you have a cold or cough, you should cover your mouth by coughing into your elbow so you don’t get germs all over your hands. Pink eye is similar. Once you have pink eye, you are just as contagious as you would be with a viral upper-respiratory infection. The use of antibiotics does not make you any less contagious.
In the workplace, you should be able to return to work with pink eye as long as you use good hygiene, don’t touch your face and touch others, wash your hands well between contacting things like keyboards, calculators, phone, etc.
It is safe to go to work when you have pink eye. Pink eye usually lasts 3-7 days and if there are no complications, it usually resolves itself without intervention and/or medication.
If your symptoms do not improve or get worse, reach out for your primary care provider. If you can not reach your provider, reach out for Righttime Medical Care at www.MyRighttime.com
In this Apple Per Day, Dr. Graw discusses H1N1 (Swine Flu) symptoms, treatment options, home care, returning to work and school guidelines, and when to see a doctor. If you are unable to reach you doctor, you can contact us at nighttime.com. Stay tuned for more Apple Per Day videos. Stay Healthy!
The Apple per Day Blog is a public service of Righttime Medical Care. Righttime was founded by Dr. Robert Graw to provide urgent care solutions 365 days a year, even at night when the doctor is away and the ER is too busy. Visit www.MyRighttime.com to learn more or call 888-808-6483 for an appointment.
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