Surviving the Medical Meltdown (29 page)

FUNGUS

Skin rashes caused by fungus are common, the most common ones being jock itch, athlete’s foot, and ringworm. Remember the old science experiment you probably did in grade school where you covered a slice of bread and left it in a dark place and it became green with mold? Skin fungus is similar in that it loves dark, moist
places. So, jock itch happens in “sweaty” athletes, but it also happens in anyone who lets moisture stay trapped under clothing for prolonged periods. Fungal rashes occur under clothing and in areas of skin folds primarily. Certain things, like a T-shirt under clothing that traps moisture, can cause ringworm to develop in the chest area.

These rashes are flat and red and, in the case of ringworm, have a characteristic circular ring. Candida (another common fungus) rashes have red, flat, itchy spots with a spreading edge of tiny little “satellite” lesions.

As noted earlier, rashes caused by fungus respond rapidly to a good antifungal over-the-counter cream. In addition, it is important to avoid moisture trapping. Remove T-shirts and wear blousy clothing. After showering, dry areas of skin folds with a towel and/or blow dryer, being careful to dry thoroughly under breasts, in the groin, between toes, and between butt cheeks. (Painful cracking between buttock cheeks may be a sign of a fungal rash.)

INFECTION

Cellulitis is not a “rash” but presents as red, sometimes itchy skin. Cellulitis is an infection in the skin, usually spreading from some source of the infection such as a splinter or wound. This is generalized redness over an area (not spots) and may be painful and tender. Cellulitis is usually flat and may be streaking, and it is almost always warm to the touch. Cellulitis should send you to the doctor. But if no immediate care is available, look for and remove the source (a splinter, for example), and start antibiotics as previously discussed. Cipro and clindamycin are a good choice. Soak open wounds in warm water. Then try to get help because these things can go bad quickly.

INSECT BITES

Sometimes multiple insect bites can mimic a rash, but technically these are a different thing altogether. The most common bite “rash” comes from
chiggers
– tiny little insects that get into the waistband
of your pants or the tops of socks while you are working outside in grasslands or woodlands. These bites are terribly itchy but resolve without much of a problem. If you need treatment, calamine lotion or topical cortisone is usually effective. Fleas and bedbugs should be suspected if the problem is ongoing. Fleas you can usually see eventually, but bedbugs are often invisible except in the mattress. Bedbugs may give a regional rash and may persist because of continued biting.

As mentioned earlier, new diseases are being introduced into the United States with the illegal immigrant population. One such disease is malaria, a disease spread to humans from mosquito bites. Surprising to some, malaria was once endemic (common) in the Midwest at the time of the pioneers. The more human carriers of malaria, the more chance of mosquitos acquiring the parasite from a human bite and then spreading it to the next victim. To prevent infection from biting insects, you must know their habits, wear appropriate clothing, and use an effective bug spray. For mosquitos, avoid being out at dusk, wear a long-sleeved shirt when possible, and use an effective repellant as indicated. Repellants containing Deet are usually effective against mosquitoes.

20
COLDS AND FLU-LIKE ILLNESSES

I
t is common for every viral illness to be called “the flu.” But in reality, “flu” is one specific disease caused by a family of viruses called
influenza
. Most colds and flu-like illnesses are not influenza but, rather, are caused by a host of less serious but annoying viruses that give us the well-known symptoms of running nose, itchy eyes, achiness, fever, and sometimes nausea and vomiting. Food poisoning – food contaminated with bacteria – is probably the most common reason for diarrhea and vomiting, especially when those symptoms occur together. But food poisoning is often misdiagnosed by both patients and doctors as “flu.” Here are some specifics on the various culprits that make you feel sick:

Colds:
A cold is annoying to miserable but generally not serious. The major problem is disruption of sleep and productivity. Symptoms of a common cold are well known to most people – runny and/or stuffy nose; runny, itchy, or burning eyes; feverishness; sore throat; fatigue; and sometimes chills.

Treatment for most colds consists of making the symptoms better. Since colds are caused by viruses and antibiotics do not treat viruses, we do
not
use antibiotics for the common cold. Unwarranted
use of antibiotics can cause a person to develop an immunity to antibiotics, and this can limit options later in life when more serious illnesses may hit.

Treatment is generally rest, keeping warm, taking fluids, avoiding alcohol, and giving the cold time to resolve. Although it is controversial in standard medicine, many in the anti-aging community
¹
believe in high-dose vitamin C for treating acute cold symptoms. Years ago, I was in a busy spinal surgery practice with a high overhead that didn’t stop when I got sick. I developed a bad cold with all the classic symptoms, including a terrible runny nose and fatigue. But I had a full OR schedule the next day. (It is tough to operate with a nose running into your surgical mask; trust me.) So I went to my nurse friend and asked her to plug me into an IV that I supplied, containing 50,000 milligrams of vitamin C. This is a very high dose – the usual tablet being 250 to 1,000 milligrams. But I had read and heard about this protocol at an anti-aging meeting and decided to give it a try. My friend was dubious at best, but I assured her I would not hold her responsible for the outcome! She plugged me in to the IV as I sat at her kitchen counter with a red runny nose, runny eyes, feverishness, and chills. During the hour it took to run in the liter of vitamin C fluid, we sat at the counter and chatted. She told me at the end of the hour that she could actually see me getting better by the minute, as the redness in my nose faded before her eyes. My eyes stopped watering, and I felt about 80 percent better. I was fine by the next morning and was able to finish my surgery day. Placebo effect? I don’t think so, because so many docs have had similar experiences with themselves or their patients. Since then I have kept IV supplies and large-dose vitamin C in my office for desperate times.

Now, you won’t have the ability to plug into IV vitamin C, but you can boost your levels by taking vitamin C orally. However, you cannot take massive amounts of vitamin C orally without getting diarrhea, so the best option is to take 1,000 milligrams every hour or hour and a half. The minute you feel any loose bowel movement
coming on, back off. In lesser cases of cold-like symptoms, I do just this: at the first sign of a cold, I start taking 1,000 milligrams every hour for a few hours, then every hour and a half.

As noted earlier, don’t take Tylenol and don’t take any anti-inflammatory to lower your temperature or treat achiness. The body has a well-developed system for fighting infection. When a viral or bacterial invader is discovered, the immune system cells that encounter the germs send out a chemical alert to call for help in fighting the invaders. Just as in war, the front-line troops (in this case white cells) hold the invader at bay, sacrificing themselves in the process, while calling for reinforcements. Through chemical signaling with “cytokines,” these cells have called for other cells to join them. When enough invaders are present and a big response is required, the front-line troop cells send out so many cytokines that we refer to it as a “cytokine storm.” A cytokine storm is a normal, healthy response to invading organisms. When we use chemicals to lower the temperature, we disrupt this signaling mechanism. Sponging, or applying a cool T-shirt and other nonmedicinal means, physically lowers the temperature but does not impair the body’s immune signaling. Even so, I do not recommend decreasing a fever unless it is over 104 degrees or very uncomfortable. Usually temperature is not a predominant complaint with the common cold.

The cold symptom that makes me most miserable is a stuffy nose and inability to breathe at night. I like using a nasal spray, like Afrin, spritzing a little into each nostril at bedtime. But do this only for three days, as prolonged use of Afrin or its generic counterparts can cause damage to your nose from over-constriction of the blood vessels.

An antihistamine such as Zyrtec or Claritin – or my favorite OTC antihistamine, cetirizine – really helps runny noses and the itchy-eye problem. These second-generation drugs tend to be less sedating than, say, Benadryl. But at nighttime you may want the Benadryl. I tend to stay away from liquid combination cold remedies because many contain Tylenol.

And “forcing fluids” – making yourself drink fruit juice, water,
watery soup, even soda pop – when you would rather just lie there, makes sense. The curative power of chicken soup may be just an old wives’ tale, but it sure seems to be what the body wants during a cold. As they say, “Feed a cold, starve a fever.” In recent years, kale seems to have become the fashionable veggie, and during a cold this year, my hospital administrator gave me kale vegetable soup. It sure seemed to turn the tide of the illness, and it tasted just like what my body needed. I believe in listening to the body.

As a preventive measure, I make sure to take high-dose vitamin D – 10,000 units a day to boost my immune system. Also I take at least 1,000 milligrams (1 gram) of vitamin C a day. I love the GNC version of chewable C from rose hips. It just flat-out tastes good and can be chewed without gagging. And I keep vitamin C at my office computer so I can chew some regularly if I am exposed to someone with a cold. When I have a cold or any illness, I take 1,000 milligrams of vitamin C every couple of hours while awake.

There is an over-the-counter nutriceutical called Epicor, which I believe helps decrease all such illness. The drug was developed in Iowa by a farmer who created it for his cattle. With it, he was able to decrease the stillbirths and improve the health of his herds of both beef cattle and pigs. His homemade fermentation became so popular among the farmers in his area that he gave up farming and went into full-time production. His company grew, and his business split into a factory building and an administrative building. Some years later, when health care and insurance got more complicated and expensive, he hired a firm to set up a self-insurance program. In running their actuarial studies, they noticed that those employees who worked in the factory never got sick or took any sick days. But the employees in the administration building got sick as usual. Furthermore, if a person from admin went to work in the factory, after about three months he or she no longer had sick days, and vice versa: people going from the factor to the admin building were good for about three months, then they started getting minor illness and took time off from work. It caused them to really study the product
the farmer had created. It turns out that the product doesn’t directly kill germs or directly affect white cells. But if you think of the body’s immune system as an orchestra with many different instruments, Epicor somehow acts like an orchestra conductor, optimizing how the immune system components work together.

So what do I do? I take 10,000 IU of vitamin D a day, 1,000 IU of vitamin C a day when not sick, and one tablet of Epicor a day. Although I have been sick and although it is good to challenge our immune systems occasionally, since doing all this I rarely get colds or flu-like illnesses as I did in the past. And the same is true of my patients on the same anti-aging regimen. A controlled study? No. Convincing in my clinical practice? You bet. Ultimately you can choose.

Influenza:
Sometimes things start out as “colds” but ultimately manifest as something else. True influenza may begin with cold-like symptoms but develops a different constellation of symptoms with time, including higher fevers – up to 105 degrees – chills, and more severe malaise (tiredness, achiness, and a general feeling of being unwell). The fever may come and go. Muscle aches and pains may be prominent. You may have headache and photophobia (light bothering your eyes). Some people progress to pneumonia, but this is rare. (It was a rapidly fatal pneumonia that resulted in the deaths during the pandemic of 1918 that killed millions.) True influenza can last up to two weeks. The treatment for influenza without any complications (see next section) is the same as for the common cold, with one exception. You may need to take measures to lower your temperature if you are quite miserable, but don’t do it with pills. Instead, you can sit in a bathtub and sponge down with tepid water, or you can put on a T-shirt soaked in warm water, then let it cool off in the room air while you are lying in bed. I have found that very effective.

Complications:
Complications of a cold or flu are usually “superimposed infections” – pneumonia, bronchitis, or sinusitis. You may
start with a runny nose that plugs your sinus passages. Then bacteria colonize the backed-up nasal secretions, and the next thing you know, you are blowing out yellow or greenish slime from your nose. That is the hallmark of bacteria taking over an otherwise viral illness. Although antibiotics don’t help the viral part, they will help clear the bacterial infection. Similarly, a cough that was producing clear mucus may begin producing phlegm that is colored yellow or brownish. In these cases you need treatment with antibiotics and should seek medical care. These infections need to be completely cleared, and this takes more than a few days of antibiotics. You need a full course of meds and supervision. Generally, we treat from five to ten days depending on the severity of the illness and the strength of the antibiotic chosen.

Of course, any infection that causes throat swelling and airway compromise is a flat-out emergency.