By Emily Harrington
As soon as the temperature drops below 40 degrees, my son’s nose starts to run. And run. And run. In fact, it seems to run until March.
It’s the season for a lot of festive activities, but it’s also the season for coughs, colds, flu and other nasty bugs. As a newish mom I have many questions that I often forget to ask my pediatrician during our frequent winter visits. Here’s a compilation of my frequent winter wonders, answered by two area professionals.
Hand sanitizer: It’s hanging from every backpack and in the bottom of every purse. I happen to love this astringent-smelling lifesaver. In fact, I find it easier to squirt hand sanitizer on my son’s hands rather than prop him up in front of the sink to wash them. But, alas, this is one of the many cases when faster is not always better.
According to Carle Hospital pediatrician Dr. Ricardo Lema, if you’re out and about and traditional soap and water is not available, use at least 60 percent alcohol-based hand sanitizer in lieu of nothing at all.
And just like with hand-washing, there’s a proper method to achieve maximum germ-fighting power. For hand sanitizer, make sure all surfaces of the hands are coated with the gel, and rub the sanitizer around the hands until they are completely dry.
Amber Oberheim, certified family nurse practitioner for Christie Clinic in Monticello, has a similar interpretation. She added that the thoroughness of the hand-washing is the key to its usefulness. If the hand-washing isn’t done properly, the effectiveness may be comparable to hand sanitizer.
“Hand-washing is the No. 1 thing to do for the prevention of cold and flu symptoms and to fight germs in general. But, there are different versions of hand-washing,” Oberheim said.
Both referenced information from the Centers for Disease Control and Prevention, and said hand sanitizer is not supposed to be used on hands that are visibly dirty. In these cases soap and water must be used in order to effectively clean hands. Good hand-washing hygiene includes scrubbing all areas of the hands with soap and water for the length of time it takes to sing the “Happy Birthday” song twice. The act of scrubbing with soap gets all the germs mobile and readies them to slide off and down the drain where they belong, Dr. Lema said. Give your hands a thorough rinse with running water, and dry them thoroughly with a clean towel or by air.
Dr. Lema emphasized the use of standard soap versus soap with antibacterial agents.
“The concern with using antibacterial-based products is that in theory the bacteria are going to morph to become stronger and more resistant,” Dr. Lema said.
Soap is statistically just as effective as killing the germs while not causing concerns for antibacterial resistance, Oberheim said.
Snot. Phlegm. Mucus. Oh my.
An allergen, bacteria or virus causes pesky runny noses. But, why do I scoot my child in the other direction when I see a child with thick, green snot versus a kid with clear snot? Somewhere down the line I have been programmed to think green means more ill than clear.
“The color of your mucus doesn’t always tell us what’s happening,” Oberheim said. “When you start to see that green color, your immune system has started to kick in releasing white blood cells — specifically neutrophils are being released which contain a green protein. When these are present in large quantities you see the green tint to mucus. This change still doesn’t tell us whether it is a virus or a bacteria-caused illness. The color just lets us know the cold has been around for a bit and if there is immune system involvement.”
Oberheim said statistically about half of these colored secretions are simply viral colds and just need time and rest to resolve since viruses can’t be helped with antibiotics.
“It’s a myth that green/yellow nasal secretions are bacterial and warrant antibiotics,” Lema said.
If you have a runny nose for 10 days or more (including a fever for three days or more near the end of those 10 days), you may need an antibiotic and medical attention, Dr. Lema said.
The consensus: Green mucus is not a definitive variable for a bacterial infection. The color is just one piece of the bigger diagnosis picture.
I love that pink bubblegum goodness in a bottle. When our pediatrician says the words, “What pharmacy would you like us to use?” I do an internal cartwheel. Because now I know my son is going to feel better really soon. And so is mommy!
But, when we aren’t prescribed the magic syrup, I feel a bit helpless and defeated. Stupid virus.
After talking with the experts, I realize maybe going home empty handed with the prescription of just time and rest is better in the long run. Antibiotic resistance, much like the aforementioned antibacterial resistance issue with soap, is a real concern among health care professionals.
“Only get antibiotics when absolutely necessary,” Oberheim said. She added it’s important to have trust that your primary care physician will provide prescription treatment when absolutely necessary.
If antibiotics are overused to battle an illness that is not bacterial (thereby unaffected by them), antibiotic resistance can occur. Over time the bad bacteria begin to morph and become more and more powerful against the antibiotics when they are really needed in the future.
“A good majority of patients that come in are for a viral illness,” Lema said. “Antibiotics don’t work for a virus. Overuse of antibiotics builds resistance. If we have resistance to certain bugs, we have to keep trying different antibiotics. Everyone wants them because it makes you feel like you are doing something. But, what you really need is time. Antibiotics kill even good bacteria.”
He added the importance of completing the entire round when necessary antibiotics are prescribed.
“In three or four days the child is running around the kitchen table feeling better. So, it’s easy to just stop the antibiotics, but this also increases the resistance in patients that truly warrant the antibiotic use,” Lema said.
I will say this. Even though I feel like my son has a chronic snotty nose, and we spent a lot of the fall at the doctor’s office, I do feel like we have had a respite from illnesses over the last few months. Knock on wood.
Maybe I can attribute this lapse to building a bit of immunity? When I complained to my pediatrician about all of our visits last year, he told me the story of a patient who came in over her first year of life all the time. But during the second year of her life the visits decreased dramatically. Immunity? Is there something to be said about not keeping your kids in a bubble?
“We don’t think about germs until we become parents — then we become paranoid,” Lema said. “It’s true that kids who are exposed to infections (like children that are in daycare setting and are exposed often), have a stronger immune system.”
Bottom line: You can’t panic every time they put something in their mouth, and they might be stronger for it in the long run.
“Everything you are exposed to now you are building immunity to later,” Oberheim said. “If you previously contracted strain x and are re-exposed to strain x later, you will have a stronger defense against that strain. The problem is there are infinite amount of strains.”
Lema also explained that the immunity is short lived, however. The next year you will not have that same recognition and will probably get it again when exposed.
It’s no secret that with the extra time confined indoors, the more likely germs are to get spread around. Thankfully with good hand hygiene, short-lived snot and vigilant antibiotic use, we will all reemerge with stronger immune systems this spring.
Meanwhile, I’ll be considering stock in Kleenex.
Emily Harrington is a Chambana townie who left her 8 a.m. to 5 p.m. job to be a 24/7 mom to a dreamy son. Still interested in writing, Emily uses some of naptime to practice her passion and keep her mind right. Emily is a happy wife with a happy life, because she fell for a fellow townie. Oh, and let’s not forget her other son—a degenerate canine named Heppenheimer.