When we feel miserable with a sinus infection, we just want a magic pill to make the symptoms go away. Some people expect to go to their doctor and get an antibiotic for treatment. This can be a bad idea if it’s not the cause of the infection. We live in a time where antibiotic resistance is a big problem. Handing out antibiotics for treating colds that are due to viruses, is the main reason for this resistance problem. So here are some things to know…

The correct term is actually, “rhinosinusitis.” This is when the mucous lining in the paranasal sinuses and nasal cavity become inflammed. It effects 1 in 7 adults each year in the U.S. It causes swelling and blockage of the normal openings that drain mucous. It also decreases the function of cilia (small hair-like structures) which are responsible for sweeping out mucous and debri from the nasal cavity.

Most (>80%) infections are due to viruses, which originate from the common “cold”. We catch these colds from direct contact by touching a surface with the virus on it and then touching our face, wiping our nose or mouth. The other way it is spread is through airborne droplets that occur when someone coughs.

In the first 3-4 days of illness,  you can’t tell a viral or bacterial infection apart. Symptoms are similar which includes nasal congestion, runny nose, loss of smell or taste, post nasal drip, sore throat, tooth and facial pain/pressure, fatigue, headache, bad breath and fever. Thick green mucous does not mean it is a bacterial infection needing antibiotics. This can be viral or it can indicate that the infection is coming to the end of its cycle and almost cleared.

During the first 7-10 days, it is best to do nasal washes with saline which you can make on your own, using 1 cup of warm filtered water and adding 1/4 tsp of sea salt and 1/8 tsp of baking soda. You can also use this solution for gargling if you have a sore throat. Decongestants are also helpful with nasal swelling and post nasal drip. You can try a homeopathic remedy or use over-the-counter Sudafed. Drink lots of water, get rest and fresh air. Exercise is fine as long as you are not running a fever. Try to avoid sugar, alcohol and coffee which can compromise the immune system.

So when to think about antibiotics? If your symptoms worsen over 10 days or you improve after the first few days and then your symptoms come back much worse. Also, predominant sinus pain on one side and discharge that looks like pus are times when you should see your practitioner.

Always wash your hands and cover your mouth with your arm or a tissue, (rather than your hands) when sneezing or coughing. Try to stay away from sick people if you can. There are some people that need to be referred to a specialist if symptoms continue to worsen after maximum treatment.

Aring, A et al. Current Concepts in Adult Acute Rhinosinusitis. American Family Physician. July 15, 2016 Vol. 94. Number 2

Its American Heart Month and I feel like I will be telling readers what they already know…We know what NOT to do.

1. Don’t Smoke
2. Don’t be a Slug…Exercise- 30 minutes at least 5 days per week.
3. Don’t eat processed foods that you typically find out of a box.
4. Don’t eat too much sugar. Find out how much you eat daily and cut back. Granola bars and smoothies = Lots of sugar!!
5. Don’t drink alcohol, or at least make it a rare thing.
6. Don’t ignore your weight. If the pounds have been creeping up, do all of the above and get tested for food allergies.
7. Don’t be so Stressed out!  This is probably the hardest for most of us. Chronic stress leads to high blood pressure (by the way, the new guidelines are to keep blood pressure below 120/80). It also leads to insomnia. When we don’t sleep, we gain weight, raise our risk of diabetes, arteriosclerosis, cancer and dementia. Plus we feel tired, depressed, irritable and people don’t want to be around us. Then you feel isolated which is an independent risk factor of heart disease. It’s a vicious cycle.                                                                                                                                                                                                                                      So find ways to relieve stress. Know that you will survive. It will be OK. Take some deep breaths and stay in the moment. See if you can perceive the situation differently. Are you being triggered from a fearful story from the past that still needs healing?  Take a walk…ideally in nature, learn to meditate, do yoga or tai chi. Knit or learn a hobby. And if nothing else…talk to a close friend who will listen, or meet with a therapist and get some perspective. It will add years to your life.

Anti-inflammatory medications have been known to be harmful to the developing fetus. Many pregnant women instead have used acetaminophen (Tylenol) for fever or pain relief. Recent research has shown an increase in the risk for attention-deficit/hyperactivity disorder (ADHD) in children from prenatal acetaminophen exposure. The question is whether this is due to acetaminophen exposure or parental ADHD.

To answer this question, researchers compared data from a Norwegian registry of approximately 113,000 children born between 1999-2009 (including 2246 with ADHD) with data on maternal and paternal ADHD symptoms, pre-pregnancy use of acetaminophen, and conditions for acetaminophen use. These were the results:

1. When mothers used acetaminophen for < 7 days during pregnancy, they had a slightly lower risk for ADHD in their children.

2. When mothers used acetaminophen for >7 days during pregnancy, they increased the risk for ADHD in offspring in a dose-dependant manner.

3. Pregnant mothers’ use of acetaminophen for >29 days more than doubled the risk for ADHD regardless of why women were taking this medication.

4. Maternal acetaminophen use before pregnancy was not associated with an increased risk of ADHD in offspring. Pre-pregnancy use was used as a control which strengthens the argument that acetaminophen exposure, not maternal ADHD symptoms explains the findings.

5. Paternal pre-conception use of acetaminophen for >29 days was also associated with a higher risk for ADHD in offspring!

I think the most surprising finding was that the father’s use of acetaminophen prior to conception increased the risk for ADHD in offspring. This medication may influence spermatogenesis (the process of sperm cell development).

This is another risk factor for developing ADHD. Women should limit their use of acetaminophen during pregnancy and find other ways to reduce pain. Mindfulness and yoga are a few ways to help tolerate the stress of parenting. ADHD is primarily determined by genetic factors so no woman should feel guilty about their prenatal acetaminophen use. I’m sure we will continue to find other risk factors as well as advances in treatment of this complex condition.

Ystrom, E et al. Prenatal exposure to acetaminophen and risk of ADHD. Pediatrics 2017 Nov; 140:e20163840.

Wolraich ML. An association between prenatal acetaminophen use and ADHD: The benefits of large data sets. Pediatrics 2017 Nov; 140e20172703.

This is a great article to read as we venture out in the sun this summer. If you are like most people, picking up sunscreen with a high SPF number thats on sale is usually good enough to keep you from burning. But is it actually doing more harm than good??

About 3/4 of the products on the market not only fail to protect you from the dangers of the sun, but can actually enhance the sensitivity of those damaging rays. Lack of regulation seems to be the problem.

What does SPF (sunburn protection factor) really mean?

Read this article and then go to the recommended list of EWG (environmental working group) approved products to choose the right sunscreen to prevent burning and guard against skin cancer.

Your Sunscreen Is Probably Failing You: “”