Winter illnesses come in what might best be described as "waves." Technically, they are not epidemics, but they are also not just random sicknesses. When half of an elementary school is home with a fever, ugly stuff dripping from their noses, and a rash, it may not meet the medical criteria for an epidemic but it sure as the dickens is not just coincidental.
This pattern is exactly what one would expect because we all know that gross jokes, dress fads, and germs are passed through groups of youngsters at the speed of light.
So far, the high plains has had one wave of beta hemolytic strep and is now in the latter stages of a wave of a GI illness characterized by what is an almost instantaneous onset of vomiting and diarrhea.
"Hi honey, how was school?"
"It was okay. I have a lot of homework and ,,,grooughalkph â ¦padddapoom â ¦brrrrattttttttchablop. Uh Mom? You got a towel â ¦and a mop â ¦and â ¦oh boy, is this gross."
The illness lasts from 24 to 36 hours. It's capable of dehydrating the littlest ones, but adults complain the most. ("I'm dying. I know I'm dying. Just let me go. No â ¦HELP me go. Where's the shotgun? Shoot me.") They are not, however, at as great a risk as are small kiddos unless they have a debilitating disease. People with diabetes, cancer, or significant heart disease should be watched closely.
Home treatment is aimed at balancing what comes in against what the body throws outâ from both ends. In this regard, the only concern is fluidsâ forget trying to eat anything.
The fluids should be administered in small frequent feedings. A big gulp is liable to create a big cramp and a grim sprint to the john. Early on, simply not drinking anything at all may be appropriate. As the time between episodes of vomiting increases, trials of small amounts of waterâ one or two sipsâ are a reasonable way to begin your rehydration.
Vomiting may continue for 8 to 10 hours. Later stages may be characterized by the beloved "dry heaves." Sudden vomiting of brown material is not uncommon and represents vomiting of bile from the gall bladder.
It is very common, even in healthy young adults, for blood pressure to fall during later stages of the vomiting. Because of this, patients should not move quickly, and should absolutely not stand up quickly. People who have compromised vascular systems should be particularly aware of this risk.
A trip to your doctor or an emergency room should be considered if vomiting shows no sign of slowing, if a person's mental status is altered ("Oh look, there's a giant condor in the bathtub), or if an accompanying disease is compromised, e.g. glucose readings go sky high or drop suddenly, or COPD patients have increased difficulties breathing.
Doctors will treat with IV fluids. This allows the opportunity to rapidly replace fluid losses. It also allows the establishment of strict bowel restâ absolutely nothing going in by mouth. Doctors can administer anti-nausea drugs to offset the toxic condition that spirals into place as nausea causes vomiting, vomiting causes weakness, weakness adds to toxicity, toxicity adds to the nausea, and nausea causes more vomiting.
As I said, the typical acute episode of this viral illness lasts for 24 to 36 hours. However, recovery takes much longer. Even the healthiest person may feel washed out for 1 to 2 days. If a person did lots of vomitingâ and this particular illness carries the joy of LOTS of vomitingâ gastro esophageal reflux, GERD, may be an acute problem, even in those who did not have GERD before the flu. This is because the violence of prolonged vomiting leaves a swollen and dysfunctional esophagus. In this state, food is as likely to go up the line as down the line, or go no place at all. The result is heartburn and a queasy feeling of fullness. A bland diet of small feedings is the best treatment for this condition.
Post-flu, there may also be diarrhea for 3 to 5 days (and even longer.) This occurs because the lower GI tract loses the little villi that absorb fluidâ they are literally blown off the bowel wall. It takes time for these little bumps to grow back again. Treating the GI tract in a very kind and gentle manner helps that growth. Sound stupid? Well just try knocking down a couple of burritos or a double half pounder with cheeseâ treatment that is NOT kind and gentleâ within two days of this stomach flu and see how your GI system feels about your attitude.
People may develop an intolerance to dairy products that lasts as long as a few weeks. This is because the body loses some of its ability to produce the enzyme that breaks down lactrase, the sugar in milk. This inability usually reverses itself.
The disease is spread via the fecal-oral route. Wash your hands and keep them away from your mouth. Unlike what goes on during the eighth inning of a game at Coors Field as the Rockies ninth relief pitcher walks in from the bullpen, this is not a wave you want to join.
Dr. Waggoner is a family practice specialist at Weisbrod Memorial Hospital in Eads, Colo.