Stepdaughter - rude and nosy
New gran - can I be involved?
Family conflict - what to do?
It's that time of year again when older people are that little bit more prone to catching the dreaded lurgy. From colds and sinusitis to norovirus and other nasties, Dr Rosemary Leonard, media medic and GP, offers her tips on how to stave off bugs during the colder months and keep yourself healthy.
How can I protect myself from getting norovirus during winter? | What are the best ways to keep winter illness at bay? | Do I need a flu jab? | Is rest and recovery all it's cracked up to be? | Treating a cold | Should I just sweat it out? | When a cold may well be something else | How can I avoid the dreaded cough? | Seasonal Affective Disorder (SAD) | How can I treat dry skin during winter? | Avoiding winter weight gain
Q: From this time of year until spring, I live in dread of norovirus aka the 'winter vomiting bug'. I would like to know the best ways to protect yourself from getting it, how to get over it if you do get it, how to stop it spreading and the best way to clean up vomit safely.
A: Norovirus is the 'winter vomiting virus' which can cause sudden onset of persistent vomiting and diarrhoea. It's truly horrible and you feel absolutely dreadful, but most people do get over it in 24-48 hours. The best way to protect yourself is to have scrupulous hand hygiene, wash your hands especially before cooking, and also keep your hands away from your face. Chewing your cuticles after you have been using a shared computer at work is an excellent way of giving yourself norovirus. Clean shared keyboards with alcohol wipes. Likewise if an infected grandchild has been playing on your iPad!
Both vomit and diarrhoea from an affected person are full of the virus so it does need to be cleaned up safely, wearing rubber gloves and then disinfecting the area afterwards.
Q: Regarding the idea that getting chilled brings resistance to germs down, I believe that a bracing plunge into cold water is good for the system and builds resistance. So what is true please, Doctor?
A: You get colds and the flu from other people. This means that you are much more likely to catch one going out doing your Christmas shopping in a crowded supermarket or department store than going for a brisk walk on the hills on a cold winter's day.
Some research has been done about going out in cold weather and if your head is thoroughly cold (for instance if you have wet hair) then the blood supply to your nose is slightly reduced and this can mean a reduced a supply of the important white blood cells that are needed to fight infection. So if you are brewing a cold, or have a cold, I would advise you not to plunge yourself into cold water or go out with wet hair. The best way to stop yourself getting a cold is to keep your hands away from your face!
"I carry a sanitising gel in my handbag and also wash my hands every time I've been out of the house. I've only had one cold in the last few years."
"I swear by garlic capsules. I have taken one every day for years and hardly ever get a cold - when I do it is very mild and short-lived."
Q: Would you recommend flu/pneumonia inoculations for someone diagnosed with Chronic Obstructive Pulmonary Disease (COPD)?
A: Having COPD means you have permanent damage to your lungs. It's mainly caused by smoking, but in the past it was also caused by exposure to coal dust. Historically, it has been common in men, but now we are diagnosing an increasing number of cases in women who have smoked.
The main symptoms are a persistent cough and breathlessness. The lung damage means that any infection can be very severe and difficult to clear. And as always, prevention is best. This means I absolutely recommend anyone with COPD to have both the flu jab every year and the pneumonia jab once every two years. They are available free from your GP (and they can't give you either flu or pneumonia!).
Q: I wonder whether one gets better from a cold more quickly by sitting down and resting or continuing as before. Please say that it is better to sit down and watch rubbish daytime TV!
A: I like this question! It is true that sometimes it's good to be a couch potato! Doing a lot of exercise adds stress to the immune system, and resting (as well as knowing how to cope if you are suffering from a chronic lack of sleep) is actually a good way to help your recovery from any illness. Having said that, once you are feeling better you do need to get active again.
Q: I bought a bottle of zinc tablets today as I heard that if you take them within a day of developing cold symptoms, the duration of the cold or cough should be shortened. Is this true? If so, why?
A: We need zinc for a strong immune system and there is some evidence that taking zinc can help to shorten a cold very slightly. However, the effect of this is less if your zinc levels are already good. You can get a blood test to test your levels of zinc from your GP. The best natural source of zinc is oysters! There are also cheaper options such as baked beans, cashews and chickpeas.
Q: Disagreement with my husband about what is best to take for a bad cold. I say paracetamol. He says ibuprofen. Who is right?
A: There is no best treatment. Both paracetamol and ibuprofen are excellent painkillers and can help reduce a fever, but what works well for one person won't necessarily work well for another. Generally, ibuprofen has more side-effects and is not suitable for people who have problems with indigestion. It's also not a good idea for older people to take ibuprofen on a regular basis as it can cause fluid retention and make heart problems worse.
"Take zinc supplements at the first sign of a cold - quite a large dose (five 15mg tablets for a few days then just one for a couple of days). That should stop it in its tracks."
Q: When I was young we were always encouraged to "sweat things out". Is this still advised?
A: A fever is nature's way of killing off bacteria and viruses, and there is a theoretical argument for "sweating things out". The only reason for taking either paracetamol or ibuprofen for a fever is to make yourself feel better and there is nothing wrong in doing that. The advice for young children now has changed and while it always used to be recommended to give paracetamol or ibuprofen immediately to stop a fever and prevent febrile convulsions, it is now only recommended if a child is clearly distressed, on the basis that the fever will help fight the infection.
Temperature control when you have a fever can be incredibly difficult - one moment you're boiling and the next you are freezing. The answer is to to try and be comfortable, so take covers on and off as required.
Q: I rarely get colds but I do have frequent bouts of blocked sinuses. I can breathe alright but have pressure in my face and behind my eyes and a headache, often with shooting pains behind my right eye. It usually lasts two or three days and then drains away. Can you suggest anything please?
A: Some people do seem more prone to sinusitis and this probably indicates that the drainage passages from the sinus to the nose are less effective than normal. The best way of keeping your sinuses clear when you have a cold is good old-fashioned inhalations.
My father had a hideous basin which he used for his Friars Balsam, which is a thick brown liquid which he put in hot water. He then would sit at the kitchen table with his head over the basin, covered in a tea towel breathing in the steam.
I think a better alternative is menthol and eucalyptus oil used in the same way. But do be prepared for your mascara to run down your face. During the day, taking decongestant tablets, such as Sudafed, can help, but these are not suitable for people with high blood pressure. Its ingredients are similar to adrenalin and can stop you sleeping, so don't take after 4pm!
"I am a great fan of tea tree oil but would never ever gargle with it. You could put some on a hanky or a tissue and sniff, or mix some with almond oil or a body lotion and rub some on your neck and chest if you have been near someone with a cold...or you could put a couple of drops in hot water and inhale the steamy vapours."
Q: I cough each year from October to May. It's a dry cough from a tickle in my throat. My lungs are clear - I have had several asthma tests all negative. I've been told it's likely an allergy and have been prescribed anti-histamines. Any other suggestions for those who get winter coughs?
A: In the summer months, allergies from tree and grass pollens are very common, but in the winter months fungi are often to blame. Problems from fungi tend to be worse in mild, wet winters. Anti-histamines should help and some people also benefit from inhaled steroids for this type of problem. That said, dry, tickly coughs can also be caused by acid reflux from the stomach, so if you ever suffer from heartburn please go back and see your GP.
"We've had the same family physician for almost 40 years. Last year, our good doctor pointed out that I'd been coming to him with the same 'cold' symptoms (congestion, coughing, malaise, sinus headache) for a very long time. He then added with a smile that 37 years of records showed a pattern more indicative of a seasonal allergy than a cold. He suggested an allergist/immunologist and mentioned mold spores (from falling leaves) as one possibility."
Q: Many people experience SAD during the winter months and, of course, anti-depressants are often prescribed for this. I have recently heard that all antidepressants are cardio-toxic to some degree. I find this very scary as I have been taking fluoxetine for several years now. Should I stop?
A: Anti-depressants are generally extremely safe. The main ones that are prescribed are SSRIs and in a large overdose there can be heart side effects. However, in normal dosages, the commonly used ones such as fluoxetine, citalopram and sertraline are not cardio-toxic. They can make life much more bearable for a lot of people in the winter months, but obviously every individual needs to discuss their own situation with their GP.
Q: I have quite dry skin and in the winter it gets so much worse. What do you recommend that doesn't cost a fortune?
A: Many people find that their skin becomes much more dry during the winter due to a combination of cold wind outside and central heating inside. In my opinion there is never any need to pay a fortune for skin creams unless it makes you feel good! I always recommend cheap basic brands that are suitable for sensitive skin. I personally use the Olay range. I slap on loads in the morning and evening. If I am not wearing makeup at the weekends, I put more on in the middle of the day!
Q: I find that I always put on weight during the winter months and would welcome some suggestions for keeping the extra pounds off this year. Also, is it true that BMI is less important than we are constantly told?
A: Many people find they put on weight in the winter months simply because they are less active - it's much harder to go out for a brisk walk if it's cold and rainy. And only the brave play tennis in the UK in the winter!
It's also true that traditional winter food tends to be higher in calories than salads. However, there are ways around this. Last night we had venison casserole, but it contained more vegetables than meat and I served it with broccoli and green beans and no potatoes. The main things to avoid are puddings and cheese!
Exercise really does make a huge difference to weight control when you get older. So it's important to try and make sure you do something that makes you puffed for at least 20 minutes every day. This could be just walking faster to the next bus stop and not using the car when you nip out to the shops to get some milk.
Regarding BMI (body mass index), this is a measurement based on height and weight. However I reckon a better measurement of health risk is your waist size and for women, it should be less than 31.5 inches measured around your tummy button. This can be particularly tough to keep it below this after the menopause, as lack of oestrogen means you are more likely to gain weight in the abdominal area. Not only that, but your metabolism falls as you get older, making weight control even more difficult. So yet again, exercise is all-important.
"Get out into the fresh air and take a brisk walk for half an hour every day."
"A good diet, a daily walk and dressing for the season is my personal mantra - and stocking up on Benylin."
Find out more about Dr Rosemary by visiting her website.
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