Flu Season Tips

updated 2/25/20

Flu season has arrived and the sad fact is that no matter how hard you try, sometimes you just can't avoid getting the flu. Dr. Adam Naddelman, MD, FAAP, President, Princeton Nassau Pediatrics, P.A. has a few tips on how to elude the flu, spot the virus in it's early stages, and what to do when you think that you've been bitten by the bug.

Preventative measures (from flu.gov)

Avoid close contact with people who are sick. When you are sick, keep your distance from others.

Stay home when you are sick. If possible, stay home from work, school, and errands when you are sick. This will help prevent spreading your illness to others.

Cover your mouth and nose with a tissue when coughing or sneezing. Flu and other serious respiratory illnesses, like respiratory syncytial virus (RSV), whooping cough, and severe acute respiratory syndrome (SARS), are spread by cough, sneezing, or unclean hands.

Clean your hands. Washing your hands often will help protect you from germs. If soap and water are not available, use an alcohol-based hand rub.

Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.

Practice other good health habits.Clean and disinfect frequently touched surfaces at home, work or school, especially when someone is ill. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

Early flu signs

• Fever, usually 102º - 104º

• Cough

• Body aches that can be severe

Once symptoms begin
People who are high risk (chronic illness like diabetes and asthma, elderly or kids under 2) should seek medical care quickly. If the flu is diagnosed within the first 48 hours, antiviral drugs can be prescribed in hopes of shortening and/or lessening the effects of the flu. A full list of who is considered to be high risk can be found at Flu.gov.

For those considered low risk, Dr. Naddelman believes the best treatment is supportive care, including plenty of fluids, antipyretics to reduce fever and body aches, and lots of rest. 

Considering emergency medical assistance? Listen to episode 307 of the Juicebox Podcast

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Dr. Adam Naddelman, MD, FAAP

Dr. Naddelman stresses the importance of being on the look out for secondary infections with the flu, particularly pneumonia. Signs of influenza leading to a secondary bacterial infection like pneumonia include a high spiking fever several days into the illness, increasing cough and lethargy, and decreased appetite and oral intake. These signs require immediate medical attention.  

Once you've kicked the flu waiting twenty-four hours to reintroduce yourself to the public after your symptoms and fever have resolved is considered best practice.

Dr. Naddelman practices pediatrics, but his advice is transferrable to patients of all ages.

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I've gathered some links from the Children's Hospital of Philadelphia (CHOP) that you may find helpful if your child with type 1 diabetes falls prey to the flu.

Ketone/Sick Day Rules - Insulin Pump - pdf

Ketone/Sick Day Rules - NPH - pdf

Sick Day Log Sheet - pdf 

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This is a very good time for me to remind you that I am not a doctor and that nothing I write on Arden's Day or anywhere else should be taken as medical advice. My disclaimer says it all but you should really contact your own physician whenever you have questions about your or a loved ones health. Especially when the flu is involved. 

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Corona Shelter In Place: Update One

Before I began podcasting I did a fair amount of blogging, please bear with me while I remember how to write.

It’s March 19, 2020 and my family has been voluntarily sheltering in place for six days. Overall the time has been pleasant but I want to share a few things that I’ve noticed as the days pass.

Arden seems to like distance learning better than going to school, this was not surprising as she has been able to adjust her busy hours to meet her natural sleep pattern.

Kelly is working more hours which is allowing her to conquer tasks that would normally take more time. Saving commuting time is helping tremendously. I do worry that she isn’t taking enough breaks.

Cole has been sent home from college and the NCAA has cancelled the spring sports season. He is figuring out how to channel the massive amount of energy that he usually directs into playing baseball. Yesterday he got outside for the first time and the activity was good for him.

The house has never looked better, cleaning has become a pastime for a few of us. Arden spent a day cleaning the kid’s bathroom and it is sparkling.

Everything still feels pretty normal with the exception of how often we visit stores but the specter of what may still be coming is difficult to ignore. I find myself worrying most about food, security and diabetes supplies.

I’m going to spend this time working on the Juicebox Podcast by recording, editing and prepping future episodes. I’d like to add some home exercise to my day - I need to do that.

I’m hoping that you will use your time for something that you haven’t previously had the bandwidth for. Refocus on diabetes management, try that planking challenge - whatever. Just as long as you can look back on these days and feel like they weren’t wasted. I’ve been re-listenning to my Pro Tip series with Jenny Smith to brush up on my T1D management skills. I’ve picked a few books to read and I think that I may have an idea for bolstering the community around this blog and podcast.

Last two things: Those of you who aren’t able to stay home, please be safe and for anyone who feels uncertain about the coronavirus and what you should and shouldn’t be doing, I just recorded a very easy to follow conversation with Adam Naddelman, M.D. on the subject. Adam will be back on the show as events unfold.

Talk soon.

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I want a better A1C

In two months Arden will have diabetes for five years. Today, for the first time I’m finding myself very vested in seeing an A1C decrease at our visit. I think that I may take it very personally if we don’t. Ninety minutes from now we’ll enter the exam room for the (I’m guessing) twentieth time and I don’t think (with the exception of one time) I’ve ever felt this anxious before an appointment. I don’t like feeling like this.

I just really want this to go well...

EDIT

We’re back from the endo and since I don’t want to bury the lead... A1C was terrific!

Here’s a little background. For the past two years Arden’s A1C is always in range and it fluctuates only a tiny bit. At her last appointment it jumped almost a full point but three months later it was back to the lowest that it’s ever been!!!

I think I know why too but you’ll have to wait until I get a chance to write about it to find out. Thank you so much for all the well wishes here, on Twitter and FaceBook, you guys rock!

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The following are archived comments from this post. You can post new comments below.

Anna

Good luck!

Monday, June 27, 2011 - 11:54 AM

MoD4acure

Good luck and I totally understand the taking it personally comment.  When you feel like you  have worked so hard to get a better A1c you want your hard work to show through!  Keep us posted on how it went.

Monday, June 27, 2011 - 12:52 PM

Stacey D.

Yay!  Isn't it such a sense of accomplishment to see a good number?  I'm glad it went well.  And I hope that you continue to see such good results :)

Monday, June 27, 2011 - 05:39 PM

StacyMitchL

Fabulous!  Kudos to you & Arden!

Monday, June 27, 2011 - 09:42 PM

Back Cover

A few months back Arden’s aunt was given a magazine to read. When she finished reading it she laid it face down on the counter - this is what she saw...

Last spring Arden did a photo shoot for the Children’s Hospital of Philadelphia and they have been so sweet all year, using her photos in numerous places. Thank you to CHOP for their amazing care and for spotlighting Arden and type I diabetes so brightly!

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The following are archived comments from this post. You can post new comments below.

Patrick McConnell

That`s Great, You`re a Very Lucky Dad... Congrats

Friday, June 10, 2011 - 04:25 PM

Microalbuminuria

Microalbuminuria occurs when the kidney leaks small amounts ofalbumin into the urine, in other words, when there is an abnormally high permeability for albumin in the renal glomerulus.-an indicator of subclinical cardiovascular disease.

Significance

1. ■ an indicator of subclinical cardiovascular disease

2. ■ marker of vascular endothelial dysfunction

3. ■ an important prognostic marker for kidney disease

   ■ in diabetes mellitus

   ■ in hypertension

A number of months ago I was speaking to another type I parent, she follows the site and we speak every now and then. During the course of our conversation she mentioned that reading blogs like mine is incredibly helpful but that sometimes she has to stay away because they can make her feel like she isn’t doing a good job of caring for her child. It took me a moment but I understood what she was saying. I don’t write very often about the things that I flat out mess up or the fears that live inside of me... Honestly, the latter is tougher to blog about then the former but today I’m going to give it a shot.

This one’s for you Michelle...

Three months ago I received an email from Arden’s NP, she said that she needed to talk to me about lab results. This email made my stomach turn as she and I do everything via email and that she was trying to set up a phone call was very out of character and I assumed not good news...

She called a few hours later and told me that Arden’s microalbuminuria level was alarmingly high, she was 57 and the high end of except able is 30. I tried to listen to the rest of what she was saying but it was difficult because I was also trying not to cry. When I got off of the phone I searched 

microalbuminuria on the web and found the information that is at the top of this post. Then I called Kelly at work, she researched it further while we sat in silence on the phone. Assuming that this test is correct, it looked like Arden was having serious kidney issues.

That’s when the dark thoughts show up. If our six year old is having kidney issues after only having type I for four years, well, it doesn’t seem like this is going to be a very good life for her. Sadness creeps in, silence becomes painful and I can’t seem to find one thing that I can do to help. The helplessness has returned. It took me a year to stop feeling helpless after Arden was diagnosed and in an instant that debilitating feeling came right back. Arden is sick, I can’t do anything to make her better, nothing seems fair - I’m lost.

A few days went by and I couldn’t shake it. My mind raced with the realities of what it would mean to need a kidney. I began having trouble looking Arden in the eye, I wasn’t sleeping, I couldn’t eat, I was in trouble and so was Arden. 

Now keep in mind that my NP said not to worry, we set up a time to retest her - I was specifically told that it was “not time to worry” but I couldn’t help it.

A couple of days after the NP and I spoke Kelly and I were still furiously Googling and reading everything that we could about microalbuminuria - ugh even the name sucks... As that was happening Arden seemed to be getting sick, Kelly thought that she had a UTI so I took her to her pediatrician. During that visit Arden told her doctor that it “burned” when she went to the bathroom. He tested her for a UTI in the office, the test came back negative but he sent a sample to the lab for a more complete analysis (thank goodness that he did) and a day later he called to say that Arden indeed had a UTI as Kelly had thought. He starts telling me that, “UTIs are common in girls this age and.........” just then I stop listening to him because I remembered that Kelly read online that a UTI can cause false positives in microalbuminuria tests - and with that, I could breath again.

Elated, I called the NP told her what had transpired, she couldn’t confirm that a UTI could cause a false positive so she checked into it, called me right back and confirmed that what I read was indeed correct... we decided to not retest Arden until her next quarterly appointment. That appointment was Monday.

I collected the sample in the morning and began my day...

By the time I had to get into the shower I was beginning to experience a fair amount of anxiety (and I am not an anxious person). I actually called Kelly and asked her to tell me about her morning at work, I cleaned the kitchen, vacuumed, I was trying everything to not think about the pee in the refrigerator. I knew that there was nothing to worry about but I just couldn’t help it.

So to anyone reading this but especially to you Michelle, please don’t ever think that I am living in some diabetesutopia... things get as shitty here as they do at your house and I promise to try to do a better job of showing all sides when I write. :)

This all ends well obviously. The NP emailed last night with the results of Arden’s microalbuminuria retest... 7.1! Her kidneys are fine and we are relieved but never will we be free of that little question that lives way in the back of our minds that asks, “what’s next?”. 

The picture at the top of this post is a random shot of a very little Arden...

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The following are archived comments from this post. You can post new comments below.

alexis aka @sugar_nova

I was on the edge of my seat reading. This I love your blog and I love love your love for Arden. I love sahds :) 

For some reason though I can't get blogger to add you in my feed with updates on new posts...help! Lol its a year of it knocking you off my blog roll.

Sunday, June 26, 2011 - 06:08 PM

Scott

Hi @sugarnove!

I will be moving my blog to a friendlier platform this summer and then it will be easy to track it. Until then you can try this link...

http://web.me.com/skca/Ardens_Day/Daddys_Blog/Daddys_Blog.html

Some people have luck tracking it.

ps. I have a theory about your 'allergies' drop me an email if you want to hear it... skca@me.com

Sunday, June 26, 2011 - 06:52 PM