Dr. Mona Khanna offers advice to make the transition from fall to winter a bit easier. She also discusses dosage recommendations for over-the-counter-medicines for children.
Rebecca: Love it or hate it, the end of day like savings time in the fall signals the beginning of a host of health concerns from millions of Americans, colds, flu, seasonal affective disorder and oh yes disrupted sleep patterns are a few of the winter health issues we face. Here to help make the transition from fall to winter a bit easier is icyou’s medical editor Dr. Mona Khanna. And Dr. Mona, thanks so much for being here. Dr. Mona Khanna: Sure. Rebecca: I want to start with that time change you know I know I’m not alone whenever I set my clock back in hour, it throws off my schedule for—gosh at least a week, why is that? Dr. Mona Khanna: Well, anytime you do anything that affects the sleep wake cycle there’s going to be an issue. Basically, it all goes back to our circadian rhythms which are the body functions that are regulated by our biochemical processes, our physiological processes, all that internal processes. We don’t have a lot of control over it and believe it or not the thing that affects that the most significantly, is sunlight, any kind of light actually. So, that’s the reason and the rationale behind why people really feel changes when we either turn the clock forward or back. Rebecca: So, how can I make these transitions smooth? Dr. Mona Khanna: Well, the first thing you can do is recognize it for what it is and don’t feel guilty, don’t feel bad and don’t certainly don’t get frustrated. I mean, like said it’s something that’s beyond your control when you’re full with the internal clock. The second thing is you can actually—if you're really committed you can try to make it easier on yourself before the change happens and it always happens on early Sunday morning. So, a few days before you can either start to turn the clock again depending on where we are in the fall or the spring backwards or forwards 15 minutes incrementally everyday for a few days before. You can start to wake up 15 minutes earlier or wake up 15 minutes later and you can do that for few days so by the time Sunday comes around you're all adjusted. That’s one strategy. The other thing is to remember the sleep tips that you know we really use all the time and those are simple you know make sure you sleep in a dark quiet room, so you can get well rested. When we talk about sleep there is two kinds of sleep, there's falling asleep, how long it takes you to fall asleep and then staying asleep. So, what we want to do is we want to create the conditions that make it easy for you to fall asleep and stay asleep. So, that when you wake up you're refreshed. So, dark quiet room, no alcohol, no exercise, no caffeine and no heavy meals before you sleep, those are the best ways. We used to tell patients you know make sure you don’t watch TV before you go to sleep. We find out that a lot of people actually fall asleep to television; it makes them drowsy, probably one of those talk shows. Rebecca: I actually fall asleep to TV quite a few nights. With the time change though, how does that decreased light affect the people with seasonal affective disorder? Dr. Mona Khanna: You know seasonal affective disorder or sad is a very real and known diagnosis for us and it is to be taken seriously. What happens is with the shorter days the decrease in light hours during the fall in the winter months, people get depressed. And when you get depressed you eat more and you feel sluggish and you get frustrated and you are more irritable and people don’t like to be around you at work and you yell at your kids and all of those things. So once again, awareness is key. Be aware of what’s happening and don’t get doubly frustrated because of it. Sleep tips again that we just went over important to get a good night sleep so that you wake up refreshed. And you give your body the best chance it is going forward. There are some people though that respond very well to light therapy and although it is an FDA approved or it isn’t a treatment that a lot of people use yet we know that it is effective for certain group of people and you can buy light boxes. You can go to see your doctor and you can have your doctor recommend some kind of light that you want to expose yourself to early in the morning hours especially if you're waking up and it is still dark outside and that has a tendency to elevate your mood and rid yourself of some of those symptoms. So, recognize it for what it is, know that in some cases it’s beyond your control and avoid eating more with just the regular tips, get good exercise, socialize, you know see family and friends, try not to eat the bad stuff, the complex carbohydrates that are going to make you sluggish and weigh more and sleepy. And if worse come to see your doctor and maybe you need an anti-depressant medication, maybe you need an anti-anxiety medication. There are those options as well as the light therapy. Rebecca: You know we can’t talk about winter health concerns without mentioning the colds and the flu. Recently, I heard that centers for disease control and prevention, they’ve launched this campaign talking about the appropriate antibiotic use. Dr. Mona Khanna: Right. Rebecca: How can antibiotics be misused? Dr. Mona Khanna: Oh, it’s incredible. You know when I saw patients, we live in somewhat of an entitled society, a give me society where you going to see the doctor, you want to come out with something more than a lollipop anyway. So, I would have patients come in and eventhough I would you know beg and plead with them that you just have a cold and most colds are caused by viruses and viruses don’t respond to antibiotics, they have to walk out with that prescription or they have to walk out with those sample of antibiotics or something and so education is key here. Again, viruses which cause most colds do not respond to antibiotics so that is not an indication for antibiotic prescription. Influenza, cause by a virus again does not respond to antibiotics. So, unless you have a super infection with the bacteria which in that case you would need antibiotics then antibiotics are going to be of no use. So, that’s the most important thing to remember. Now, there are some things we can do to prevent the flu. Obviously, get vaccinated not only can you get vaccinated with the shot but we now have the flu mist which is good for very young children all the way to people ages 49. And that is mist inside the nostril and that will vaccinate you against the flu as well. So, that’s the most important thing to remember and of course the regular things if you're—if you have a cold or if you have a bacterial infection and that’s upper respiratory infection, stay at home, minimize the risk of spreading that infection to others. When you sneeze even when you cough try to cough in the crook of your elbow either one. So, you can minimize the spread, the aerosolization of those particles, drink lots of fluids, stay well rested, get your regular exercise if you can. The key to exercise during those winter months and the cough and cold and flu season is really—if the process is affecting you from the neck up in other words just a runny nose, just a cough. You're probably okay to exercise if it’s from the neck down. In other words you’ve got an infection inside your lungs, then you may want to take it a little bit easier. So, those are all tips to get through the cough and colds season. Rebecca: You know I think adults, they know how to self medicate with over the counter medications, it’s a little bit more confusing now when it comes to the children and it seems like there's new recommendations coming out all the time. Dr. Mona Khanna: Right. Rebecca: What do parents need to know? Dr. Mona Khanna: You know that’s a really good point, there certainly is. Actually the Food and Drug Administration has asked manufacturers of cough and cold medicines and again this is very, very recent to start labeling their products a little bit differently. And the genesis of this move was that we had noticed, we had about 1500 cases in the past year of children who are over medicated. They were over diagnosed with cough and cold medicines and they were seen in the emergency room or they had really terrible reactions to those medicines and we went back and we, you know, we looked at the little kids and we said, “Hey, wait a minute what are we doing, why are we medicating these kids in the first place, do we know that these medications actually work?” And what we found is that a lot of the test and the trials that had been done that made those medications be approved for adults had not been done in children amazingly enough. So, we didn’t know whether these medicines were effective in kids. We were giving it to them and on the medication box is there are children’s doses without knowing whether they were effective. So, what the manufacturers have agreed to do is basically say that these medications are not to be used in children under the age of six. Now, there is some controversy of whether that age should actually be four whether that age should be two but right now we have settled on between the ages of four and six, we should not be giving those medications as a starting point. Again, if those medications are for adults, restrict them to adults. Rebecca: When in doubt, you can always ask your healthcare provider too. Dr. Mona Khanna: Absolutely, ask you family doctor, ask you pediatrician. I mean those are the experts in child care. Rebecca: A whole host of concerns we have to pay attention to this winter. Dr. Mona, thank you so much. Dr. Mona Khanna: You're welcome. Rebecca: And you can watch more videos about winter health concerns such as colds and flu on icyou. For icyou on topic, I'm Rebecca Fox.