Friday, January 24, 2020

Should You Exercise When You Are Sick?

This is a question that comes up quite often, especially this time of year.  The answer depends on several factors, including what type of illness you have and what type of exercise you are doing.  Let's talk today about the role that exercise plays in your immune response to illness and whether that can be helpful or harmful when you are ill, as well as how a routine exercise program impacts your susceptibility to infection.

Can routine exercise decrease the chances of getting sick?

Exercising while sickThe answer is a definite yes, but there are some exceptions.  Research indicates that people who participate in moderate exercise on a regular basis (approximately 150 minutes per week) have significantly fewer respiratory infections than people who are sedentary.  This includes colds, flu, sinus infections, and other respiratory infections.  There are positive immune changes that take place during each bout of moderate physical activity, which translate to this protective benefit.

On the other hand, people who are pushing beyond normal exercise limits, such as regularly participating in high intensity exercise or exercising for excessive time periods, have significantly more respiratory infections than people who perform moderate exercise.  This includes people who are participating in high intensity work outs for more than 90 minutes at a time on a regular basis, such as marathon runners.

What if you already have a cold?  Should you exercise?

In general, mild to moderate exercise is usually fine when you have a mild upper respiratory illness, such as a cold.  Exercise can even help to temporarily open your nasal passages and relieve some congestion.  However, there are times when exercise may cause more harm than good.

Here are some general guidelines to consider when deciding whether to exercise when you are sick:
  • Do not exercise if you have the following symptoms:
    • Fever, body/muscle aches, or fatigue
    • Chest congestion, wheezing, or a bad cough
    • Upset stomach, nausea, vomiting
  • You can exercise if you only have the following symptoms:
    • Runny nose, head or nasal congestion, sneezing, minor sore throat
Some people like to use the distinction "above the neck" or "below the neck."  If your symptoms are all above the neck, it is ok to exercise, but if you have symptoms below the neck, you should not exercise.  I usually say, if you feel miserable, you should take a few days off from exercise.  If your symptoms are bothersome, but not making you feel miserable, go ahead and exercise.

If you do want to exercise when you are sick, here are some things to consider:
  • Reduce the intensity and length of your normal work out; maybe go for a walk instead of a run.
  • Consider doing some indoor exercise, rather than exercising outdoors in winter weather conditions.  If the weather is not harsh, the outdoor air might do you some good.
  • Listen to your body.  If you get tired or your muscles start hurting during your workout, you should stop the workout.  The next day, try something less strenuous.
  • If you start coughing or wheezing during a workout, stop the workout.
If you do take a few days off from your regular exercise routine while you are sick, this should not have any adverse effect on your exercise performance.  As you start to feel better, gradually get back into your exercise routine.  Start at a lower intensity and pace, and gradually increase to your normal routine.  Within a few days to a week, you should be back to your normal workout.

If you have any questions about exercising when you are sick, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Saturday, January 18, 2020

RSV Infection – Part II

We have talked about influenza in the past couple of weeks, but this is also the time of year that we see another serious viral infection.  RSV can cause severe illness and even death in very young children.  Each year in the United States, there are over 57,000 hospitalizations among children less than 5 years old due to RSV infection, and anywhere between 100-500 deaths from the infection.  This winter, RSV infection has been spreading faster and causing more hospitalization in children than usual thus far.  Let's talk more about RSV and the illness it causes.

RSV InfectionWhat is RSV?

Human Respiratory Syncytial Virus, also known as RSV infection, is a viral infection of the respiratory tract that commonly affects children less than 2 years of age.  It actually can cause illness at any age, but in healthy older kids and adults, it usually just seems like the common cold, so you may not even know that it is RSV.  In children younger than 2 years old, especially those younger than 6 months old, or children with decreased immune function, RSV can cause a severe illness, leading to hospitalization and even death.

What is bronchiolitis?

Bronchiolitis is an inflammation in the smallest bronchial tubes in the lungs, called bronchioles.  Don't get this confused with bronchitis, which is an inflammation in the larger bronchial tubes.  The vast majority of cases of bronchiolitis are caused by RSV.  Inflammation sets in when the bronchioles become infected with RSV.  Because these bronchioles are so small, and especially small in young children, any inflammation in the tubes can obstruct airflow.  This obstruction results in wheezing, or other signs of difficulty breathing.  Rapid breathing starts as a response to try to keep the blood oxygen at the normal level.  This rapid breathing can interfere with a baby feeding, and if it is severe and lasts long enough, a baby may not have enough energy to keep up the rapid breathing.  This, in turn, leads to low oxygen levels, which can cause serious consequences.

Who is at risk for serious RSV infections and bronchiolitis?
  • Premature babies
  • Infants less than 6 months
  • People with compromised immune function (including those on chemotherapy)
  • Those with underlying health problems, such as asthma or heart disease
  • Elderly adults
What are the symptoms of RSV infection?

Initially, RSV infection may seem like a common cold.  In fact, most RSV infections are mild and never get diagnosed.  However, the symptoms can progress quickly.  Symptoms include:
  • Sneezing
  • Runny nose (usually with lots of nasal mucous) and nasal congestion
  • Fever
  • Sore throat
  • Headache
  • Problems breathing (including wheezing or rapid breathing)
When should you call a doctor?
  • If your child is less than 6 months old and has symptoms of a cold, 
  • If your child has a fever lasting more than a few days, 
  • If your child is wheezing, breathing more rapidly, or having some difficulty feeding, call your doctor right away.
When is this an emergency?
  • If your child has more serious symptoms, such as difficulty breathing, discoloration of the lips, skin, or fingernails, or other signs of respiratory distress, you should call 911 for immediate help.  
Next week we will talk more about RSV infection, including how the diagnosis is made and how it is treated.

If you have any questions about RSV infection, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Friday, January 10, 2020

RSV Infection

We have talked about influenza in the past couple of weeks, but this is also the time of year that we see another serious viral infection.  RSV can cause severe illness and even death in very young children.  Each year in the United States, there are over 57,000 hospitalizations among children less than 5 years old due to RSV infection, and anywhere between 100-500 deaths from the infection.  This winter, RSV infection has been spreading faster and causing more hospitalization in children than usual thus far.  Let's talk more about RSV and the illness it causes.

RSV InfectionWhat is RSV?

Human Respiratory Syncytial Virus, also known as RSV infection, is a viral infection of the respiratory tract that commonly affects children less than 2 years of age.  It actually can cause illness at any age, but in healthy older kids and adults, it usually just seems like the common cold, so you may not even know that it is RSV.  In children younger than 2 years old, especially those younger than 6 months old, or children with decreased immune function, RSV can cause a severe illness, leading to hospitalization and even death.

What is bronchiolitis?

Bronchiolitis is an inflammation in the smallest bronchial tubes in the lungs, called bronchioles.  Don't get this confused with bronchitis, which is an inflammation in the larger bronchial tubes.  The vast majority of cases of bronchiolitis are caused by RSV.  Inflammation sets in when the bronchioles become infected with RSV.  Because these bronchioles are so small, and especially small in young children, any inflammation in the tubes can obstruct airflow.  This obstruction results in wheezing, or other signs of difficulty breathing.  Rapid breathing starts as a response to try to keep the blood oxygen at the normal level.  This rapid breathing can interfere with a baby feeding, and if it is severe and lasts long enough, a baby may not have enough energy to keep up the rapid breathing.  This, in turn, leads to low oxygen levels, which can cause serious consequences.

Who is at risk for serious RSV infections and bronchiolitis?
  • Premature babies
  • Infants less than 6 months
  • People with compromised immune function (including those on chemotherapy)
  • Those with underlying health problems, such as asthma or heart disease
  • Elderly adults
What are the symptoms of RSV infection?

Initially, RSV infection may seem like a common cold.  In fact, most RSV infections are mild and never get diagnosed.  However, the symptoms can progress quickly.  Symptoms include:
  • Sneezing
  • Runny nose (usually with lots of nasal mucous) and nasal congestion
  • Fever
  • Sore throat
  • Headache
  • Problems breathing (including wheezing or rapid breathing)
When should you call a doctor?
  • If your child is less than 6 months old and has symptoms of a cold, 
  • If your child has a fever lasting more than a few days, 
  • If your child is wheezing, breathing more rapidly, or having some difficulty feeding, call your doctor right away.
When is this an emergency?
  • If your child has more serious symptoms, such as difficulty breathing, discoloration of the lips, skin, or fingernails, or other signs of respiratory distress, you should call 911 for immediate help.  
Next week we will talk more about RSV infection, including how the diagnosis is made and how it is treated.

If you have any questions about RSV infection, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor