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www.PHAssociation.org PATHLIGHT WINTER 200912 PATHLIGHT WINTER 2009 PH Helpline: 1-800-748-7274 13

Staying Healthy and Feeling Better During Cold and Flu Season

it’s BAAAAACK! yes, it’s that time of year again — cold and flu season. While staying healthy is important for everyone, it is particularly important when you have pulmonary arterial

hypertension (PAH). Getting sick with colds and the flu is no fun for anyone, but for patients with PAH, it can be especially difficult. Here are some tips for staying healthy this time of year and some practical advice on what to do if you do get sick.

An Ounce of Prevention is Worth a Pound of Cure

Our mothers were right. The single best thing you can do to feel better during cold and flu season is to keep from getting sick in the first place. Although it is best to stay way from others who are sick, this isn’t always possible especially given all the family gatherings and parties this time of year. Frequent hand washing along with good technique are great ways to prevent both getting and spreading illness. To effectively kill bacteria, rub your hands together with a soapy lather for at least 20 seconds prior to rinsing. Try singing the “Happy Birthday” song a couple of times to yourself as a mental timer. Using an alcohol-based sanitizer is an acceptable alternative to soap and water, but remember to use enough to cover all surfaces on your hands and allow the product to dry completely before touching anything else.1

Another great way to prevent illness is get your influenza vaccination, or “flu shot” every fall. Some people falsely believe that the influenza vaccination can “make them sick.” Because the influenza vaccination is made from killed viruses, you cannot get the flu from the vaccination. However, if you are ill or have a fever, it is recommended that you wait to receive your vaccination until you feel better.2

What if I do get sick?

Let’s face it, sickness happens even to the best of us. If you do become sick, there are some important steps to take in caring for yourself while you are ill.

Stay Hydrated• — Vomiting and diarrhea can affect your electrolyte (potassium and sodium) levels. Chicken soup or broth is a great way to stay hydrated while keeping your electrolyte levels up. Check with your healthcare provider regarding strategies for staying hydrated if you have other health problems, such as kidney failure or you tend to gain fluid in your legs (edema) or in your abdomen (ascites).

Good Nutrition • — Nutrition becomes especially important when you are sick. A diet balanced with protein, carbohydrates and fat will help your immune system while you heal.

Rest• — One of the reasons you feel so awful when you are sick is that your body is trying to tell you something, “take it easy.” If you need a nap, take it!3

What medications are OK for me to take?

It is important that you continue your current medications, especially your PH medications, even when you are sick. If you are having trouble doing this due to nausea, vomiting, diarrhea or other symptoms, contact your PAH provider so that he or she can help you with strategies for taking your medication.

Certain medications should absolutely be avoided. These medications can be dangerous to you if you have pulmonary hypertension.4,5 If you aren’t sure what is in a product, show this list to the pharmacist and ask him or her to help. Remember, your pharmacist is a great resource! w

By Lisa L. Roessel, R.N., F.N.P.-B.C.Pulmonary Hypertension Program CoordinatorLegacy Clinic NorthwestPortland, Oregon

Products containing these ingredients should be avoided:

Pseudoephedrine * Phenylephrine * Ephedra (Ma Huang)

Check with your PAH provider prior to taking products containing these ingredients:

Over the Counter Products:Aspirin * Ibuprofen * Naproxen * Ketoprofen * Caffeine

Herbal Products:Don Quai * St. John’s Wort * Ginseng * Vitamin K * Garlic * Ginko * Danshen * Papaya Extract * Vitamin A * Vitamin E

Products containing these ingredients are OK to take:

ExpectorantsGuafenesin

AntihistaminesDiphenhydramine * Brompheniramine * Chlorpheniramine * Dimenhydrinate * Doxylamine * Cetirizine * Loratadine

Pain RelieversAcetaminophen (Check with your PAH provider if you have liver disease or are on Tracleer or Letairis.)

Cough suppressantsDextromethorphan

References:Handwashing Guide1. . Department of Health and Human Services, Centers

for Disease Control and Prevention. URL: http://www.cdc.gov/print.do?url=http%3A//www.cdc.gov/cleanhands/. Accessed 9/12/2008.

Key Facts About Seasonal Flu Vaccine2. . Centers for Disease Control and Prevention. http://www.cdc.gov/flu/protect/keyfacts.htm. Accessed 9/12/2008.

Taking Care of Yourself: What to do if you get sick with the flu3. . Centers for Disease Control and Prevention. http://www.cdc.gov/flu/takingcare.htm. Accessed 9/12/2008.

Fink, C. & Dipersio, D. (2007). Medications to Avoid for Pulmonary Hypertension Patients.4. A Patient’s Guide to Understanding and Managing Pulmonary Arterial Hypertension.

Recommendations on Over the Counter Medications in Patients with PAH5. . Fact Sheets. Consensus Statement, Pulmonary Hypertension Association. http://www.phassociation.org/Learn/Consensus-Statements/display.asp?id=8. Accessed 9/12/2008.