Keeping Well

By Susan Bean Aycock

4 experts weigh in on how to keep your kids and family healthy this season

Though the worst of the pandemic may be behind us, COVID-19 is still active, and it’s cold and flu season to boot. But keeping well is much more than just avoiding getting sick; it’s a whole set of habits and practices that can seem overwhelming if faced all at once. So maybe instead of the grand gesture of a New Year’s resolution that’s probably already broken by now, pick a few doable improvements to tackle. Then stay with them before adding others.

What are the best ways to make sure you stay well this year? Start with simple: walk further to park your car; make sure you always carry a water bottle; eat fast food one meal less per week . Even if you know the basics, do you do them consistently? Routinely washing your hands is a slam dunk, but what about managing stress by taking an hour to do something enjoyable? The healthcare providers in this article stress one thing over all: get solid medical advice from a trusted source and quit trying to diagnose yourself with Dr. Google. Bonus: If you practice better health behavior, your kids and aging parents will likely benefit too.

How can you improve your general health and resistance to getting sick? How do you even get started? The Wacoan posed these questions and more to four local healthcare providers, whose observations and tips can help you get and stay healthy in 2023.

LaShonda Malrey-Horne
Director of Public Health, Waco-McLennan County Public Health District

Director of Public Health LaShonda Malrey-Horne is responsible for the day-to-day operations of the Waco-McLennan County Public Health District, with six divisions and nearly 90 employees. Services include not just monitoring and dealing with infectious diseases such as COVID-19, flu, TB, HIV and STIs [sexually transmitted infections], but a WIC [Women, Infant and Children] nutrition program and environmental health services that include food and restaurant inspections and inspecting pools, spas and sewage and septic systems. The Health District also provides health education and birth and death certificates. With nearly 20 years’ experience in community and public health, Malrey-Horne has served in her current position since March of 2021. She says, “My job consists of making a lot of moving parts work in a straight line, while also trying to make healthy choices easy choices for the community.”

What does the health situation look like in McLennan County with regards to COVID-19 and flu?

We’ve seen an increase in reported COVID-19 cases since November. But because many people test at home or don’t test at all, it’s hard to have an exact number. The CDC [Center for Disease Control] community threat level for COVID in McLennan County is low. That’s a good thing – but it’s still high enough to pay attention to; we’re not completely out of the woods. It’s been a very active flu season, the most active since 2019, and flu can be as devastating as COVID. Flu and COVID are both viruses, and you don’t need antibiotics to treat them.

What should we keep doing that we already know?

You should keep doing basic mitigation efforts that reduce risk, mainly remembering to wash your hands, or use hand sanitizer if you don’t have access to soap and water. Hand sanitizer is just as effective as washing your hands and parents should send their kids to school with a small bottle of sanitizer. Cover your mouth when you cough or sneeze. These are things you learn in elementary school that just work.

Consider wearing a mask in large crowds, because when you cover your face, you decrease the opportunity to spread disease. Stay home when you don’t feel well and keep your kids at home when they don’t feel well. We understand that people sometimes don’t stay home when they don’t have paid time off from work, but stay home if you can. It may seem as though flu and colds have diminished, but that’s partly because of living life in the pandemic – there was a decrease, but just because people were getting together less.

Do masks still have a place and if so, where?

In my opinion, masks will always have a place as we move forward because we know that covering coughs reduces the spread of respiratory viruses. There are strong opinions out there about wearing masks, and we just hope that each family and community member will respect the decision of others. We’ve all been through a lot, and we don’t know what conditions or illnesses others may have. Masks may also provide a sense of comfort for people who have dealt with anxiety and mental issues through the pandemic. Masks are still a good idea in large crowds and on airplanes.

It seems like everyone is constantly sick. What’s your best advice for keeping well short of staying home all the time?

Number one: Get vaccinated! Both COVID and flu vaccine can help decrease the spread of the viruses and how sick you become if you get infected. The only way to end the pandemic is to keep doing our due diligence to prevent the spread [of COVID]. We need to keep doing basic mitigation efforts and increase vaccine uptake – especially with the Omicron-specific Bivalent booster. People with chronic conditions and compromised immune systems should really get the booster. Even during the pandemic, public health has stayed true to its mission to prevent, promote and protect.

Dr. Floyd Barry
Pediatrician, Waco Family Medicine

Dr. Floyd Barry has been a pediatrician for 32 years as of June 2023, and with Waco Family Medicine for 20 years. “When I did my Pediatric rotation, it was just clear to me in a way I can’t explain; I’ve never been unsure that this was the field of medicine I should practice. At a ceremony where a coach was being inducted in a hall of fame, he told his mother, ‘I feel like I’ve never gone to work.’ And I understood because that’s how I feel about Pediatrics.”

How do you know if your child has COVID, flu or something else?

You have to have your child tested to know what you’re dealing with. Since COVID, flu, RSV [respiratory syncytial virus], strep and other prevalent viruses and bacterial infections share some common presentations, it’s difficult to know which it is without testing. Treatments and infection control rules are different, making this tough.

What’s frontline intervention with sick kids, and when should parents bring them to a healthcare provider?

Supportive measures include calming your child, encouraging rest and fluid intake, suctioning secretions with a bulb syringe for younger children, positioning older children at a 30- to 40-degree angle and antipyretics (ibuprofen or acetaminophen, never aspirin) for fever. Remember, dosing is by body weight, not age. A conversation with a healthcare provider can help you make the best decision, since with multiple diseases circulating, we need to test to know what we’re up against.

When is it time to go to an emergency facility?

Seek emergency care for severe symptoms that could include: your child being confused or restless, having blue lips or nails, retractions – pulling in the skin between the ribs or at the neck and collar bone – nasal flaring, drooling or inability to swallow and grunting and breathing pauses, especially in young infants.

With so much sickness going around, what do you want to stress to all parents about their children’s health?

The best way to keep well is to follow Benjamin Franklin’s adage, “An ounce of prevention is worth a pound of cure!” This is so much beyond whether to vaccinate or not in our politically-charged world. Use a common-sense arsenal of layers of prevention: handwashing or sanitizer, wearing a mask, distancing, staying home when you’re ill, seeking medical advice and following it correctly and vaccinations – if that’s your choice. Teach children to consistently follow these suggestions like the DPS [Department of Public Safety] emphasizes seat belts: every rider, every ride.

How effective is hand sanitizer as opposed to good old-fashioned hand washing?

Alcohol-based hand sanitizer is very effective when soap-and-water washing isn’t readily available, though not to be used for visibly dirty or greasy hands. But after visiting friends, stores, sick people or being out and about, it’s a good idea as germs are everywhere. Sanitizer is a good alternative when logistics just don’t allow for proper lathering with soap, covering the back of the hand, between the fingers and under nails for 20 seconds, then rinsing.

What are the riskiest health situations for children to be in?

The riskiest situations for children with any illness are parents who are not following the rules for keeping them and all of us healthy. Children don’t control a lot in their lives, but do learn what they live, like the old saying, “I hear what you say, but I see what you do.” Children don’t understand data, so there is a responsible obligation to teach them to manage their and our collective health. Children learn what we teach them; let’s just do it right for their health, their families and for all of us in the community.

Is there anything we can let up on?

Things are never going to go back to where they were before the spring of 2020. Regardless of your beliefs, teach your children that when they’re ill, they shouldn’t put at risk elderly people, those with serious medical conditions or those not vaccinated against COVID. You don’t have to vaccinate, but do all the other measures: have children tested when they’re ill to know what you might be exposing people to, delay get-togethers and stay home from school and day care until they’re well.

Tony Podbielski
Family Nurse Practitioner, Coryell Health Medical Clinic-Waco

A Family Nurse Practitioner since 2021, Tony Podbielski has worked in healthcare since he was 18: as a Certified Nurse Aide, Certified Medication Aide, staffing coordinator and supervisor in a Waco nursing home and as a hospital ICU nurse. He says, “Seeing patients feel like they’ve been heard and helping them take an active role in their health is absolutely one of the most rewarding parts of my job.”

What health advice do you find yourself giving over and over to your patients?

It’s all too familiar: wash your hands and stay home when you’re sick. Probably everyone knows this, but we tend to forget.

What keeps people from following that advice? How do they get themselves in trouble?

It’s not always convenient to wash or sanitize your hands, but getting sick isn’t convenient either. Thankfully, the most recent strain of COVID hasn’t been putting people in the hospital like it was last year. Patients are still coming in with COVID, but their symptoms are usually milder and with shorter recovery. One of the bigger concerns is that people may have symptoms longer than with flu or other viruses. These residual symptoms can be frustrating when you’re just ready to feel better and get back to your usual state of health. With flu, patients tend to feel bad quickly and intensely, but generally recover well within a week or so.

How risky is it that you’ll catch something at a clinic or doctor’s office?

There’s risk in exposure to illness in any public place. People go to the doctor’s office because they don’t feel well, so they’ll be coughing, sneezing and touching things while waiting to be seen. Minimize what you touch at the doctor’s office; instead of picking up a magazine, maybe bring a book or look at your phone.

What advice do you wish your patients took more seriously?

Unfortunately, there’s still a small percentage of patients who don’t believe these viruses can cause serious illness. Getting vaccinated for flu and COVID helps to lower risk of becoming seriously ill. But just because you don’t get seriously ill doesn’t mean others won’t. You don’t have to agree with everyone, but something as easy as washing your hands or staying away from high-risk people when you’re sick can make a huge difference – especially to the person who might be spared [infection] because of your efforts to protect them.

Are there any health practices we can let up on?

Wearing masks can be controversial and I see mask fatigue firsthand. Do I think we need to wear masks 24/7? No. Do I think patients with signs or symptoms of one these respiratory viruses should wear a mask when in close proximity to others? Absolutely.

When is it time to see a healthcare provider? When should you go to an emergency facility?

See your healthcare provider if you’re having symptoms that aren’t improving with conservative treatments such as OTC [over the counter] medications, rest and hydration, or if you have any concerns about your symptoms’ impact on chronic health issues such as heart or lung disease, high blood pressure, diabetes or asthma. People experiencing severe symptoms such as high fever or difficulty breathing should go immediately to the nearest ER.

What should we keep doing that we already know?

Wash your hands, cover your mouth when coughing or sneezing, stay home when you’re sick and use OTC medications as recommended by your healthcare provider to treat symptoms. There’s no silver bullet to getting over these viruses; it requires consistency with treating symptoms, often with OTC medications. These are viruses; antibiotics will not treat the symptoms.

What can help boost our immunity to getting sick?

First, stay hydrated. A lot of patients are dehydrated when they come in to see me. There is no magic amount of water to drink, but a good rule of thumb is to drink when you’re thirsty. Second, get adequate sleep – seven to eight hours per night on a regular basis. Rest is never more important than when we’re sick; it’s when we recharge and give our bodies the best chance to recover.

Karrie Crosby
Physician Assistant, Baylor Scott & White Clinic Family Medicine

Physician Assistant Karrie Crosby will complete 25 years at Baylor Scott and White Clinic this May. She’s made numerous presentations to nonprofits, churches and City of Waco employees on “How to Get the Most Out of Your Medical Appointments” and is a clinic manager and current president of the Texas Medical Board of PAs. She says, “I love science and the idea of helping people, and being a PA has offered me that.”

What health advice do you find yourself giving over and over to your patients?

Get adequate, restful sleep. Manage stress effectively – go outside, read, enjoy a hobby, exercise, see friends. Drink plenty of water and avoid excessive caffeine. Eat a well-rounded, nutritious diet. Keep your hands away from your eyes, nose and mouth – they’re an entry point for germs. Sanitize your hands regularly. Get vaccinated. So many people discount the flu shot and other vaccines, but vaccines save lives, especially in higher risk patients.

What keeps people from following that advice? How do they get themselves in trouble?

People don’t have time to be sick and it’s human nature to seek a quick fix. Viral infections don’t respond like allergies or bacterial infections, and it’s a misconception that antibiotics will help you get better faster; on the contrary, antibiotics have risks and side effects. When you go to the cold and flu aisle at the store, medicines are marketed by symptom and it can be hard to identify the active ingredients. When you’re eager to feel better faster, you may unintentionally take redundant ingredients. Just because a medication is accessible over the counter or is an herbal remedy doesn’t mean that it’s safe for all patients. If in doubt, ask your medical professional or pharmacist.

I tell patients this time of year that they could probably start a support group in our waiting area – everyone out there is just as unhappy as you are suffering through their illness. My 16-year-old daughter wasn’t getting well as quickly as she wanted with over-the-counter medications I was giving her. She asked for a second opinion and got the same answer: it has to run its course; be patient. I treat my patients as I would my closest friend or family member.

When you do go to a clinic or doctor’s office, how risky is it that you’ll catch something there?

Any time you’re in proximity of someone who is ill with a cold or other viral respiratory infection, it’s possible to be exposed. Cold and viral respiratory illnesses are expelled in the air through coughing, sneezing and blowing your nose. Germs are also on shared objects like doorknobs, armrests, phones and computer keyboards.

What health advice do you wish your patients took more seriously?

Quit smoking. It’s a significant risk factor that may cause other complications in ill patients and makes treating chronic and acute medical issues more difficult. Take medications as directed; more is not always better and may lead to drug interactions or severe side effects. Don’t take medications prescribed for someone else. Continue regular preventive healthcare visits. Don’t rely on possibly incorrect medical information from social media or the internet. Knowledge is power – but credible and reliable information is vital for a successful treatment plan.

When is it time to see a healthcare provider? When should you go to an emergency facility?

It’s important to establish a relationship with a primary care provider you trust. Don’t just assume symptoms are your seasonal allergies or a sinus infection. If you have escalating symptoms despite symptomatic care – especially chest pain, shortness of breath, prolonged elevated temperature, dehydration, rash, abnormal bruising, feeling like you may pass out – it’s best to be evaluated at an urgent care facility. Higher-risk patients have a much lower threshold for close follow-up and reevaluation if they have worsening symptoms.

How has the COVID-19 pandemic changed health care practices and what have you learned from it?

The pandemic contributed to us falling behind on routine screenings like mammograms, colonoscopies, pap smears and regular visits for chronic disease follow-up, and there were delays in early diagnosis and prevention. Preventive health maintenance improves the health of our patients, and early diagnosis and intervention save lives.