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Flu-Like Symptoms? What to Expect From a Visit to the Doctor

January 07, 2015

The flu is running rampant in our community.  In fact, it is “widespread” in our community and the vast majority of the country according to the U.S. Centers for Disease Control.
 
We have received several emails from patients and family members expressing concern about their experience in the emergency department not being what they expected.  We asked Dr. David Dubow, an emergency department physician with Wake Emergency Physicians, to help us understand what patients visiting a healthcare provider with flu-like symptoms can expect.  Here are his answers to our questions:

Should I seek medical care if I think I have been EXPOSED to the flu?
The flu is a highly contagious virus, but exposure to a sick person does not mean you will get the flu.  The best thing to do if you have been exposed to the flu is to watch and wait for symptoms to appear and then treat the symptoms.  Of course, if you have an underlying chronic health condition like COPD, asthma or are very old or very young, it never hurts to consult your primary care physician for advice.

Should I seek medical care if I think I HAVE the flu?
Since the flu is a virus there is very little doctors can do to help you through.   In other words, if you have the flu, we can’t fix the problem or make you feel better quickly.   We’ll probably mostly recommend rest, hydration, and a healthy diet to help get you well as soon as possible.  There are a few things we can do, however:

  • We Can Confirm You Have the Flu
    We can confirm that you actually have the flu using a swab test, which is fast but not very accurate.  Many doctor’s offices and urgent care offices use this kind of fast antigen test.  In the hospital emergency department, we use a much more accurate test but it takes about 3 to 4 hours to receive the results, so often we opt not to run the test if the patient is at low risk for complications and is not being admitted into the hospital.  As physicians, we often diagnose the flu based on prevalence in the community and symptoms (If it looks like the flu, smells like the flu and acts like the flu, it probably is the flu and there is no reason to make patients wait hours for a result that won’t change the treatment plan.)
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  • We Can Recommend Medications to Control the Symptoms
    We can recommend medications and medication dosages to help manage the symptoms of flu.  We may also prescribe a medication called Tamiflu, which is an antiviral that may reduce the symptoms of the flu on the back end by about a ½ a day.  There are catches with Tamiflu.  The side effects can be bad – nausea, vomiting and diarrhea.  Add these side effects to the symptoms of the flu itself and you may wish you just had the flu for a little longer instead of suffering through the combined misery. Tamiflu is right for some people, however, who have chronic medical conditions and are likely to develop complications from the flu.  These patients include those with COPD, asthma, emphysema, cancer, heart disease, other chronic health conditions or those who are very old or very young.Please do not be disappointed if your doctor does not offer you a prescription for Tamiflu – instead rejoice.  No prescription means you are healthy enough to fight the illness on your own and the side effects are not worth the few benefits Tamiflu may deliver.

When should I come to the emergency department?
As always, come to the emergency department if you think you are having a medical emergency.  The American College of Emergency Physicians (ACEP) offers a list of warning signs that indicate a medical emergency.  These warning signs include:
 
•         Difficulty breathing, shortness of breath
•         Chest or upper abdominal pain or pressure
•         Fainting, sudden dizziness, weakness
•         Changes in vision
•         Confusion or changes in mental status
•         Any sudden or severe pain
•         Uncontrolled bleeding
•         Severe or persistent vomiting or diarrhea
•         Coughing or vomiting blood
•         Suicidal feelings
•         Difficulty speaking
•         Shortness of breath
•         Unusual abdominal pain

If you have a question about the flu you would a physician to answer, please either comment here or email us at info@wakemed.org.

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