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Feeling lousy? You’re in a long line

April 28, 2007

For some it starts with a sore throat. Others start coughing or get the sniffles.

No matter what the symptoms, many people are feeling effects of a string of infections and colds making their way around the area.

“It just came on last night,” said Brian Schuessler of Lafayette, who shopped for cold medicine Thursday to treat his head congestion. “Somebody at work probably got me sick.”

No specific virus or infection is hitting the masses, local health professionals said, but there has been a high incidence of upper respiratory infections, colds and mononucleosis.

Dr. Keith March, who works at Sigma Medical Group’s Med Express urgent care clinic, said even those who have a “garden-variety cold” may experience symptoms for 10 to 14 days.

He said the bugs going around highlight the need for people to wash their hands and take extra precautions to avoid passing germs.

March said the urgent care clinic is seeing high traffic, though it isn’t quite as busy as it was last month, when doctors there saw on average 60 patients a day.

“What we’ve seen very commonly is mononuecleosis that’s causing a lot of adults to be fatigued and is contributing to the upper respiratory infections — because it weakens the immune system,” March said.

“I don’t think this is influenza any longer. Most of these are viral and can last for weeks.”

Walgreens pharmacist Jim Rhoades said there’s been an increase in prescriptions in recent weeks, specifically for respiratory infections. He said the store has been selling a lot of Z-Paks, a fast-acting antibiotic used for several common infections.

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Janet Hession of Lafayette said her husband was recently sick for a week with a cold. Even though she’s usually pretty healthy, Hession was shopping for over-the-counter cold medicine at Walgreens Thursday.

“I got it from my husband,” she said.

March said it’s important for family members to avoid sharing glasses and use a dishwasher, if they have one, when someone in the house is ill.

He also urged parents to keep their children home from school if they are showing symptoms so they don’t infect other students.

Officials at Lafayette-area schools reached Thursday said they aren’t seeing high rates of absences right now. Similarly, Douglas Mansfield at Kirby Risk Service Center in Lafayette said he hasn’t had an abnormally large number of employees out sick.

For those working in offices with sick co-workers, March said it’s not inevitable that it will spread to everyone.

“Immune systems are all different,” he said. “There are those who are more resistant to infections — and those who work harder to avoid infections, too.”

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Urgent care clinics growing in Shreveport-Bossier City

April 26, 2007

If you’ve come into town to play at the casinos and come down with the flu, where do you go?

“I see a lot of people from out of town,” said registered nurse Shelia Jackson, who owns the Shreveport Family Medicine/Urgent Care and Kid-Med Clinic on Pines Road that is staffed with a physician, nurse practitioner and physician assistant. “We see just about everything — colds, breaks and strains — but we don’t see trauma.”

Urgent but not emergency.

Understanding the difference in the level of health care you need can save you a lot of time and expense, according to industry experts as urgent and mini-urgent care clinics continue to grow.

Wal-Mart Stores Inc. said Tuesday it will contract with local hospitals and other organizations to open as many as 400 in-store health clinics in the next two to three years.

Doctors’ Express Care is set to open in mid-May, the most recent addition to the local landscape of urgent care clinics that includes four that are hospital affiliated and three that are independently owned.

Accessible and affordable is the selling point for these clinics, which each offer a spectrum of services and prices.

“There were no urgent care centers on this side of town and the location makes it very accessible to downtown Shreveport,” said David Holly, president and CEO of Doctors’ Hospital on Louisiana Avenue. Doctors’ closed its emergency room in March. “The hours will be extended well beyond that of what the other urgent care clinics have.”

Doctors’ Express Care plans to be open from 6 a.m. to midnight daily and will be staffed by physicians, nurse practitioners and physician assistants.

Along with extended hours, urgent care clinics have much shorter waiting times and a much lower price than a trip to the emergency department, excluding the discussion on co-pays and negotiated insurance prices.

“Depending on the insurance plan our cost will be one-third to one-half that of the ER,” said Dr. Stephen Smith, director of Willis-Knighton Quick Care Urgent Care Centers.

The Agency for Healthcare Research and Quality estimates the average cost of an ER visit to be $560, with a mean of $299.

Small, independently owned urgent care clinics, which might not be staffed by a physician, cost less. For example, a patient with a sore throat who was given a strep throat test would be charged $48 at Total Care Medical Clinic, 2328 Line Ave., and $59 at Rapid Relief Xperts, 4822 Youree Drive.

For a sore throat, Christus Schumpert First Care Clinics, which are staffed with physicians, would charge between $47 to $175 for an established patient, depending on the number of diagnostic tests done, said Sally Croom, spokeswoman for the health system.

“A new patient would start at $82,” Croom said.

The cost difference is because ER patients are paying hospitals to be prepared, said Pat Keel, chief financial officer of Christus Schumpert Health System.

“Emergency rooms have to be prepared to deal with whatever occurs, even if it is infrequent, so there’s a need for much more equipment and more sophisticated and expensive equipment,” said Keel, adding that patients in an ER are also paying to have highly-qualified staff needed for those emergencies on duty.

Paring down the services and overhead even further, like manning the Rapid Relief Expert clinic with a nurse practitioner, helps lower the price even more. The quality of service is maintained by offering only services for the most common ailments, says Dr. Chris Earnhardt, the medical director of the clinic.

“The mainstay of our business is acute complaints and we let patients know up front what it will cost; that’s our niche,” said Earnhardt, who opened the clinic with several partners in mid-March and is happy with business so far. “We’re seeing about eight to 10 patients a day. We’ve seen what we expected to see, things like sore throats, colds, muscle strains and many people have come in to utilize the cheaper blood work.”

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Most urgent care clinics take cash, private insurance and some accept Medicaid/Medicare. Jackson warns this is sometimes misleading for Medicaid patients.

“A lot of times Medicaid patients who haven’t been referred by their primary family physician will be turned away from the hospital urgent care clinics because the clinics are afraid they might not get paid,” said Jackson, who expanded her services and became a Medicaid and Kid-Med CommunityCare provider for exactly that reason. “You have to be smart in this game or you can’t play. There’s a very large Medicaid population here, and I needed to add that to become a full-service business.”

Total Care Medical Clinic, which opened about a month ago, accepts cash only.

“I take no insurance, I have very little overhead, and those savings are passed on to the patient,” said Dr. Howard Lippton, owner and physician on staff from noon to 7 p.m. daily. “What you get is access to a physician with great hours and very discounted labs.”

Lippton will also treat chronic illness, such as diabetes or asthma, while most urgent care clinics do not.

“I do everything from treat to following a disease,” said Lippton, who is planning to extend his hours to midnight in the coming months.

For hospitals especially, the trend in urgent care clinics has been to alleviate the strain on overcrowded ERs, caused largely by noncritical patients.

According to the Centers for Disease Control and Preventions’ 2004 National Hospital Ambulatory Medical Care Survey, only 12.9 percent of 110 million emergency department visits were classified as emergencies. The other 87.1 percent of visits fell under the categories of urgent, semi-urgent, nonurgent, or unclassified.

“It definitely has helped,” said Smith, whose clinics have been open seven days a week, 8 a.m. to 8 p.m., since 2000. “Since we are tied to the W-K system we don’t do screening tests and don’t do follow-up visits. We also have a health match that helps them find a doctor.”

Being tied to a hospital is one benefit both Quick Care and First Care tout.

“We always have a physician on duty, and we’re always close to the ER,” Smith said.

Everyone agrees the concept for urgent care clinics is a good one but say a large segment of this population is still unaware of urgent care centers and what they offer.

Jackson opened in 2005 with hours from 8 am. to 8 p.m. weekdays and 10 a.m. to 6 p.m. on the weekends. Six months after she opened she scaled back to 8:30 a.m. to 5 p.m. weekdays, and an occasional weekend.

“There just wasn’t that much need for it at that time,” said Jackson, who stays plenty busy during the day seeing up to 50 patients in the clinic on some days. “These other places are going to find that out too.”

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Which cold & flu remedies work?

April 22, 2007

Winter brings with it a few things that are hard to avoid – the cold, the desire to sleep late and inevitably a spate of colds and flu. Everyone seems to have their own little remedy or ritual for dealing with either a cold or flu — ranging from overdosing on Vitamin C to putting drops of dilute hydrogen peroxide in the ear.

While some of these remedies work, others clearly don’t and could even be detrimental to your health. Perhaps the best place to start debunking the myths about cold and flu remedies is to distinguish between a cold and the flu. A head cold in a fluey body More often than not, the two are lumped together and used interchangeably. While both are viruses, they manifest differently. A cold usually involves a runny nose and sore throat and sometimes a cough. Colds are generally not accompanied by headaches or fevers. Flu, which usually comes on quite quickly, is often characterized by a fever, headaches, sensitivity to light, body or joint aches and extreme tiredness. A runny nose and sore throat are less common, but you can get quite a severe cough. Colds tend to last a week and are generally not very serious. Flu can last between two and three weeks and can lead to more serious infections such as pneumonia. Is there a cure? Until quite recently, there was no medication which actually treated flu and medicines that you can buy over the counter such as Corenza C or Med Lemon, only treat the symptoms and not the cause of the virus. While this can definitely make you feel better, you are not actually being cured. However, there is a new antiviral medication, Tamiflu (oseltamivir) which gets rid of the actual virus, says general practitioner Dr Rosamund Carey. This medicine can be used if you feel flu coming on or if you are already suffering from the symptoms of flu. Unfortunately it doesn’t cure colds. Does the cold really give you a cold? Cold mythology and grannies all over tend to argue that you get a cold from being cold However, this is often regarded as nonsense and the real cause is attributed germs festering in stuffy buildings. Dr Carey says that both are actually true. While you get colds and flu from germs (and not the cold), your body is more susceptible to the viruses if you are cold. The reason for this is that your immune system takes a bit of a knock. So how can you make sure that your immune system is at its best? Clinical Nutritionist, Sally-Ann Creed, suggests that there are a number of ways of maintaining optimal immunity. There are many non-dietary factors that can impair immunity such as stress, lack of sleep, not enough exercise and infrequent exposure to sunlight. On the dietary front, you can boost your immunity by taking a daily dose of Vitamin C (around 2 grams), antioxidants and an essential fatty acid from fish oil. Oh, and stay away from junk food. “Eating healthily by avoiding junk food, refined grains and sugary food is also really important. These deplete nutrient stores in the body and are ‘nutrient robbers’, leaving you open to bugs,” she says, suggesting instead that you eat green leafy vegetables, fruit, nuts and seeds - high in antioxidants, chlorophyll and other “disease-fighters”.

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Fight flu with food Eating the right food can help prevent a cold, but does it actually help when you’re curled up in bed with a runny nose and sore throat? Dr Carey suggests taking Vitamin C to boost your immunity and drinking lots of fluids to thin the mucus. “When you get sick, your appetite decreases,” she says “just listen to your body and you’ll know how much you should be eating.” Sally-Ann Creed agrees that you should eat less and advises a diet high in raw vegetables, fish and chicken soup. In terms of supplements she suggests Olive Leaf and Vitamin C – both in high doses for several days. “These nutrients work wonders, and very often a cold or flu will either be less severe, or averted by the following day.” Rest is best Ah, now this myth is actually true. Dr Carey confirms that getting into bed really is the fastest way to get rid of a cold. While it’s important to exercise to keep your immunity up while you’re healthy, exercise is a big no-no when you have a cold or flu. Even if you only have a mild cold, you still run the risk of damaging your heart. An alternative approach Not all medical traditions approach colds in the same way. Dr Phil Burnham, acupuncturist and doctor of Chinese medicine, explains that in Chinese medicine you get both hot and cold colds. If you have a cold cold, you’ll feel cold, experience chills and have white mucus. If you have a hot cold, you’ll have a fever, a sore throat and yellow mucus. As these are two distinct ailments, the treatments will be different. The approach to treatment is more personalized and the doctor will prescribe different herbs depending on how the patient is dealing with the symptoms. Acupuncture is also used to either clear heat or warm the patient up. Dr Geraldine Mitton, medical director of the Sante Wellness Centre, advises that if you would prefer to go the homeopathic route, you should take ‘Anis barb’ for prevention of colds and flu or for acute symptoms. If you are suffering from a sore throat you can suck zinc lozenges and Infludo drops are great for both colds and flu. To boost your immune system, she suggests taking “Echinacea and of course Vitamin C - take 500 mg 4 times a day to start, then daily”. Folk lore There are a number of popular remedies for treating the symptoms of colds and flu. My favourite is a cup of hot water with lemon, honey and a Disprin – some people prefer a shot of whisky to the Disprin. Ginger tea (basically chunks of ginger in hot water) has also been found to be effective as has gargling with salt water for a sore throat and sucking lozenges for a cough. Cayenne pepper and garlic and onion also feature in many folk remedies. However there are also some more controversial remedies such as putting a couple of drops of dilute hydrogen peroxide in each ear. Many people are convinced that this remedy works and do it religiously. Dr Carey is skeptical however, stating that there is no scientific reason why it should work and suggesting that you are more likely to damage your eardrum. So, while some remedies work, others should be taken with a pinch of salt. Focus on boosting your immunity, get lots of rest and treat your symptoms with ingredients that you wouldn’t mind putting in your dinner. If your symptoms persist for more than a week or if you have a very high temperature or green/yellow phlegm, go and see a doctor!

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Cats and compassion

April 18, 2007

Sammy Sosa is on the sick list. My Sammy Sosa, that is. He’s a portly12-year-old cat of black and white Holstein hue.

I can tell he’s ill because he no longer play-wrestles with his bro Wayne Gretzky who is younger and blonder. Nor does he eat much and he’s sleeping 24-7.

When he stops eating at all, I call the vet and a taxi. On the way to the vet, Sammy cries piteously and the cab driver talks about the weather and the Stanley Cup.

All of a sudden, his voice changes. “Look at that,” he almost shouts.

“That” is a man, more like a boy, asleep on the sidewalk this cold morning under several grungy sleeping bags.

“He’s homeless,” I say mildly, hoping to get the driver back to hockey. “They wouldn’t know how to live any other way,” he snorts.

“Where are the police?” the driver demands as though I ought to instantly produce at least two of them.

Intrigued, I ask him what the police should do. “Take him away,” he says firmly. “What good are all our tax dollars going to security when this sort of thing goes on.”

I consider pointing out that “this sort of thing” is a young man suffering perhaps with schizophrenia or perhaps a druggie and definitely sound asleep. Hardly a security risk. I content myself with asking: “Away where?”

“Out of the city. All of them,” says the driver in a tone of voice that suggests I’m the stupidest passenger he’s transported this week.

“They’d just come back,” I say. And before I can stop myself, I add: “What they really need is housing.”

The driver twitches so violently I worry we’re going to plow into an oncoming truck. Sammy starts crying again.

“They wouldn’t know what to do with housing.” The driver has lowered his voice to “I-am-talking-to-a demented-fool” level.

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“They wouldn’t stay in their room if you gave them one. They wouldn’t know what to do if you gave them $100,000. They like it on the streets. They choose to live on the streets.”

I say nothing, Sammy whimpers and the driver, perhaps bored with this idiot in his backseat, shuts up.

Mercifully, we have arrived. The vet first weighs my tubby cat and politely does not comment on his 6.7 kilos. Then he squeezes, pokes and prods Sammy who, being the good-natured fellow that he is, does not try to bite him.

“The good news,” says the vet, “is that he’s in perfect health … from the neck down. He’s got gingivitis. Gum disease. He can’t eat.”

He gently pries open Sammy’s mouth again and shows me red, sore gums.

He gives the uncomplaining Sammy three shots, gives me some antibiotics to be mixed in with his food, warns me Sammy’s teeth will soon need $300 worth of cleaning, along with about $200 for blood work.

He’s an experienced, caring vet who obviously likes cats. “Bye, Sammy,” he says.

Almost $130 later, we’re out the door.

It’s still cold but I hardly feel it because I’m so relieved that my Sammy does not have diabetes or cancer or something else dreadful. Two little boys, mother in tow, stop to peer into the carrier and have a conversation with Sammy.

Out of the corner of my eye, I see a bundle a few yards away. It is indeed another young man asleep on the sidewalk, his head barely peeking out from under blankets that look too thin to protect him from the morning chill.

Leaving Sammy momentarily in the care of the two little boys, I walk over to the sleeping man. Glancing around carefully to make sure my former cab driver is nowhere in sight, I slip a $5 bill under the blanket.

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Maggie Moo’s Ice Cream opens on Cason Lane

April 15, 2007

Finally, Maggie Moo’s Ice Cream and Treatery has opened its doors on Cason Lane.

Have you been there yet?

Co-owner Heath Smith said everyone should come and taste the shop’s premium ice cream because it is the best in town.

“It is a fact,” she assures. “Everyone says that I am sure, but we do.”

Maggie Moo’s ice cream has won eight consecutive blue ribbons from the National Ice Cream Retailers Association.

No grand opening event has been scheduled yet at the 505 Cason Lane location just past the Wynnsong 16 movie theater.

Maggie Moo’s does catering, parties and helps with fundraisers.

Shop hours are Monday-Thursday 11 a.m.-10 p.m., Friday-Saturday 11 a.m.-11 p.m. and Sunday noon-10 p.m.

Portrait Innovations, a cutting-edge photo studio, is planning to open at The Avenue, the massive lifestyle mall under construction on Medical Center Parkway.

The Charlotte, N.C.-based studio has submitted plans to the Murfreesboro Building and Codes Department for interior build out of its retail space.

According to the Portrait Innovations’ Web site, the studio is the industry pioneer in integrating traditional portrait photography with the latest digital camera technology.

Portrait Innovations is rapidly opening new locations in lifestyle shopping malls across the country.
No formal plans have been submitted but a city official said Select Comfort also plans to open a retail store at The Avenue.

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The mattress company is known for its Sleep Number bed that allows couples to set how hard or soft they want their side of the mattress.

For those of you who haven’t heard of this yet, I wanted to let you know about a cool new feature at MapQuest.com.

It is now possible to check gas prices at more than 100,000 stations across the country from the site. Supposedly, the site is updated several times a day.

The Web site looks pretty accurate when casually scoping out prices for Murfreesboro gas stations, but the site could be pretty valuable when planning a summer road trip especially if you have the capability to check the site on the road.

On the same site, users can map out the best route for the trip and the best gas stations to fuel up at along the way.

Users also can find what stations sell alternative fuel like diesel, biodiesel, compressed natural gas, E-85, electric, hydrogen, propane and liquefied natural gas. Other gas-saving tips and data on alterative fuel are accessible.

Oh, and for your information, the W.T.’s Market at 925 Old Fort Parkway had the cheapest unleaded gas at $2.21 when I checked the MapQuest site the morning of April 12.

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Shoulder sore, but Wright also is encouraged

April 12, 2007

An examination yesterday by Orioles team orthopedist Dr. Andrew Cosgarea revealed no structural damage or acute pain in Jaret Wright’s right shoulder, and the veteran pitcher remains tentatively scheduled to start Sunday’s game against the Kansas City Royals.

“As far as the strength in the [rotator] cuff, I thought it was better than expected,” Wright said. “We’re just going to try to treat it and go from there.”

Wright left Tuesday’s game in the sixth inning with tightness in his shoulder. He said the pain is similar to what he felt in 2005 when he missed more than half the season with a strain. Wright has had two surgeries on the shoulder and gone on the disabled list four times since 2000.

“There’s a lot of pain, but today, after the treatment and stuff, it feels a lot better than when I got here this morning, so that’s encouraging,” he said.

Hayden Penn figured to be the Orioles’ first choice to replace Wright if the veteran went on the disabled list, but Penn was scratched from Tuesday’s start at Triple-A Norfolk because of soreness in his right forearm area. He’s scheduled to pitch tomorrow if the discomfort subsides, but David Stockstill, director of minor league operations, said those plans could change because of the cold weather.

Jim Duquette, vice president of baseball operations, said Penn is “probably not an option at this point” for the Orioles.

Opportunities keep slipping away from Penn, who allowed two runs and struck out six in five innings during last Thursday’s start for Norfolk. Last season, he underwent an emergency appendectomy May 23 after being recalled from the minors to start in Seattle, and this year a sprained ankle in spring training hurt his chances of making the team.

The Orioles could turn to Jeremy Guthrie, who has allowed two runs in 5 2/3 innings - both appearances coming in relief of Wright - or Norfolk left-hander Garrett Olson.

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“We’ve just hashed a few things around,” manager Sam Perlozzo said. “We haven’t come up with anything yet. We’ve got a couple plans.”

In the statistical packet that’s distributed in the press box before every game, three Orioles pitchers were listed as having no appearances before last night.

Kris Benson and Sendy Rleal are on the disabled list. Kurt Birkins was in the bullpen, waiting for a call. He finally got it in the 12th inning, the eighth Orioles pitcher of the night.

Birkins had warmed up the past two nights without pitching. His last appearance came at the minor league camp on March 30.

“I’m fresh,” he said before the game. “I feel good. I feel ready.”

Birkins was supposed to be starting for Norfolk, but the Orioles recalled him after placing catcher Ramon Hernandez on the disabled list. He originally was scheduled to start Sunday’s game for the Tides.

“I was surprised when I got the call from the Orioles, but I wasn’t going to question it,” said Birkins, who went 5-2 with a 4.94 ERA in 35 games with them last season. “I felt like I had a good year and I was hoping I’d still get an opportunity. I just didn’t think it would come three games into the year. But three games, three months, I don’t care. I’ll take it.”

After five Minnesota Twins stole bases against him in the second game, backup catcher Alberto Castillo threw out two Detroit Tigers and picked off Carlos Guillen at first base during Tuesday’s loss.

“They held the runners real well, I was quick from the plate to second base, and I got a chance to get them out,” he said.

Four of the Twins steals came with Daniel Cabrera on the mound. Wright has a quicker delivery.

“Daniel’s so big, it doesn’t matter if he goes with a slide step or not. They read his movements,” Castillo said.

Norfolk starter Rob Bell, who made a strong impression on the Orioles in spring training, was sent to the minor league camp in Sarasota, Fla., because of an infected middle finger on his pitching hand. … The first 20,000 fans at tomorrow night’s game against Kansas City will receive an Orioles knit beanie cap.

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Cold Sore Prevention And Protection

April 7, 2007

Most people contract the cold sore virus, caused by the herpes simplex one virus, when they are young and it is spread in saliva or mucus that comes from the nose and mouth.

If you already have cold sores, you can protect others by following these simple precautions:

– Change your toothbrush and towels regularly, and don’t let anyone else use them. By the same token, do not use those belonging to other people either.

– Don’t share eating utensils or cups and glasses.

– Avoid kissing anyone - particularly babies and small children who are so vulnerable.

– Wash your hands frequently and take care to avoid rubbing your eyes or having contact with the genital area in order to stop the virus spreading.

The life cycle of a cold sore takes about ten days but the good news is that if you feel a cold sore coming, it is possible to treat the cold sore immediately thereby preventing it from taking a hold. However, if a cold sore does make an appearance before treatment can be commenced, the following tips can help in making the cold sore better:

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– Use a natural healing formula made from essential oils as soon as possible as such a product has been found to be very helpful.

– Take a non prescriptive pain killer.

– Resist the temptation to lick or touch the area, while keeping it as dry and clean as possible. An alcohol solution can help.

– Wrap some ice in a damp, clean cloth and apply this to the cold sore every 5 to 10 minutes.

– Try a moistened tea bag pressed on the cold sore every few minutes - the tannic acid in the tea has anti-viral properties.

– Powdered common salt and spirit of camphor may also be helpful in shortening the appearance of the cold sores.

– Avoid eating acidic food - for example lemons, grapefruit.

– Make sure to protect the area from the sun and wind.

In the long run, however, strengthening the immune system while adopting a healthy lifestyle with good eating habits and avoiding too much stress can only help to reduce recurrences. It is also wise not to expose the face to too much sun.

The companion natural healing product made from essential oils has also been found to be very helpful when applied on a daily basis. This assists in controlling recurring outbreaks by strengthening the immune system and helping cleanse the system of viral disease.

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Cold sore virus is not usually acquired by sexual contact

April 5, 2007

DEAR DR. DONOHUE: In a recent column, you stated that cold sores are the result of oral sex. How soon does a cold sore appear after you’re infected? How long does the sore stay? What is the remedy?

— Anonymous

Let’s go over the herpes virus story to straighten the picture.

Herpes simplex virus type 1 (HSV-1) causes most cold sores. Herpes simplex virus type 2 (HSV-2) causes most genital herpes infections.

HSV-1 — the cold sore virus — is usually acquired in childhood and not through sexual contact. Its incubation period, the time from the virus landing on the lips to the time of the sore’s appearance, is between two and 12 days. It begins as a red patch with small blisters on it. Eventually the blisters break to form a sore that lasts 10 days to two weeks. Not all infections cause an outbreak of a cold sore. Quite a few people have no symptoms from the infection, but they, like the ones who do have an outbreak, remain infected for life. The virus travels up a nerve to its home and stays there from that point on. From time to time, in some but not all, the virus springs into action and travels down the nerve to generate a new cold sore. Most adults have antibodies in their blood — proof of prior infection.

In a very limited number of instances, herpes simplex virus 2 — the cause of genital infections — can be transferred to the lips through oral sex. The result is a cold sore that has the same appearance as the cold sore of HSV-1.

Remedies for both herpes infections include acyclovir, which is available as a tablet or an ointment. Famvir and Valtrex, both oral medicines, are two other herpes fighters.

Readers have a great devotion to lysine as treatment for cold sores, not genital infections. It’s an amino acid and can be found on the shelves of all drugstores. I can’t testify to its effectiveness, but I can testify to people’s praise of it. It can’t hurt.

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DEAR DR. DONOHUE: I recently woke with an ankle that felt irritated. I worked that day. By the end of the working day, I needed help in finishing my job. My ankle and foot had swollen very badly. That night I woke with a soaking sweat, and my foot and ankle were killing me. They were twice the size of the other foot and were red and throbbing. I drove myself to the ER, and they put me on an IV antibiotic. I was somewhat better by the morning. They said I had cellulitis. What is it?

— M.D.

Cellulitis is an infection of skin cells and the tissues directly beneath the skin. It usually happens on the legs, and most often it’s caused by the Staph or Strep bacterium.

The bacteria enter the skin through a cut, a puncture wound or a boil. The break in the skin can be so small that a person isn’t aware of it. Once the infection gets a start, it spreads rapidly, turning the skin red, causing the leg to swell and producing severe pain. Infected people often experience fever and chills.

Antibiotics have to be given quickly to stop the infection’s advance. Left alone, it can get into the blood, with grave consequences.

DEAR DR. DONOHUE: I am 82 and active. I read that there is an inoculation to prevent shingles. Is this true?

— H.S.

DEAR DR. DONOHUE: I am 74. I had chickenpox at 20. Should I get the shingles shot?

— B.B.

Everyone 60 and older should get the shingles vaccine Zostavax. It works.

The vaccine has to be kept at low temperatures, and some doctors’ offices don’t have the resources to store it at those temperatures. The family doctor can, however, tell you where it’s available in your area.

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