 Welcome back, dear viewers. This is the time that we're going to be talking more about medical infections and things that really affect the lungs. So if you missed the last programme, please do watch it again. It explains the anatomy physiology of the lungs. So we're going to go in this session about talking about really things that most of us will face winter time and things like flu, pneumonia, colds. We are very blessed to have with us. Join with us Dr. Seyf Motherney. Welcome. Thank you so much for joining us. Thank you for inviting me here. It's a pleasure to have you. Just to echo the words of Zara as well, make sure that you do watch the last episode with Seyddi Asr because it gives you the foundation of what we're going to speak about for the rest of the episode. So, as she mentioned. Have you had flu this year? Coincident? No, coincident. We're going to be talking about Iraq in this episode because we talked about this before we went on air. I came back from Iraq just not long ago. I had this really, really bad flu. I'm not sure if it was directly from Iraq. I probably think it was. I came in for about two, three weeks. I still had the symptoms. I didn't want to take anything to do with the doctors because I know it's just one of those things. However, you kind of get worried after a while because if it's two, three weeks, your voice is still not good and you still have, for example, runny nose. You feel like maybe it's something that you need to get checked out. So, to give Ali his consultation now, we will refer to the expert for your man flu. Is there such a thing as man flu? Any of you know, general flu. We're talking about things that are kind of the everyday common illnesses that affect the lung. All the lungs because there's two of them. We found that out from the past episode. But yeah, tell us first. I think it was the cold, the common cold, the flu. What can we really do to... What causes them and I guess what can we do to help treat them and to avoid sort of, like I said in my intro, that you know, A and E, GPs, these are all places where people turn up. So what is it that we are doing the right thing as patients? So the common cold, let's just distinguish between common cold and flu. Flu is just short for influenza. They're both viruses. The flu is called by the influenza virus. There's different types A, B, and within them there's different strains. And then the common cold are due to more benign viruses, if you like. Less serious than influenza such as adenovirus, rhinovirus, coronavirus. There's a long list of viruses. So the common cold often just causes symptoms such as runny nose and sore throat and just feeling a bit groggy, maybe a bit of laryngitis, pharyngitis, which is inflammation of the throat. And it can then lead on to air infections as well, in science infections. Very rarely can it lead to a viral meningitis, which is not the serious type of meningitis. But it's mainly up here. It's air, nose, throat, if you like. Influenza actually can make you generally unwell. Again, runny nose, sore throat, cough. You can have a cough with common cold as well. Flem, which would generally feel run down. Which one is the one that gives you a bit of a fever? So they can both give you a fever, but more so with influenza. And influenza can just make you feel listless, very tired. And one of the things that often distinguishes between the two is, with the flu you just feel like you can't get out of bed or you can't go to work. With the cold you can probably just crack on and go to work, etc. The flu can also cause other symptoms outside of the air, nose and throat. It can cause diarrhea, vomiting. And it can cause headaches as well. And your immune system is going to be quite busy. Try to find that cold. And therefore people that are at risk, which we'll talk about shortly, if they get the flu they may get superimposed bacterial infections on top. So they are at risk of getting a pneumonia in the lungs on top of the flu. They may have even pre-existing lung conditions, which already put them at risk of pneumonia along the influenza. So there's a double hit, if you like. So it's normally a self-limiting illness. And the virus dies on its own. There's no treatment that will kill the virus. There are some treatments that in some situations we can give, such as Tami Flu, for example, in the case of influenza, not the other viruses, which will reduce the duration of the illness, but will not kill the virus as such. And actually those antivirals, if they're not started within about 48 hours, there's no point taking them if you present later than that to A&E or to your GP. So there's some simple things that can be done for both the flu and the common cold. And probably worthwhile doing those rather than trying to pitch up, you know, in A&E or actually waiting to see your GP. Because there's more important things that the GP will be seeing than the common cold. The flu, people can be sick with it, so if you do have certain red flag symptoms and you're very unwell with it, even if you're healthy and you don't have those red flags, you should probably go and see someone because you could develop a complication of the flu. But if you don't have those red flags and you just have a common cold, then simple things like bed rest. Keeping well hydrated. One of the things that you can... Fresh orange juice. Fresh orange juice, absolutely, definitely. Literally that's what I do. I squeeze the oranges myself and make fresh juice because that contains a lot of vitamin C which is very useful for the immune system. There are other things like onions actually. In our culture, we use a lot of onions and garlic. They are very good antiseptics. In fact, it's a bit gross, but some people actually cut an onion in half. Leave it in the room? Leave it in the room because it sucks all the germs from around the room. You're coughing up all these bugs. Keeping the room well ventilated, so opening the window for all those germs to leave. Just getting a cup, hot water, lemon, ginger and honey. Very good for the pharyngitis and the laryngitis sore throat. Really soothes that. Just simple remedies from over the counter. A lot of which I don't believe in personally. Losanges are good for the sore throat. Again, they last for a bit and then you have to take another one. But all these things are self-help things. They're just symptomatic things. None of them kill the cold. There's again cough syrups that you can buy, et cetera. I don't believe strongly in them, but you can use them. That's probably no harm. Ibuprofen probably has more evidence scientifically than all of these other remedies. Ibuprofen, as long as you don't have asthma or stomach ulcers or heart failure or kidney failure, Ibuprofen is safe to take just for a couple of days. Not on an empty stomach after you've eaten. That's quite good for sore throat. Paracetamol is good for general aches and pains. Both are good for fever. So there's a lot that you can do without needing to actually go and see your GP about these things. And people should be doing that. Unfortunately, we block up our GP waiting rooms and our A&E's and urgent care centres and walk-in centres with things that don't need to be there. A lot of that includes the common cold. So I guess what you're saying is try to do the sort of treat at home as much as you can. If you develop certain red flag symptoms then obviously consult the doctors. So say I start getting symptoms of flu or a cold and then what's the time period for your contagious and sort of how to avoid spreading your germs so that others aren't going to be... That's a very good question actually. I was going to touch on that. Thank you for asking that question. So it's very basic, just simple hygiene. Anytime you cough, anytime you sneeze cough or sneeze into a tissue discard that tissue straight away. Don't put it back and reuse it and put it somewhere. Wash your hands. Cos those viruses are not just spread by coughing and sneezing, they're spread by contact. Contact as well. Avoid shaking hands or touching people or embracing people or hugging people. Avoid close contacts. Just for those 48 hours, 72 hours whilst you're contagious and once your symptoms start to get better then you'll probably no longer contagious. It's probably worthwhile avoiding contact with people that are high risk of having complications of the flu should they get the flu. Those people are pregnant women. If you have a cold or the flu yes, the cold is not as serious as the flu but you may not know the flu may start as symptoms of the cold and some people find it difficult. So it's easier to just stay away from people that are high risk people above the age of 65 people that have long term medical conditions heart disease, lung disease, kidney liver disease diabetes, all of those things to an extent can make your body weaker because they affect those major organs. But also they can suppress the immune system relatively speaking. Anyone who is a transplant recipient anyone that has received an organ whether it's liver, kidney lung, heart should by default be on anti-rejection tablets which prevent the body from fighting that foreign organ. Those anti-rejection tablets suppress the immune system so they are more prone to infections. So avoid contact with the organ so avoid contact with those people. Babies and infants as well avoid contact with them because they are prone as well. Those are the major categories of people that are at risk. Avoid contact with them. Do that basic hand hygiene. If you have diarrhea and vomiting as well probably avoid using that same toilet as the person. So use one toilet in the household if you have more than one and let the rest of the family use another toilet if you can. Don't use the same towel whether you have cold and cold or diarrhea and vomiting whichever. Don't use the same towel or separate towel for the duration of the illness. So cold influenza, these are the kind of the symptoms. Is there something worse than that that we need to consider? I think there was one. Influenza in itself as we said can preters pose people to develop pneumonia. Those are at risk and I've just mentioned those categories that are at risk. And those even that are healthy. So sadly we do see people die from influenza. Not uncomplicated influenza. Those that have developed complications. So influenza can lead into pneumonia whether it's a pure viral pneumonia. The virus has caused pneumonia in the lungs or has led to a bacterial or predisposed someone to have a bacterial pneumonia either way. I mean it's slightly academic, it's difficult to distinguish. You treat for both anyway to cover the virus and the pneumonia. But that can develop into other complications such as respiratory failure. Just before we go into pneumonia what are the symptoms? So breathlessness, cough, phlegm. Cough and phlegm without breathlessness can just be the cold or the flu. So don't get too alarmed just because you have a cold and phlegm, you're not going to die. But if you start developing breathlessness you shouldn't generally develop breathlessness with a cold or just a flu that has not affected the lungs. Once you start getting breathless you start worrying that something is happening in your lungs such as a pneumonia. Chest pain. Chest pain is not a common symptom of pneumonia. So by pneumonia we should probably take a step back and define it very simply. It's just infection in the lung tissue and the air sacs getting filled with fluid and pus and what have you. Do you feel anything that your lungs feel? I don't normally feel anything but as I was just about to say if the infection is touching the pleura if you guys and also our viewers remember from the previous episode we talked about anatomy the pleura is a thin lining around the lung if the infection is close to the pleura it's touching the pleura it can cause a sharp pain each time you breathe in. But other than that it doesn't normally cause pain you don't feel the gunk and the secretions in your alveoli. If it's a bit more proximal the secretions are on your tubes and your airways so you cough up phlegm often you feel your chest rattling you feel a bit wet. So that's another symptom of phlegm in the chest rather than phlegm up here. So those are the symptoms and then if you have a fever which is not settling if you're shivering a lot if you're sweating a lot these are other symptoms. Again not every fever means you have pneumonia probably most people that are fever just have the flu or the common cold but if certainly if it's not settling and it's a very high fever or above degrees Celsius and definitely if you have underlying medical conditions if you have a fever you should probably see a doctor. Do you think that people roll up into A&E and see their GPs because they're concerned that they don't know how to handle the flu that they generally feel unwell or do you think they worry about that it's something that's more serious than actually what it is and what they can do at home but do you think there is a concern that people think they're worse than they actually are? Only because I work in re-monitored A&E intendances it's quite fascinating to see the numbers that roll up in the winter time so what is the cause do you think? So that's a very interesting question it's the answer to that question is quite long and I'm certainly no expert in this but I think a lot of it is if a person is very stoic and blasé I've just got the cold, I'll stay at home like men often do when they have the flu they stay at home they're sensible and they stay at home rather than pitch up, I'm joking but there's people that have a high degree of anxiety associated with either the flu or cold or health in general or life in general not blaming them symptoms of breathlessness are unpleasant symptoms if people can't breathe or have a chest pain they might feel that they're going to die so those symptoms even in a healthy person they should seek because something could be going on but I think there are many inappropriate attendances to A&E whether it's colds or flu or other things other minor injuries that can be easily sorted out at home so there are inappropriate attendances and on the converse there are people that don't present when they should present and present when it's too late or they're very sick the other red flags to mention as well pneumonia is an infection and any infection whether in the lungs or outside the lungs can cause sepsis sepsis can be life threatening people die from sepsis one of the major killers worldwide is the body's response to infections and sometimes that response actually is damaging to the rest of the organs the immune system becomes very active and there's a lot of release of inflammatory mediators in the body and in fact they start to in some way or another attack the body so the kidneys start to shut down the heart starts to shut down the liver, the brain etc so sepsis needs to be tackled urgently with antibiotics and supportive treatment and one of the signs to look at is when the hands go cold that's quite a late sign actually when the skin becomes mottled when the person becomes confused that means there's less oxygen or less blood going to the brain when the urine output reduces so they're producing less urine or the urine becomes very dark which is that they dehydrated those are very serious sometimes they probably need to get themselves to any straight away so those are things to be aware of your adventures in Iraq and what you've seen there but in shalom we will have time as for now, once again a very informed session for the viewers and don't forget if you do have a cold or a flu, stay at home it's probably the best thing for you and don't forget the onions as well but obviously there's more things to consider it might work, we have to try but yeah, thank you so much for your time thank you so much we look forward to the next session so hopefully do stay tuned and as we were saying listen, we listen to the first show that we went through the background of the lungs and the function after a break we're going to be joined by Saed Aynawab for more jurisprudential issues stay tuned, we'll see you then