SCI, Flu, and the Coronavirus

We all have been hearing a lot about the coronavirus. It is quite powerful. There is currently no vaccine. The good news is that the danger of this virus was brought to the attention of the world quickly which enabled attempts to keep it contained. Still it is extremely slowly spreading across the globe.

Could you get this specific virus? Any one can but it is important to remember that it is not yet prevalent in many parts of the world. Your chances of running into someone who is contagious is unlikely at this point in time. However, it can spread before the person who carries it knows that they have it, in other words, before they have symptoms.

The coronavirus is primarily spread through coughing and sneezing or by coming in contact with a carrier’s saliva, tears or vomit. You can pick it up by being close to an infected person and breathing their moisture from their respiration. Also, the virus can live for short times on surfaces. Something touched by a carrier and then you touch and wipe your hand on your mouth, nose or eyes.

COVID-19 Virus 3D model

The virus has the capability to spread quickly so we all must be wise to wash our hands thoroughly. For more updated information about the coronavirus, you can log onto the World Health Organization (WHO) and Center for Disease Control (CDC) websites. They are experts in epidemic (spread in a large area like a city or state) and pandemic (spread across countries) control. From their expertise, they have developed protocols for keeping you safe as well as leading the efforts to control and treat such illnesses.

There are many types of viruses like the flu that do travel around the country. The main types of flu currently spreading in the US are type A and type B. There are so many cases of flu in some areas that schools are closed, and workplaces are affected.

Flu can be especially hard for individuals with spinal cord injury and other types of neurological disease. Lung capacity and volume can be affected by the flu making it more difficult to exchange oxygen in your body. Getting a good deep breath by pulling air into your lungs can be hampered by muscles not working as strongly as necessary. To breathe in, three sets of muscles are used. The diaphragm is located under the lungs and pulls down to draw in air. The intercostal muscles are between each rib and expand the ribs around the entire outside of the lungs. The abdominals also engage to help draw air into the lungs. Each set of muscles supplies intake for the lungs. To push air out, the sets of muscles relax. Air is then expelled.

Along with taking air into the body, the airway needs to be clear. Coughing helps achieve this goal. A cough should cause air, mucous and any collected fluid to be forcefully expelled from the lungs and throat. Not doing so blocks oxygen from entering the body. Lingering fluid and mucous can allow bacteria to settle in and multiply.

The flu can affect the body through fever which is a method of the body attempting to heal itself by making the internal environment of the body too warm for bacteria to survive. The flu can alter body temperature. Temperature control can be an issue for some individuals with spinal cord injury so additional fever and chills can be harder and more difficult to control with neurological affected issues.

How do you know if you have the flu? People who have the flu typically know it right away simply because it makes you feel so awful. Once you have had the flu, you quickly recognize it again. There are laboratory tests that can be done to confirm the diagnosis. Most people will become diagnosed by presence of some or all these symptoms.

  • Fever over 100.4 F (38 C)
  • Aching muscles
  • Chills and sweats
  • Headache
  • Dry, persistent cough
  • Fatigue and weakness
  • Nasal congestion
  • Sore throat

Flu can affect your body quickly. If you think you have the flu, contact your healthcare professional to see if you are eligible for one of the antiviral medications that are now available to combat the symptoms of flu. These need to be taken within hours to reduce flu symptoms and decrease the amount of time that you have the flu. Always check before taking a new medication to ensure that it will not interact with your current medications, even if it is an over the counter drug. Drug interactions can be very powerful and harmful.

There are some things you can do to help yourself if you get the flu. Monitor your temperature to make sure it does not get too high. If you do develop a fever after spinal cord injury, your body might not be able to control it. A cooling bath or cool cloths placed on your forehead, underarms and groin can help reduce a fever. If your fever is over 102°F and not resolving, you will want to call your healthcare professional or 911. Tylenol can help reduce fever if you are able to take it.

Check for symptoms of autonomic dysreflexia (AD) especially if you have a spinal cord injury at the cervical and thoracic levels, even if you have never had AD symptoms before. If you have a new onset of AD, immediate treatment is required. You will need to call for emergency care (911) if you do not have an established treatment plan. If you have had episodes of AD, follow your individual instructions for AD. More information about AD is available using the autonomic dysreflexia wallet card.

Maintain fluid intake to avoid dehydration if not affected by vomiting. Keep your airway clear. Cough and deep breathe to clear your airway or use your airway equipment. If you are vomiting, drink clear fluids as soon as you are able. Electrolyte replacement fluids such as Gatorade or Pedialyte can help replenish your hydration.

Diarrhea can be an issue with the flu. If diarrhea is long lasting, you could become dehydrated from the quick loss of fluid. Drinking the electrolyte replacement fluid can help. Avoid sugary drinks because that will stimulate more diarrhea. Eat yogurt to resupply the good bacteria in your bowel. When diarrhea has resolved, resume your bowel program. You may get little results, but you want to keep the bowel moving to avoid impaction of stool.

To prevent the flu, wash your hands often. Insist your caretaker wash their hands. You might pick up flu germs by touching anything including things in your own environment such as wheel rims, door knobs and in your own bathroom. Be aware of what you are touching and who else may have touched something outside of your home. These things can include doors, menus, shopping carts, the list is endless. Carry hand sanitizer with you for ready access for hand cleaning.

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It is never too late to get a flu shot. February is consistently a month where a ‘second wave’ of flu passes through the country. People become complacent thinking winter is almost over, but February is a big flu month and winter will continue for weeks. People can get the flu any time of year, including in the summer so flu is always possible. The flu vaccine in developed each year for the predicted strains that scientist think will be the strongest in the upcoming year. People will still get the flu because many people will not get inoculated. Even if you have your flu shot, the flu is still out there, morphing itself just enough to try to survive in you. Flu needs a host to live. That is the purpose of any virus, just to survive.

If you do have the flu or a family member gets the flu, isolate yourself. This can be hard to curtail your social life and even harder to stay away from sick family members. but it is something that must be done to protect yourself. Getting the flu is a lot harder on your body so being in another room is helpful to avoid transmission of the flu through touch, breathing or coughing. Have a backup plan for how you will receive help if your caretaker gets the flu.

Coughs and sneezes spread the flu quickly because of the force that air is expelled from the body. Be sure you and the people around you cover their face and nose either by using a tissue or by coughing into their inner elbow. Once you have used a tissue, dispose it. Do not save it for a second sneeze as it is not contaminated. Using your hand to cover your mouth puts germs on your hand which is then spread to everything touched until that hand is thoroughly washed. If you are in a situation where you need to shake hands with someone, offer the arm bump or elbow bump.

Taking care of yourself in flu season is imperative to your general health. The flu can have complications such as pneumonia or other systemic infections, even sepsis (a life-threatening infection within the organs of the body). It can be challenging to avoid the flu. Do what is needed to keep yourself healthy. Nurse Linda

Pediatric Consideration: Children have less reserve than adults. They become ill more often due to their environment of school and being with other children. Younger children have their hands and toys in their mouths more often. All these factors lead to flu being easily transmitted to kids.

Wash toys and the environment often with hot water and soap. Bleach wipes can be effective if toys are not put in children’s mouths or wash/wipe with bleach and then wash the items. This allows the bleach to kill the flu germs but also remove the bleach residue from the items for safety with children’s use.

Hand sanitizer should be used by the parent, caregiver and child if soap and water are not available. The friction of a good hand wash will help remove germs from your hands. A spritz under the faucet basically does nothing. Practice good hand hygiene with your child. This will keep the flu at bay for both of you.

About the Author - Nurse Linda

Linda Schultz, Ph.D., CRRN is a leader, teacher, and provider of rehabilitation nursing for over 30 years. In fact, Nurse Linda worked closely with Christopher Reeve on his recovery and has been advocating for the Reeve Foundation ever since.

Nurse Linda

The opinions expressed in these blogs are the author's own and do not necessarily reflect the views of the Christopher & Dana Reeve Foundation.