Brian Elkins, M.D., N Bolton Avenue, Alexandria, LA (2025)

01/11/2024

If more of us ate “real food” as described here, we would have less of all the health problems that plague us, from high blood pressure and diabetes to heart disease and cancer.

12/11/2023

Today we are seeing a significant increase in cases of the flu (Influenza A) in Central Louisiana--along with ongoing high activity of all the common respiratory viruses. If you have a "common cold" (sore throat, runny nose, cough, maybe fever in the first day or two), it's OK to tough it out at home and treat your symptoms as needed (and please avoid sharing it with others, especially older people). Contrary to the belief of some, we still do not have a cure for the common cold! But if you have fever with body aches and/or other more severe symptoms, you might want to be evaluated and possibly tested for the flu.

11/08/2023

Happy wellness Wednesday!

08/31/2023

In case you are wondering: yes, there's a significant wave of COVID occurring right now. Those at risk should be aware and take reasonable precautions; and if you are sick, please avoid exposing those at risk, especially older people. Although most people are experiencing mainly anything from mild cold symptoms to moderate flu-like symptoms, older people are bearing most of the brunt of serious illness. The graph below of daily hospitalizations for COVID in Louisiana stratified by age should help you understand the impact of age on that risk.

For those worried about mask mandates, I doubt that will be an issue since the new variants are so contagious that mask mandates, as they tend to be practiced (very poorly), don't reduce their spread significantly. That's not to say that individuals who are at risk won't potentially benefit from wearing a well-fitting mask, especially an N95 mask, in crowded settings or around sick people, or that sick people shouldn't wear a mask around others, especially those at risk.

04/05/2023

is back! When we are feeling anxious or scared, we tend to breathe quicker, shallow breaths. These emotions lead to a lower concentration of carbon dioxide in our blood, causing us to feel lightheaded, clammy, sweaty, and have tingly fingers or toes. Next time you are feeling anxious, scared, or upset, try this:
· Sit comfortably. Close your eyes if you want to.
· Breathe slowly and steadily through your nose for a count of 4.
· Hold your breath for a count of 2.
· Breathe out slowly and steadily for a count of 4.
· Repeat for a few minutes.

01/21/2023

Here’s a great team that I’m privileged to work with. They are a gifted group doing good work!

12/30/2022

We have definitely seen a significant bump in Covid cases since Christmas. Please take care not to expose the vulnerable, especially older adults or the immunosuppressed or those with chronic conditions, if you are sick.

12/27/2022

Good news: as of a week ago, flu activity was declining significantly in Louisiana; COVID activity remained at modest levels and was also slightly declining, as were hospitalizations for COVID among people 65 and older; and RSV activity has declined to the point that RSV season appears to be over.

We could still see a bump in any of the above following Christmas and New Year's. Anyone with a fever and respiratory illness should continue to take steps to prevent transmitting it, especially to those at risk (65 and older, or with chronic health conditions). Also, it wouldn't surprise me to see a second peak of flu, which could come at any time between now and April, especially after this recent bout of very cold weather.

Happy New Year!

12/12/2022

Flu activity is still very high in Louisiana. Please take care to protect those who are vulnerable--with flu that's children under 5 (and especially under 2), adults 65 and older, and those with chronic health conditions or immunosuppressed.

COVID activity is moderate in our area, and most cases are not severe, but this graph illustrates what concerns me the most: hospitalizations for COVID-19 are significantly up in the 70+ age group. Please take care to protect the vulnerable among us and keep away from them if you're sick, even if it's mild, since what's mild for you could become serious in a more vulnerable person. If I could get two messages across to everyone in our area right now, they would be:

** Don't go to work or be around others if you're sick with a cough or fever.

** Stay away from the vulnerable elderly if you're sick even with something you think is just a cold; if you must be around them, wear a medical-grade mask or an N95 mask and keep the time as short as possible.

12/07/2022

Is it too late for a flu shot?

While it would have been more ideal to have gotten it sooner, it's not too late--even if you have already had the flu this season, since there are multiple strains circulating, and some people get the flu twice or even more in a single season.

Don't judge your prospects for this season based on your experience with flu seasons of the past 10 years. This one is already more active than any in the past 10 years and is still ramping up. Your personal chance of getting the flu is much higher this year than it has been any time in the past 10 years, and that's likely to be true whether you get your flu shot or not--but the flu vaccine can reduce (though not eliminate) your risk.

The flu vaccine provides coverage against four strains of influenza, and there's a high degree of match this year between the vaccine and the strains that are circulating. Although the protection against infection is far from perfect (40-60% effectiveness on average in the past), when you consider the number of people who have had and will have the flu this season, reducing that number by 50% can make a big difference for your family, your community, and your local hospitals.

Flu shots are quite safe. I've had a flu shot every year for the past 30 years. I don't recommend things to my patients that I wouldn't do for myself and my own family.

12/06/2022

Flu activity is high enough that the most common treatment, Tamiflu (osteltamivir), may be in short supply. Some things to remember:

1) The benefit of treatment with Tamiflu for most people is modest at best and is not nearly as dramatic as, for example, treatment of a bacterial infection with an antibiotic. Tamiflu may shorten the duration of flu symptoms by about a day (average duration without treatment is about a week).

2) Treatment with Tamiflu can reduce risk for severe illness resulting in hospitalization, which is most important for people at highest risk such as children under 5 years (and especially under 2 years), adults 65 and older, pregnant women, residents of nursing homes, and people with certain health conditions or suppressed immune systems.

The upshot: in shortage situations, we want to make sure people who need Tamiflu the most have access to it. If you're a young healthy non-pregnant adult and are not offered a prescription for Tamiflu, please understand we are trying to make the best use of a scarce resource.

And, unfortunately, some common antibiotics such as amoxicillin are also in short supply. We don't treat viral infections with antibiotics (because they have no effect), and this distinction is especially important in shortage situations so that we can help ensure people who need/will benefit from antibiotics can get them.

Last note: if you are having flu-like symptoms, do not assume it's flu without a test for flu AND COVID-19. Flu activity is very high, but COVID-19 is currently surging. Please don't expose people who are at-risk only to later discover you actually had COVID.

12/05/2022

Respiratory illness (Flu, RSV, COVID-19) current activity summary:

Flu activity is very high in Louisiana right now--at the highest level anytime in the past 10 years, and much earlier in the season than usual. If you have fever, body aches, and cough, please seek treatment if you have risk factors (health problems, or if you are an older adult), and try not to spread it to others. Fever and absolute misery for a solid 5 days is not unusual, and some have nausea, vomiting and diarrhea, especially with flu type B. Flu is not only miserable, but some people will develop pneumonia and other complications--even people who are otherwise healthy.

RSV is around and causing a lot of childhood illness and hospitalizations. Most adults will have nothing but a common cold from RSV, but young children and also older people are at increased risk of serious infection if they contract RSV.

With all the flu, RSV, and COVID-19 activity (see below), people who are older or have chronic health conditions should take care to avoid being around people who are sick, and consider wearing a high-quality medical or N95 mask when in crowded spaces. If you are sick, please do what you can to avoid spreading it to others, especially those at risk.

COVID-19 activity has been fairly low but is currently rising. While the current wave where it has occurred around the world has resulted in fewer cases and hospitalizations overall than Omicron did, it continues to cause serious illness and hospitalizations mainly among people 70 and older, which is what we are seeing in Louisiana now as well.

Should you get the COVID-19 bivalent booster? If you're vaccinated and it's been at least 2 months since your last dose of any COVID vaccine, the answer is yes. So far, immunity from both natural infection and from vaccination wanes over time, and the current variants are evading most prior immunity. We need a better strategy long-term (i.e., a nasal vaccine that protects against infection better and that more durably protects against multiple variants), but in the meantime, the vaccines remain effective to greatly reduce risk for serious infection...if you keep up with the recommended boosters.

I have taken flu vaccines annually for the past 30 years and have taken the COVID vaccine and all recommended boosters, including the currently available bivalent booster. I have never had the flu or COVID-19 yet. That's not to say I couldn't get one or both tomorrow, but I know my risk for infection and especially severe infection or hospitalization is greatly reduced, and I wouldn't recommend them unless I felt the benefits far outweighed any risks both for myself and for my patients.

Brian Elkins, M.D.

01/11/2024

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01/21/2023

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