Coastal Direct Primary Care

01/05/2026

COVID, Flu A, and RSV on the rise in our region! Protect yourselves. Lots of hand washing, masks, and azelastine nasal spray is what I'm doing.

Shared from Dr. Ruth Ann Crystal's newsletter. You can follow her on Substack or sign up for her newsletters here: https://drruth.substack.com/about?utm_source=subscribe_email&utm_content=learn_more

Respiratory Illnesses
Influenza A is VERY HIGH or HIGH in most of the U.S. due to a high prevalence of the novel H3N2 subclade K variant (see chart below). RSV activity is also HIGH in many parts of the country as expected for this time of year, with emergency department visits and hospitalizations increasing among children 0-4 years old.

Nationally, the CDC ranks COVID activity as “low but increasing nationally”. CDC data is outdated and I prefer to use up-to-date sources like WastewaterSCAN.

COVID, RSV, Flu A, Flu B wastewater levels by region from WastewaterSCAN:

01/04/2026

Homemade cough syrup

3/4 c raw honey
1/4 c Extra virgin olive oil
3 tbl lemon juice
2 tbl pure vanilla extract (for taste, adjust as you wish)
1/4 tsp cayenne pepper
1/2 tsp ground ginger

Heat in a small saucepan until warm and mixed. Do not heat above 110 F.

1year-6years old: Take 2.5mL (1/2 tsp) three times daily as needed.
6years and older: Take 5mL (1 tsp) three times daily as needed.

***Remember, no honey in those less than 1 year old. It can cause infant botulism, a rare but potentially fatal gastrointestinal problem.***

Can store in fridge for up to 6 months and at room temperature in a cool, dark place for up to 30 days. Do not give if mold has collected on the top.

01/02/2026

TGIF! Are you doing "Dry January" this year? Or are you cutting out alcohol because the World Health Organization classifies it as a Group 1 Carcinogen, the highest risk category, along with to***co and asbestos? Or do you just want to try something new? Here's one of the mocktails from a previous post, from Forks Over Knives.

Winter Mocktail Mule:

A fizzy cranberry mock mule served in a copper mug filled with ice, garnished with whole cranberries and a lime wedge, with warm-toned lighting.

Bright cranberry, lime, and ginger create a crisp, fizzy twist on the classic mule—minus the alcohol and excess sugar. Makes 4 servings

1 inch fresh ginger, sliced
¼ cup frozen dark sweet cherries
2 tablespoons pomegranate arils
1 cup unsweetened 100% cranberry juice
1 tablespoon pure maple syrup
2 limes
3 cups (24 oz.) sparkling water
Fresh cranberries, for garnish (optional)

In a bowl muddle ginger, cherries, and pomegranate arils. Stir in cranberry juice and maple syrup. Cover and chill at least 1 hour or up to 1 week.

Strain juice through a fine-mesh sieve into a glass measuring cup; discard ginger and fruit.
Squeeze 3 tablespoons juice from 1½ limes. Cut the remaining lime half into wedges. Add lime juice to cranberry juice mixture. To serve, pour juice mixture into ice-filled mule mugs or glasses. Slowly add sparkling water. Garnish with lime wedges and, if you like, fresh cranberries.

PER SERVING 67 cal, 0 g fat, 0 mg chol, 9 mg sodium, 18 g carb, 1 g fiber, 15 g sugars, 0 g pro.

https://www.forksoverknives.com/how-tos/dietitian-created-holiday-mocktail-recipes-less-sugar

01/02/2026

From the NPR Life Kit Guide to Building Strength:

"Challenge yourself: Build toward — or beyond! — a full pushup
Whether you can already do one, or are working toward it, a pushup is a great way to test and build your strength.

Beginners should start by practicing against a wall. If you can do a full pushup on the floor, you can make it harder by moving both of your arms closer to your body. Once you get that down, try an uneven pushup.

Place one hand on an object like a yoga block. This will distribute more of your weight into the lower arm. You can make this harder by moving the object farther away.

Try this challenge adapted from Kotarsky’s study.
Assess your current level of pushup proficiency on the scale below. Try the easier levels first, until you get to one that’s tough for you to complete 3 sets of 6 reps.
Practice that level at least twice a week, up to three times. Keep going until you can do 3 sets of 8 reps.
Now, you’re ready to level up!
If you’re still at a beginner level, remember, strength grows with repetition. Keep practicing and you’ll get there!
Pushup progression scale
Wall pushup. Beginner
Kneeling pushup Beginner
Full pushup. Proficient
Close pushup. Advanced
Uneven pushup. Advanced
Struggling to hit the next level?

Kotarsky has a word of advice: Add another set (up to 6 total). “Extra volume builds the strength and endurance needed to unlock tougher variations,” he says.

https://www.npr.org/newsletter/strength-training

01/02/2026

Please note the date change!

New date is Wednesday, January 28th from 4:00pm - 5:30pm. All are welcome, RSVPs appreciated.
The Frozen River by Ariel Lawhon... a gripping historical mystery set in 1789 Maine, centered on real-life midwife Martha Ballard who investigates a murder linked to a r**e accusation, using her diary to uncover truths in a time when women's voices were silenced, blending factual history with a compelling whodunit.
Available at Browseabout Books https://browseaboutbooks.com/book/9780593312070
And did you know you can buy audiobooks from Libro.fm and choose Browseabout Books to support, so a portion of your purchase revenue goes to the store?

POSTPONED!!! New date is Wednesday, January 28th.

Our next book club will meet on Wednesday. January 7th from 4:00pm - 5:30pm. All are welcome, RSVPs appreciated.

The Frozen River by Ariel Lawhon
... a gripping historical mystery set in 1789 Maine, centered on real-life midwife Martha Ballard who investigates a murder linked to a r**e accusation, using her diary to uncover truths in a time when women's voices were silenced, blending factual history with a compelling whodunit.

Available at Browseabout Books https://browseaboutbooks.com/book/9780593312070

And did you know you can buy audiobooks from Libro.fm and choose Browseabout Books to support, so a portion of your purchase revenue goes to the store?

01/02/2026

Friday Funny. Have a great weekend and a Healthy New Year!

12/31/2025

There have been at least 7.5 million illnesses and 3,100 deaths from flu this season, according to CDC data. And flu cases are expected to rise significantly in the coming weeks.

Flu season is off to a rough start this year, according to new CDC data. The virus is spreading faster than in previous years and the surge is likely to get worse. Here's what you need to know.

12/30/2025

We received a shipment today and are now well stocked with azelastine nasal spray for cold, flu, and covid prevention!

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2838335

12/30/2025

Azelastine for the win!

This just one study, but when I weigh the risk vs benefit of using azelastine to prevent catching a cold, the flu, or COVID, it's worth it for me! More studies are needed to confirm these results, but we are seeing A LOT of coughs, colds, some flu and, yes, some COVID.

"The spray also appeared to help against other respiratory viruses. Rhinovirus, which often causes colds, was the most common non-COVID infection detected.

Only 1.8% of azelastine users tested positive for rhinovirus compared to 6.3% of placebo users, translating to about a 71% lower risk of infection.

Overall, 8.4% of azelastine users had at least one laboratory-confirmed respiratory infection during the study, compared to 18.8% of placebo users."

Researchers say people using a common allergy nasal spray, azelastine, were 69% less likely to contract COVID-19. Participants in the trial were additionally 71% less likely to catch the common cold than placebo users.

12/30/2025

Oooh, these look tasty! No sense bringing in the new year with a hangover! Try these mocktail recipes and wake up feeling fresh!

These holiday mocktail recipes offer festive flair and zero processed sugar. Each recipe is dietitian-developed and uses whole fruits, teas, herbs, and spices to create layered flavor without relying on syrups.

Ginger-Fig Apple Tea-ni
Winter Mocktail Mule
Orange-Vanilla Sparkler
Rosemary-Cherry Spritzer
Spiced Chai Nog

These holiday mocktail recipes deliver sparkle with no processed sugar, emphasizing whole-food ingredients for clean, layered flavor. Perfect for parties—get the recipes!

12/30/2025

Do You Have These Unusual Physical Traits?

Morton’s Toe

Morton’s toe, named for the American orthopedic surgeon Dudley Joy Morton, who first described the condition in the early 20th century, is a trait in which the second toe is longer than the big toe. It’s often genetic, caused by the relative lengths of the bones in the foot. A study of American college students found that 42.2% of participants had longer second toes, with 45.7% of men and 40.3% of women reporting the trait. Other studies around the world report a wide range of prevalence, from just 3% in one Swedish study to a whopping 90% in a study of the Indigenous Ainu population of Japan.

https://interestingfacts.com/rarity-of-physical-traits/

12/28/2025

There are estimated to be upwards of 2,000 varieties of fruit grown around the world. While we’re likely all familiar with apples, oranges, and bananas, there are also hundreds of fruits you may never have heard of, let alone tried for yourself.

With 2,000 varieties of fruit grown around the world, there are bound to be a few you've never heard of — perhaps including the ones on this list.