Podcast 8: Fighting the Flu and Zika with Nurse Practitioner Kim Bookout

Posted by: Penny Rackley   |   Comments Off on Podcast 8: Fighting the Flu and Zika with Nurse Practitioner Kim Bookout   |  Posted on: Feb 27, 2016

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Bleh! Who has time for illness? And don’t you know, when the kids are sick — we all get sick!

In this episode, Nurse Practitioner and owner of Pediatric Health Partners, Kim Bookout shares her strategies for staying healthy through the end of flu season, updates us on the Zika virus, and tells us what kinds of supplements we and our children need most.


My family and I met Kim when our boys were five and nine, and ever since that first visit, she’s been the health care provider we turn to whenever we need medical advice and information. Kim has helped us through the flu, strep throat, sports injuries and the terrors of adolescence, and she’s also been an enormous help to us in getting through a major illness with one of our boys. 

But just as important to me as Kim’s considerable qualifications and experience, she is a kind, empathetic and trusted member of our little family village — one of the people we count on to help us live a healthy life. If I have a question about a medical issue, I ask Kim, and if she doesn’t know the answer, she’ll find it. And that’s why she’s here today — to help us parents! Here is my interview with Kim.

What made you decide to care for children as a career? 

My mother says I was born with a baby in my hand! I always wanted to take care of kids — it’s been a lifelong passion, so from a very early age, I can remember making the decision to go into healthcare. I thought about being a physician, but I also wanted a family, and had to balance out how that was going to go. Being a nurse practitioner seemed to be the best of both worlds. It’s a good mommy job.

She is the ultimate mommy. Sometimes I feel like she’s my mommy!

Health in North Texas

Here in the Dallas area, we really never got a winter this year. That’s a marker for us — parents usually can stop giving allergy medicines once we’ve had a good, cold, hard freeze. That’s when we get to ease up on things like asthma treatments.

This year we didn’t see it, so the allergy sufferers are still having some symptoms, and taking antihistamines a little more quickly than normal. Typically we start them in late February, early March. This year we’ve been on them all winter.

I don’t think we’re out of the woods yet. I think there still may be some cold weather that comes along. If you think about this time last year and the year before, we had ice storms in North Texas.

Are we through the flu season for this year?

The flu season got a really slow start. Based on 2014 numbers, we hit flu season pretty early. In December 2014, most of the ERs around town were full, a historical high. This year, Dallas county is reporting that only about 6% of all cases being tested come back as positive for flu. The last statistic we have on that is from February 6th.

That means that the numbers on the people who appear to have the flu symptoms are testing as not having the flu — it’s some other viral illness 93% of the time.

Is it too late to get the flu shot?

It’s kind of a roll of the dice. We know that getting the flu shot does not give you the disease. It’s usually because there’s been a bad match for the vaccine, and the strains that are out in the community are actually different than the ones we captured in the vaccine.

This year the vaccine was actually a better match. In last year’s vaccine, the H1N1 component was less stable when it got to warmer temperatures in shipment. So what they found was, if we keep it colder or if we change the strain to one that’s more hearty, then it will last longer.

The flu vaccine is still available, but getting it now might be a little late. I don’t know that I would. If you became sick, and you feel like you have the flu, I always tell parents, if you need to be at work, then Tamiflu might be a good option for you.

I don’t use it as often in low risk children and children who do not have comorbid diseases, such as asthma or heart disease or renal failure. If people have chronic illnesses, it’s unlikely that we’ll give them Tamiflu because we don’t want to tax their immune systems more than it needs to be taxed. Their bodies are already working really hard.

So Tamiflu is a great option for working parents who need to get back on their feet and into the office, or the stay-at-home mom who needs to be there for her family. We want her to feel better, faster.

There are also remedies that you can pick up over-the-counter at the local health food stores that are meant to help control symptoms of the flu. They don’t cure the flu.

Let me tell you what Tamiflu does. As an antiviral, it’s not going to obliterate the flu from a person’s body. When you contract the flu or a viral illness, you have virus in your body. That virus gets worse, and people get sicker, because that virus continues to replicate itself.

The antiviral Tamiflu comes in and stops the replication process. So the day that you’re sick, and the day you test positive for the flu, that amount of virus is going to live in your body the whole seven days, BUT it won’t replicate as quickly because within the first 48 hours of illness, we’ve started the Tamiflu. (That’s a stipulation of the anti-viral: It must be started within the first 48 hours of the onset of symptoms, or it’s not as effective, Therefore, if the symptoms have been present for longer than 48 hours, then we won’t prescribe Tamiflu.)

What other illnesses are you seeing in school kids these days?

Right now in our area we’re seeing a lot of a gastrointestinal bug, and it is usually about 24 hours of vomiting followed by 3-5 days of diarrhea. It’s virulent and moving its way through entire families. So if your child has these symptoms, don’t send them to school!

What do we do to keep from getting this bug?

Lots of good hand washing. That’s really the number one prevention. If you’re wiping your face or blowing your nose in a tissue, wash your hands. When you go to the restroom, wash your hands. When you’re around a lot of people, wash your hands, especially if you’ve been shaking hands with others.

Zika Virus in North Texas

I don’t know of any cases in Dallas. It is a mosquito-borne virus, that’s how it’s transmitted — through the bite. The mosquito bites a person who has Zika, then bites another person and transmits the disease to them. That’s how it moves along. The symptoms are fever, rash and joint pain. It kind of looks like other things. You can get conjunctivitis — that’s the infection in the eye where the it becomes red and you’ll have discharge. That looks like so many other childhood illnesses, that I feel like people are going to see those symptoms in their children and be panicked that it’s Zika.

The good news is that not everyone who has the Zika virus becomes ill from it, according to the statistics from Dallas County Health and Human Services. If you ever have questions about the disease burden in your area, that is a terrific resource — the Health and Human Services website for your county.

Zika is more concerning for women who are pregnant and getting near the time of delivery. Another piece of good news: There have been no cases reported where Zika was spread through breast feeding.

When there is a confirmed case of Zika virus, there is not a treatment for that, kind of like with flu symptoms — you’re just going to treat the symptoms and try to make them feel better. So, lots of rest, plenty of water, supplementation to help your immune system bounce back more quickly.

Keep your eyes on the news. I would not panic about Zika. We can avoid it the same way as the other mosquito-borne illnesses we’ve had in our area for the last several years.

  • Use DEET

  • Avoid being outside at dawn and dusk when mosquitoes are most active

  • Wear long sleeves and pants

  • Make sure there’s no standing water on your property, because that’s where the mosquitoes are going to live

As a mom and a woman over 45, and someone who comes in contact with lots of sick people, what kind of supplements do you take?

One caveat: They say your first year in pediatrics is probably the sickest of your life. Probably true! They also say that your first year with each child is your sickest. So with four children at home, I had four of those really good sick years that built my immune system to be rock solid. I rarely get sick, just a few occasional allergy symptoms. But I do take supplements.

I am a firm believer in whole food supplementation. A whole food supplement is one where there have been very few synthetic materials brought into it. You’re getting the vitamin straight from that vegetable or fruit, and it is broken down in the easiest way for you to take it in, and in the easiest way for your body to recognize it.

The cute, candy-like vitamins that our kids love to eat have a lot of extras that our kids (and we adults!) don’t need. I look for supplements that are more of a product that my body is going to know what to do with right away. So much of the time I feel like our vitamin supplements just give us expensive urine, because our bodies don’t know what to do with those formulations.

A good, whole-food multivitamin is the first step. Then gauge what your body needs. Surprisingly, even though Texas is a sunny state, most of us are still low in vitamin D. Over 30-100 milligrams per decaliter is the “normal” range for vitamin D. Most kids I test are low in vitamin D, so that’s a supplement I recommend right away.

Also, all breastfed babies should have a vitamin D supplement, since breastmilk is typically very low in D.

Children under four years of age should have a supplement of 400 international units of vitamin D3 a day. Kids over four should have 600 IU a day. You can buy vitamin D at health food and grocery stores, and doctor’s offices. It’s a really easy, cheap way to keep your immune system healthy — vitamin D has a good antiviral component and an antibacterial component, so it really does help you fight disease.

If you need extra C during times of illness, there are popular over-the-counter products that you can add to water and drink a couple of times a day. They also have some B vitamins in them, and proprietary blends of echinacea and herbal remedies.

I like these if you’re feeling really down and need an energy boost, like after the flu. They can help your immune system bounce back a little more quickly.

Where to find Kim

Pediatric Health Partners is at 4305 Windsor Center Trail in Flower Mound, Texas. We are near the Texas Health Presbyterian Campus on 2499 and Windsor. You can also find us on the web at phpflowermound.com. You’re welcome to submit questions to our office through a portal on our site. Our phone number is 972-355-7900. We’re there from 8am-5pm Monday-Friday.

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