What to do when you have had the flu?

Caroline Foran: This winter, chances are either you or someone you know (or your entire household, for that matter) have found themselves utterly floored from the flu. A country-wide epidemic, this season's "killer flu" has seen countless patients hospitalised, while an unforeseen number of Irish people have sadly died from the virus.

Lest we need any reminders, a bad bout of influenza – not to be confused with a light head cold – is something to be taken very seriously. Upon diagnosis, you’ll take to the bed, relying on the likes of paracetamol to control your fluctuating temperature, while a high intake of liquids should see you through the worst of it.

Unlike other 48-hour illnesses, a proper whack of the flu can leave you bedridden for up to two weeks. Where most people run into dangerous territory, however, is the assumption that the flu is something you can bounce straight back from, in the same way you might recover from a stomach bug. Thing is, it’s during this “am I, am I not okay” phase of post-flu frustration, where we run the risk of triggering a relapse, or worse still, pneumonia. You might feel better, and you might be fed up, but the sickness has not yet run its course.

Not ones to wallow in our illness, we Irish return to work too soon, wearing our recovery like a badge of honour. We rarely give ourselves the adequate amount of time needed to fully restore equilibrium in our bodies, diving into work projects, killing it at the gym in the hopes of “kick-starting” our immune systems and essentially burning the candle at both ends.

PATIENCE

CF: First thing's first, it's of paramount importance that we understand what's happening inside our bodies and why such patience is required.

Kaman Ryan: After a bout of flu, our bodies are depleted in several ways. First, and arguably most importantly, is that we may be dehydrated.

This is particularly important to watch out for if you have had a sore throat or upset stomach, or anything else that meant your usual intake of food and liquids was reduced. Even mild dehydration will seriously inhibit recovery, and severe dehydration is a serious medical issue that can require emergency intervention.

Second, fighting the flu puts the body’s systems under a level of prolonged general strain that can mean vitamin and mineral levels are below where they would normally be. Again, this is particularly important to beware of if you have been unable to eat and drink normally while sick. It is important, as soon as you are able, to eat nutrient-dense foods: the obvious, basic ones are a good way to start.

Bananas for lost electrolytes, fruit (especially citrus) for vitamin C, garlic for natural antibacterial and antiviral protection, and if you can get it, a good bone broth for, among other things, replacing minerals and salts. Even if you don’t usually take one, a good multivitamin can be a useful supplement at this point. Green tea, ginger, and turmeric are all used to improve circulation and regain vitality.

CF: And this is the clincher:

KR: Remember this; because your system is run down after the flu, you will be more susceptible than usual to catching something else. This can be particularly true if you were sleeping poorly during your illness. So, while a little sunlight and fresh air can help you feel better after being stuck inside, go easy and make sure you are well wrapped up and rested.

ANTIBIOTICS

CF: For the most part, you will have to ride out the flu alone. However, if you've had an added infection, such as in your chest or sinuses or throat, you may have been prescribed antibiotics. While these can often be miracle-workers for attacking the infection in question, they can leave your body reeling long after their job is done. Being mindful of this, if you had to take antibiotics yourself, is key.

KR: The downside of antibiotics is that they come with collateral damage, done to the good bacteria your body uses and needs every day for innumerable internal processes. This doesn't mean anyone should ever ignore a doctor's advice to take antibiotics, but does mean that, in addition to recovering from the effects of a cold or flu, if you took antibiotics your system must also rebuild its bacteriological makeup.

How quickly this happens is very near impossible to measure, and there are myriad medical opinions on the subject. But it is relatively uncontroversial to say that a full recovery of “good” bacteria after a course of antibiotics depends on a number of variables, including your age, general level of health, type of antibiotics (there are many different types) and how long or aggressive the course of antibiotics was.

There is also a view that the bacterial make-up within a person is influenced by factors including where they live (eg whether in a city or in the country), what type of environment they work in, etc.

Acidophilus is classified as a “good” bacteria found in the intestines (in particular the bacteria responsible for synthesizing Vitamin K – important for blood health) and is considered essential to a properly functioning digestive system, so it is often recommended as a supplement following a course of antibiotics in order to return healthy levels of the bacteria to the digestive system as quickly as possible.

Live yoghurts and fermented soy products (like miso) are considered natural sources of live good bacteria, and if you have undergone a particularly aggressive course of antibiotics or feel especially run down following antibiotics, there are numerous supplements in good health food stores that contain multiple strains of healthy bacteria.

However, for most people following moderate courses of antibiotics, normal life will restore lost bacteria over time – aided of course by eating nutrient dense food to encourage general digestive and overall health.

One word of caution on probiotics: anyone who is still ill or has a compromised immune system should talk to a doctor before taking any probiotic.

In my own experience, long-term noticeable effects relating to loss of “good” bacteria from taking antibiotics are very rare. The supplements mentioned above can certainly aid the process but in general, your bacterial make-up should self-restore within a few weeks after finishing a moderate course of antibiotics.

If you experience particular continuing stomach or other symptoms that you think might be related to having undergone a course of antibiotics, it is probably wise to discuss with the prescribing doctor, as it may be something other than a “good” bacteria issue.”

EXERCISE

CF: If you're an avid gym-goer, you'll find it even more frustrating to be told to take it easy, but after a flu, you need to be mindful of where you're body's at.

KR: Again, this really depends on age, level of general health and fitness, and how bad the cold and flu was. I think the most important thing to emphasize is that people should listen to their bodies.

If you are recovering from a flu and don’t feel 100 per cent, don’t let the fact that it’s January and you swore you were going to run three times a week jeopardize your health. You will not be doing your resolutions any favours by relapsing or catching something new. In addition, being tired and run down makes you more susceptible to injury.

A general rule of thumb is that you should not work out again at all until you have felt 100 per cent back to normal for three days (in a row). Even then, ease yourself back in to avoid any nasty surprises (like an injury or dizzy spell due to lingering dehydration). Again, a lot of this comes back to hydration – makes sure you have been able to take in plenty of salts, electrolytes and fluids for a few days before doing any exercise.

Finally, if you usually engage in very tough workouts, I would recommend NOT going straight back to your usual level of intensity on your first day back training after a bad cold or flu – even if you feel 100 per cent, pushing your body hard could expose some lingering weakness that sets your recovery back.

NEXT WINTER

CF: One of the easiest ways to equip yourself against the flu next season is to avail of the flu vaccine. While the focus of the flu vaccine on healthcare workers obviously makes sense, the vaccine is available to anyone who wishes to get it, and is particularly recommended for vulnerable people in certain age/health groups. It's always advised that the elderly and women who are pregnant, for example, should get the vaccine, but if you feel that your general health may be less than optimal and that you are susceptible to flu, or if you have had a bad bout of flu this year and/or in previous years, it is absolutely worth talking to your doctor about getting the vaccine.

KR: While there are contradictory and strong opinions on the safety of vaccines in general, it is my experience that most medical professionals believe them to be safe and a good option with minimal side effects for anyone worried about flu.

CF: Aside from that option, the best way to give yourself a fighting chance against colds and flus is to take care of the big three, Kaman Ryan advises:

1. Eat a balanced, nutritious diet rich in vegetables, fruits and some good fats. A properly nourished and hydrated body, with a robust digestive system (no recurrent stomach or bowel issues), is the first line of defence against an array of maladies – not just colds and flu but more serious and chronic problems too. Think of it as arming your own personal-health-military with everything it needs to defend against invaders.

2. Wrap up and take precautions. Dress properly, wash your hands regularly (especially before eating) and drink alcohol in moderation. Many people get sick around Christmas, when they are attending parties and maybe having a few more drinks than usual. Some research suggests that your body prioritises metabolizing alcohol above other tasks, which might give a cold or flu time to get a toehold when – but for those few extra glasses of wine – your immune system might otherwise have been able to nip it in the bud. Equally, if you’ve shaken hands with 20 people before dinner, it is worth taking the time to go and wash those hands before tucking into the hors d’oeuvres! Lastly, obey your mom (not the fashion police) and wear a scarf and hat when venturing out, especially at night.

3. Sleep. An overtired and stressed immune system is a welcome mat for colds and flu. Take special care to ensure you are getting enough proper (non alcohol-induced) sleep during cold and flu season.

CF: Of course, you can do everything right and still get the flu, but taking a little bit of extra care around flu season could give you that extra bit of luck just when you need it.