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  • Most simple insect stings in a nonallergic person require no more than first aid at home.
  • Avoid further stings by wearing protective clothing, using insect repellant, and avoiding infested areas.
  • Remove any stingers remaining in the skin (most likely from bees) immediately. Some experts recommend scraping out the stinger with a credit card. However, it is probably more important to get the stinger out as quickly as possible than to be overly concerned about how it is removed.
  • Application of ice to the sting site may provide some mild relief. Ice may be applied for 20 minutes once every hour as needed. Cloth should be placed between the ice and skin to avoid freezing the skin.
  • Consider taking an antihistamine such as diphenhydramine (Benadryl) for itching.
  • Consider taking ibuprofen (Motrin) or acetaminophen (Tylenol) for pain relief as needed.
  • Wash the sting site with soap and water. Place an antibiotic ointment on the sting site.
  • If it has been more than 10 years since your last tetanus booster immunization, get a booster within the next few days.
  • Most insect stings require no additional medical care. More serious reactions may need immediate medical care.
  • If you have been stung by a bee or wasp and have previously had a serious allergic reaction, seek medical attention. Consider taking an antihistamine such as diphenhydramine (Benadryl) as soon as possible. If any allergic symptoms develop, consider using the epinephrine part of an emergency allergy kit (EpiPen) if previously prescribed by a doctor.
  • If you have a single sting with no allergic symptoms, you may require only local wound care (such as cleaning and antibiotic ointment). Any retained stingers will be removed. Itching may be treated with an oral antihistamine such as diphenhydramine (Benadryl). Pain may be treated with medicine such as ibuprofen (Motrin), acetaminophen (Tylenol), or both. Also tetanus immunization will be given as indicated.
  • If you have mild allergic symptoms (such as a rash and itching all over the body but no problems breathing or with your vital signs), you may be treated with an antihistamine. You may also be given steroids. In some cases, you may also be given an epinephrine (adrenaline) injection. Some of these treatments may be given at the scene or in the ambulance by emergency medics. You may be sent home if you are doing well after observation in the emergency department.
  • If you have a more moderate allergic reaction (such as rash all over the body, and some mild problems breathing), you will likely receive injections of antihistamines, steroids, and epinephrine. Some of these treatments may be given at the scene or in the ambulance by emergency medics. You will likely need to be observed for a prolonged period of time in the emergency department. You may need to be admitted in the hospital.
  • If you have a severe allergic reaction (such as low blood pressure, swelling blocking air getting into the lungs, and/or other serious problems breathing), you have a true life-threatening emergency. Treatment may include placement of a breathing tube into your trachea. You will likely be given injections of antihistamines, steroids, and epinephrine. IV fluids may also be given. Some of these treatments may be given at the scene or in the ambulance by emergency medics. You will be closely monitored in the emergency department and likely admitted into the hospital-perhaps the intensive care unit.
  • If you have multiple stings (more than at least 10-20 stings) but no evidence of an allergic type reaction, you sometimes may require prolonged observation in the emergency department or admission into the hospital. Multiple blood tests may be indicated.
  • If you are stung inside the mouth or throat, you may simply require observation in the emergency department, or you may need more intensive management if complications develop.
  • If you are stung on the eyeball, you may require consultation or evaluation by an ophthalmologist (an eye doctor).

Symptoms and Causative Agent

Tetanus is a disease of the nervous system caused by bacteria called Clostridium tetani. This bacterium produces two exotoxins, one of which (tetanospasmin) is a neurotoxin that causes the symptoms of tetanus.

The early symptoms of the disease are lockjaw (the most recognizable of its physical effects), stiffness, and problems swallowing. Later symptoms include severe muscle spasms, seizure-like activity, and severe nervous system disorders. Generally, between 10% and 20% of tetanus cases result in death, though fatalities are more likely among patients older than 60 years of age, and among unimmunized individuals. In the most common type of reported tetanus (“generalized tetanus”), spasms continue for 3-4 weeks, and recovery may take months.

Neonatal tetanus refers to a case of tetanus in a newborn infant whose mother was not immune to the disease. It is rare in the United States, but common in certain developing countries.


Tetanus is not passed from person to person; it is unusual among vaccine-preventable diseases in this regard. Instead, tetanus is transmitted via the entry of Clostridium tetani bacteria into injured skin and underlying tissues. Surprisingly, tetanus infection is more likely from a minor wound than a major one, but this is because severe wounds are more likely to be properly treated and cleaned. The incubation period is between three and 21 days.

C. tetani is widespread in spore form in soil, as well as in the intestines and feces of animals (including cats, dogs, rats, guinea pigs, chickens, horses, sheep, and cattle). It also found on skin and has been found in contaminated heroin. Although C. tetani is heat-sensitive and cannot survive in the presence of oxygen in early stages of growth, C. tetani spores, which develop as the bacteria mature, are extremely hardy. They can survive temperatures of nearly 250°F for 10-15 minutes, and are resistant to antiseptics.

Treatment and Care

For patients suffering from spasms, supportive treatment is provided, and procedures are performed to maintain an open airway. Treatment of the underlying illness generally involves tetanus immune globulin (TIG) to remove tetanus toxin that has not yet bound to nerve endings.

It should be noted that surviving a tetanus infection does not result in future immunity to the disease. Tetanus immunization is recommended for survivors after full recovery.

Complications and Mortality

Complications from tetanus can be quite severe. Spasms of the vocal cords or the muscles used for respiration can cause breathing problems; sustained muscle spasms and convulsions can result in broken bones. The disease’s effects on the nervous system can lead to high blood pressure and abnormal heart rhythms.

Available Vaccines and Vaccination Campaigns

Protection against tetanus is provided via tetanus toxoid—inactivated tetanus toxin, which is available both as a single immunization against tetanus alone, and in multiple combination preparations (the two most common are DTaP, which provides protection against diphtheria, tetanus, and pertussis for children younger than seven; and Td, which protects against tetanus and diphtheria for people seven or older).

The extreme rarity of tetanus cases among individuals immunized up to 10 years prior to infection suggests an efficacy rate of nearly 100% for tetanus toxoid. Immunity levels do decrease with time, however, so that boosters against tetanus are recommended every 10 years in order to maintain protection against the disease.

A tetanus booster is recommended for individuals who sustain any wound that is not clean and minor, if more than five years have passed since their last dose of tetanus toxoid.

U.S. Vaccination Recommendations

The U.S. childhood immunization schedule recommends five doses of DTaP to provide protection against tetanus, as well as diphtheria and pertussis, with the first dose given at two months of age.

The Td (tetanus and diphtheria) immunization is given to both adolescents and adults every 10 years as a booster (or, in some cases, after a tetanus exposure). It is recommended that one dose of Td be replaced with Tdap (tetanus, diphtheria, and pertussis) for adults 19 and older to boost immunity against whooping cough.

Who Gets Ice Pick Headaches?

You’re more likely to get ice pick headaches if you’re prone to migraines or cluster headaches. But you could get them even if you don’t normally have migraines. People usually first notice them between the ages of 45 and 50.

What Causes These Headaches?

It’s not clear what causes ice pick headaches. But doctors do know they’re not brought on by disease or injury. You may get them because something is wrong with the way your brain sends pain signals to your body.

You may find that certain things can trigger this type of headache, like:

  • Sudden movements
  • Bright light
  • Stress

 Track Your Triggers

It’s a good idea to keep a headache diary. Write down when you have an ice pick headache and what happened before it started. If you had a stressful day at work before it hit, write that down. You can also use a mobile phone app instead of a diary.

Take this information to your next doctor’s appointment so you can discuss ways to prevent these headaches. He may be able to suggest lifestyle changes, like relaxation, to reduce stress.


Ice pick headaches may come and go quickly, so they’re hard to treat. One medicine you might try to prevent an attack is indomethacin (Indocin). It’s a nonsteroidal anti-inflammatory drug. It could cause side effects like nausea, stomach bleeding, heartburn, and eye or kidney problems. You’ll need to get an annual eye exam to make sure your eyes are healthy if you take it.

When to Seek Emergency Help

Ice pick headaches aren’t serious in most cases. But other brain conditions that are could make you feel similar pains. If you have brief headaches that feel like stabbing, see your doctor to rule out other health concerns.

Could it be your diet?

We all need sodium. It plays an important part in regulating blood pressure and fluid levels. But you only need a small amount. If you have too much in your system, your body holds in water. Table salt is one source of sodium, but we get more of it from processed food like lunch meat, crackers, chips, canned vegetables and soups, fast food, and even soft drinks.

Check the sodium levels of food and drinks before you buy them. You can help balance your sodium by eating potassium-rich foods like bananas and spinach, and drinking plenty of water.

Could it be your lifestyle?

Do you have swollen legs and ankles? Gravity keeps blood lower in your body. That increases the pressure inside the blood vessels in your legs and feet and causes fluid to leak into those tissues.

Sitting or standing too long can cause your tissue to hold water. If your job keeps you on your feet, you may notice swollen legs and ankles at the end of the day. It’s also common after a long time on an airplane.

The key is to keep blood circulating. If you stand or sit all day, it’s important to take time to move around.

Could it be hormones?

It’s normal for a woman to feel puffy or bloated in the days leading up to her period. It usually goes away after a few days. Hormones taken for birth control or hormone replacement therapy can also cause you to hold water.

Could it be your medication?

Many medicines have water retention as a side effect. They include:

  • High blood pressure medication
  • Pain relievers known as NSAIDs, including ibuprofen
  • Antidepressants
  • Chemotherapy medication

Ask your doctor if your meds may be the problem. If so, there may be something else you can take instead.

1.     You’ll be paying more. Even as the pace of increases in the cost of health care has eased, prices continue to rise. Consumers who get health care through work will pay 5 percent this year for premiums, an average of $6,251 ($17,545 for a family), with workers contributing an average $1,071 ($4,955 for a family). Health care costs are also increasing, along with deductibles. 

The high cost of health care is having an impact on whether consumers access treatment at all. One in three Americans say they have put off medical treatment for themselves or a family member because of the cost.

2.     It’s becoming easier to shop around. In addition to higher-priced plans, more consumers are enrolling in high-deductible health plans, hoping that they won’t need medical care. Cost concerns are prompting consumers to compare pricing and outcomes at various providers.

Insurers are increasingly offering tools that allow consumers to do so through their sites, and there are also several third-party apps and web sites offering similar services. “Consumers obviously want more transparency around pricing, now that they’re dealing with these huge deductibles,” says Trine Tsouderos, a director of PwC’s Health Research Institute.

3.     Care goes retail. Time-crunched, cost-conscious consumers are skipping scheduled appointments with their family doctor in favor of a stop at a walk-in clinic located in a pharmacy, retail chain or supermarket. “Those models are actually letting consumers access care more quickly and at a lower cost,” says Joel White, president of the Council for Affordable Health Coverage.

The retail health industry is surging to accommodate the growing demand, with the number of clinics expected to grow 12 percent next year from around 2,150 clinics this year to about 2,400 by the end of 2016.

4.     Telemedicine continues to rise. More insurers are covering telemedicine services in 2016, which also allow consumers to access health care 24/7 from home, without the inconvenience of visiting a doctor and at a fraction of the price. The cost of a telemedicine call is usually around $25 to $30 and can be covered with FSA or HSA dollars if it’s not covered by insurance. 

Telemedicine is expected to grow around 40 percent per year over the next five years, from its current $645 million to more than $3.5 billion in 2020, according to a report from IBISWorld.

5.     Medical-grade wearables come to market. FitBit and Apple Watch are great for the casual health enthusiast to keep track of his vitals, but the potential for so-called “medical-grade wearables,” devices designed to aid in the prevention or treatment of a specific disease is just starting to be realized. “We’re starting to see more and more devices going through the FDA approval process,” says Robin Farmanfarmaian, author of The Patient as CEO: How Technology Empowers the Healthcare Consumer.

Some products in this space include the Modus Health Watch, which the VA is using to help monitor patients with prosthetics, and the Empatica Embrace Watch, which can detect seizures in patients with epilepsy. A Soreon Research report expects the market for wearables, which is still in its infancy, to reach $41 billion by 2020, driven by growth in devices aimed at combating diabetes, sleep disorders, and cardiovascular disease.

6.     Drug prices come under pressure. Lawmakers and regulators  (and presidential hopefuls) have been ramping up their scrutiny of drug pricing practices amid several flagrant instances of alleged price gouging (see Turing Pharmaceuticals and Valeant), and consumer advocates are becoming more vocal about the price of even generic pharmaceuticals. Both companies have since rolled back their price increases, and experts say that while drug prices will continue to rise the practice of hiking prices purely for profit may be on the wane.

7.     Medical ID theft is an even bigger problem. While technology is creating amazing gains for medical care, it’s also creating serious weak spots. A recent Accenture report projects that 1 in 13 patients (about 25 million people) will be a victim of medical ID theft due to provider data breaches. Victims of medical ID theft, in which thieves steal your Social Security number and health insurance info in order to fraudulently obtain medical services or treatment, spend thousands to restore their credit and correct inaccuracies in their medical records. Unlike banks and credit card issuers, most healthcare organizations offer no protection services for victims.

8.     Your doctor may no longer be in network. As companies and insurers look for additional ways to reduce healthcare costs, they’re increasingly narrowing the networks of doctors and medical providers with whom they offer preferred rates. That means that even if you haven’t changed your insurance plan, your doctor may no longer be “in-network.” 

9. Private exchanges will continue to grow. A growing number of businesses are opting out of providing traditional insurance for workers in favor of private exchanges, which allow consumers to search for health insurance in much the same way they’d search for a vacation package on Travelocity.com. The companies are providing workers with a set dollar amount they can spend on the exchanges—and employees who want a more robust plan can make up the difference out of pocket. The number of workers who buy health care on private exchanges doubled from 3 million to 6 million in 2015, and is expected to double again in 2016 to 12 million. 

10. House calls make a comeback. Several start-ups around the country are now promising to deliver a doctor to your door within an hour or two. Apps like Heal in California, Curbside Care in Philadelphia, and Mend in Dallas are all aiming to bring back the old-fashioned house call. Silicon Valley isn’t the only one who sees value in bringing care to the patient. Since 2012, Medicare has been testing a home-based primary care program to see whether it can improve quality of care and stave off the need for a patient to move to a nursing home.

Equip in Advance for Emergencies

Be prepared for weather-related emergencies, including power outages.

  • Stock food that needs no cooking or refrigeration and water stored in clean containers.
  • Ensure that your cell phone is fully charged.
  • Keep an up-to-date emergency kit, including:
    • Battery-operated devices, such as a flashlight, a National Oceanic and Atmospheric Administration (NOAA) Weather Radio, and lamps;
    • extra batteries;
    • first-aid kit and extra medicine;
    • baby items; and
    • cat litter or sand for icy walkways.
  • Protect your family from carbon monoxide.
    • Keep grills, camp stoves, and generators out of the house, basement and garage.
    • Locate generators at least 20 feet from the house.
    • Leave your home immediately if the CO detector sounds, and call 911.

      Do This When You Plan to Travel

      When planning travel, be aware of current and forecast weather conditions.

      • Avoid traveling when the weather service has issued advisories.
      • If you must travel, inform a friend or relative of your proposed route and expected time of arrival.
      • Follow these safety rules if you become stranded in your car.
        • Stay with your car unless safety is no more than 100 yards away, but continue to move arms and legs.
        • Stay visible by putting bright cloth on the antenna, turning on the inside overhead light (when engine is running), and raising the hood when snow stops falling.
        • Run the engine and heater only 10 minutes every hour.
        • Keep a downwind window open.
        • Make sure the tailpipe is not blocked.

      Above all, be ready to check on family and neighbors who are especially at risk from cold weather hazards: young children, older adults, and the chronically ill. If you have pets, bring them inside. If you cannot bring them inside, provide adequate, warm shelter and unfrozen water to drink.

      No one can stop the onset of winter. However, if you follow these suggestions, you will be ready for it when it comes.

  • Pertussis is also known as “whooping cough” because of the “whooping” sound that is made when gasping for air after a fit of coughing.
  • Coughing fits due to pertussis infection can last for up to 10 weeks or more; this disease is sometimes known as the “100 day cough.”
  • Pertussis can cause serious illness in babies, children, teens, and adults and can even be life-threatening, especially in babies.
  • Approximately half of babies less than 1 year old who get pertussis need treatment in the hospital.
  • The most effective way to prevent pertussis is through vaccination with DTaP for babies and children and with Tdap for preteens, teens, and adults.
  • Vaccination of pregnant women with Tdap is especially important to help protect babies.
  • Vaccinated children and adults can become infected with and spread pertussis; however, disease is typically much less serious in vaccinated people.
  • Pertussis is generally treated with antibiotics, which are used to control the symptoms and to prevent infected people from spreading the disease.
  • Worldwide, there are an estimated 16 million cases of pertussis and about 195,000 deaths per year.
  • In 2012, the most recent peak year, 48,277 cases of pertussis were reported in the United States, but many more go undiagnosed and unreported. This is the largest number of cases reported in the United States since 1955 when 62,786 cases were reported.
  • Since the 1980s, there has been an increase in the number of reported cases of pertussis in the United States. In 2010, an increase in reported cases among 7 through 10 year olds was seen. Similar trends occurred in the following years; however, an increase in cases was also observed among teens.

It may already be winter, but we haven’t reached the season’s peak — and it seems the same can be said about the flu.

According to Scientific American, the flu will reach its maximum point in February. And in even better news, it will likely be mild compared to other years. This is late compared to the last three years, when influenza reached its highest point in December.

This forecast is based on a new model, which looks at past flu seasons in the United States and makes mathematical predictions based on how the flu spreads. Then, it takes into account the latest data on the current flu season to make an educated guess on what the flu has in store for us.

Based on current data, there’s less than a 20% chance that influenza will reach its peak in January, but a 57% chance it will do so in February.

The season coming later in the year likely means less cases of the flu, which is the reason why scientists predict it will likely be milder than in years past.

“Historically, earlier-peaking flu seasons have tended to be more intense…[and] later-peaking seasons tend to be more mild,” reports Dave Osthus, a researcher at Los Alamos National Laboratory who leads the flu forecast project.

As good as this all sounds, the model is still new and the lab admits there are factors that can lead to false readings. Researchers plan to pay attention to how well “the flu shot matches the strains of flu in circulation.” They also will pay attention to the number of Wikipedia searches for the flu, which can also help predict flu outbreaks, according to LiveScience.com.

For now, doctors say the later peak for flu season will allow more time for people to get the flu shot. And yes, they still recommend getting the flu shot, noting the term “mild” refers to how many people get sick, not the severity of the flu strain.

Did you know:  Sore Throat (Pharyngitis). Viral pharyngitis infection is the most common cause of a sore throat and the etiologic agents are usually respiratory viruses, including adenoviruses, coxsackie A viruses, influenza, or parainfluenza virus. It is self- limited, and normally goes away on its own. Streptococcal pharyngitis  which is the most frequent bacterial cause of infectious pharyngitis.  In the winter months during Strep outbreaks, as many as 30% of episodes of pharyngitis may be caused by Strep A.

There are many reasons for a sore throat. Allergies, postnasal drip, colds, the flu, and bacterial infections all cause a painful throat. There are some symptoms, however, that make it more likely that you have strep throat, and need to be seen by a doctor.

If you have a sore throat or feel something coming on, visit our local Oklahoma City Urgent Care Clinic located on the NE Corner of May & Britton. We will get you feeling better faster.

The CDC recommends we all get our flu shot as soon as our doctor or local clinics begin to offer the vaccination, usually in the early autumn, in an effort to protect each of us before flu season officially hits. If you wait until you see headlines about a major flu season underway (or your coworkers and family members start coming down with it), there’s a real chance you could be infected before that last-minute shot really starts to protect you. It takes more than a week or two for the benefits of the vaccination to take effect, so there’s the possibility that you could get your shot and then develop influenza if you were exposed to the virus either just before or after your vaccination.

So, your odds of preventing the flu from keeping you down increase if you’re vaccinated early in the flu season, but the window of opportunity is much larger than you might think. Getting your influenza vaccine sometime between Labor Day and Thanksgiving is considered ideal, but flu season doesn’t typically peak until January, February or March — some seasons it’s been known to last through May. And a late shot is better than no shot, so no matter whether it’s October or February, the vaccine can still help.

You’ve been sneezing, you have a sore throat and you’re beginning to develop a bit of a cough; don’t be disappointed that this year’s flu shot failed you — it’s likely you’re suffering something other than the flu. The common cold is often confused for the flu, but the two illnesses aren’t caused by the same thing. Additionally, only strains of the influenza virus are included in the flu vaccine. There are a few respiratory illnesses that can look a lot like colds and flu, despite being neither.

Respiratory syncytial virus (RSV), respiratory adenoviruses and parainfluenza viruses also cause upper respiratory illnesses that feel a lot like having the flu. RSV, for instance, usually develops as a cough with a stuffy nose, sore throat, earache and fever, and it can cause other conditions such as pneumonia and bronchitis. Adenoviruses also may cause respiratory infections such as pneumonia, as well as conjunctivitis (pink eye).

This may come as a surprise to many, but you can’t get the flu from the flu vaccination itself. You just can’t; the virus is in the vaccination is inactivated (that mean’s it’s been killed). You can’t get it from the nasal spray, for that matter, either. But despite this, many people’s personal experience sometimes suggests otherwise. There’s a good reason for this happening, though, and it’s not the fault of the vaccination; it’s your body. It takes two weeks, give or take a day or two, after you’ve been vaccinated for your body to build up a level of antibodies great enough to protect itself against the flu when you are exposed, but in the meantime you’re just as vulnerable as you were the day before you got vaccinated. Plus, the flu vaccine can only protect you from the known strains of the flu that were around when the vaccine was formulated. If a new strain develops, you won’t be covered.

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