Is it allergies? Seasonal cold or Flu? Or Covid-19?

How to evaluate based on symptoms, something I recently had to do for our adult disabled daughter. It can be a tense time to get it sorted out, as you just can’t walk in and be seen if your symptoms include a cough. I found this article to be very helpful and thought I would share it with you!

Author: Michael D. Schooff, MD, FAAFP is a Family Medicine provider at CHI Health.

With fall allergies in full swing and flu season on the way, people may be wondering if that runny nose is just pollen attacking, a seasonal cold or flu — or if it could be COVID-19. You might be asking: When should I be seen? Should I be tested? 

Symptoms That Can Overlap Cold, Flu, and COVID-19

  • Sore throat
  • Nasal congestion
  • Nasal drainage
  • Cough
  • Shortness of breath
  • Fever
  • Fatigue
  • Body aches
  • Loss of taste or smell
  • Abdominal symptoms

How to Distinguish Between Illnesses

COVID-19 unfortunately has all of those symptoms. The one symptom relatively unique to COVID-19 is loss of taste and or smell. But that only happens in about 60% of COVID-19 patients. If you lose your sense of taste or smell, COVID-19 is probably the most likely diagnosis.

Allergies usually start in mid-August and it’s usually something people have dealt with in the past. Allergies do cause a lot of histamine-like reactions, such as sneezing, itchy/watery eyes. It can cause a lot of nasal drainage and nasal congestion, so there is some overlap with COVID-19 and flu symptoms. The biggest difference is allergies shouldn’t cause loss of smell or taste. Also fevers and chills are not common for allergies.

Sinus disease tends to come on after 10 or more days of being ill, and it usually happens with green-colored nasal drainage, severe nasal congestion and tooth pain. You can also have chronic sinus disease but that wouldn’t be seasonal. That would tend to be year-round with chronic nasal congestion, smell loss and a lot of nasal drainage.

Strep throat usually begins with a sore throat and a fever. From there, you might have enlarged lymph nodes and sometimes a white coating on the back of the throat. There’s usually not a lot of nasal symptoms. Strep throat is treated with antibiotics, which lessens the duration of symptoms, lessens the chances of spreading it to others, and lessens some side effects like rheumatic fever.

RSV in infants and children usually begins with a fever or runny nose, some congestion and then develops into lower respiratory symptoms of cough, wheezing, difficulty breathing. In adults, RSV presents like any other cold you have had – some runny nose, congestion, a dry nonproductive cough.

Influenza is usually characterized by an abrupt onset of symptoms. The classic influenza patient says, “I felt fine until 3:30 this afternoon and then I felt like a bus hit me.” They develop body aches, fever, fatigue, congestion, sore throat and cough. Influenza can be treated in the first 48 to 72 hours with antivirals that can help shorten duration of symptoms. 

What to Do When Symptoms Strike

With COVID-19 still in our area, it’s important to be seen and evaluated for these symptoms so you can be treated — and help prevent the spread of illness to your family, coworkers and the community. 

Call your primary care provider’s office.

  • Depending on your symptoms and underlying health conditions, they may recommend you come in to be seen in the clinic.
  • They may do a telehealth visit over video or telephone to assess your condition.
  • Call first rather than walking in so your provider can decide the best way to see you. Let them guide you to the care you need

If you don’t have a primary care provider, you can access CHI Health Virtual Quick Care.

  • Call 402-717-1255 or go to CHIhealth.com/virtual.
  • These providers can assess your symptoms and determine if you do need to be tested and/or treated for allergies, flu, strep, COVID-19 – or something else.
  • Unless you have severe or life-threatening symptoms, avoid going to emergency rooms which can be overwhelmed with a lot of very sick people.

When in doubt about symptoms, it’s always better to be seen. Steps you can take for a healthier fall season include washing your hands, keeping your distance and masking in indoor public spaces and getting your COVID-19 and the flu vaccines.

Author:

This week in history …

217 years ago Aaron Burr was on St. Simons and rode out a hurricane while on the north end. The ruins of John Couper’s house can still be seen on Cannons Point!

After Aaron Burr killed Alexander Hamilton in a duel he came to St. Simons to avoid prosecution as dueling had been made illegal. While here he visited John Couper on Cannon’s Point and survived a hurricane. This is his letter to his daughter, it includes fascinating tidbits about life back then.

all that remains of John Couper’s house

TO THEODOSIA.

St. Simon’s, September 3, 1804.

You see me returned from Gaston’s Bluff, now called ‘Hamilton’s Bluff’, a London merchant, partner of Mr. Couper. We were four in the carriage; the three ladies and myself.

Mr. Morse informs you that this island is forty-five miles long, and that it lies north of the mouth Altamaha, commonly spelled Alatamaha. It is, in fact, twelve and a half miles in length, and lies southeast of that river. Its width is about two and a half miles. There are now residing on the island about twenty-five white families. Frederica, now known only by the name of ‘Old Town’, is on the west side of the island, and about midway between its northern and southern extremities. It was first settled by Governor Oglethorpe, and was, about fifty years ago, a very gay place, consisting of perhaps twenty-five or thirty houses. The walls of several of them still remain. Three or four families only now reside here. In the vicinity of the town several ruins were pointed out to me, as having been, formerly, country seats of the governor, and officers of the garrison, and gentlemen of the town. At present, nothing can be more gloomy than what was once called Frederica. The few families now remaining, or rather residing there, for they are all new-comers, have a sickly, melancholy appearance, well assorted with the ruins which surround them. The southern part of this island abounds with fetid swamps, which must render it very unhealthy. On the northern half I have seen no stagnant water.

Mr. Couper, with his escort of ladies, was to have met us this afternoon, but he has sent us word that he is taken ill on the way; that, owing to illness in the family of the ladies who were to have accompanied him, they have been obliged to renounce the visit. We therefore returned as we went. At Frederica and Gaston’s Bluff we were convinced that insects can subsist on this island. Moschetoes, flies, and cockroaches abounded.

Thursday, September 6, 1804

Just returned from Darien. And what took you to Darien? To see the plantation of Mr. Butler on an island opposite that town, and to meet a day sooner the letters which I expected from you. In the last object I have been again disappointed, which I ascribe wholly to the irregularity of the mails. It is most mortifying and vexatious to be seven weeks without hearing of you or from you, and now a whole week must elapse before I can expect it.

You are probably ignorant that Darien is a settlement (called a town) on the north bank of the Alatamaha, about eight miles from its mouth. Major Butler’s Island in this river is one mile below the town. It must become a fine rice country, for the water is fresh four miles below Major Butler’s, and the tide rises from four to five feet, and the flats or swamps are from five to seven miles in width for a considerable distance up the river. The country, of course, presents no scenes for a painter. I visited Little St. Simon’s and several other islands; frightened the crocodiles, shot some rice-birds, and caught some trout. Honey of fine flavour is found in great abundance in the woods about the mouth of the river, and, for aught I know, in every part of the country. You perceive that I am constantly discovering new luxuries for my table. Not having been able to kill a crocodile (alligator), I have offered a reward for one, which I mean to eat, dressed in soup, fricassees, and steaks. Oh! how you long to partake of this repast.

Wednesday, September 12, 1804.

On Friday last, hearing that Mr. Couper had returned and was very seriously ill, I took a small canoe with two boys, and went to see him. He lay in a high fever. When about to return in the evening, the wind had risen so that, after an ineffectual attempt, I was obliged to give it up, and remain at Mr. C.’s. In the morning the wind was still higher. It continued to rise, and by noon blew a gale from the north, which, together with the swelling of the water, became alarming. From twelve to three, several of the out-houses had been destroyed; most of the trees about the house were blown down. The house in which we were shook and rocked so much that Mr. C. began to express his apprehensions for our safety. Before three, part of the piazza was carried away; two or three of the windows bursted in. The house was inundated with water, and presently one of the chimneys fell. Mr. C. then commanded a retreat to a storehouse about fifty yards off, and we decamped, men, women, and children. You may imagine, in this scene of confusion and dismay, a good many incidents to amuse one if one had dared to be amused in a moment of much anxiety. The house, however, did not blow down. The storm continued till four, and then very suddenly abated, and in ten minutes it was almost a calm. I seized the moment to return home. Before I had got quite over, the gale rose from the southeast and threatened new destruction. It lasted great part of the night, but did not attain the violence of that from the north; yet it contributed to raise still higher the water, which was the principal instrument of devastation. The flood was about seven feet above the height of an ordinary high tide. This has been sufficient to inundate great part of the coast; to destroy all the rice; to carry off most of the buildings which were on low lands, and to destroy the lives of many blacks. The roads are rendered impassable, and scarcely a boat has been preserved. Thus all intercourse is suspended. The mail-boat, which ought to have passed northward last Saturday, and by which it was intended to forward this letter, has not been heard of. This will go by a man who will attempt to get from Darien to Savannah on foot, being sent express by the manager of Major Butler; but how, or whether it will go on from Savannah, is not imagined.

Major Butler has lost nineteen negroes (drowned), and I fear his whole crop of rice, being about two hundred and sixty acres. Mr. Brailsford, of Charleston, who cultivates in rice an island at the mouth of the Alatamaha, has lost, reports say, seventy-four blacks. The banks and the buildings on the low lands are greatly injured. We have heard nothing from the southward, nor farther than from Darien northward. I greatly fear that this hurricane, so it is here called, has extended to the Waccama.

The illness of Mr. C., which still continues, and the effects of the storm, have defeated all my plans. To get to Florida seems now impracticable; nor do any present means occur of getting from this island in any direction. Young Swartwout, who went ten days ago to Savannah, has not returned, nor is it possible that he should very speedily return. I have not received a letter since my arrival from any person north of Savannah (yes, one from C. Biddle, of 19th August), nor do I expect one for many days to come.

I had taken up another sheet to say something more, I know not what; but the appearance of a fine sheep’s-head smoking on the table has attractions not to be resisted. ‘Laissez moi diner’, “and then,” &c.

Madame j’ais bien diner’, and ‘j’ai fait mettre mon’ writing-desk _sur le table a diner’. What a scandalous thing to sit here all alone drinking Champagne–and yet–(_madame je bois a votre santé et a celle de monsieur’ votre fils)–and yet, I say, if Champagne be that exhilarating cordial which (_je bois a la santé de Madame Sumtare) songs and rumour ascribe to it (a la santé de Mademoiselle Sumtare), can there be ever an occasion in which its application could be more appropriate, or its virtues more (_mais buvons a la santé de mon hôte et bon ami’, Major Butler). By-the-by, you have no idea–how should you have, seeing that you never heard a word about it?–you have no idea, I was going to say, of the zeal and animation, of the intrepidity and frankness with which he avowed and maintained–but I forget that this letter goes to Savannah by a negro, who has to swim half a dozen creeks, in one of which, ‘at least’, it is probable he may drown, and that, if he escape drowning, various other accidents may bring it to you through the newspapers, and then how many enemies might my indiscretion create for a man who had the sensibility and the honour to feel and to judge, and the firmness to avow (_a la santé de Celeste un’ bumper toast). ‘La pauvre Celeste’. Adieu.

A. BURR.

Emeril Lagasse’s Gazpacho

I cannot believe I haven’t shared this recipe until now. THIS is summer in a bowl. Freezes great and one of my all time favorite soups.

Basic Gazpacho

★★★★★

Soups & Stews, Vegetable

INGREDIENTS

3 pounds ripe tomatoes, peeled, seeded and chopped

1/2 pound cucumber, peeled, seeded and chopped

1 cup chopped celery

1/2 cup chopped red pepper

1/2 cup chopped red onion

1 teaspoon chopped garlic

1 tablespoon chopped jalapeno pepper

3 tablespoons red wine vinegar

1/4 cup good olive oil

12 ounces tomato juice

Salt, pepper, ground coriander

3 tablespoons chopped cilantro

1 lime cut into slices

6 slices toasted French bread

Gazpacho Relish:

2 tablespoons each – small diced red pepper, cucumber, red onion and red tomatoes

1 teaspoon minced garlic

1 tablespoon lime juice

1 tablespoon olive oil

Salt and pepper

DIRECTIONS

Combine all ingredients in a blender or food processor (except bread and limes), and puree until smooth. Transfer to a large bowl and refrigerate for 4 hours. Meanwhile prepare relish.

Relish: Combine and chill for 1 hour. Ladle out soup into pretty bowls, top with a large tablespoon of relish, 1 crouton, and a slice of lime.

I purée in batches …
My tomato press separates the seeds and skins from the pulp
Chillin’ that first hour in the fridge. Yields about 2 quarts

Saturday morning BRUNCH is served – Peach 🍑 Dutch Baby

Caramelized Peaches within, sliced peaches on top

Peach Dutch Baby

★★★★★

Baked goods, Breakfast, Fresh Fruit

I highly recommend THE PEACH TRUCK cookbook. Every recipe I’ve tried has been a keeper 😍.

INGREDIENTS

5 tablespoons unsalted butter

1 cup chopped fresh peaches

3 large eggs

¾ cup whole milk

¾ cup all-purpose flour

4 tablespoons granulated sugar

½ teaspoon kosher salt

To Serve:

3 tablespoons powdered sugar

2 cups sliced fresh peaches

DESCRIPTION

The author’s favorite recipe from The Peach Truck cookbook

DIRECTIONS

Preheat the oven to 425 degrees F.

Melt 1 tablespoon of the butter in a 10-inch cast-iron skillet over medium-high heat. Add the chopped peaches and 1 tablespoon of the granulated sugar and cook, stirring often, until the peaches begin to brown, about 3 minutes. Remove the peaches from skillet and wipe the skillet clean. Place the skillet in the hot oven for 10 minutes.

Blend the eggs, milk, flour, remaining 3 tablespoons granulated sugar, and the salt in a blender until smooth. Add the remaining 4 tablespoons butter to the skillet and swirl the skillet until the butter has melted. Pour the batter over the melted butter in the hot skillet without mixing it in. Spoon the caramelized peaches on top of the batter. Transfer the skillet to the oven and bake for 20 to 25 minutes, until puffed and golden.

Serve immediately, topped with a dusting of powdered sugar and additional sliced fresh peaches if desired.

Ready to pop back into the oven to bake
Baked and ready for the sliced fresh peaches and powdered sugar

I source my peaches from Dickey Farms as they are the only shipper that hasn’t disappointed me. Others have arrived bruised and mealy, but not if they are shipped from Dickey Farms.

French Dip in your Instapot/Pressure Cooker

Now THIS French Dip recipe for a pressure cooker is a KEEPER! It rivaled the taste and texture of a brisket recipe I make every year at Christmas (?!?!!)

Two caveats on the time. Meat must be room temp for 15 min before starting AND there’s 25 minutes to add to cook time in the natural release (steam).

I also chilled the dipping broth so the fat rose to the top for removal. I don’t find it palatable without that step.

The meat is tender as buttah and the flavor??
To-DIE-for. Never making a chuck roast another way.

Instant Pot French Dip Sandwich
★★★★★
INSTAPOT/Pressure Cooking, Kid-Friendly, Main Dish, Meats, Sandwich
Prep 15 mins ∙ Cook 1 hr 40 mins ∙ Makes Servings: 6 sandwiches ∙ Source Number-2-pencil.com
INGREDIENTS

2.5 pound chuck roast
1 tablespoon of vegetable oil
2 teaspoons of kosher salt
freshly ground pepper to taste
1/2 teaspoon of garlic powder
1 onion sliced
1/2 cup of red wine
1 14 oz can of low-sodium beef broth
1 dried bay leaf
6 soft rolls
3 tablespoons of butter melted
1/4 teaspoon of garlic powder
pinch of kosher salt
6 slices of provolone cheese
DIRECTIONS

For best results, let chuck roast rest at room temperature for at least 15 minutes before searing.

Add vegetable oil to the Instant Pot and hit the sauté button.

Season chuck roast with 2 teaspoon of kosher salt, freshly ground pepper to taste and 1/2 teaspoon of garlic powder on all side.

Using a pair on long heat-proof kitchen tongs, sear roast on all sides in Instant Pot.

Remove seared roast from Instant Pot and set aside.

Add onions to pot and sauté just until they start to soften.

Add red wine to pot and let simmer until reduced by half.

Use a wooden spoon to scrape up seared bits from the bottom of the pot as it simmers.

Once wine has reduced, add low-sodium beef broth and bay leaf.

Return roast to Instant Pot, close lid and make pressure release valve is set to sealing.

Hit Meat/Stew function and increase time to 100 minutes.

Let Instant Pot natural release for 25 minutes, then turn valve to venting to release any excess pressure.

Remove lid and transfer roast to a serving plate and shred.

Strain liquid through a fine mesh strainer and serve warm for dipping sandwiches.

Set oven to broil and place sandwich rolls on a baking sheet.

Combine melted butter, 1/4 teaspoon of garlic powder and pinch of kosher salt in a small bowl.

Brush over rolls and toast 2-3 minutes, just until gold brown.

Pile meat onto rolls and top with cheese. Return to broiler and heat just until cheese has started to melt.

Top sandwiches with freshly chopped flat-leaf parsley and serve with warm au jus for dipping.

Pickled Vegetable Sandwich Slaw

f you’re one of those people who saw the word “pickled” in the title and said “Ugh, no, sorry, not for me,” do know, I was the same not too long ago and encourage you to fight the good fight for as long as you can, because once your tastes cross over to the vinegar side, there’s little going back.

INGREDIENTS

Pickling mixture

1 cup distilled white vinegar

4 tablespoons sugar

2 tablespoons Kosher salt

2 tablespoons yellow mustard seeds

1 cup cold water

Slaw mixture

4 to 5 cups mixed slivered or julienned* firm, raw vegetables (see above for vegetable suggestions, below for slicing tips)

Optional: Few slivers of jalapeno

DIRECTIONS

Heat vinegar, sugar, salt and mustard seeds to a simmer in a small, non-reactive pot over moderate heat, stirring only until sugar and salt dissolve. Stir in water, which should bring the mixture’s temperature down significantly. Let cool to lukewarm.

Divide vegetables between jars. (I used two 3/4 liter jars.) Pour vinegar mixture over vegetables and refrigerate until needed. You’ll find the vegetables to be lightly pickled within an hour, and deliciously pickled within a day. They will get slightly more pickled as they sit, but the change shouldn’t be too dramatic from the 24 hour level.

Eat with/on sandwiches, aside grilled food and pack it along for picnics — it goes with almost anything. Then make more, because this stuff is habit-forming.

Do ahead: Mine have kept in the fridge for a month without any change in taste or appearance. Updated to add (thanks, Erika!) that you’ll want to make sure that your vegetables are submerged in the brine for them to keep this long.

* I used a mix of a sharp knife, a simple mandoline (that includes julienne blades) and a julienne peeler (the Kuhn one), which I was embarrassed to admit I bought last year until I realized how much easier it makes getting juliennes from long, thin vegetables (carrots, cucumbers, parsnips and zucchini). Don’t fret if you don’t have a fancy peeler or mandoline; you can cut thin strips with your knife, then slice them into skinny matchsticks quite easily.

1, 2, 3 … PESTO 🌱

Nothing says summertime to me like a garden full of basil. Here’s my favorite recipe for a classic Pesto (although I do substitute walnuts for pine nuts if I happen to have them on hand).

Quick work in a food processor

I love it straight up on pasta and even freeze some in ice cube trays, to pop into sauces come winter.

Let me know in comments your favorite way to enjoy homemade pesto.

Pesto

★★★★★

INGREDIENTS

2 cups fresh basil leaves 

4 medium-sized cloves garlic, chopped

1 cup walnut meats (or pine nuts)

1 cup best-quality olive oil 

1 cup freshly grated imported Parmesan cheese

1/4 cup freshly grated imported Romano Cheese 

salt and freshly ground black pepper, to taste

DIRECTIONS

Process the basil, garlic, and walnuts in a food processor fitted with a steel blade – or in 2 batches in a blender – until finely chopped.

With machine running, pour in the oil in a thin, steady stream.

Add the cheeses, a big pinch of salt, and a liberal grinding of pepper. Process briefly to combine. Remove to a bowl and cover until ready to use.

Yield: 2 cups, enough to sauce 2 pounds of pasta

Freezes beautifully
  • After making the fresh basil pesto recipe pour it into an ice cube tray- in 1 ½ tablespoon portions. Top each cube with a drizzle of extra virgin olive oil.
  • Put the ice cube tray in the freezer.
  • After a couple hours the pesto cubes will be frozen, pop them out and store them in a freezer safe bag.
  • You can keep the cubes in the freezer for up to 6 months.
  • Pull out the delicious homemade pesto 1, 2, or 8 cubes at a time to add to your recipes.
My basil plant’s insanely huge this year 💚

It’s CORN season🌽

We live in corn country!
Whenever I buy a dozen at the farmstand, I prep it for the microwave (as shown, cut and outer husks removed) and store in the fridge.

4 minutes in your microwave


To cook:
Place in microwave for 4 minutes (mine has a fresh hard vegetable setting).
Husks and silks remove in one fell swoop!
Enjoy! 🌽

Chicken Enchilada Soup

Chicken Enchilada Soup

Chicken Enchilada Soup has everything you love about chicken enchiladas… in one big bowl of soup!


Chicken Enchilada Soup (Slow Cooker and Instant Pot)

★★★★★

Skinny Taste, Soups & Stews

INGREDIENTS

2 tsp olive oil

1/2 cup onion, chopped

3 cloves garlic, minced

3 cups less sodium chicken broth

8 oz can tomato sauce

1-2 tsp chipotle chili in adobo sauce, or more to taste

1/4 cup chopped cilantro, plus more for garnish

15 oz can black beans, rinsed and drained

14.5 oz can petite diced tomatoes

2 cups frozen corn

1 tsp cumin

1/2 tsp dried oregano

2 skinless chicken breasts, 16 oz total

For topping:

3/4 cup shredded part skim cheddar cheese

1/4 cup chopped scallions

1/4 cup chopped cilantro

4 oz 1 small haas avocado, diced

6 tbsp reduced fat sour cream, optional

DIRECTIONS

Slow Cooker Directions:

Heat oil in a saucepan over medium-low heat. Add onion and garlic and sauté until soft, 3-4 minutes. Slowly add the chicken broth, tomato sauce and chipotle adobo sauce and bring to a boil. Add cilantro and remove from heat. Pour into crock pot.

Add the drained beans, diced tomatoes, corn, cumin, oregano and stir. Add the chicken breasts; cover and cook on low heat for 4-6 hours.

Remove chicken and shred with two forks. Add chicken back into the soup, adjust salt and cumin to taste. Serve in bowls and top with cheese, avocado, scallions and cilantro. Also great with sour cream or crushed tortilla chips. Enjoy!

Instant Pot Directions:

Press saute on the Instant Pot. Add onion and garlic and sauté until soft, 3-4 minutes. Slowly add the chicken broth, tomato sauce and chipotle adobo sauce and cilantro.

Add the drained beans, diced tomatoes, corn, cumin, oregano and stir. Add the chicken breasts; cover and cook on high pressure for 20 minutes. Quick or natural release.

Remove chicken and shred with two forks. Add chicken back into the soup, adjust salt and cumin to taste. Serve in bowls and top with cheese, avocado, scallions and cilantro. Also great with sour cream or crushed tortilla chips. Enjoy!

NUTRITION

333 Cals 30 Protein 35 Carbs 10 Fats
Serving: 11/2 cups, Calories: 333kcal, Carbohydrates: 35g, Protein: 30g, Fat: 10g, Saturated Fat: 2.5g, Cholesterol: 65.5mg, Sodium: 812.5mg, Fiber: 9.5g, Sugar: 6g Blue Smart Points: 3 Green Smart Points: 7 Purple Smart Points: 3 Points +: 8