Author's note: this is part one of a two part story on staying healthy during summer vacations. Click here for part two.


Summer means getaways to de-stress and make memories. But the last thing you want is to catch a cold or worse, especially if you’re halfway across the world where health care resources might be different or scarce.

It's not too late to make some quick preparations, says Jennifer Whitfill, APRN, a family nurse practitioner at OSF HealthCare.

• Stop by the doctor’s office: Whitfill says if you haven’t seen your primary care provider for a physical exam in a while, make an appointment before vacation to address any lingering health issues. This could include getting vaccines depending on your health and where you’re going. Whitfill says typhoid fever (seen in southern Africa, Asia, Central America and South America), yellow fever (Africa), hepatitis A (remote or underdeveloped areas) and rabies are ailments to protect yourself against.
   
• Stock up on over-the-counter medication.
  
  “It’s important to be prepared,” for when these medications are needed, Whitfill says. “Consider packing Tylenol or ibuprofen, anti-allergy medicines like Claritin, Zyrtec and Benadryl. Dramamine is a good one for motion sickness or nausea. Some people reach out to their provider if they’re going on a cruise. There’s a prescription called a scopolamine patch that you can put behind your ear. It’s good for three days and helps offset motion sickness.

“Eyedrops are good if you have seasonal allergies. Over-the-counter saline or Pataday drops,” Whitfill adds. “Creams like hydrocortisone and triple antibiotic ointment are good to have.”

For outdoor trips like camping, essentials including a first aid kit, sunscreen and bug spray are must-haves, too. Know if you’re on a medication, such as certain acne creams and menstrual cycle medications, that makes you more prone to sunburn.

And regardless of what you pack, Whitfill says flyers should check the Transportation Security Administration guidelines about what can come on a plane. She says to leave medicines in their original packaging when preparing airport luggage.

• Medicine, part two – before you go: You might hear travel bloggers say to boost your immune health before traveling to reduce your risk of catching something. Is the advice overblown?
  
  Whitfill says no. She says elderberry, vitamin C and D and zinc are all good supplements to take before a trip. Start three to four weeks before departure, if you can. And if you have concerns about supplements interacting with prescription medication, talk to your provider.
   
• Check the U.S. Centers for Disease Control and Prevention website for travel advisories about disease outbreaks, civil unrest and more.

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Here’s an eye-opening observation from John Rinker, MD: Some people think just because you can get a medication over the counter, you can play fast and loose with its use.

“Because it’s widely accessible and they can easily get it from their grocery store, they sometimes don’t even view it as actual medicine,” says Dr. Rinker, an internal medicine physician at OSF HealthCare. They view it more like a vitamin, he says.

Complicating matters: Due to issues like a lack of mobility, older adults might skip getting the right prescription from a health care provider in favor of a pharmacy shelf option. Dr. Rinker warns that route could lead to unintentional medication misuse and possibly deadly side effects. Luckily, there are tips to steer your loved one back onto the right path.

Common barriers and issues

A big issue for older adults is not being able to move like they used to. So, if someone is dealing with a health problem (back pain, for example), it’s tempting to skip the long drive to the doctor’s office and just go to the pharmacy a block away. Or, the person might have medication delivered and not leave home at all.

Seniors can also be more forgetful or have trouble reading medication labels, leading to instances where they take too much of a drug. And Dr. Rinker says as we age, our ability to break down medicine and clear it from our body diminishes. The liver and kidneys just don’t work as well as they used to.

“That’s why we often adjust doses of medicine for adults as they age. We deescalate the dose. Less is more in certain cases,” Dr. Rinker explains. “The dose can last longer. The byproducts of the drug are more likely to create another problem.”

Some common over the counter medicines that are unintentionally misused, according to Dr. Rinker:

• A pain reliever like ibuprofen or Aleve (the technical term is a non-steroidal anti-inflammatory)
  
  “If it’s used temporarily, it’s probably not problematic. That’s how those drugs are meant to be used. But so many people have chronic conditions like arthritis. They’ll take these drugs for long lengths of time,” Dr. Rinker says. “That’s when we start to run into more of those long-term effects. You worry about gastric ulcers or bleeding in your gastrointestinal area. If you have underlying kidney issues, those drugs can make that more harmful.”
   
• Acid reflux medication like Nexium or Prilosec (technical term: proton pump inhibitor). Again, Dr. Rinker says a person might keep taking these drugs past their intended use.
  
  “This can create issues with how you absorb nutrients like calcium and vitamin D. It can lead to bone and kidney problems,” Dr. Rinker warns.
   
• Sudafed (also called pseudoephedrine) or Afrin for nasal congestion.
  
  “If you have an enlarged prostate, [overuse of Sudafed] can create more of an issue. You’ll have more problems urinating,” Dr. Rinker warns. Sudafed can also raise your blood pressure, he says.
  
  Afrin, meanwhile, should only be used for a few days, Dr. Rinker says. If you use it longer then stop, he says you can actually get “rebound congestion” that’s worse than before.
   
• Benadryl (also called diphenhydramine) for allergies or to aid sleep.
  
  “It can impair cognition and increase the risk of a fall,” Dr. Rinker says. Falls can lead to serious injuries in seniors like hip fractures.

And for all medications, Dr. Rinker adds they can negatively interact with each other. For example, he says you shouldn’t take ibuprofen with a blood thinner because it could impact how the blood thinner works and make you more prone to internal bleeding.

Strategies to stay healthy

Things for seniors and their caregivers to consider:

• Look into ways to remove the travel barrier to visit your health care provider. See if a friend, family member or social service agency can give you a ride. Or, see a provider virtually. Dr. Rinker says this could be as simple as calling or messaging your provider on your patient portal and asking, “Is it safe for me to take this drug?”.
   
• Caregivers should closely watch their loved one’s medication use and their behavior afterward. For example, did one particular pill make grandma woozy? It’s worth looking into if the regimen should be changed. Don’t be afraid to ask tough questions like, “I saw you take that pink pill earlier today. Are you sure you need another?”.
  
  “Just because they’ve taken it for a while doesn’t mean the drug is OK,” Dr. Rinker says.
   
• When you do visit a health care provider, make sure they know your health history and which medications you’re taking.
  
  “You can read medicine packaging, but sometimes it’s really difficult to understand the language. It’s not always clear cut for the average person,” Dr. Rinker points out. “So, your primary care provider is the best person to ask questions of. They’ll have your chart and other information. They can give you a response that’s tailored to your needs.
  
  “Your provider might have a different prescription medication or a safer over the counter alternative that works well for you. Or maybe they can figure out a way for you to take your current drug in a healthier manner,” Dr. Rinker adds.

Learn more

Read more about staying healthy in your golden years on the OSF HealthCare website.

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The "PE" comes from the drug’s active ingredient, phenylephrine (phen-uh-leh-frin), marketed as a product taken by mouth that should provide temporary relief of nasal congestion. Many other over-the-counter products contain this ingredient, including items under the brand names NyQuil, Benadryl, Mucinex, and more.

Jason Scheid, the director of pharmacy services for community and specialty programs at OSF, says the FDA is now seeking public comments on the proposal into 2025. He offers a few other alternatives you can try to lessen congestion.

“If you’re looking for an oral decongestant, the original Sudafed is a good alternative,” Scheid adds. “You have to show your ID, and there are purchase limitations. It has shown itself to be an effective alternative. There are nasal decongestants you can try, like Afrin. There are also nasal steroids and antihistamines—this gets more into the allergy nasal sprays that can help prevent congestion symptoms. You can pick any of those up over the counter at a local pharmacy.”

The FDA clarifies that while it’s proposing these products be banned from store shelves, there aren’t any safety concerns attached to them. They’re simply just not effective. Scheid says more natural remedies, like standing in a hot shower or using a cool mist humidifier, can help ease congestion.

Video Version With Chyrons

Video Version Without Chyrons

Sudafed has been a household name for decades, with the drug’s active ingredient pseudoephedrine being around since the 1920s.

Recently, the U.S. Food and Drug Administration (FDA) claimed Sudafed PE, one of Sudafed’s more popular items, is not effective and should be banned from over-the-counter use. The announcement came roughly a year after a panel of advisors to the FDA unanimously said phenylephrine doesn’t work to clear up congestion when taken orally.

The PE in Sudafed PE comes from another active ingredient, phenylephrine, marketed as a product taken by mouth that should provide temporary relief of nasal congestion. Many other over-the-counter (OTC) combination drugs contain phenylephrine, including some items under the brand names NyQuil, Benadryl and Mucinex.

The FDA advisor panel’s decision led CVS pharmacy to pull common cold and cough medicines from store shelves in October 2023, which list phenylephrine as the main ingredient.

“It is the FDA’s role to ensure that drugs are safe and effective,” said Patrizia Cavazzoni, MD, director of the FDA’s Center for Drug Evaluation and Research (CDER). “Based on our review of available data, and consistent with the advice of the advisory committee, we are taking this next step in the process to propose removing oral phenylephrine because it is not effective as a nasal decongestant.”

The FDA points out that while phenylephrine is found in many nasal sprays as well, its recommendation is only related to orally administered phenylephrine.

Entering public comment period

Jason Scheid, the director of Pharmacy Services for Community & Specialty Pharmacy for OSF HealthCare, says the FDA is now seeking public comments on its proposal until May 7, 2025. A final order will be issued after the 180-day comment period.

“At that point (after the 180 days) the FDA will provide the manufacturers with their due warning whether they have to pull the products or reformulate it to find an alternative that meets the labeling requirements,” Scheid says.

Scheid anticipates if drugmakers wanted to reformulate these products, and wanted them to remain as oral decongestants, the companies would have to put pseudoephedrine into the products. This would push more products behind the pharmacy counter, like the original Sudafed.

“If you’re looking for an oral decongestant, the original Sudafed is a good alternative,” Scheid adds. “You have to show your ID and there are purchase limitations. It has shown itself to be an effective alternative. There are nasal decongestants you can try, like Afrin. There’s also nasal steroids and antihistamines, this gets more into the allergy nasal sprays that can help prevent congestion symptoms. You can pick any of those up over the counter at a local pharmacy.”

Phenylephrine or Placebo?

The FDA clarifies that while it’s proposing these products be banned from store shelves, there aren’t any safety concerns attached to them. They’re simply just not effective. Many medications will claim to offer multiple benefits. For example, Mucinex Sinus-Max® claims to clear sinus congestion and relieve headaches, while thinning and loosening mucus. But the drug also has Acetaminophen and Guaifenesin in it. Scheid says this proposal simply targets the phenylephrine component when considering nasal decongestion, so other benefits might still be possible.

“It might provide you a placebo-type effect. You might just feel better because of the other ingredients in it, but that one (phenylephrine) solely is not meeting the effectiveness criteria to remain over the counter,” Scheid says.

Natural treatment options that can relieve symptoms

“Using that hot shower or cool mist humidifier will add moisture to where you are to help with that congestion,” Scheid says. “Something as simple as saline nasal spray will add some moisture to the nasal cavity and give some relief.”

It’s always important to clean your humidifier after each use to prevent mold and other bacteria from being released in the air.

Don’t overdo it on the nasal sprays

Another reason why it’s important to read labels is the effect nasal sprays can have if they are used longer than their intended use. Most nasal decongestant sprays will recommend using the product for three days or less.

“What happens is a rebound nasal congestion, where you lose the effectiveness of the medication to relieve that pressure, and it causes more pressure if it’s used more than just a couple days,” Scheid says.

If congestion is caused by allergies

About one quarter (25.7%) of American adults have a seasonal allergy, according to the Centers for Disease Control and Prevention (CDC), while nearly one in five (18.9%) children are affected. Scheid says treating nasal congestion for those with allergies is a longer-lasting issue.

“You’re looking at longer-term solutions then. You’re either using a long-term nasal steroid spray or antihistamine spray, or oral antihistamine.”

Scheid says if the FDA’s proposal goes through in May, pharmacy shelves will look a whole lot different than they do now.

Another way to clear congestion is to stay hydrated. Drinking water will help thin out mucus discharge from the nose and loosen up any phlegm in the lungs, making it easier to cough up.

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Warmer temperatures bring the return of pesky insects, especially at dusk.

Experts say while most bug bites are not serious, there are times when you need to see a health care provider immediately.

Most bites can be treated quickly

Andrew Zasada, MD, an internal medicine physician at OSF HealthCare, says treatment of most minor bug bites (think mosquito or bee) is down to a science.

First, move away from the area so the bugs don’t bite you again. If the insect left a stinger behind, gently remove it with tweezers.

“Put some ice on the bite site. Wash it gently. Put a little calamine or hydrocortisone on it. Keep it elevated,” Dr. Zasada says.

Don’t scratch the bite site. Leave it alone and let it heal. For children who may find it difficult not to itch, put a Band-Aid over the bite. You can take an antihistamine like Benadryl, Allegra or Zyrtec for itching and ibuprofen or acetaminophen for pain.

If you notice a rapid worsening of symptoms in the 30 to 45 minutes following the bite, or if the wound is not healing over several days, it may be a sign of a more serious problem. See a health care provider.

Serious insect bites

Dr. Zasada says in the Midwest, two types of spiders come with dangerous fangs: black widow and brown recluse.

“These bites can cause tissue destruction at the bite site,” Dr. Zasada explains. “The venom is very potent. It can cause cell death. It’s very irritating.”

If the venom gets into your bloodstream, then chest pain, muscle cramps, sweating and nausea could follow. Dr. Zasada says black widow and brown recluse bites are “very rarely” fatal, but the illness they bring is quite unpleasant.

If you think you’ve been bitten by a black widow or a brown recluse, see a health care provider right away. Your local urgent care is equipped to treat insect bites, but if your symptoms have worsened, the Emergency Department at your local hospital may be the best destination.

Another serious condition to keep an eye on after a bug bite is an allergic reaction known as anaphylaxis.

Symptoms of anaphylaxis include shortness of breath, wheezing and a drop in blood pressure. Dr. Zasada says some people with known allergies may have an EpiPen handy and can inject themselves to alleviate symptoms. Regardless, immediate attention from a medical professional is still needed.

 Leave the critters alone

It’s inevitable that a stroll through the neighborhood will bring an encounter with an insect like an ant or mosquito. But Dr. Zasada says spiders that pack a punch don’t want to mess with humans. They tend to come out at night and live in wooded areas or a dark space in the back of a garage.

In other words, don’t mess with them, and they won’t mess with you.

“When you take clothing out of storage, shake it to make sure there are no spiders,” Dr. Zasada suggests. “When you clean the garage, don’t sit on anything that’s been stored there for a while. Dust it off first.”

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