BY KEITH ROACH, M.D.

Series of infections follows after an intense bout of influenza A DEAR DR. ROACH: I contracted influenza A nine weeks ago, which was confirmed by a nasal swab. I had my regular flu vaccine in mid-November, but it was no match for this virulent strain. I was sicker than I can remember, and COVID seemed mild in comparison. During the illness, I developed a sinus infection and was prescribed an antibiotic that appeared to clear it, but I was still left feeling unwell. I lost my voice in the ensuing viral mayhem.

Fast forward nine weeks later, and I’m still not feeling well. My voice is still not back 100%. I’m still coughing, and my energy levels are low. It’s frustrating. Last weekend, I spent Sunday in bed with chills and woke up in the middle of the night in sweats. My doctor then prescribed another antibiotic, suggesting that the sinus infection did not clear.

What is happening to me? I’m 64 and in previous excellent health, and this is worrying me. Is there some underlying reason as to why I am unable to clear this horrible virus? I’m tired of this lingering illness and sick of being asked why I’m still sick all the time. — C.D.

ANSWER: It seems to me that we humans have a protective mechanism that lets us forget just how sick we were when we had the flu. As you correctly say, influenza A is a horrible virus that kills 30,000-60,000 Americans a year. It killed more people than COVID did this year, and still, I see people say it’s “just the flu.”

Like with COVID, after getting the flu, people can have long-lasting symptoms of the lungs (cough and shortness of breath), heart, and central nervous system (brain fog). But the effect it undoubtedly has on depressing our immune and inflammatory systems are part of why people can get other viruses and bacterial infections after a bad case of influenza.

Staphylococcal and pneumococcal pneumonias are two bacterial infections that can happen after the flu. They can be extremely dangerous when a person’s system is so depleted.

To be clear, I don’t think you still have the flu; I think your system was sufficiently weakened by the initial infection that you’ve had a series of other infections afterward. For example, when your nasal passages are congested, the sinuses cannot drain properly, which makes a bacterial infection more likely.

As the risk of respiratory viruses recedes in the spring, I predict you will slowly return to your previous excellent health.

DEAR DR. ROACH: I take Zepbound. I accidentally left it out for a day, and I am worried that they will be dangerous if I use them now. They weren’t exposed to the sun at all. Is it safe for me to take them? Should I put them back in the refrigerator? — T.Q.

ANSWER: According to the manufacturer, Zepbound is safe when stored unrefrigerated for 21 days. If it is stored at room temperature, it should not be returned to the refrigerator and must be the discarded if not used within 21 days. Apparently, going back and forth from room temperature to the refrigerator potentially causes more problems than just leaving it out at room temperature. As you say, you want it to be out of the sun and out of extreme temperatures at all times.

In general, expired medicines and heat-damaged medicines are inactive and not dangerous, although there are exceptions.