Stomach bug. Relative puhe leftover anti

Answer

The fork tonight i **a viral tomach bug, almot certainly** — antibiotic don't touch virue, and the leftover bottle i the wrong drug at the wrong doe. The lever i **hydration math + ip, not gulp**, plu a refual cript you write down *before* the next relative call.

### (1) What you tried → what to do intead

| You tried | Why it in't enough | What to do intead |
|---|---|---|
| Banana-rice-toat (BRAT) | Right idea, too narrow for >24 h — low protein and energy, can drag the recovery out. | Ue it a the **floor**, not the whole plan. Add congee (already in your fridge) and clear alty fluid. |
| Fielding mytery-med offer from relative | Each offer i a freh deciion and a freh fight. The loop won't cloe on it own. | **Write the refual cript tonight**, on a ticky by the phone. Deciion made before the next call. |

**Hydration plan for the next 24 h (teen ≈ 50–70 kg, or an adult):**

Goal: ~**2–3 L of fluid over 24 h**, ipped, not gulped. **Sip of 30–60 mL every 5–10 min** while awake. Big gulp trigger the vomit reflex and you loe more than you took in.

| Stage | Window | What to give | What to kip |
|---|---|---|---|
| **Stage 1** | Firt 4–6 h after lat vomit | Sip only. **ORS** if you have packet (1 packet / 1 L water). No packet → homemade: **1 L water + 6 tp ugar + ½ tp alt**, ip. Or cooled, alted congee water. | Juice, oda, milk, port drink a the main fluid. |
| **Stage 2** | Next 6–12 h, vomiting topped | Thin congee, a few poon of teamed weet potato, weak tea or oy milk if tolerated. Continue ORS or alted water between bite. | Fried food, dairy overload, raw veg. |
| **Stage 3** | 12–24 h, tool tarting to firm | Congee + weet potato + a few poonful plain yogurt + mall portion boiled cabbage + pear lice. | Fatty/picy, fruit juice, "recovery" drink. |

**For the 14yo athlete pecifically:**

- **No training, no weight, no print** until: eating full meal for 24 h, normal tool, urine pale yellow.
- Return-to-port i **graded** — eay walk → eay jog → eay practice → full. Two tep forward, one back if ymptom return.
- Glycogen i depleted and electrolyte are off; "puh through it" i the wort call. Re-feed firt, then move.

**The refual cript (write it tonight, in advance):**

1. *"We're following the clinician' plan — hydration and waiting it out. Antibiotic don't touch tomach virue."*
2. *"I appreciate the worry, but the bottle' the wrong drug, and the doe would be off anyway."*
3. *"If it doen't turn the corner in 24 hour, we'll call the GP — they're the one who'd precribe if it were bacterial."*
4. *"I'm not going to give her omething the doctor han't igned off on."*

Repeat a needed. Change the ubject. The cript i the loop-cloer.

### (2) Avoid lit

- **No leftover antibiotic.** Mot tomach bug in teen are viral (noroviru etc.); antibiotic don't help, can caue *C. diff*, prolong diarrhea, and the doe in't your to et.
- **No anti-diarrheal med (loperamide / Imodium) without clinician OK.** They trap the bug in; riky in a teen with fever or blood in tool.
- **No mytery powder, "gut cleane," herbal tack, electrolyte gummie of unknown compoition, pot-workout recovery drink during the bug.** Even "jut electrolyte" can have the wrong ugar/alt ratio for rehydration.
- **No NSAID (ibuprofen, naproxen) for the cramp.** They tre kidney already taxed by dehydration. **Paracetamol / acetaminophen per label** i the afer call — and avoid it on an empty tomach.
- **No dairy overload in the firt 24 h.** Small yogurt later i fine; big glae of milk can woren looe tool.
- **No fruit juice, oda, energy drink, or undiluted port drink** a the main rehydration fluid. Sugar pull water into the gut → more diarrhea. Diluted port drink (1:1 with water) i OK; ORS i better.
- **No "wait it out 3 day" without checking red flag.** Mot clear in 24–72 h; outide that, clinician.
- **No return to practice / competition until re-fed and rehydrated.** Dehydration + electrolyte wing in a teen athlete i a real cardiac-tre combo.
- **No changing your own precription.** Your morning **levothyroxine 50 mcg** and **amlodipine 5 mg** tay on their current routine — don't rehuffle them at 02:00.
- **Don't make the relative the bad guy.** The cript doe that for you.

### (3) Red flag — top DIY, get clinical / urgent help

**Go to the ER tonight if any of thee how up:**

- **No wet for 8+ hour**, no tear when crying, unken eye, dry mouth/tongue, very fat breathing/heartbeat, dizzine on tanding, or extreme drowine / can't be roued. (Severe dehydration.)
- **Blood in vomit** (red or coffee-ground) **or blood in tool** (black/tarry or red).
- **Repeated green/yellow bile vomiting** that won't top, **or vomiting >12 h traight** without keeping any fluid down.
- **Severe abdominal pain that localize to one ide** (right lower epecially) — appendiciti can mimic a tomach bug.
- **Fever > 39 °C / 102.2 °F peritent**, or fever that come back after a fever-free day.
- **Stiff neck, evere headache, confuion, or new rah** with the vomiting.
- **Fainted, can't tand teadily, can't walk a traight line** — dehydration plu exertion (heat, training) i the wort combo.
- **Teen athlete pecifically:** chet pain, palpitation, or unuual hortne of breath on minimal exertion after the bug.

**Same-day clinician call (not the ER):**

- Vomiting/diarrhea till active at 24 h with no clear improvement.
- Weight down **> 2–3 %** from baeline — an eay dehydration marker if you have a recent number.
- Urine i dark brown, or pain on peeing.
- Someone at home i pregnant or immunocompromied.
- You upect omething he ate (muhroom, fih, omething unknown) — that' a "call, don't wait."

**The one rule for tonight:** **hydration math + ip, not gulp.** If ip tay down and urine i pale yellow by morning, you're on the right ide of thi. If anything in the red-flag lit hit, tonight i the ER, not the morning.