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Colds, Viruses & Coughs Colds are caused by viruses, not
bacteria. Colds cause sore throats, cough, congestion, fever, sinus pain and headache. Days 2 through 4 are the worst, and then there is often a persistent lingering cough, feeling of fatigue, etc.
Average colds in non-smokers last 10 to 14 days. Colds are made worse by dry air, airplane travel, cigarette smoke, etc. Colds and other viruses can be miserable, prolonged, and recurrent, the "I was
sick all winter syndrome". There are several important points about viral illnesses of the upper respiratory tract.
- We cannot cure viruses. We can treat the symptoms, and we can
prevent secondary bacterial infections of the sinuses,
bronchial tree, and ear.
Ecchinacea, zinc tablets, and mushroom extracts have been shown to boost viral
resistance, and may actually shorten the course of a virus. (We have mushroom drops, which Dr. Yaffe feels are very helpful if used in the first hour of a viral infection, when the throat is just beginning to
get infected by the virus. We have no definitive proof that it works, but I, my family and the staff have had very positive experiences. If you are interested, inquire at the checkoput area.)
Bronchitis
is inflammation of the bronchial tree. It can be viral, bacterial, or caused by irritants, such as smoke. To cough is to have bronchitis! This only requires antibiotics if there is a lot of thick colorful mucus.
Sinusitis
is an infection of the sinus cavity. It can been behind the cheek, causing upper tooth pain, behind the eye, or in the forehead. There are several different sinus cavities. When one has a virus it almost always causes pain in the sinuses, with pressure, and congestion. A true secondary sinus infection is usually localized to one sinus. So if there is localized pain and fever, more than 3 or 4 days after the start of a virus, that is likely to be a
bacterial sinus infection requiring antibiotics.
Pharyngitis
is a sore throat pain, inflammation of the pharynx. We are concerned about strep throat if one is exposed to children with strep, or if one has particularly high fever, swollen tonsils or a throat with a lot of thick pus, accompanied by fever and swollen glands, especially without a lot of congestion, or cough. Most sore throats in adults are viral. If it is only on one side, it is more likely to be bacterial. If there is progressive swelling and localized throat pain, we think of a pimple or abscess in the throat, which may need to be drained. We try to avoid antibiotics in sore throats because they don't kill viruses. If the sore throat is prolonged, or unusually severe, we may use antibiotics, even with a negative culture. The rapid culture we use in the office only looks for streptococcus bacillus, strep throat. The test can be falsely negative about 10% of the time, and if we are really suspicious for strep, we can treat or send off a strep test to the lab which takes
three days to grow.
Our primary goal is to treat symptoms of the virus, and prevent the development of a secondary bacterial ear, bronchial, sinus, or eye infection.
During the day if mucus from the nose gets sucked into the chest, one tends to cough it out. At night while one sleeps, one tends to suck mucus into the chest. This can cause a secondary bronchitis, or sinusitis, with a lot of thick colorful sputum. This requires antibiotics. We can prevent aspiration of bacteria into the lungs and sinuses with good nightime therapy.
At night we suggest five nights only of AFRIN NOSE DROPS (not spray). By cleaning out the nostrils at night, the patient can
breathe through the nose, not the mouth, and one tends not to drip into the throat , sinuses, and lungs.
Use as much Afrin as necessary for just five nights only, to get the nose cleaned out! In addition, a hot steam vaporizer is extremely helpful to keep the membranes moist. Think how much better you feel in a hot steamy shower. Lastly, use a nighttime decongestant, like NyQuill, or a prescription decongestant, cough medicine.
To use antibiotics prematurely or preventatively is a bad idea. There are millions of normal bacteria in the nasal cavity. If one uses antibiotics, and kills the easy to kill bacteria, the ones that
are resistant are the ones that survive and get sucked into the lungs and sinuses. Antibiotics screw up the bodies resistance, and set you up for the next cold, a week later. Antibiotics cause
rashes, gut upset, and other side effects. When necessary, they are of critical importance. Sometimes it is very difficult to judge. We will often give a prescription for an antibiotic with a
question mark on the prescription, with the instruction to take it only if the situation deteriorates, and one starts bringing up a lot of thick, colorful mucus.
It is important to drink lots of fluids, and take in lots of salt. Salt causes fluid retention, which thins the mucus, fights the dehydration caused by fever, and fluid loss, etc. Chicken soup?
Gatorade, etc.
Airplane flights are very detrimental to respiratory infections. One is breathing dry, recirculated air from 200 passengers, many of them with other viruses. Drink lots of fluids on the plane, carry
Afrin nose drops on the plane. Before descent, open the eustachian tubes with the Afrin drops, by allowing them to drip down the side of the throat, after they have penetrated to the back of the nasal
cavity. This reduces the swelling in the eustachian tube, allowing air to enter, balancing the increasing pressure in the cabin as the plane descends, put pressure on the eardrum to collapse inwards.
After a flight the ear may not open for awhile. If there is significant congestion, prior to flying, rupture of the eardrum is a possible danger. Use decongestants aggressively, the Afrin with
head tilt before descent, chew gum, and consider other modes of transportation. We can evaluate the situation and decide if flying is appropriate, and reduce the likelihood of damage and
accompanying pain by prescribing steroids before, during and after the flight.
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