“DOC, THIS COLD IS KILLING ME…”

As we approach the end of the ‘cold and flu season’ as we docs refer to October-April, I wanted to share some thoughts about one of the most common aspects of the Family Doctor’s everyday routine this time of year.  Specifically, I wanted to write about the ever-present battle with the common cold, also known as an “Upper Respiratory Infection” (URI).

The dreaded “URI” is one of the most common things we see in the office this time of year.  On some days, we might see 3-5 cases – per doctor!  While patients often think they have sinusitis, bronchitis, “the flu”, or some other terrible disease, more often than not the clinical history and physical exam suggests a viral URI.  While it’s true we don’t usually test for what type of virus is wreaking havoc (ex: Rhinovirus, RSV, Adenovirus etc…), the clinical syndrome of a URI is fairly typical.  Namely, patients complain of runny or stuffy nose, sneezing, post-nasal drainage, cough which is usually hacking but can be productive, sore throat (usually at the onset), low grade or high grade fever (usually at the onset), low energy, and just feeling lousy.  The symptoms can last anywhere from 4-7 days but might last up to two weeks and beyond.  Unlike with “the flu” or bacterial infections which usually confine a patient to the bed, patients with a URI are often going to work, and/or trying to carry on with their life.

When a patient presents to the doctor with a URI, it is quite common for them to make statements such as: “Doc, I know it’s probably a virus, but can you just give me something to knock it out?”, “Doc, my sister has the same thing and her doc gave her an antibiotic for it.”, “Doc, I just can’t take this anymore!”, “Doc, I’ve tried everything I can think of, and I’m still not getting better.”, and “Doc, I don’t usually come to the doctor, but I really think this cold is killing me!”.  If any of this sounds familiar, you are in good company.

So, when you next find yourself stricken by the common cold (or URI) in the future, let me save you the trouble of an office visit, gas money and a co-pay by sharing some simple strategies to help you get better faster. 

First, try using a “netty pot” or over the counter sinus rinse product to clean out your sinuses.  Usually, just doing this once or twice a day will make you feel better faster and will reduce your symptoms.  If you can’t tolerate the netty pot or sinus lavage mentioned above, try steam treatments with either a steaming device or a boiled pot of water on the table with a towel over your head (we do this at our house when our kids are sick and it really helps to get the snot flowing). 

Next, I recommend a twice daily dose of something like “Emergen-C” or some other product high in B and C vitamins and anti-oxidants.  Dissolve these products in either cold or hot water, and drink.  Anecdotally at least, this really seems to help my patients (and me when I’m sick) – but at the very least this will help maintain hydration.  Speaking of hydration, I recommend drinking so much fluid that your urine runs clear. 

Oh yeah, and get plenty of rest.  This might seem obvious, but the number one reason why colds last so long, is that us Americans don’t like to take sick days.  We’d much prefer to go to work sick, infect the keyboards and door handles in our offices and ultimately share our viral misery with our workmates.  Please take a day off (or two), use those sick days that might be part of your work package – and you will get better faster.  

Over the counter meds like Sudafed, Nyquil, Robitussin, throat lozenges (and the hundreds of other products out there) may reduce symptoms and make you feel better too – but this is quite variable.  By the way, since sleep is really important for your body to heal, I would preferentially recommend using these meds at bedtime to boost your body’s ability to fight off infection – simply by sleeping. 

Finally, please remember something that I learned in medical school: 90% of what happens to the human body is self-limited – meaning it will resolve on its own.  A tincture of time is often all that is needed when we contract a viral URI. 

So there you have it.  This is what us docs usually tell our patients during their visits when we diagnose a URI.  All that said, if you have symptoms of infection that might be more suggestive of bacterial infection, namely high fever above 101 that lasts more than 3 days, shortness of breath and chest pain (which might mean pneumonia), severe ear pain (which might mean an ear infection), severe sore throat in the absence of other cold symptoms (which might be strep throat) or other specific symptoms, please do come to see us to make sure that you don’t have something other than a viral URI. 

So, as you cross off the Kleenex multi-pack from your Sam’s Club shopping list, I hope that you enjoy the Spring season (which seems to be fully upon us now) and Summer which will be here soon enough, and will be ready for the next cold and flu season come October.  Oh wait, you allergy sufferers are just getting started right about now, so on second thought, go ahead and buy the Kleenex multi-pack after all…….

Michael Weizman, MD