Dr. Vazquez' Big Talk on Colds

Owen - Sleeping - Fever - Couch

Nooooo...I’m not going to get sick! I can’t...I refuse. Grrr...I hate getting a cold. Aaugh.

It seems everyone has a stuffy nose and can’t stop coughing this year. Let’s talk about some things that can make this miserable time a bit easier.

What is a cold?

The common cold is caused by a many different viruses and generally causes runny nose, nasal congestion and cough.  Any illness can cause fever, as that is way for the body to help fight the infection. Colds are usually mild and don’t usually increase the risk of bacterial infections (bacteria are what we treat with antibiotics). The best way to treat a cold is to let the body fight it on it's own.  

The common cold usually lasts between 3 - 7 days, but the cough may linger for 3 - 8 weeks according to the CDC.

What is influenza, “the flu”?

The flu usually makes you feel terrible. It’s also a respiratory illness, but is caused by influenza, a specific type of virus. Flu usually causes fever, significant fatigue, muscle aches (feeling like you were hit by a truck), some mild nasal congestion/runny nose, headache, sore throat, and cough.

Flu can lead to severe illness and complications, including pneumonia and death. The best way to treat the flu, is to prevent it, by getting a flu vaccine. While the vaccine isn’t a complete guarantee, it can help the illness be a bit more mild.  There are antiviral medications (Tamiflu and others) that help treat Flu, but it is really only indicated for people that are high risk.

Flu symptoms generally last 5-7 days and the cough can still linger for 3 - 8 weeks. 

Oh, that nasty cough!

Coughing is the body’s way of preventing warm, sticky mucus from entering the lungs.  The sticky mucus is a great place for bacteria to set in and grow and cause pneumonia, so the body does everything possible to prevent this.  So, if you think about it, coughing is a good thing and getting it of it before it is time, could cause more problems.

Often the nasal congestion and mucus in the nose and sinuses causes a post nasal drip that produces a cough; worse when lying down.

What do you do when you have a bad cough? If you reach for the cherry-flavored cough medicine, you're not alone. Every year, people spend billions of dollars on this stuff. But does any of it actually work?

But, my mucus is green!

I often hear from people concerned that their mucus is green and convinced that they have an infection that requires antibiotics, but that actually isn't true—it really just means that your immune system has been fighting something (often a virus) for a couple days. The green color comes from a protein in the guts of the courageous white blood cells that sacrifice themselves on the field of battle (aka your nose).

What the Color of Your Snot Really Means | Cleveland Clinic

What the Color of Your Snot Really Means | Cleveland Clinic

Things to do

  • Rest  -  is the most important thing.  The body uses a lot of energy to stimulate the immune system and help fight the infection. 
  • Fluids  -  help make the mucus and other secretions thinner so that you can get them out easier.
  • Tylenol/Ibuprofen  -  Help you to feel more comfortable. They help with pain and fever. 
  • Saline Nasal Spray -  While it is not a medicine, it can help flush out a lot of the mucus and therefore help you feel a bit better. 
  • Honey  -  studies have shown that honey works just as well as over the counter cough suppressants. Take a teaspoon with lemon in the morning and at night before bed. Or drink it in a tea. 
  • Decongestants are not recommended, as they increase blood pressure and heart rate and can make people feel jittery. People with high blood pressure or anxiety need to be especially careful about using decongestants.

So when should I call my doctor?

You should contact your doctor if you develop trouble breathing or shortness of breath, chest tightness, chest pain, rapid breathing, your cough isn’t gone after 3-4 weeks or your symptoms get better and then get worse. Of course, if you have underlying conditions such as asthma, COPD or heart problems, you should contact your doctor to discuss your symptoms.

At Altucare, we are always just a phone call away, anytime. 

Let’s talk about antibiotics

If an otherwise healthy person "needs" antibiotics every year for a respiratory infection (including "bronchitis"), I would suggest one of the following is almost certainly true:

  1. There is an underlying lung disease (COPD/chronic bronchitis or more rare stuff) that had been un-diagnosed.
  2. There is an underlying immune system problem (IgA deficiency, CVID or similar) that had been un-diagnosed.
  3. The antibiotics are purely placebo for an illness which would have resolved on its own within 1-3 weeks regardless. (There is another theory about anti-inflammatory properties of azithromycin (Z pak), but blinded studies don't show it helps symptoms of bronchitis.)

My experience has been that #3 accounts for 90% of frequent unexplained antibiotic use with bronchitis. However, it's best to consider all of the above in people who have frequent stubborn coughs or respiratory symptoms. 

Taking antibiotics for respiratory symptoms on an annual (or more frequent) basis is NOT NORMAL. A physician who throws antibiotics at someone frequently -- even if they are pleased by it -- without an explanation is doing them a disservice.

For more information, see The Centers for Disease Control and Prevention (CDC) article:

Get Smart: Know When Antibiotics Work

Most of acute bronchitis symptoms last for up to 2 weeks, but the cough can last up to 8 weeks in some people.