With the cold and flu season in full swing, the attempts at illness prevention can be for naught. While hopefully the majority of readers have gotten a flu shot by now (if not, it’s not too late, and go get one), even colds and coughs that aren’t the flu can turn even the toughest immune systems for a loop. Especially with the winter holidays upon us, complete with office holiday parties, celebrations with family and friends, and travel plans for many, staying well can be a challenge. In the majority of cities, the weather has changed, either subtly or significantly, there are fewer hours of daylight (which can mean the kids are indoors more– sharing colds), and the cold season is just becoming in full force.
You’ve done everything to prevent getting sick– you’ve gotten your flu shot, your family’s gotten their flu shots, you get enough rest, you wash your hands diligently (but not obsessively), you try to avoid getting close to that office mate who’s sneezing all over their desktop, and you take your daily Vitamin C pill. Wait– Vitamin C? Sorry, despite countless studies, there is no evidence that Vitamin C supplements prevent, treat, or shorten the duration of colds.
And now that you’re sick, with a low-grade fever, cough, stuffy nose, runny nose, headache, and sore throat, what can you do? The first thing to do is to stay at home and rest. Doctors are notoriously bad patients, and if you go see your doctor when you’re sick, there’s a reasonable chance that he or she will be suffering the same illness as you are, but they are foolishly slogging it out at work, likely with a handful of over-the-counter medications in their system to get through their day.
Most respiratory illnesses, including coughs, colds, sore throats, sinusitis, and ear infections are caused by viruses. So put the notion of a quick fix from antibiotics to the side, unless you get evaluated by a physician who is recommending them. Policy statements from many medical organizations, including the American Academy of Otolaryngology-Head and Neck Surgery and the American Academy of Pediatrics are dissuading overuse of antibiotics for respiratory illnesses. Overzealous use of antibiotics is one of the main reasons for worldwide antibiotic resistance. Most viral illnesses need to run their course, not get complicated by a bacterial super-infection, and ideally not spread from person to person. So when prevention doesn’t work out, the emphasis needs to be on symptom relief:
- Never underestimate the value of nasal hygiene. Cold viruses love to live and grow in the warm, wet environment of a drippy nose. So keep it clean! Nasal saline spray is the best stuff on earth. Get a bottle for each family member, and don’t share. Best prevention for colds is to spray each nostril a couple of times per day when you’re well. It’s great to use on kids, and even safe for infants.
- Go topical. If your nose is just so stuffy that it’s hard to breathe, you’ll get dry mouth and likely a sore throat. Before going to the pills, start local. Topical nasal decongestants such as oxymetazoline (Afrin) or phenylephrine (Neo-Syneprhine) can open up the nasal passages for up to 12 hours at a time. But even though these are just sprays, check with your doctor first, especially if you have a history of high blood pressure or heart disease. And don’t use these for more than two days at a time, as overuse can cause a rebound effect, meaning you’ll be stuffier than before you started using them if you spray every day for days and days.
- Cut your cough. Many colds come with coughs– wet cough, dry cough, cough that keeps you up at night, cough so bad that it hurts your chest and head. Some studies on children show that honey works just as well as cough medicine for cough symptoms. So for children over age one year (don’t give honey to infants under age one, due to risk of infant botulism), but for older toddlers and adults, a spoonful of honey may, indeed prevent the medicine from going down.
- I want some cough medicine. If you don’t like the honey idea, dextromethorphan, found in combination medications such as Mucinex, PediaCare, Robitussin DM, Sudafed Cough and Cold, and Tylenol Cold and Cough, are all options. But remember these are combination medications, which have the benefit of getting at several symptoms, but may contain ingredients that have some negative side effects. For ANY medication, even these over-the-counter products, do check with your doctor (or your kids’ doctor) first.
- Runny/stuffy nose. If your nose is still stuffy and runny despite the topical sprays, an oral decongestant may be your medication of choice. These either contain antihistamines (Benadryl, Claritin, Zyrtec, Allegra), or pseudoephedrine (Sudafed). All of these can help with that stuffy “head cold”and headache, but may also come with side effects, including fatigue, jitters, and blood pressure issues. So you guessed it– check with your doctor first.
- It’s thick. Sometimes it’s not just the stuffy or runny as the problem, but it’s also that the mucus is so thick (in the nose or from the chest) that you can’t seem to clear it out. Some of the medications, especially oral decongestants and antihistamines, will dry you out but thicken your mucus. To combat this, the ingredient guaifenesin acts to thin out the mucus, to make it easier to clear. Brands such as Mucinex and Robitussin often contain guaifenesin.
- Hot stuff. Now you have a fever. Fevers just makes everything worse. A fever, in and of itself, especially if under 101.5 degrees Fahrenheit (38.6 Celsius), is not worrisome (unless it’s an infant under age 6 weeks– then seek medical attention right away), is not dangerous, but it makes anyone feel pretty crummy. High fevers can come with rapid breathing, some sweating, chills, and even dehydration While many physicians do not recommend immediate treatment of a fever, there’s no reason not to get that temperature down, in the name of feeling better. Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) are the most commonly used fever reducers. These are traditionally safe, but limit the use of either of these, as overuse of acetaminophen can lead to liver failure, and overuse of ibuprofen can cause kidney problems. Read the labels and follow the directions. And yes, even check with your doctor. Acetylsalicylic acid (commonly known as aspirin) has gotten a bad rap over the years– it can cause a rare disorder called Reye’s Syndrome if given to young kids, and its daily use to prevent heart disease falls in and out of favor, depending on the latest study. That said, it’s one of the oldest medications to treat aches, pains, and fevers.
Welcome to the heart of the cold season. If cold prevention didn’t work this time around, there are medications out there that treat the various symptoms. But treatments come with side effects, and some of these side effects may not be worth the benefits of taking the meds. And (I can’t say this enough) just because you don’t need a prescription, doesn’t mean a quick call to your doctor isn’t in order to make sure what you’re taking is safe for you.