Colds & Flu: Caused by viruses which are not affected by antibiotics. Medical science has not yet developed a cure or vaccine against the common cold, although zinc lozenges can reduce the duration by half. Influenza (the flu) is a devastating illness, usually associated with a very high fever and severe muscle aches, that can cause a fatal pneumonia - especially in the elderly and those with chronic illnesses. Unlike the common cold, influenza can be prevented and sometimes treated with pills.

Sore Throat: Many are caused by untreatable viruses, some by germs that are treatable with antibiotics. Mononucleosis (Mono) must be monitored. Tonsillectomies are rarely needed. Untreated strep throat can damage the heart and joints. Peritonsillar abscesses can be very dangerous and occasionally fatal. Cold fluids (ice water, popsicles), gargling with salt water, and over the counter medicines such as Chloraseptic are very helpful. Dairy products often increase mucus, and can sometimes make the throat feel worse. When white spots (pus) are seen in the tonsils, especially with swollen glands, medical attention is needed.

Aches, Pains, & Fever: Acetaminophen (Tylenol and others) is safe for virtually everyone - but overdoses can be fatal!!! Aspirin and NSAIDS such as ibuprofen and naproxen can cause stomach aches and intestinal bleeding, and aspirin must never be taken by children (particularly with chicken pox and influenza). Brief steroid treatment (shot or pills) can be extremely effective very quickly. Lukewarm to cool baths are very effective. Alcohol rubs should not be used as they can cause a dangerously low blood sugar. Fevers greater than 102 in adults and 103 in children usually require medical attention.

Sinus Congestion: Salt water nose sprays (such as Ocean and Nasal) are very effective and safe. The oral decongestant pseudoephredrine (Sudafed and others) are excellent treatments but can cause jitteriness and insomnia - blood pressure elevation is rarely a problem. 12 hour decongestant nasal sprays (such as Dristan, Afrin & Neosynephrine) twice daily for up to 3 days are safe and effective. Newer nasal sprays like Astelin (which opens up the nasal passages), and Atrovent (which stops the drip and mucus) appear safe and very effective. Steroid nasal sprays don’t help much for colds. Antihistamines (chlorpheniramine, clemastine and others) are rarely helpful unless allergies are present, and they can cause side effects such as drowsiness, dry mouth, blurred vision, constipation, urinary retention, and glaucoma. The decongestant PPA (phenylpropanolamine) can be dangerous and should be avoided. Try to avoid "multisymptom" medications such as Contact, Triaminic, Comtrex, Nyquil, etc. If sinus pain is severe, especially when moving the eyes, see a physician.

Cough: Frequently rinsing the nasal passages with salt water often removes a common cause of cough - excess mucus. Coughing often irritates the bronchial tubes, resulting in further coughing. Spasm of the bronchial tubes can cause wheezing and coughing and can be relieved by bronchodilators (such as Ventolin) or cortisone (shots or pills). Dextromethorphan (DM) is very helpful and rarely causes side effects. Benadryl (Benylin) stops coughing, but can make you very sleepy. Narcotics, particularly codeine, are very effective but can cause nausea, fatigue and constipation - and turn bronchitis into pneumonia if infected mucus is not removed from the lungs by coughing. Medical attention is needed if the material coughed up is any color but clear, white or light yellow - particularly if accompanied by chest pain or a fever.

Chest Congestion: The best expectorant is hot chicken soup, although all hot beverages are helpful. Guiafenesin is in most over the counter preparations and can cause nausea.

Vitamins/supplements: Many people believe vitamin C helps. The scientific data does not prove a clear benefit. Beta carotene (vitamin A) can help some people, but safety is an issue that has yet to be determined by scientific studies. Echinacea may help some people.

Rest: Can be helpful when significant fatigue is present, but the benefits of bed rest are not clear and can often worsen fatigue.

Fluids: Fever, sweating, and diarrhea can cause significant dehydration. Rehydration fluids such as Gatorade and Powerade can be very helpful, but reddish colors should be avoided to prevent confusion regarding passing blood per rectum.

Diarrhea: Can be treated with over the counter medicines such as Kaopectate and Imodium. Prescription medications such as Lomotil can also be helpful. Dairy products should generally be avoided. If blood, fever, or severe pain accompany the diarrhea, medical attention is needed. In addition to fluids like Gatorade and Powerade, an excellent fluid replacement for diarrhea and/or vomiting can be made at home: to one quart of water add 1/2 teaspoon of salt, 1/2 teaspoon of baking soda, 1/4 teaspoon of salt substitute (potassium chloride), and 8 tablespoons of table sugar. Fluids with a high sugar content can be absorbed through the mouth (especially under the tongue), which can be very useful when vomiting is a problem.

Vomiting: Prescription medications such as Tigan and Phenergan can be very helpful, and should be kept at home in the refrigerator.

Prevention: Stress has been proven to increase your risk of viral infections. Most colds are caught by touching someone who has a cold, and then rubbing your eyes, nose or mouth with your hand. Washing your hands prior to touching your body offers the best protection. Try to stay away from people who are coughing and sneezing. A good diet, adequate rest and exercise, and maintaining a cheerful, optimistic attitude seem to help prevent many illnesses, including the common cold.

(updated October 22, 1999)