By definition an acute cough is one that has lasted less than 3 weeks. Most coughs are not serious and are due to viral illnesses or allergies. There is truly no point seeking medical attention for typical viral infections and contrary to popular myth- antibiotics do not help these syndromes. Most folks are going to get better on their own in 3-10 days. Reactive airways disease/asthma can also be a reason why someone doesn't recover quickly. In that instance inhaler prescriptions can provide significant relief of symptoms.
Hopefully you have had your seasonal flu vaccine and thus your chances of getting the seasonal flu have been cut down by approximately 75-90%. We do have vaccine available if you haven't been vaccinated. There is always a chance the flu virus will change and if it does the vaccine provided might not offer protection. Depending upon the year and patient group studied the effectiveness of the influenza vaccine is different. I wanted to remind everyone that there is a good, rapid nasal/throat swab test which we have available in our office that can diagnose definitively influenza (the flu).
If we know for sure a person has the flu, we can provide antiviral prescription medication for the infected patient as well as consider preventive medication for those living in close contact with the patient. This protocol can greatly lower the chances of spreading infection within the community. Antiviral medication for the flu can also shorten the duration and severity of an acute influenza infection if the patient can get diagnosed within 2-3 days of their symptoms.
Many of you have seen the following information concerning Upper Respiratory Illnesses (URI) in a handout that I dispense to most of my new patients and during the cough, cold and flu season . Use this reference in order to manage cold symptoms at home on your own. Please do note the indications for medical evaluation such as pneumonia can develop as a complication to URI's.
Upper Respiratory Illnesses (URI)
URI's are very common through the fall, winter, and early spring seasons. Most causes are viral and cannot be treated with "antibiotics." We do not want to use antibiotic medication unless there is evidence clinically of an actual bacterial infection- this will only promote bacterial resistance and not increase your rate of recovery.
When is my cough possibly an emergency? Symptoms that should prompt your immediate concern and a request for a same day appointment are: teeth-chattering chills, sudden onset of local rib or localized chest pain, bloody sputum, fever over 101.5, shortness of breath, confusion, or wheezing. Our clinical staff have been instructed to work such complaints in on the nursing schedule in order to facilitate a rapid triage of the patient. As noted below we can test for influenza if a review of symptoms suggests this is possible. We are also able to check your oxygen levels with a simple finger probe- low oxygen raises concerns for much more serious illness than a simple cold or allergy.
Clues for typical viral illnesses such as the common cold include: occurring in outbreaks (the neighbors or other family have had it), sudden onset of nasal stuffiness, muscle aches, sneezing, and sore throat. Mild fever is common (under 101.5). Yellow and green sputum or nasal discharge is also common and not specific for bacterial infections. Most viral illnesses last between 3-14 days. You should definitely be trending in the improved direction by the end of 10 days; if not, an evaluation in the office is recommended.
For Viral illnesses some remedies do make sense and are backed up by reasonable studies. There are a few things that can be used and probably won't hurt you in any significant way. These include:
1) High doses of vitamin C can shorten the duration of the common cold. Studies show taking daily vitamin C (citric acid) does not prevent the common cold, but can shorten the duration by taking 1000mg 3 times a day.
2)Zinc gluconate (Coldeez brand specifically) at 13.3 mg dissolved in the mouth every 2 hours does improve symptoms and decrease the number of days you are ill. Take 5 to 6 lozenges per day.
3) Both green and black tea have antibacterial activity against multiple bacterial pathogens that can complicate the typical respiratory illness. No studies prove it helps definitively, but theoretically it may improve your symptoms and complication rates.
4) Antihistamines include Loratidine, Tavist, Claritin, Alavert , and Zyrtec as directed for drying secretions/nagging cough can be very helpful. Don't forget the old Vicks menthol rub to the chest, throat, and upper lip at bedtime.
5)Nasal saline to irrigate the nostrils and over the counter guaifenesin or dextromethorphan cough formulas can be helpful although not officially endorsed by most physician sources. An excellent nasal irrigation product is NeilMeds nasal wash system.
6)If you are not allergic to or have contraindications to ibuprofen (Motrin or others), this over the counter pain and anti-inflammation medication can be very helpful in reducing fever, muscle aches, and producing an overall improved sense of well being when ill from respiratory viruses. Contraindications to ibuprofen include a history of gastric bleeding or being on blood thinners.
Influenza is best prevented with vaccination. Despite this, you may still get an active infection. We now have an office test that can quickly confirm influenza infection (the flu). If you believe you may have the flu please inform the scheduler/clinical staff and we can arrange same day testing and evaluation. Signs of true influenza include invariably: fever of at least 100.5 orally, sudden severe muscle aches (especially in the back) running nose, followed in 2 hours by a sore throat, nonproductive cough and often frontal headache.
Strep throat can also be diagnosed quickly with a throat swab office test. Symptoms include: very sore throat (painful to swallowing), fever over 99.5, fatigue, muscle aches, and whitish coating in the tonsil areas located at the back of the throat.
