So, my favorite 1am phone call for a patient with a sore throat, cough, of course nasal discharge which goes by the technical term, snot. The patient is miserable as I roll into the exam room, feeling way more no thrilled about this than I hope I was showing.  Nice enough gentleman who was not really in distress but had a nice hacking cough and of course using tissues like, well like they were tissues. “What can you do for me?” My reply is less than stunning for him I am sure…

See recently a new admission came in and developed symptoms and he had, survey says, influenza.  Of course, this was not caught until he had infected his roommate and his roommate was moved and he infected 2 guys and so an and so on…None of whom wanted a flu shot this year, are you seeing a theme yet?

I love cold and flu season about as much as I enjoy surprise sunlight. It’s not that I am beyond the human plight, after all providers do get sick as well, it’s just that a colds, sore throats, and flu are really a guess on what is going to help the patient feel better.  Yes, you read this correctly, it’s really a guess and just about treating symptoms.

When you come in to the office you expect something for your copay.  You are after all billed for my time and it seems that I should do something more than do a couple of tests and shrug my shoulders when those tests come back negative.  Why don’t we do more?  Because there isn’t much we can do.  We can ask you to treat the symptoms of course but, the evidence shows that symptom management does not reduce the length of time of the illness and none are truly effective in resolving symptoms.

Of course, you and I know that no magic pill exists and that I am going to tell you a whole lot of stuff to do that may “help” (kinda, sorta, maybe…) Which is what I told him.

Well I can offer you the usual suggestions, as well with no guarantee of benefit and if you have any chronic conditions at all check with you provider as this is basic schtuff.

Fluids, plenty of them.  There is a reason your grandmother made chicken soup for you when you were sick (well at least my mother did). This has both the effect of warm fluid that has a high salt content to help counteract the loss of “salts” in the body as well as it is fluid and it is really a sweet loving gesture.  Well unless your mother threw the can of soup at you and told you to make it yourself…

Humidified air.  Nursie poo lives in the desert and with climate change we may all soon be doing that.  Running a humidifier, especially in a room you are in and the room where you sleep will help “loosen” things up. It will also help while you sleep which is next.

Get some damn sleep.  Yeah you can lay in bed and watch the Price is Right (because we all do that when we are sick, even Drew knows you do that). Stay home from work and if you have a jackass for a boss that “doesn’t care if you are sick” well wear a mask around your co-workers you like and make sure to spend a lot of quality time around your boss, sans mask (you can take my sarcasm however you like here).  If you are in healthcare, please for the love of dog, stay home. You are going to infect someone vulnerable no matter how much you mask and glove. I know, I know, staffing, other people are out, I need money (which I know is real, but if you end up sicker a day now is hella better than a week in a few days).

Nettie pot. I am indifferent to this as there are a couple of potential issues and constant.  If you do not use a sterile water you are opening your self up to all the bugs that might be in tap water.  Also, if you are not careful in the cleaning of the pot or god forbid share it with someone, you can pick up bacteria, which is really not fun.  The constant issue is that as an ENT friend put it, you can end up with water residue that pools in there and of course it does not help with congestion and once again bacteria source.  I recommend using a saline spray to keep things loose in there as well.  There are other devices that will push a large amount of saline in that drains immediately and those can be helpful although it is weird as hell to have that much water rush up your nose at once.

When do I get to the drugs?  Well right here and it is not without a little bit of protest that we reach this point.  Let me just make a plug for VapoRub (no I do not own stock). Using this can help keep things open in the schnoz as well.  Ok, first off for a cough is a simple dextromethorphan and guaifenesin cough syrup if you have a cough.  Take it as directed on the bottle, don’t walk around with the bottle like a flask taking sips.  In between for the cough you can use any throat lozenge.  The cough syrup will have some effect on secretions (we hope) but it may take a dose or too.  Make sure you get the one for the time of day you need.  Obviously nighttime for sleeping and day time, if you need to go sneeze on your boss.

As a side note here, if you are a boss these subtle hints are here to tell you to grant your employees sick time (paid or unpaid) with little hassle especially in the cold/flu season.  I know that the world will stop if you don’t have everyone there, every day, for a million hours (which is partially why we get sick, we over stress our bodies).

Ibuprofen.  You can take as directed.  This will help with headaches as well as inflammations caused by all the snot in your sinuses.  This is better than Tylenol since it Tylenol does not work with swelling.  If you develop a fever (100.4 or higher and no I don’t care if your normal temp is 96 someone is misreading it and you need to read above again slowly) you should see your provider. This may be more sinister than a cold.  Doesn’t mean there is much more, but see your provider.

Sudafed.  Ok this is the stuff you have to go to the pharmacist to get because people abuse it to make drugs. If you do that, well thanks for making it tough for me to take care of a cold (I have a special bat for you and it doesn’t fly).  It really does not do any good to take the stuff you don’t have to see the pharmacist for (phenylephrine) might as well skip this if that is all you can get. Take it as directed of course.  Do not take at bedtime, you will not sleep well.  Also, if you have high blood pressure or any chronic condition ask your provider who will give you alternatives or just tell you, you are shit out of luck (better here than in Vegas).

Flonase or Nasacort can help they can reduce swelling and help keep things open.  You can get this OTC now although it is spendy.  Like everything medicinal use as directed and if you are confused you can contact your provider and if things get worse than better, sorry you probably need to fork over your co-pay and see your provider. Please take care of yourself this season after all if you made it this far, I know you are reading these…haha!

Well time to bundle up and check the belfry.  Its so damn cold that they are down stairs by the fire.