As we get into the heart of winter, I am seeing an increasing number of patients with a cold or the flu. They both make you feel pretty miserable and many people think they have the flu when they actually have a cold.
Colds tend to come on gradually, with the symptoms typically appearing in a specific order. As there are multiple different viral upper respiratory infections that we call colds, the march of symptoms can vary. Often there is first a sore throat that lasts about two days. Next come moderate fatigue and a runny nose, then congestion, and finally a cough. Other times the runny nose and sneezing comes first. Kids may get a low-grade fever (100 to 102 F) when they have a cold, but it is unusual for adults to get one. Still, grown-ups can feel pretty lousy without a fever.
There is a lot of overlap between flu and cold symptoms, but flu symptoms are much more severe. Overlapping symptoms are sore throat, congestion, and cough. Symptoms that usually indicate the flu are extreme exhaustion, high fever (101 F or higher), headache, muscle aches, and soreness all over the body.
Whether you have a cold or the flu, you have to ride it out, do what you can to ease your discomfort and not spread it to others. There are anti-flu meds, but healthy adults don’t really benefit much from them, especially if they are not started in the first 2 to 3 days of the illness.
Over-the-counter decongestants can help with nasal discomfort, as can rinsing out your nasal passages with saltwater solution using a neti pot or sinus-rinse squeeze bottle. If your nose becomes irritated, apply some petroleum jelly to the inside and outside to soothe it. Fever, aches, and pain can be eased with medications like acetaminophen, aspirin, and ibuprofen. Do NOT give aspirin to children younger than 18. If you have a dry, nonproductive cough (i.e., you are not coughing up sputum), you can take an over-the-counter cough suppressant.
Constant coughing is pretty miserable and tiring, but if you have a productive cough, you actually want to keep coughing. It is your body’s way of clearing out your lungs and avoiding complications like bronchitis and pneumonia. If coughing is keeping you awake at night and you do take a cough suppressant, some good coughing in the morning after a hot shower will help clear out your lungs.
It can be difficult to know if you are developing any complications like a sinus infection, bronchitis, or pneumonia, especially toward the end of a cold when producing thicker, darker mucus is normal. Here are some rules of thumb to help you know when you should see your doctor about possible complications.
If you have a cold and your symptoms do not seem to be improving after a week, consider calling your health care provider and discussing your symptoms with him or her. You may need to come in for an evaluation.
If you have the flu and your fever returns after having no fever and no medication to treat a fever for a day or two, discuss your symptoms with your health care provider. Lingering shortness of breath and a productive cough are reasons to get in touch with your doctor as well.
Other symptoms that warrant consultation with your health care provider include a fever lasting more than five days or a sore throat that lasts more than three days. This year we’ve seen viral illnesses in which the cough lasts more than three weeks, but you should be feeling less sick even as that cough lingers.
Dr. Bob Riggs is a family medicine physician practicing at Group Health’s Riverfront Medical Center.
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