DR. HOOK- It's that time: One-upping the common cold
One uppers... don't you just hate them? They're people who have to prove their problem is far worse and their lives are far superior to yours.
You: "I've been really tired lately because I've been working 12 hours a day."
One Upper: "Ah! I'm exhausted because I'm working 12.5 hours a day, probably have brain cancer, and just bought a new yacht."
We've all been taught to empathize, to relate more to other people. But sometimes people make it all about themselves. When it comes to illness, are we a kinder, gentler civilization?
I have a lot of patients coming in right now with the common cold: coughing, sneezing, blowing noses, sounding congested, low-grade fevers, scratchy throats, headache– just not looking like Tyra Banks on the cover of a magazine. The common cold is the #1 acute illness: 500 million cases a year!
Kids get the cold about four to seven times a year, adults two to three times, which leads to 23 million days lost from school or work and $22.5 billion lost to the good ole USA a year. (I wonder if I can patent the common cold?)
But boy, people sure get mad if someone misses work with a cold, because we're probably the most demanding society in the Milky Way. So most folks with the cold grab cold medicines off the shelves like bottled water before an ice storm. The problem is that no medicine cures the common cold, and they aren't 100 percent effective at alleviating all symptoms. Let's discuss what the literature shows:
Cromolyn sodium (like Nasal Chrome) is an over-the-counter nasal spray. Compared to placebo, it's about 30 percent effective in reducing snot in the nose. (Can we spray this on snotty people we all know?) Not sure if prescription nasal steroids are effective, because they tend to take two weeks to fully kick in.
Atrovent nasal spray is a medicine I like to prescribe because it dries the dickens out of the nose to reduce sneezing, postnasal drip, and nose blowing. Some researchers say that blowing the nose can push bacteria up into the nasal sinus cavities to cause bacterial sinusitis, so it's good not to "blow your horn" too much.
I love my Netipot though I don't see any research that it helps the common cold. I bought my Netipot at Whole Foods for $16, and it says, "Made in China. No Lead." (Like China's "lead free" toys?) I make my own salt and baking soda concoction, which I share only with my own patients (it's kind of like hiding Mrs. Fields' cookie recipe). People think it's gross, but it's like putting my sinuses and nose into a washing machine and coming out with Downy April Freshness!
Antihistamines, unfortunately, have not been shown to help much, except the sedating types— and who cares about anything when they're asleep!
For coughing, prescription inhalers like albuterol can be useful. Over-the-counter dextromethorphan, like Robitussin, has been shown to be somewhat effective. Expectorants, such as guaifenesin in Mucinex, don't stop coughing, but they can loosen sputum in the sinuses and lungs.
Oral decongestants for the nose are so-so in effectiveness, like pseudoephedrine in Sudafed, but they also can raise blood pressure (as well as make illegal drugs, so they're behind the counter now).
I have info on zinc, herbs, and vitamins on my webpage, but I have a feeling it's going to irritate Day Dream Believers in them. I do feel for my patients who want a day off for a cold, especially when I'm sneezing and coughing on them myself. But I don't want to one-up anyone.