DRHOOK- Feed a cold: When you have the flu, you know it!

the handsome doctor John Hong

"It's beginning to look a lot like Christmas," has been a classic holiday song for like 60 years now! I don't like to sing Christmas songs after Thanksgiving because they drive me crazy. On the other hand, I tend to hum them the rest of the year. Go figure!

I've heard from everyone from psychologists to religious academics that it is nice to have an annual ritual– something you can repeat each year to give a sense comfort and nostalgia. 

Should the flu and common cold fall into that category?

Every winter, what happens? We either have the common cold or flu, or someone else has it– usually a coworker who we fear won't make it to work, which means you have to pick up the slack.

It can be hard to know if you have the flu or a really bad cold because not everyone has the classic symptoms. There are rapid influenza tests, but they aren't 100 percent sensitive. If you go to a primary care doctor's office, most insurance won't pay for a rapid flu test, so the patient often is scooted out the door with a Tamiflu prescription in hand.

What are the classic symptoms of the flu? Like Peggy Lee sang: fever. Sudden fever and headache usually hit like a Mack truck. On the other hand, a cold doesn't usually present with a fever, and if so, it's more of a mild temperature (less than 100 degrees Fahrenheit). Now if the cold leads to a secondary bacterial infection, like sinusitis or pneumonia, then the fever can come on. Usually it takes a few days to a week before the bacteria complicates things.

Sore throat and stuffy runny nose are common at the onset of a cold, but not so with the flu. It takes about 24 hours of extreme fatigue, loss of appetite, and fever before the flu makes people's throat feel like they swallowed broken glass and their nose turn into the Trevi fountain. 

Notice I mentioned loss of appetite with the flu? I wonder if that is how that expression "Feed a cold. Starve a fever" came about. With the flu, folks are so sick and bedridden from fatigue, they could sleep for days without eating– which is dangerous! Dehydration from the fever and not drinking fluids makes the bodyaches and headaches worse. Also, getting dehydrated does not help the sinuses and lungs clear out– who can honk out mucus as dry as sand?

The fever tends to go away on day five of the flu. Even if the ill person doesn't get a secondary bacterial infection, he usually feels wiped out for weeks. I'm telling you: the flu will kick your tuckus. 

Now some colds can be a pain in the butt and appear to be influenza. Usually, though, the "Virus of the Month" for the common cold is prevalent, so a clinician can guess the sick person has a cold. The same holds true with influenza, and the CDC and local health department always send out notices to clinicians when an influenza outbreak occurs. A flu epidemic tends to hit a lot of people the first two weeks and then leave everyone in its wake about two weeks later— making for a month of misery in a community. 

You are in double trouble, though, if the flu and the common cold are out at the same time. I'm telling you, these holiday songs are here for a reason: to distract us from the next viral illness!


Dr. Hook cracks a joke or two, but he's a renowned physician with an interesting website, drjohnhong.com. Email him with your questions.