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By
Dr David Delvin
STOP
PRESS RE SARS FROM DR DELVIN 22.4.03.:
The
'flu-like illness SARS has now affected over 4,000 people and about 250 of
them have died. Worst affected areas are Hong Kong, mainland China,
Singapore and the Toronto (Ontario) region of Canada. The infection
has also entered Britain.
The
bug is now believed be a CORONA VIRUS - a mutant relative of the common
cold virus. NO antibiotic has proved effective against it - but the
lives of many seriously ill patients have been saved by putting them on
breathing-support machines.
COLDS, SORE THROATS, COUGHS AND INFLUENZA
- AREN'T THEY A NUISANCE?
Yet
they plague us all - particularly those of us who are over about
50. Outbreaks of them persist far into the Spring and early
Summer. Hence the famous advice: 'Ne'er cast a clout
till May be out.' (in other words, wrap up warm until the
summer comes!)
Furthermore,
this April 2003 has seen the arrival of a new and deadly 'flu-like
illness: the extremely unpleasant 'Severe Acute Respiratory
Syndrome' (SARS) - of which more in a moment.
Why
are these infections such a nuisance to the over 50's? Partly
because a lot of people in the retirement age-group have lowered resistance
to infection,. Also, many men and women over 50 have lung or
heart problems - and those problems can be exacerbated by a chest
infection.
So
it's as well to know how to avoid these bugs - and how to cope with
them when they do hit you.
First
of all, let's deal with avoidance.
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Obviously, it's better if you can
avoid catching these nasty respiratory bugs in the first
place.
So what can you do to prevent
yourself from getting colds, sore throats, coughs and 'flu?
There are 2 basic strategies: being
in the best possible physical shape, and steering clear of the
germs:
Being in the best possible physical
shape: The fitter you are, the less likely you are to get
infected. I have to admit that even super-fit athletes do catch
germs - but not as often as folk who are out of shape. So, use
the following strategies throughout the year:
*
Do not smoke.
Smoking makes you far more liable to respiratory infections (though
a lot of 'fag-puffers' find that hard to accept!)
* Avoid smoky
atmospheres
* Get a reasonable amount of
exercise - and plenty of fresh air in your lungs
* Have a 'flu jab each year - provided
you fall into one of the categories of people for whom it is
recommended
What about taking vitamins to keep
you in good shape - and so ward off colds, 'flu and coughs?
Well, many members of the public believe that this is
essential. And journalists who write about health in magazines
and newspapers are always going on about how important vitamins are
in protecting people against infection.
However, I have to tell you that
hardly any Doctors would bother to take vitamins for this
purpose! It's not something which orthodox medicine is interested
in. But if you want to take vitamins - for instance - Vitamin
C, which so many people believe in - then it's unlikely they'll do
you any harm.,
Steering clear of the germs:
This is something that a lot of people don't think of. If
you aren't exposed to the germs of colds, 'flu or even the dreaded
SARS, you cannot catch them. It's just impossible.
That's why men and women who go on
solo treks across the Arctic do NOT get these infections - there's
no one there to catch them from!
Of course, in daily life we have to
meet other people - and so we are exposed to their germs. That's
how we get colds and 'flu and so on. But it is possible to reduce
your exposure to these germs by taking certain practical
steps. They are:
1.
Don't sit in 'healthcare' buildings
where the atmosphere is bound to be thick with 'bugs'. The
worst possible spot is a GP's waiting room - where there are invariably
people breathing out nasty viruses over everybody else. Naturally.
hospitals have an awful lot of viruses too - so don't hang about in
one unless you have to. If the SARS epidemic really takes off
in the UK (see below), then a medical waiting room will be the ideal
place to catch it ...
2.
Avoid crowded transport environments
like rush-hour trains and buses. The atmosphere is quite likely
to contain germs - especially as so many passengers now think that
it's perfectly acceptable to cough and sneeze all over their fellow commuters
- without using a hanky! Many of them have never heard of the
old wartime slogan: COUGHS AND SNEEZES SPREAD DISEASES
3.
Similarly, avoid crowded
offices - especially air-conditioned ones, in which (obviously)
there is no fresh air. If you employ staff, tell them that if
they get a cold or cough, they should STAY AT HOME.
4.
Avoid ill-mannered people who
cough and splutter their sputum in your direction.
5.
If the SARS outbreak really
does get going in this country, consider wearing a mask when you are
in crowds - just like the Chinese are doing now. These little
facemasks can be bought very cheaply indeed from good chemists.
So
that's prevention dealt with. Now let's look at how you can cope
with these infections if you are unlucky enough to get them.
COLDS:
Let's first be clear about what a cold IS. I find that a
lot of (jolly brave!) people aged over 40 talk about 'just having a
cold' - when they've actually got a rampaging chest infection!
A
cold involves only the nose and the area round the palate and upper
throat. It's a miserable business - no matter how stoical you
try to be about it.
TREATMENT:
Because colds are caused by a virus (and because antibiotics
have no effect at all on viruses), there is absolutely no point in
asking your doctor for penicillin or any other antibiotic treatment.
In fact, it's pointless to go to your GP at all - she can do nothing
for you.
Your
best move is stay at home (so you don't infect other people). Have
a good rest, and drink plenty of fluid.
The
following over-the-counter remedies are helpful in relieving cold symptoms:
*
Ordinary aspirin
*
Paracetamol
*
Anadin Cold Control Capsules
*
Beechams Cold & Flu Hot Blackcurrant
*
Contac 400
*
Karvol Decongestant Capsules and Drops
Traditional British 'home' remedies which are good include:
*
Breathing in steam (from your bath, shower or over a basin)
*
Drinking hot lemon juice/squash with honey
*
Having really COLD iced drinks
*
Drinking whisky (in reasonable amount only, please!)
Over
the last 20 years, many people have come to support Zinc tablets (available
from your chemist) as a great cold remedy.
I
have to say that during those 20 years, I've been waiting for a scientific
trial which shows that they really do work - so far, it hasn't happened!
What
does work in 'un-bunging' your nose is gentle injection of warm,
salty water - a technique I have used successfully for about 10
years. Unfortunately, it's quite difficult to do for yourself
unless you have a good working knowledge of nasal anatomy! If
you want to try it, get a doctor or nurse to show you how.
One
final point: MIND YOUR HANDS. British research has
shown that colds are very often passed on to other people via the
hands. So while you've got a cold, try if possible not to touch
other folk at all. Basic hygiene is to be taken seriously in
trying to avoid colds and keep them from spreading.
Nearly
all sore throats are caused by one (or more) of three factors:
*
Smoking
*
Germs
*
Over-use of the voice (uncommon)
So
if you have a sore throat and you are a smoker, the first thing to
do is NOT TO SMOKE. Amazingly, a lot of smokers don't understand
this at all - and keep demanding antibiotics, whilst continuing to 'bathe' their
throats in irritating cigarette,. pipe
or cigar smoke.
If
you've got a sore throat and you're not a smoker, then try and keep
well away from people who are smoking.
Germs:
What about germs? The majority of the germs which cause
sore throats are viruses. Therefore,
antibiotics will
have no effect on them. So the average sore throat will not
respond to penicillin or erythromycin or tetracyclines.
Fortunately, most sore throats which have been caused by viruses
will get better in a week or so.
However
- a minority of sore throats are due to bacteria - that is, the kind
of germs which are 'done in' by antibiotics. So in general, if
you have a bad throat that has gone on for more than about a week,
it was worth consulting your GP to see if a course of penicillin (or
some other anti-biotic) would help.
'OTC'
Remedies: But for most sore throats, the best thing
is to
use an 'Over-The-Counter' remedy. Good ones include:
*
Beechams Throat-Plus
*
AAA Mouth & Throat Spray (but avoid if you're sensitive to Local
Anaesthetics)
*
Bradosol Plus Lozenges
*
Dequadin Lozenges
*
Meggezones
*
Aspirin, Paracetamol or Ibuprofen are also helpful. Herbal
or
homeopathic treatment may be worth a try - and are certainly less likely
to cause side-effects than antibiotics are!
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I'm not dealing
here with the sort of coughs which are caused by long-term medical conditions,
like asthma or chronic lung disease.
Most coughs which
affect the average person are due to either smoking or infection -
or a combination of both. Fortunately, a lot of coughs do get
better on their own - particularly if the sufferer wraps up warm,
and stays out of smoky or dusty atmospheres.
But if a cough
goes on for longer than a week, then you should at least consider
ringing your GP's surgery for advice. Personally, I reckon
that you should see a doctor if you have any of the following symptoms:
* Coughing
up green or yellow stuff
* Coughing
up blood
*
Experiencing chest pain while coughing
* Having difficulty
in breathing
If a doctor
thinks that your cough is probably due to a bacterial infection (as
opposed to a viral one) she'll almost certainly put you on
antibiotics for five days or so. These days, GPs do not prescribe
'cough remedies' very much.
However, if the doctor
reckons that your coughing is being caused by 'muck' dripping down
from your nose (which is very common), she may prescribe nose drops
or other anti-catarrh medication.
What about 'Over-The-Counter'
remedies? There's generally no harm in taking these if your
cough isn't bad enough to necessitate a visit to the doctor's.
Chemists are always very willing to sell you cough medicines;
indeed, a good deal of their trade depends on them! They will usually
ask you whether your cough is 'dry' or 'productive', and will
recommend something accordingly.
However ....
please bear in mind that some 'OTC' cough products (those which contain
codeine) should NOT be used by anyone who has serious liver or lung
problems. Furthermore, codeine products are also very
constipating.
Also, cough
medicines containing a drug called theophylline can cause agitation,
palpitations and insomnia - particularly in elderly people.
Finally, please
remember that antihistamine-containing cough medicines are likely to
make you rather drowsy - and probably unfit to drive safely.
Don't take alcohol while on them!
Frankly,
most people who say that they have 'flu actually have colds or chest
infections!
Real
flu is an extremely unpleasant and potentially dangerous condition -
particularly for anyone over 60. Some strains of 'flu do kill,
I'm afraid.
Symptoms
vary, but generally include:
*
Feeling so awful that you can hardly walk across the room;
*
High temperature;
*
Severe aching in the body and head;
*
Profuse sweating
If
you think you have 'flu, ring the doctor's surgery, or the Emergency
Doctor Service, or NHS Direct, and tell them your symptoms.
Then follow their advice.
Do
not attempt to go out. Stay in bed. Drink plenty of
fluids (but NOT a lot of alcohol). Take Aspirin or Paracetamol
or Ibuprofen - unless these drugs upset you, in which case seek a doctor's
advice.
If
your condition seems to be deteriorating badly, then don't hesitate;
get on the phone and ask for medical help!
This
influenza-like illness first hit the headlines in Hong Kong in March
of this year. By the beginning of April it was beginning to
spread around the world in an ominous way, clearly being carried by
airline passengers.
It's
almost certainly caused by a virus. Therefore, the 'bug'
cannot be killed by antibiotics. But fortunately, seriously
ill victims can often be saved by good nursing an artificial 'ventilation'
of the lungs. At present, the death rate is about one in 25.
Main
symptoms are:
*
High fever;
*
Headache;
*
Sore throat;
*
Aches and pains;
*
Difficulty in breathing.
At
the moment, you should simply be aware of the existence of SARS -
particularly if you live near an airport, or have contact with people
who have just flown in from the Far East or Canada.
If
you think you may have it, then ring a doctor for advice immediately.
DO NOT GO OUT. Stay in bed until you've been told that it's
safe to get up. Up-to-date advice will be available on the
Net, and from sources such as the teletext on your TV
Q
My husband says he 'has a
cold all year long', because his nose is always running. Can
anyone really have a cold that goes on as long
long as that?
A
No.
He must have some kind of nasal allergy. This is called
'allergic rhinitis.' He should see his own doctor for a more
precise diagnosis - and some treatment.
Q
I
am on penicillin for a nasty cough, and all my friends say that this
means that I cannot drink! Is this true?
A
No. In many parts of
Britain, people believe that 'you mustn't take alcohol with
antibiotics'. But in fact, there are only one or two antibiotics
which react badly with grog. You can safely drink while on penicillin.
So have a snifter - with my best wishes! (to be on the safe
side, check with your pharmacist)
Q
I'm a lifelong smoker, and
I have been coughing for the last 3 months - despite taking cough
remedies. My partner wants me to go to the Doctor's, but I
don't think this is necessary
A
Well, I'm afraid you're
wrong. Any long-term smoker who develops a cough that won't
clear up needs to have his chest examined - and probably needs an
x-ray as well. Don't delay
Q
My wife has been a singer
for 40 years. But in the last few months, she has had a really
bad sore throat, and has found it difficult to produced a decent
note! Why?
A
When people who've been
singers for years get a persistent bad throat and voice problems,
there's always a worry that they are developing 'corns' on their vocal
cords. This conditions has afflicted many fine artistes,
including Julie Andrews. So your wife should see her doctor -
and ask for a referral to an ENT specialist.
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Q
Since
turning 60, I have developed a tremor in my right hand. This
is interfering with my snooker! My doctor says that it isn't
Parkinsonism. He thinks it's what he calls an 'essential
tremor'. Can anything be done about this?
A
Essential
tremors are quite common, and may run in families. Very often
they respond well to a daily does of a beta-blocker drug
Q
I'm
a retired male, and ever since I turned 65 I have found that the old
'bedtime hydraulics' aren't quite what they used to be.
I bought bought some Viagra off the Internet
but it didn't work. Any other ideas?
A
Well, for a start this may not have been real Viagra that you bought
via the net. Also, you may not have been taking it the right
way. So I think you should see a doctor who is experienced in these
matters, and discus the problem with him. There are 2 other
excellent oral pills on the market now - and there are also other
ways of encouraging a reluctant erection.
Q
Do you think I'll be able
to fly to Canada on holiday this summer? I had a heart attack
2 years ago.
A
Plenty of people who have
had heart attacks are able to carry on flying. Provided your
GP or cardiologist says that you are fit to travel, then
go ahead. But you must declare your medical history whey you take
out your travel insurance.
Q
Five years after retiring, I'm
still in pretty good shape. So can you answer a tricky
question? Is it inevitable that I'll become deaf or blind?
A
No, not at all! It's
true that the eyes and the ears do tend to deteriorate with
age. But there are plenty of people in their 90's who have excellent
hearing and eyesight.
Q
Would I be able to continue
playing golf after I have a knee replacement operation?
A
Probably, but this is quite a big 'op', so ask your surgeon's advice.
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