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By
Dr David Delvin
Have
you got a cold or a cough this month?
Well as they say, join the club! There's been an awful lot of bugs around, and many people - particularly middle-aged and elderly people - have been hit by them. In this article, I want to tell you a bit about colds and coughs, about how to avoid
them, how to treat them yourself - and when to go to the doctor.
Let's start off by looking at COLDS - and then we'll move on to
COUGHS.
I find that a lot of people of a certain age use the word 'cold' to mean almost
any respiratory infection. For instance, this week I saw a chap
of 55 who was gasping away with a very bad chest bug. He really wasn't very well at all. But he said to me: 'Oh, it's only a cold on my chest, doctor!'.
In fact, you can't have a cold 'on your chest'. A cold is something you get in your
head - and, to be specific, in your nose and the upper part of your throat. If trouble starts spreading elsewhere, then you've got not just a cold, but some complication of it, and probably need medical help.
The medical name for the common cold is 'coryza'. It can be cased by
any one of dozens and dozens of tiny viruses which circulate widely throughout the population in winter - and to a much lesser extent in the other seasons too. You have to
'catch' it from somebody else - because of the fact that it's caused by a virus.
So, if you were living totally on your own, you couldn't catch a cold - no matter how chilly or wet you got. You have to come into contact with someone else who has the virus. For example, Antarctic explorers who have been on their own in the freezing cold for months do
not catch a cold - they only pick up the virus when other people come to rescue them!
How do you catch the cold virus from other folk? In one of the following ways:
The person with the virus breathes over you;
The person with the virus COUGHS over you (nasty!);
The person with the virus SNEEZES over you (very nasty!);
The person with the virus has physical contact with you, i.e TOUCHES your
hand, KISSES you etc.
The person with the virus has physical contact with an OBJECT which you touch
immediately afterwards.
Generally, the virus gets into you through your nose, or your mouth, or your eyes. So how do you get it from your hands? Quite simple: most people unconsciously raise their hands to their faces several times a minute. And if the cold virus is on your hand, it may go straight into your eye or nose!
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Of course,
most of us know the miserable symptoms of a cold only too well:
Runny or blocked nose;
Sneezing;
Running eyes;
A congested sensation;
Generally feeling really rotten!
Yes, colds do make you feel awful - often you feel worse than you would if you had a more serious illness! But at least, a cold is soon over.
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There's an old medical saying: 'If you don't treat a cold, it lasts seven days. If you
do treat it, it lasts a week'.
And I'm afraid that that's pretty well the truth. The average cold does last about a week - and no treatment has really been shown to shorten that period. You take anything you like, but the cold will still drag on for a good seven days.
Now you may say 'But wouldn't antibiotics help?' No, they wouldn't. Penicillin and the other antibiotics have
NO effect whatsoever on viruses - they only work on other types of
germs or infections. Taking them for a cold is a rather expensive waste of time, and might even do you harm - especially if the antibiotics cause side-effects.
What about things you can buy 'over the counter?' Well, they can certainly relieve the
symptoms of a cold, an make the whole thing more bearable. If you wish, you can buy quite expensive cold remedies from the chemist's. But cold-ridden doctors who are treating
themselves tend to stick to very simple (and cheap) things like aspirin and paracetomol. My own personal anti-cold medication is warm saline (salty) nose drops four times a day - but that's not everyone's cup of tea!
What about vitamin C and zinc and the other remedies which are so often extolled in the papers? Well, there's no harm in trying them. But so far, no really good scientific trial has shown them to be of real value.
So all in all, if you've got a bad cold the best things to do are:
Stay at home - there's no point in going out and infecting other people, especially if you're retired and have no commitments;
Stay in bed as much of the day as you want to;
Have some nice baths or showers - the hot water and steam will ease your symptoms;
Drink plenty of fluid;
Take whatever proprietary remedy you fancy;
If your taste runs to a LITTLE soothing drink of whisky or whatever - then go ahead!
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Now can you actually prevent colds? Unfortunately, all the efforts of the British Common Cold Research Centre over many years failed totally to come up with any medication which would do this. But if (like many people) you yourself believe in a
'cold-preventer' - such as vitamin C or daily swims in the sea - then that's
fine - who's to say it doesn't work for you?
What about immunisation against colds? You may remember that up till about 25 years ago, doctors used to administer a
'cold vaccine' to their patents each winter *. Tens of thousands of British people had these jabs every year, at enormous financial cost. Sadly, it turned out in the end that this injection was completely useless - so it was abandoned.
NB * Not to be
confused with the 'Flu' jab that is available each year and often
recommended by GPs.
So what can you do to try to prevent yourself getting a cold? Basically, during the chilly months of the year you should
attempt to minimise or keep away from crowded , enclosed or
stuffy places. The following situations are absolutely ideal for picking up coryza(cold) germs:
Buses & Trains;
Small, enclosed rooms with the windows shut;
Shops - especially small ones without a lot of ventilation;
Doctors' waiting rooms!
In crowded places, be particularly wary of those ill-mannered idiots who
cough or even sneeze over everyone else - without even troubling to get out their handkerchiefs! They're usually spraying out cold germs in all directions. Alas, none of them appear to have heard of the old wartime slogan:
'COUGHS AND SNEEZES SPREAD DISEASES'!
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Unfortunately, the common cold does quite often lead to complications - and a few of these can be quite nasty, especially for older people and those who have weak chests or hearts. Complications are generally caused by other bugs seizing the opportunity to attack someone whose already under the weather with a cold. The common complications include:
Sinusitis -
when infection gets into the air cavities (sinuses) in the face bones;
Pharyngitis -
when infection gets into the throat;
Laryngits -
when it gets into the voice box;
Tracheitis -
when it gets into the wind-pipe;
Chest infections -
when it goes down into the lungs.
If you think you're getting a complication of the common cold, then it's usually a good idea to ring either your doctor's surgery or
NHS Direct for advice. Alternatively, consult your local
chemist/pharmacist.
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Now let's deal briefly with the subject of Coughs. These, as you know, can often follow colds.
Coughs can be caused by all sorts of things, but in winter and spring far and away the commonest cause
is an Infection. However, additional factors which may well provoke a cough are:
Smoking.
Living with somebody who smokes;
Being in a dusty atmosphere.
Because infection is such a common cause of coughs, once again the best way to prevent them is to steer clear of people who are coughing and sneezing! Avoid smokey atmospheres - and if possible, do not smoke yourself!
What about treatment? If the cough is only mild, you can treat it yourself - with something bought from the pharmacy. Pharmacists and their assistants are trained to ask people a few details about the cough, and then to recommend an appropriate remedy.
But when should you go to the doctor? In my opinion, you should seek your GP's advice in the following circumstances:
If a cough has gone on for more than a week;
If you are coughing up green, or yellow stuff;
If you are coughing up BLOOD;
If coughing is painful;
If you are not only coughing, but breathless.
Smokers should take particular care about coughs. If a 'smoker's cough' goes on and on, this may indicate that your poor, inflamed, blackened lungs are starting to run into trouble! See your doc - and if
the Doc says that the cough is a warning that you should give up
smoking and heed the advice.
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Q. I got a cold in January, and ever since I've had real pain in my cheek and my forehead. Why?
A. This is almost certainly SINUSITIS - which often follows a cold. Please see your doctor. He'll probably prescribe a special antibiotic and maybe some nose drops or inhalations
Q. Is it all right to kiss my grandchildren when I've got a cold?
A. No, ma'am. Kissing children is an excellent way of passing germs to them. Leave it till your cold is better.
Q. I recently had a 'cold sore' on the lip. Is this caused by a cold, as I have heard?
A. No, sir. A 'cold sore' is nothing to do with the common cold. It's actually caused by a type of herpes virus - which is probably living inside your body and flaring up from time to time. The odds are that you actually acquired this virus back in your childhood.
Q. I was planning to go and visit my husband in a nursing home tomorrow. But I have a bad cold. Should I call it off for his sake?
A. Absolutely. Colds are very infectious during the first few days. And the people who run the nursing home aren't likely to thank you for introducing the virus into their establishment!
Q. I'm a man of 58, and have been a smoker (cigars and cigarettes) for about 40 years. I've always had a bit of a smoker's cough. But in the last few months it has got worse, and I am racked with coughing every day. Should I be concerned?
A. A worsening cough in a long-term smoker is always worrying. Please go and see your doctor this week and have your chest examined. I shall be amazed if he doesn't order an urgent x-ray.
Q. I had TB when I was a little boy just after the war. Now I've got a persistent tickly cough. Do you think that the tuberculosis could have come back?
A. This is very unlikely, sir. Nonetheless, I think you should have a check-up from a doctor - just in case.
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Q. Unfortunately, my wife has just started to develop really bad memory loss. She can remember all about her childhood, but doesn't know what date it is now - or even what year it is. She knows me, but is 'hazy' about other members of the family.Could this be Alzheimer's, do you think?
A. I do fear that it could be Alzheimer's - or some other form of dementia, sir. Please ask your GP to do some preliminary tests, and to send her to your local Psycho-Geriatric Consultant.
Q. I went to my GP because of a bit of pain in my knees. I'm 64, by the way. I was staggered to be told that it was due to arthritis. Does this mean I'll be crippled for life?
A. Not at all. It's not generally realised that by the age of 64, most of us will have some degree of arthritis in our joints. But that DOESN'T mean it's the crippling kind. In your case, it's probably just a little OSTEO-ARTHRITIS. You'll very likely be able to control it with pills, rub-in applications, warmth and maybe physiotherapy - plus sensible exercise. If you're overweight, you'll need to slim down. In the unlikely event that it got very bad, surgery might well help. Good luck.
Q. I'm male, 53, and have just been diagnosed as having a groin rupture. My doc wants to send me to our local hospital, but a friend has suggested that I go to a specialist 'Hernia Centre'. What do you think?
A. The new 'Hernia Centres' do the latest rupture operations. Furthermore, they do them all day and every day; they don't do anything else!
Obviously, this gives them terrific expertise. That's where I would go myself if I had a rupture. The cost should be under £1,000 if you're 'done' as a Day Case.
Q. I'm female, 65 - and very happy on HRT, which seems to keep me young. Is there any reason why I shouldn't keep taking it throughout the rest of my 60s?
A. None at all, ma'am. And provided you have regular health checks, you can probably keep taking the female hormones until far into your 70s!
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