Worst cold ever!
This must be a chest infection…..
Many people have been telling me this autumn that they’re suffering the worst cold ever and are concerned they have something more than an ordinary viral cold, perhaps a chest infection or something that needs an antibiotic. I think this is because colds are lasting so long this winter - I’m not sure I can medically rationalise them being longer than usual but it certainly feels that way! I share the frustration that there isn’t much we can do other than manage the symptoms until it goes away. We’re also seeing a lot of end-on-end viral infections where the next one creeps in before the last one has fully gone.
Last year we had very little in the way of colds and flu as one of several silver linings to the cloud of lockdown. However, this year has come as something of a shock to many as our children mingle, noses start streaming, and the sound of coughing (just about the least socially acceptable thing you can do these days) once again punctuates our lives. Whether this is because we have forgotten how a cold feels, or our immune systems have weakened without an annual boost against these viruses I’m not sure. It may even be that it’s just more relentless with more variants flying around. Whatever it is though here are some tips I’ve been sharing with my patients.
Breathe through your nose.
Easier said than done when your nose is congested, I know, but mouth breathing, especially at night, can make symptoms worse, especially sore throats, dehydration and coughs. If you can find a way of clearing your nose it will make a difference. When you blow your nose and you can’t clear it that’s generally because the blockage is not mucus, it’s some fleshy structures called turbinates in your nasal cavity which are swollen, so no matter how hard you blow they won’t come out, they’re attached to you! Half the challenge is removing the mucus, but the other half is trying to reduce that swelling.
Some of the things you can try are:
Steam inhalation. A long hot bath or shower before bed (ideally an hour before bed so your melatonin kicks in to help you sleep too) with plenty of nose breathing is a good idea. If it’s the children then pour a really hot bath, don’t let them in it obviously, shut the door and windows and read them a story in there. Try to get as much of the mucus out as possible.
Menthol. Vicks make a number of products, and Calpol make a plug-in vaporiser.
Eucalyptus. Olbas oil delivers this, a few drops on a tissue next to your pillow can help but will need recharging in the night if you wake up. If you have a humidifier try adding it in (check the instructions first!).
Nasal sprays. Use these with caution and for short periods only, they work well for some but they also come with a risk of symptoms returning afterwards worse than they were.
Saline sprays. There is some suggestion that these not only loosen the mucus but can act on the surfaces of the nasal structures to reset them and reduce mucus production.
Decongestants. Pseudoephedrine (Sudafed, or also combined with paracetamol in Day Nurse) reduces those swollen turbinates in the nose to make you feel much less congested. As a stimulant it’ll also keep you awake though, good when you’re feeling drowsy at your desk, so you’ll want to swap to an alternative for bedtime, something like a Lemsip or Night Nurse which have phenylephrine which does the same but without so much stimulant activity.
Humidify your bedroom.
The purpose of your nose is to warm and humidify the air that is hitting your lungs. With mouth breathing you have cold and dry air irritating the throat and lungs, and you’ll not only lose more fluid through water vapour exhaled through the mouth but also perpetuate your cough. If you can take the edge of that dryness it might ease things a little.
If you have air conditioning, turn it off as it further dries the air.
Add some steam to your bedroom. Something as simple as boiling a kettle a couple of times in the corner of your room might just take the edge off the dryness (some kettles keep boiling if you take the lid off, but do keep an eye on it!).
If you have a humidifier, plug it in. Sometimes you can add a little Olbas oil or menthol to the water as well for that extra decongestant action.
Take paracetamol.
Don’t forget good old paracetamol. Many people tell me it doesn’t work for them. I agree it’s weak but it works well and comes pretty close to being the perfect drug (it works, basically no side effects for most, it’s cheap, stable and easy to make) with the only downside being you are good at metabolising it so need to keep taking it. Four times a day is fine but do watch out for an accidental overdose if taking other things with paracetamol in (Lemsip, Day/Night Nurse and others).
Control any other conditions.
If you have other long term conditions such as asthma or diabetes then do try to keep on top of them as losing control will only slow down your recovery. If you need to step up management but aren’t sure how then speak to a doctor about what you should be doing. Everyone with asthma should have a personalised asthma action plan with clear written instructions on what to do if symptoms worsen.
Speak to your pharmacist.
They’re not just dispensers of medication, pharmacists have extensive training and are expert at advising on many products they can sell you without a prescription.
Get a Covid PCR test.
If you have any of a temperature, a new continuous cough or a loss of sense of taste/smell then you need a PCR test. Lateral flow tests are ok for picking up the odd case in the community who didn’t know they had Covid, but they miss a lot too, even if you do lots of them. When you have symptoms, you need a proper PCR test to rule Covid out. These are available online for free or through a variety of private providers.
Speak to a doctor.
You know your body and we can easily see you to ensure there’s nothing untoward going on if you’re unsure. Certainly if you’ve been coughing for 3 weeks or more you should check in (although at this time of year it’s usually because you’ve caught another bug before getting better). We do need to be avoiding excessive antibiotic use - there is concern about the risk of a new pandemic of antibiotic resistant bacterial infections due to inappropriate prescriptions. Lisle Medical will do a fingerprick test to give an answer in 2 minutes as to whether you have a likely bacterial infection needing a prescription – appropriate use of antibiotics will save you some misery, avoiding inappropriate antibiotics will save you unnecessary side effects like thrush and diarrhoea. Most times you should be advised when to get back in touch, but if you can’t recall the specifics just ask!
Look after yourself.
Make sure you eat healthily, hydrate yourself and get good sleep. Fighting infection drains our resources which is why you can feel so wiped out afterwards. As soon as you’re better, keep living healthily and get some exercise. Providing your body with what it needs will optimise your recovery and ensure you’re in the best condition you can be to fight off the next one.
