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The Doctor Is In
February 2009
Some things never die, like the myths I address in this issue of The Doctor is In. Almost everyday I encounter patients who are convinced they caught a cold by being out in the cold and that they now have to swear off dairy because it thickens their mucous, or that they definitely need antibiotics because they have a fever, etc. So, I hope this puts some of these old wives’ tales to rest---at least for this week!
Myth Busters in Medicine: Respiratory Infections
- “If you don’t put on a coat you will catch your death from pneumonia.”
- While it’s true that certain stresses can lower your immune system’s ability to fight infection, what causes upper respiratory illnesses are viruses, not cold weather. We tend to see them more in the colder months because people are inside cooped up with each other more and sharing germs more, not because it’s colder outside. It’s still a good idea to wear proper clothing when out in the elements though.
- While we are on the topic of colds, remember antibiotics don’t help them. They don’t prevent sinus infections. They don’t cure sore throats caused by viruses. (They don’t even really make a sore throat from Strep throat feel better much sooner—they are used to prevent complications of Strep like rheumatic fever). They do cause yeast infections, severe diarrhea in some people, and they can lead to resistance so that if you really need an antibiotic it may not work for you. This is why we are very careful to prescribe antibiotics only when we think they are indicated.
- “Don’t drink milk when you have a cold. It makes phlegm thicker.”
- This has never been found to be true, but even a lot of doctors profess this old wives’ tale. Milk has protein and fat in it that coats your tongue for a very short time. This is why gourmet ice cream tastes “soooo” good. The fat coats your taste buds in deliciousness. But this has absolutely nothing to do with the secretions you blow out your nose. When you are sick your body needs nutrition and fluid. Drink whatever tastes good, within reason, and get lots of rest. Chicken soup has been shown to make you feel better sooner, but it has to be the good old fashioned, made at home, variety. Sorry, Campbell’s!
- “If I’m not vomiting I can’t have the flu.”
- When health care providers refer to “flu” we are usually talking about influenza, which is a respiratory virus, not a stomach bug. While some small children may vomit when they have influenza (they also do with Strep throat), adults usually have the sudden onset of muscle aches, fever, headaches and sore throat when they get the “flu”. The best way to treat influenza is by prevention. Flu shots work very well, in most years, to prevent illness. They can be given at anytime until the end of flu season, which is typically from November-March, but work best if given at least 4 weeks before the flu hits the area. Anti-flu medications have already been made nearly obsolete because of resistant flu bugs. Stay home if you have symptoms of influenza. While most people just feel really sick for 4-5 days, some people (pregnant women, immunosuppressed people and babies) can get very sick and die from influenza.
- “Feed a fever, starve a cold.”
- Or is it the other way around? Either way is incorrect. When you are ill, you need lots of fluids to keep secretions flowing and also to replace the extra fluid you use by breathing through your mouth instead of nature’s humidifier (your nose). If you have a fever you will also need to get extra fluids. Eat what tastes good. If you can’t taste, eat what feels good on that throat that’s probably irritated as well. Juice pops, pudding, ice cream, and fruit smoothies are good ways to go. Most of us won’t waste away to nothing if we miss a meal or two, but you can get seriously dehydrated if you are not careful.
- “Fevers must be brought down.”
- Actually, fevers are your body’s way of letting you know it is hard at work to clear out an infection. And, no, you can’t tell if it’s a bacterial or viral infection by the height of the fever. And a higher fever doesn’t mean you are sicker than a lower fever. A temperature up to 101.5 actually helps your immune system work. You may feel better if you take acetaminophen or ibuprofen to lower your temperature, because your skin feels less sensitive and your muscles hurt less, but it isn’t necessary to treat a low grade fever, and it may actually be better to let it be. Just make sure you compensate for the extra fluids you are losing by drinking more---water, sports drinks, ginger ale---some combination. Not just water, because your body needs electrolytes to function properly.
Good web sites to consult regarding respiratory infections:
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Supporting you in good health,
Gail Hacker, MD
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