Science & Religion

I have recently retired after a 44-year career in Emergency Medicine. A great experience for the quintessential “adrenaline junky” in me. Those years were a privileged participation in the lives of my patients. In their painful experiences. And in their varying degrees of physical and mental disarray. And yes, in their joyful recovery and escape from pain and incipient crashing out of life! That is the “drama side” of life in the ED.

But there is an interesting back story. Many folks brought less dramatic health problems to the ED.

Many times, these “ lesser problems” could be resolved quickly and effectively by a little common sense use of our vast store of simple “tricks of the trade”!

And it is by drawing from this experience that I am hoping to give you insights and “how to’s” to cope with the myriad medical problems that can crop up every day.

So, let’s get started with a so-so common problem- the home management of the common “cold” or Upper Respiratory Tract infection (URI) in medical jargon).

Have a stuffy or runny nose, that constant post-nasal drip, uncomfortable scratchy throat, never ending coughing, sneezing, headache, body aches, fever?  We have all been there, and chances are most of us will be there again.

An Upper Respiratory Infection (URI).

All upper respiratory infections have a common progression: a wet phase with inflamed throat (pain) followed by a dry phase of healing that can last weeks with coughing, malaise and weakness. But there are things you can do at home over the course of your illness that can help you to more comfortably overcome your next (or current!) pesky infection.

Initial Medication Treatment

Initial medication treatment starts with Tylenol (generic name -acetaminophen) with an adult dose of 1000mg every 6 hours for up to 10 days AND a Non-steroidal anti-inflammatory drug (NSAID).

I recommend Aleve 220mg Gelcaps (generic name-Naproxen) one every 12 hours for up to 7 days.

NSAIDS (others include Ibuprufen and similar) can cause stomach lining problems (erosion and serious stomach bleeds).

Tylenol and Aleve work in different ways to reduce pain.

Tylenol acts by reducing pain perception centrally in the brain.

The NSAID by reducing local inflammation in the throat causing swelling and the resulting pain.

Additional Treatment of the Wet Phase:

1. Steam inhalation produces dilution of the nasal discharge making it easier to blow your nose or cough up the excess mucus produced by the action of the virus on the mucous membranes lining your nasopharyngeal spaces. You can achieve this simply by leaning over a bowl of heated water, and with a towel draped over your head to trap the steam, breathing in deeply.A more convenient option is to purchase a steam inhalation device, sold in your local drugstore (see the example, one of many, in the illustration). They should not cost more than $50 and are good for many years and many infection episodes. Remember to sterilize the plastic mask with hot water and/or white vinegar every 24 hours and before putting it up in the medicine cabinet until the next time.

2. Hypertonic nasal saline (salt water) spray. Hypertonic saline has a 3% salt concentration. It works by an osmotic actionand sucks moisture out of the boggy, swollen membranes. Thereby reducing the mushy swelling of those same membranes. A small bottle of hypertonic nasal saline can be purchased at the pharmacy. An example would be NeilMed Nasamist Hypertonic Extra-strength Saline amongst others.
3. Classic ( Regular) Coca-Cola gargle.When used as a gargle, Coke has a mild anesthetic effect and “numbs” the painful, and inflamed membranes (the actual site of the acute viral infection process).

The wet phase usually lasts a short time and treatment but may be needed for 3-5 days (and nights!). As your body starts to overcome the infection, your immune response will cause the typical malaise, upset stomach, fever (viruses are killed off in part by the fever induced as part of the immune response) and the swelling in those infected membranes.

Remember those transient, uncomfortable symptoms you went through 24 hours after your Covid or Influenza shots? They are due to the activation of your powerful immune response system. It does not take prisoners!

Treatment of the Dry (healing and recovery) Phase

1. Steam Inhalations. Continue to use at least every 4-6 hours. And before getting your head down at night and upon arising in the morning. Taking inhalations regularly is critical to speeding up your recovery. As they recover after a viral invasion those irritated and inflamed mucous membranes quit hyper-secreting mucus and instead reduce mucus production. Often the mucus they do produce is thicker and more glue-like than normal. This is particularly a problem in an RSV (Respiratory Syncytial Virus) infection when the mucus is abnormally tenacious throughout the illness. The steam inhalations soften and dilute the crusting (drying) mucus “glue” layering over your recovering mucous membranes. Making it easier to cough up and get rid of the nasty stuff.
2. Normal Saline Spray In this healing phase use a normal (isotonic) saline spray (no need to have an osmotic action). You can make your own salt solution by stirring in a tablespoon of table salt in 6 ounces of boiling water. Let it cool then decant off the salt solution into a clean container and keep it in the refrigerator. Over the counter options exist for normal saline such as Arm and Hammer Simply Saline or NeilMedNasaMist Isotonic Saline Spray.This flushing process within your nose is particularly comforting when it rinses the turbinate bones on each side of your nasal passages that support a large area of sensitive mucous membranes.Use the saline spray at least every 4-6 hours or whenever you feel an uncomfortable dryness in your nose.

3. Coca-Cola Gargle: This is where Coca-Cola really comes into its own! Now gargling with Coke (from a screw cap bottle (so you retain the fizz) scours all that crusting and contracting drying mucus from your throat lining, relieving the pain of swallowing as it yet again provides its mild numbing effect.

You may find it necessary to continue this phase of treatment for several days but usually, used day and night, symptoms are gone in a couple of days of diligent adherence to the above treatment plan.

Then the step that we all seem to forget in our busy lives-convalescence!

Recovering from a viral illness, which may manifest with localized upper respiratory symptoms, is actually a whole-body infection. We need to give our bodies adequate time to recover fully, get our appetites back to normal, our sleep hygiene restored to its usual routines, and recover our muscle and joint health. Covid brought home just how true this was for that viral infection and just how long convalescence was needed for many folks.

Hopefully this handy home management plan for the course of your URI illness will help you navigate your next URI in more comfort than before.

Stay healthy and keep up with your vaccinations.