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I haven’t had a cold in years. This is an amazing fact, since I work with people who are often sick and may come to see me because they have a cold, in addition to the evaluation of their female maladies.
We have office policies for dealing with these situations:
1. Identify the patient as possibly infectious quickly.
2. Offer the patient a mask.
3. After this patient leaves, the staff goes into CLOROX mode. Of course, the exam table, all counter tops, and stethoscopes are always cleaned between patients. But when a patient with a cough or sneezes has just been in the office, we Clorox all doorknobs and clipboards, throw away the pen used by the patient, and then everyone has a group Purell hug.
I take Vitamin C daily from October 31 to April 15. I get the flu shot. During the respiratory and flu infectious season, I don’t take public transportation and I avoid movie theaters. I wouldn’t be caught dead at any event in Madison Square Garden. When I go out I always carry several masks, just in case: I offer them to those in need, and when they refuse, I put one on myself. When I fly on a plane during this season, I am the well-dressed woman who is wearing a mask whose nasal openings have been filled with Boroleum to trap those pesky viruses. No one wants to intrude into my private space on planes during the cold and flu season, I can assure you.
This year, in spite of my over-the-top precautions, I did get the respiratory plague that dozens of patients, friends, and family members have suffered through. It began with the infamous “My throat has been torched with a flame thrower.” Within 12 hours, an alien army of mucus-producers invaded my sinuses, soft palate, uvula, and then begin their quick march past my vocal cords, producing laryngitis so terrible that I sounded like a three-pack-a-day Camels smoker of 30 years, who loved her bourbon as well. Twelve hours later I developed a deep, unpleasant cough. This particular 2013–2014 respiratory infection was not associated with fever, chills, muscle aches, headaches . . . nothing to suggest that what I had was influenza, just a respiratory infection, generally caused by a nasty virus.
Cough receptors are scattered throughout the airways. When these receptors get triggered by an accumulation of excess mucus, they send a signal to the cough center in the brain. The brain processes this information and sends signals that certain respiratory muscles should rapidly contract, and this results in a cough. Coughing drives fast-moving air from the lungs; this causes the airways to vibrate. This vibration loosens the mucus that’s stuck to the mucous membranes in the airways. Coughing propels this mucus upwards and out of the airway. Thinner mucus is easier to cough up and out of your airway.
Almost everyone who gets a little cold seems to want a prescription for the “Z-Pack,” or azithromycin. Just because it has a cute, easy-to-pronounce nickname, most patients don’t realize that it is a serious antibiotic, with side effects. In addition, too much use of this and other antibiotics for no documented reason causes the body’s bacteria to become resistant to these over prescribed antibiotics. In other words, when you really need the antibiotic for something serious, it might not be effective.
The doctor diagnosed herself—“Bad Cold”—and took Thursday and Friday off from work to rest and not spread the germs to her patients. In fact, she actually took to her bed for four days, including Saturday and Sunday.
Mucinex TV commercial
The doctor treated herself with gallons of Eli Zabar chicken soup and fresh-squeezed orange juice, Mucinex (those graphic Mucinex TV commercials that portray the mucus aliens moving into the lungs with suitcases planning to stay are not commercials, but documentary film making at its best). Mucinex thins the mucus and makes it easier to be coughed out. Those mucus aliens and their suitcases just move right on out of the lungs after Mucinex arrives. I had the humidifier on 24/7 and soaked the floor through and through. The Husband was so solicitous it almost made me want to be slightly sick more often.
I returned to work on Monday, Day Five, with the worst cough. Still no fever, no chills, and no chest pain. Just a BAD COLD. I wore a mask all day. I think my patients appreciated this. The staff scrubbed everything and would only let me use the phone in my consultation room. At 11 a.m. I called a colleague who is an ENT specialist to discuss an urgent referral of a patient with new dizzy spells and probable vertigo. He agreed to see her that day.
Then I coughed.
“What was that?” the ENT asked.
“I have a BAD COLD,” I replied.
“Was that a productive cough?” he asked.
“Of course”, I said. “I am taking Mucinex.”
“What color?” he asked. (Doctors have NO boundaries, I thought.) Again he asked, “What color?”
“Green,” I said
“ How long have you been sick?” he asked.
“ I have had this BAD COLD for five days,” I said.
“What antibiotic are you taking?”
“None,” I said.
“You need to start a Z-pack” he said.
“I plan to die saying I have never used azithromycin unless I have a serious illness,” I replied, tired of this pushy doctor.
He closed his argument with “If you don’t start the Z-pack today for your serious bronchitis, you will likely get pneumonia. Will that be serious enough?”
“I got all this advice, and he doesn’t even take insurance,” I complained to myself. But I was tired of coughing and blowing my nose, so I began the Z-pack. I took the first two pills as ordered. And, dear reader, a miracle happened. Twelve hours later, I began to have fewer symptoms. Two days later, the mucus was clear in color and I no longer sounded as if I had terminal consumption. I finished the five days of azithromycin, but this BAD COLD is still hanging around two weeks later. I am so much better, but I still have the cough and runny nose, and have cornered the market on Kleenex.
Sometimes all the precautions we take won’t prevent a cold or the flu. The best thing to do is to consult a doctor when you don’t get better quickly. There is an aphorism in medicine: “The doctor who treats herself has a fool for a patient.” A bit harsh, I think.