Colds – A Self-Care Instructional Guide

Viral upper respiratory infections, ”URI” or the “common cold,” are indeed common. Over 200 subtypes of viruses cause “colds.” Although each of these usually causes a person to become ill only once, the large number of viruses means that most people have many colds. The average adult experiences 2-3 colds per year. Americans experience an estimated 500 million colds per year. Most colds do not require treatment by a healthcare provider; self-care is adequate. Other illnesses which have similar symptoms include “strep throat,” mononucleosis, and influenza (“flu”). Rarely, complications occur during a cold. These other conditions/complications may require medical care.

These self-examination skills will help you determine if you have a cold, or some other illness:

SELF-EXAMINATION OF THE NECK

• Using the middle three fingers of your right hand, feel and press on the left side of your neck using a gentle up and down motion to examine any nodes in the neck.
• If you find any nodes, use a circular motion around that node to check for size and shape.
• Using the middle three fingers of your left hand, repeat Steps 1 and 2 on the right side of your neck. (See picture at right for location of nodes in the neck)

WHAT YOU CAN EXPECT TO FIND

• When you are well, you probably won’t feel any nodes and will not feel any tenderness. However small, soft nodes in the front of the neck (anterior nodes) that are not tender may be common in healthy people.
• Enlarged, tender nodes are common with colds. As these nodes get smaller and less tender, you know you are getting better.
• If the parotid gland is tender, you should be seen by a provider.

SELF-EXAMINATION OF THE THROAT

• Use a mirror, flashlight (or penlight).
• Sit or stand in front of a mirror, tilt your head back slightly and open your mouth so that you can see into it.
• Stick out your tongue and say "ah." If you cannot clearly see the tonsils and throat, you can use a clean spoon to press down on the tongue.

WHAT YOU CAN EXPECT TO FIND

• When you are well, the throat should look like the illustration and be a healthy pink.
• When you are ill, your entire throat (pharynx) may be red. This is common with a cold, especially if you have a sore throat. This may also occur with severe allergies.
• Your tonsils may be red, swollen and tender. This also is common, especially if you have a sore throat.
• Small, red patches (lymphoid plaques) on the back of the throat commonly occur with colds or allergies.
• Exudate, the presence of white or yellow patches may be seen on your tonsils or walls of your throat. These should be evaluated by a provider.
• Streaks of mucus (post-nasal drip) may be seen in the back of the throat.

YOUR TEMPERATURE

In one study, body temperature of healthy subjects ranged from 96.0 to 100.8 degrees F, with a maximum 0600 (6 am) temperature of 98.9 (37.2 C). The maximum at 1600 (4 pm) was 99.9 (37.7 C). Body temperature may vary by 1 º F (0.5º C) throughout the day. A fever, defined as 100.4º F or greater, may occur for a number of reasons, one of which is an infection. Fever is an important immune system response. Most fevers are self-limiting. When your body temperature is rising you will have chills, possibly shiver, and want to cover up. When your temperature is decreasing, e.g. after taking acetaminophen or ibuprofen, you’ll feel hot and sweaty and want to uncover. This cycle is frequently referred to as “chills and sweats.” Fluid intake is very important since fever increases fluid needs. If your fever exceeds 104º F (40º C), and/or does not decrease after taking medication, seek medical care.

(In contrast, hyperthermia, from heat exhaustion/stroke, metabolic diseases, and drugs (e.g.”ectasy”) is an emergency and the person should receive immediate medical care.)

The simplest way to take your temperature is with an oral thermometer. One option is a digital thermometer that will give a reading in about a minute. These are reusable with a fairly long battery life. Another option is a thermometer that has a series of dots on the handle, such as Nextemp (brand name). Holding it under the tongue for about a minute will cause a color change in the dots, with the reading indicated by the last dot to change color.

To get an accurate reading from your oral thermometer, wait for 30 minutes after taking a bath, eating a meal, drinking any liquid hot or cold, smoking a cigarette, brushing teeth, using mouthwash, or coming in from the cold outdoors. When ready, place the thermometer deep under your tongue and close your mouth but do not bite down on the thermometer. Follow the directions for your thermometer regarding length of time held under your tongue, reading and cleaning.

Ear thermometers that measure the temperature of the heat given off from the eardrum are also available, but are usually more expensive than oral thermometers and not necessarily more accurate.

Other symptoms associated with fever may include headache, dry mouth, increased thirst, rapid heartbeat, loss of appetite, fatigue, light-headedness, and not urinating as much as usual. Your face may be flushed and your skin may feel hot and dry.

Most people will want to lower their temperature for comfort reasons. You can use aspirin, acetaminophen, or ibuprofen to reduce fever. Use as directed unless advised differently by your provider.

YOUR COLD

The most common cold symptoms are: sore throat, stuffy nose, clear nasal drainage, hoarseness, dry hacking cough, headache, fever, body aches, and fatigue. Cold symptoms appear from one to three days after the virus takes hold in your body. You can transmit your cold to others even before you experience symptoms, which is one reason why colds are hard to prevent.

The first indication of the infection is usually scratchiness or tickling in the throat. Within a few hours, your nose becomes stuffy, you have general feelings of discomfort and illness and you may start sneezing. Within 48 hours, your cold is fully developed. Each of the many viruses that cause upper respiratory infections has a slightly different incubation period, group of symptoms, and duration. Most colds can last anywhere from 3 to 14 days. There are no medical cures or antibiotics to “cure” a cold or speed up recovery. Your body’s immune system must deal with the virus.

Viral infections do not improve with treatment by penicillin or other antibiotics, and antiviral medications do not work on these viruses. Inappropriate use of antibiotics can cause drug reactions, infections, and/or antibiotic resistance.

Rest - Try for 8-10 hours of sleep each night. This gives your body a better opportunity to combat the cold viruses.

Fluids - Drink plenty of liquids. To be sure you get enough: drink a full glass of water or other liquid every two hours. Fluids help to keep the mucus more liquid and easier to clear out, and also help prevent complications such as bronchitis and ear infections. Alcohol and drinks containing caffeine in large quantities are not good fluid replacers since they tend to dry the throat. Broth or chicken soup is excellent when you have a cold because they soothe your throat. You may also want to consider drinking juices.

Stop Smoking - Smoke irritates the bronchial passages, which prolongs the cold symptoms. Refrain from smoking on those days when the cough and scratchiness of the throat are a problem.

Steam - Take steamy showers to relieve congestion in the chest and nasal passages. If possible, buy a "cold steam" vaporizer to add moisture to the air in your bedroom.

Diet - Unless your provider has advised a particular diet, you may safely eat whatever you want as long as your diet is balanced and includes all food groups.

Alternative Medicine: Echinacea may help alleviate symptoms and duration if started early in the course of a cold. The evidence that zinc lozenges shorten the duration of a cold is very sparse. Zinc nasal swabs are not recommended.

HOW TO REDUCE A FEVER

• Dress lightly. Cottons and cotton-blends are best.
• Taking a shower with tepid (warm) water may be helpful. If dizzy or lightheaded, simply sponge off with tepid water while sitting.

CAUTIONS

• Do not take someone else's medication, or antibiotics you may have “saved.” You may be causing a more serious problem than you already have.
• Don't bundle up to sweat out a fever. It only increases your temperature. If you feel cold, cover up; if you feel warm, dress lightly.
• Nasal sprays such as oxymetazalinemay help congestion but should not be used for longer than 3 consecutive days, as longer use may cause rebound nasal congestion.
• Don't spread your cold. Wash your hands often.

CALL THE DIAL-A-NURSE AT 333-2700 OR YOUR PROVIDER’S OFFICE NURSE IF YOU HAVE

• Enlarged tonsils with exudate and a fever
• Sore throat that persists longer than seven days
• One tonsil much larger than the other
• Fever lasting three or more days
• Fever greater than 103º F
• Cough lasting more than two weeks
• Cough occurring frequently at night, coming in “spells” and possibly causing vomiting
• Worsening of chronic respiratory disease such as asthma
• Chest pain, wheezing, or shortness of breath
• Earache
• Rash, any type, anywhere on body, not previously diagnosed
• Headache with stiff neck, fever, confusion, vomiting and/or rash
• Sore throat with a rash
• Sore throat symptoms after exposure to strep throat

References