Dear Dr. Jeff: How should students treat colds? How can we prevent them when, say, our roommate has one? A.K.
Dear A.K.: Good questions, and certainly timely ones!
Colds are caused by viral infections. There are no antiviral medications, which kill off the viruses that cause colds, so you're left with supportive treatments that aim to relieve symptoms and get you feeling better sooner.
If you have a runny nose, sinus congestion, or post-nasal drip, you'll need some kind of decongestant, like Sudafed, or mucolytic, like guiafenesin. If you're coughing, you'll need some cough syrup, like dextromethorphan. For headache, fever, and aches and pains, try Tylenol or Ibuprofen, which work best if taken on a schedule, every six to eight hours, than just when you feel like you really need them. If your throat is sore, gargle with warm salt water or aspirin dissolved in water.
To shorten the duration of your cold and to lessen the severity of your symptoms, you'll need to rest?a lot. That may mean missing class or postponing work, or missing practice or working out less. It will definitely mean getting as much sleep as your body is begging for?so give in to that fatigue! You'll need to drink plenty of fluids. Water, fruit juice, and broths are all fine. If you have access to a stove or microwave, you can cook up some chicken soup, a mainstay home remedy for at least three world cultures. Try loading it up with lots of fresh garlic and ginger. Minimize your drinking of alcohol, and definitely avoid smoking altogether.
Here's another question: When should you come in to the health center?
The vast majority of people who have colds can take care of them themselves, and they do not need medical attention.
Most of the remedies listed above are freely available in our self-care packets. The remainder can always be found at the campus convenience store or out in the community. Remember, colds typically last about a week, and they rarely lead to complications.
When should you come in? If you run a fever for three days greater than 101.5 degrees, if your tonsils are red and swollen and covered with white spots, if you have severe ear pain, or if you have prolonged sinus pain that has not improved after 10 days or so, or that has progressively worsened after five to seven days, you should visit the health center.
Here's what you shouldn't do: Don't take antibiotics for a cold. They won't help, and they'll probably make you worse. Unnecessary antibiotics may have side effects like allergic reactions, nausea, diarrhea, and yeast infections, to name a few. They'll kill off helpful bacteria that help you digest food and offer protection against viral pathogens. And they'll increase the development of antibiotic-resistant bacteria, so that diseases that used to be easy to treat become more difficult to cure?like MRSA.
According to most experts, nearly half of the antibiotic prescriptions written each year are inappropriate. Over half of the adults who go to their health care providers for a cold are treated with antibiotics. Despite the absence of evidence of any benefit for most people from these treatments, more than 23 million prescriptions a year are written for colds, bronchitis, and upper respiratory infections. These 23 million prescriptions account for nearly one-fifth of all prescriptions for antibiotics written for children and adults.
Now, A.K., about preventing colds, and about your roommate. Let's be honest. Given the realities of student life, colds are pretty much unavoidable. And you can't really ask your roommate with a cold to move out until she or he is better. But you can insist that coughs and sneezes are properly covered with elbows or with disposable tissues. You can both be very careful about washing your hands?often, and not sharing a towel to dry them off.
And more generally, you can try hard every day to do some of the things that shorten colds?to prevent them. Like getting enough sleep, eating a balanced diet, exercising regularly, not drinking excessively, not smoking at all, and very importantly, always finding time to relax and relieve the stresses of college life.
Do those things daily, and you'll be preventing a lot of illness and promoting a lot of well-being.
Hang in there, and get that chicken soup a-cooking!
Jeff Benson, MD
Dudley Coe Health Center