Sore Throats & Colds

Sore Throats & Colds

By Bill VanBurkleo, D.O. FAEP 

   IT'S A COLD!
    Have  seen lots of runny noses, coughs, headaches, and some  fevers. Almost  all of it is viral. Remember,  antibiotics  (penicillin,  etc.) don't  do  a thing for virus. The treatment for a  viral infection  is symptomatic.... rest, fluids, Tylenol for pain and fever, and  sometimes a decongestant  might help. These viruses are spread mostly  by  hand contact.  Good  hand washing will help keep other  family  members from getting  it. Most of you can handle these situations yourself  and  save money on an office call. Situations in which you should  probably seek medical  attention include: history of lung or heart disease,  over  40 years of age and a fever of 101 degrees or greater, under 1 year of age, sore  throat or ear ache longer than two days, persistent chest pain  or uncontrolled  vomiting  or diarrhea. There are probably a few more but these are the main ones.

     SORE THROATS
   I  have  been seeing lots of sore throats lately. The cause  of  sore throats is varied. The major cause that I worry about is Strep. We  call it Strep because it is caused by a bacterium called Streptococcus. Other causes  are : "Mono", viral infections, epiglottitis, allergy with  post nasal drip, foreign bodies in the throat, nasal obstruction which causes mouth breathing, smoking, thyroiditis, and cancer. There are probably  a few more but the are the major causes. The big question is  whether to treat or not? As all of my readers should know by now, if it is a viral infection antibiotics are not indicated. However, if it is a  bacterial infection,  especially a strep infection, then antibiotics are indicated. Strep  can  cause kidney disease and Rheumatic fever.  The  most  common Strep age group is from 2 to 8 years of age. Occasionally, children less than one year of age are found to have Strep infection. In the older age group, one has to rule out infectious mono as an alternative cause.  The best  way is to do a throat culture. We just take a Q-tip and  swab  the throat  and then rub the Q-tip on a culture plate and see  if anything grows in 48 hours. There are some quick Strep test out  that can be read in  a matter of minutes. However, I have seen many negative  tests  that have,  upon culture, proved to be positive. We can check for  "Mono"  by drawing off some blood and doing a "Mono Spot Test".
   One  of  the hardest things to do is treat the  sore  throat.  Here's why...The mother brings in her child who can just barely swallow. I  run some  test and they tell me that this is not Strep but a virus.  I  tell the  mother how to treat the symptoms but do not order any  antibiotics. The mother looks at me with a "jaundiced eye" and says, "Don't you think you  should give MY CHILD a shot of penicillin? It always cleared me  up when I  was a child. " It is at this point that I have difficulty  not raising the white flag.
   For  Strep positive throats, I prefer to use oral Pen-V-K unless  the patient just can't swallow anything, then I will give a shot of Bicillin LA . If one is allergic to penicillin then I will use Erythromycin. The oral medicine must be taken at least a full ten days even though the  patient may feel  better and the sore throat is gone by the third  day.  The most common cause for recurrence is stopping the antibiotics too soon.


     RELIEF FOR DEPRESSION
   I had a patient that was having symptoms of depression. He was having trouble sleeping. He was irritable. And he said he couldn't  get  along with his wife. I told him to get up every morning and jog 10 miles.
   After 14 days he phoned. "Doc, I feel great. I'm sleeping again and  I'm not irritable."  "Super," I said. "But how are you getting along with  your wife?" "How should I know?" he replied. "I'm 140 miles from home!"

02-10-2008 22:00 Bill VanBurkleo Published in Health, Newsletter

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