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December 11, 2008

Cold or Flu?
Posted by Jim Macdonald at 02:06 PM * 199 comments

‘Tis the Season.

Signs/Symptoms Cold Flu
Sneezing Usual Sometimes
Stuffy nose Common Sometimes
Sore throat Common Sometimes
Fatigue; Weakness Sometimes Usual; lasts up to two or three weeks
Chest discomfort; cough Mild to moderate; hacking cough Common; can be severe
General aches and pains Slight Usual. Often severe.
Headache Rare Common
Fever Rare Usual; high (100° to 102° F; occasionally higher; especially in young children). Lasts three to four days.
Extreme exhaustion Never Usual; at onset of the disease



  • Antihistamines
  • Decongestants
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)


  • Antiviral medications under medical supervision



  • Wash your hands
  • Avoid close contact with anyone who has a cold


  • Annual vaccination
  • Wash your hands
  • Avoid close contact with anyone who has the flu



  • Sinus congestion
  • Middle ear infection
  • Asthma


  • Bronchitis
  • Pneumonia (can be life-threatening)

If you have a cold or the flu, strongly consider staying home until you are well.

See also:

I am not a physician. I can neither diagnose nor prescribe. These posts are presented for entertainment purposes only. Nothing here is meant to be advice for your particular condition or situation.

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Cold or Flu? by James D. Macdonald is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 United States License.

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Comments on Cold or Flu?:
#1 ::: Adrienne ::: (view all by) ::: December 11, 2008, 02:27 PM:

How about onset? I've read (and found true in my experience) that colds come on more gradually, whereas flu comes on like being hit with an 18 wheeler. The one time I had it I thought I had a bit of a sore throat around 4PM; by 7PM I was huddled under many blankets having chills and sweating at the same time.

#2 ::: Mary Dell ::: (view all by) ::: December 11, 2008, 02:37 PM:

My personal experience is that Tamiflu antiviral, taken within 24 hours of symptom onset, is AWESOME. (Spending 12 hours in a pediatric emergency room with a sick baby while taking Tamiflu and fighting the flu meant that I skipped over most of the flu part of things but got a lower-resp infection anyway. But I was not nearly as sick as I usually am when I get the flu/bronchitis 1-2 punch).

My personal experience is also that ColdEze sugar-free zinc lozenges are extremely effective for colds if started when the symptoms start, and are palatable, in the narrowest sense of that word. They taste bad, but not awful--kind of like sucking on a cherry-flavored nickel. The with-sugar ones make my mouth hurt after half a day's worth, whereas the sugar-free are just icky.

Because I have used both of these things and have predictable reactions, the cold-eze become my best "flu or cold" test. Cold-eze doesn't help with flu symptoms (per the box, also my personal experience) so I take it right away and if it doesn't help that means it's not a cold. Of course, that doesn't automatically make it the flu--recurrent sinus infections can come along without a viral predecessor, although the viruses can give them a boost.

Tamiflu, by the way, costs a ridiculous amount of money, and it can have creepy side-effects*, although I didn't experience them. So it's something to consider carefully before trying.


*"sudden confusion, delirium, hallucinations, unusual behavior, or self-injury"

#3 ::: Zack ::: (view all by) ::: December 11, 2008, 02:39 PM:

I'm curious why you don't recommend NSAIDs for flu as well. The last time I had it, regular doses of ibuprofen made it possible to sit up in bed and read books instead of just being miserable and failing to sleep all day.

#4 ::: Chris Quinones ::: (view all by) ::: December 11, 2008, 02:40 PM:

A question about the flu kit: Should someone with hypertension (like myself) be concerned about the salt, the decongestant, etc. that can potentially cause problems with blood pressure? Are there ways to accommodate the issues raised, or is treating the flu the priority in the immediate event?

#5 ::: David Dyer-Bennet ::: (view all by) ::: December 11, 2008, 02:43 PM:

Funny, I grew up thinking flu by definition included major digestive upsets of one sort of another.

Are anti-virals ineffective against colds, or merely so expensive / dangerous / need supervision that they're not worth using on colds?

And three questions on washing hands, which this reminded me of (and I've reviewed your post on the topic).

First, is the water temperature particularly important for any other reason than comfort? (I tolerate pure cold well enough nearly all the time, and don't want to either wait or waste the water to get hot up to the basin if there's no benefit other than comfort.)

Second, is time the key factor, or is it really number of passes rubbing each surface? Just curious, I don't think I rub particularly fast or slow when washing my hands.

Third, you say to wash hands before and after preparing food, but don't mention before eating. And to use the alcohol sanitizers for other washings (beyond the cases listed in your article). How close to real washing do the alcohol sanitizers come, for health purposes? And should we be making a point of doing something before eating? I'm trying to establish some better habits so I don't have to do it under pandemic conditions.

And an observation: so many of the suggestions for improved health increase resource use; in the hand-washing instructions I noticed both waiting for the hot water to come up, and leaving the water running while I dried my hands (so I could then use the towel to turn off the water). (And then how do I open the bathroom door?)

#6 ::: BuffySquirrel ::: (view all by) ::: December 11, 2008, 02:54 PM:

I often get ear infections with flu, too. Heck, I get ear infections just thinking about them.


#7 ::: Lori Coulson ::: (view all by) ::: December 11, 2008, 02:55 PM:

David Dyer-Bennet @5:

Opening the bathroom door is done by keeping the paper towel in hand after you've turned the water off, and using the it to touch/open the door. Then you lob it into the trash container.

If the door opens outward and is pushable, you could open it by pushing with your shoulder or hip.

#8 ::: James D. Macdonald ::: (view all by) ::: December 11, 2008, 02:56 PM:

On hand washing: Water temperature is of no concern. The mechanical action of rubbing with soap to loosen the bugs is what you're after, to rinse them away.

Yes, it's a good idea to wash before eating (or putting anything else in your mouth).

As to salt/whatever when you have hypertension: Ask your doctor. Your situation is your situation.

For opening bathroom doors, I usually hold onto the same paper towel that I used to turn off the spigot and use that to open the door too (then chuck it in the wastebasket that should be by the door).

If NSAIDs help you with the flu, by golly, use them.

As to anti-virals with colds: It's a tradeoff. Antivirals (such as Tamiflu) can have serious side-effects. Colds, by themselves, have little chance of long-term harm.

Good luck, stay safe, and sneeze into your elbow.

#9 ::: G. Jules ::: (view all by) ::: December 11, 2008, 03:07 PM:

I'm curious: where does vomiting fit on there? Is it just not that common a symptom for flu?

I had the flu last year. I travel a great deal and have allergy-induced asthma, so I'm usually good about getting a flu shot, but last year I'd been sick through most of vaccination season, and somehow I never managed to get it together and get the shot.

I also hadn't planned ahead for being sick, which meant no broth, juice, Vitamin C, tissues, etc. At least I had toilet paper and painkillers.

This year I got my flu shot in O'Hare Airport (giving flu shots in major airports is a fabulous idea). I've doubled my minimum inventory levels for TP, tissues, juice, and broth, and added a backup supply of applesauce, canned fruit, painkillers, guaifenesine, Vitamin C drops, and similar items.

I'm not going to say I'm ready for the flu or anything, but if I do have it get it, at least I know it'll be easier to deal with than it was last year.

#10 ::: Nadyne ::: (view all by) ::: December 11, 2008, 03:35 PM:

Yesterday, I tweeted a whinge about getting the flu this week even though I got my flu shot a few weeks ago. I got a reply from someone I don't know: "So stop getting flu shots and creating super bugs that will eventually kill us all. Broad spectrum antibiotics for the lose :)"

I get the concerns about using too many antibiotics and antibacterials. I did some searching and couldn't find anything about flu shots being in the same camp. Does a flu shot fit into this category, or was my respondent just a nutjob? My search-fu is weak right now, which I'll attribute to my flu-addled mind.

#11 ::: Zack ::: (view all by) ::: December 11, 2008, 03:44 PM:

#9 where does vomiting fit on there? Is it just not that common a symptom for flu?

I have the impression that digestive upset is not a primary symptom of influenza, but can easily be a complication due to a secondary infection, or because your electrolytes have gotten that far out of whack, or just because your intestines have partially shut down to conserve energy (digestion is expensive).

The disease commonly referred to as “stomach flu” has a completely different cause.

#12 ::: Emily ::: (view all by) ::: December 11, 2008, 03:45 PM:

This reminds me, and it's as good a topic as any for it...

Why does a US bottle of generic guaifenisen say not to use it when you're an asthmatic? This seems slightly stupid to me after doing some research... turns out it's the generic version of Organadin, which I've taken in one form or another for most of my life. (for those of you who haven't... be glad it comes in pill form these days. the syrup with codeine is the most vile thing I have ever tasted)

The only thing I've come up with is that some asthmatics are terrible about getting treatment, and tend to keel over dead as a result. The problem with this theory is that guaifenisen is one of the better maintenance medications (better in the sense of "not inhaled", "not prone to abuse", "not prone to overdose" and "not likely to alarm the patient who is sure it must be addictive because it is a steroid"), and it's the only one that is available OTC. And ordinarily you *want* asthmatics on their maintenance meds... in order to prevent the whole keeling over dead bit.

#13 ::: Remus Shepherd ::: (view all by) ::: December 11, 2008, 03:49 PM:

Lucky me, I skipped over both the cold and the flu and have been wrestling with bacterial pneumonia for the past week. I now have antibiotics and codeine and an albuterol inhaler, so I'll be okay...but it's a lost week that I'll never get back. Maybe two, we'll see.

By the way, my illness was contracted at a child's birthday party. One of your recommendations for prevention of all disease should be 'Avoid Children'.

#14 ::: Lori Coulson ::: (view all by) ::: December 11, 2008, 03:51 PM:

Nadyne @10: No flu vaccines don't help create "superbugs."

Your correspondent is confusing vaccines (which are made from the viruses they're designed to prevent) with antibiotics and antibacterials (improper use of these does create superbugs).

The reason you have the flu is that the vaccine that you get does not contain strains of all the flu viruses currently active. Each year the companies making the vaccines guess at which strains will be most active in that year's flu season, and tailor the vaccine to combat those strains. When they guess wrong, lots of people who got the shot still get the flu...

G. Jules @9: Digestive and/or intestinal upsets are not common flu symptons though they can also be caused by of the most common ones, often encountered on cruise ships, is known as Norovirus.

When these symptoms appear during the flu, I would suspect that something else has set up housekeeping in the wake of the flu overwhelming the victim's immune system. Most flu deaths are caused by secondary infections.

#15 ::: Ginger ::: (view all by) ::: December 11, 2008, 04:03 PM:

Vomiting is a highly non-specific sign that is caused by too many different things to be diagnostic.

There are some decongestants that are safer for hypertension patients, or you can use steam therapy to loosen things up. As Mr. Macdonald said, talk to your doctor about your needs.

Cold viruses are many, plentiful, and all have the same course of illness: if treated aggressively, the patient gets better in 7 days; OTOH, if treated conservatively (rest, tea, sympathy), the patient will be fine in a week. There's little point to using anti-virals against colds.

What Lori said: flu "shots" are vaccines, and they trigger your immune system to become more active against specific viruses. Since the flu virus is highly mutable, it changes very easily, requiring new vaccines to be developed yearly -- and there's more than one version, so the vaccines need to be developed against the most common ones for the year.

Antibacterials are non-specific; antibiotics are specifically designed chemicals that kill or stop bacterial organisms. They don't make your immune system change in any way, but not using them properly will change the bacterial population.

#16 ::: R.M. Koske ::: (view all by) ::: December 11, 2008, 04:07 PM:

Much to my dismay, my early "getting sick" symptoms seem to have become bodyaches/fatigue and a slight sore throat. This is dismaying because it is also my "I've been glutened" symptoms, minus the brainfog and depression. It makes it hard to judge if I should stay home to avoid infecting others with my cold* or just muddle through.

*I assume the last one was a cold and not flu - it was almost all upper respiratory, but I'm still slightly tired and achy a week later. I gave up taking my temperature when I feel bad because for the last year it has always read at 96.8F when I was feeling poorly, which is Not Helpful.

#17 ::: Connie H. ::: (view all by) ::: December 11, 2008, 04:12 PM:

David @3 -- Handwashing gets a third of its benefits from hand-drying afterwards. Dry hands don't gather as many germs from surfaces, even doorknobs and handles, so if you don't dry your hands sufficiently you'll just reinfect them promptly.

So even if there's no soap available, it's still a good idea to wash in plain water and then dry.

#18 ::: Summer Storms ::: (view all by) ::: December 11, 2008, 04:13 PM:

I seem to be one of those odd folks for whom even a simple cold often leads to bronchitis. Yuck. I've had my flu shot for the year, though, and I'm a compulsive hand-washer, so let's see how I do this season...

#19 ::: abi ::: (view all by) ::: December 11, 2008, 04:16 PM:

Everyone in my house has been ill this winter: vomiting, coughs, cold. The flu has swept through my office like a marauding army. And I've had only one evening where I felt iffy.

Last winter was the same. One two-day illness. This is not like me.

The only thing I can think of that differentiates me from my family is that I commute by bike, 6 km each way, even in the freezing cold and bitter rain.

Surely that can't be making me healthy?

#20 ::: G. Jules ::: (view all by) ::: December 11, 2008, 04:17 PM:

To explain that question: I've had both stomach-not-actually-flu and full-on doctor-confirmed influenza, and I vomited with both. When I had influenza, the vomiting was during the first 24-48 hours only. I had no idea it wasn't a normal symptom for influenza.

I've long suspected that my body tends to hit the "Vomit!" button more readily than average, though.

#21 ::: James D. Macdonald ::: (view all by) ::: December 11, 2008, 04:37 PM:

#10 Does a flu shot fit into this category, or was my respondent just a nutjob?

Your respondent is a nutjob.

#22 ::: lohengrin ::: (view all by) ::: December 11, 2008, 04:39 PM:

Colds can also turn into bronchitis, yes, especially if you have asthma. Happens to me at least once a year.

#23 ::: Daniel Klein ::: (view all by) ::: December 11, 2008, 04:51 PM:

This year was the first year I ever got a flu shot. Got it all the way back in October I think. No flu so far. Had a pretty bad one back in January that pretty much knocked me off my feet for two weeks.

Let's see science kick the viruses' ass this winter.

#24 ::: Summer Storms ::: (view all by) ::: December 11, 2008, 04:54 PM:

Lohengrin @ 22: That's the interesting thing; I don't actually have asthma, though at least one of my first cousins does. I do have seasonal allergy symptoms, however, which can on occasion involve some mild wheezing, and when I develop bronchitis I also seem to develop a sort of temporary asthmatic condition to go along with it. The worst is when I get a bout of bronchitis right at the changeover from winter to spring, which then leaves me transitioning between bronchitis-induced wheezing and pollen-induced allergic wheezing. Fun times. At least my doctors finally got smart about that and began issuing me various inhalers when I'm in that situation.

#25 ::: Teresa Nielsen Hayden ::: (view all by) ::: December 11, 2008, 04:57 PM:

That can't be right. I got a flu shot. This isn't fair.

#26 ::: Adina ::: (view all by) ::: December 11, 2008, 04:57 PM:

Does the suggestion of using a towel to turn off the water and open the bathroom door also apply at home? I read David@5's observations as taking place at home, and therefore find it a bit unsettling to be told to throw out my towels after one use.

#27 ::: lohengrin ::: (view all by) ::: December 11, 2008, 05:01 PM:

@24 Allergies can do it too, yeah. I have a double whammy of asthma and year-round/indoor allergies. Any vulnerability in your respiratory system can be an invite for bronchitis, alas.

#28 ::: Summer Storms ::: (view all by) ::: December 11, 2008, 05:02 PM:

Teresa, you're sick? :-( Just don't cough on the computer; I'd hate to have to disinfect my internetz.

#29 ::: albatross ::: (view all by) ::: December 11, 2008, 05:02 PM:


Perhaps the aviveld works on virus reproduction?


Is there any research on whether you get a benefit from previous years' flu shots? It intuitively seems like there should be some benefit, but that has to depend on how likely the antigens your body saw from last year's vaccine are to happen to show up in this year's strain.

Alternatively, is there any evidence about whether the live 'flu vaccine (Flumist) has any better outcomes than the more common injected dead vaccine? It sort of seems like the live vaccine might be better (instead of just setting up an antibody response, you also set up a cytotoxic T-cell response), but I don't know enough to trust my intuition here. (And randomized trials >> anyone's intuition for this sort of question.)

#30 ::: albatross ::: (view all by) ::: December 11, 2008, 05:03 PM:

Summer Storms: Just remember to update your virus scanner.... :)

#31 ::: Lori Coulson ::: (view all by) ::: December 11, 2008, 05:04 PM:

Adina @26: That's paper towels not the cloth ones you have at home.

But contamination is contamination -- and it happens in the home as well as elsewhere. So maybe have facial tissue on hand, so to speak?

#32 ::: Summer Storms ::: (view all by) ::: December 11, 2008, 05:04 PM:

Albatross, I was wondering who'd be the first to take that opening...

#33 ::: sharon ::: (view all by) ::: December 11, 2008, 05:08 PM:

I always thought it was simple:

If you can get out of bed, it's a cold.

If you can't, it's flu.

If you made it to work, you definitely didn't have flu. (But WTF were you doing coming into work if you even thought you might have flu?)

Also, every time I go to type 'flu', I actually type 'flue' and have to delete the superfluous 'e'. Why is this?

#34 ::: Steve C. ::: (view all by) ::: December 11, 2008, 05:08 PM:

It might be an interesting thought experiment to calculate how many more people get sick because we have Christmas in the winter instead of when Jesus was most likely born, which was probably in the spring.

#35 ::: mjfgates ::: (view all by) ::: December 11, 2008, 05:09 PM:

At home, you *wash* the towel after one use. Or use paper towels to dry your hands, and throw them out. Or just leave the door a hair open when you go to the bathroom, so you can wedge it open with your foot. It's your house, after all.

Or I suppose you could make the eight-year-old do all door-opening for everyone in the house, but if you suggest that, don't be surprised if she kicks you in the leg.

#36 ::: Summer Storms ::: (view all by) ::: December 11, 2008, 05:16 PM:

Lucky me, I have faucets with the kind of handle I can just nudge with a clean wrist to turn them on and off, so I save on towels. I also leave the bathroom door open when I'm in there unless we have company.

#37 ::: Debbie ::: (view all by) ::: December 11, 2008, 05:22 PM:

abi @19, I've always heard that things like brisk walks outdoors, Kneipp cures and saunas have a positive effect on the immune system, although I'm not clear about the nuts and bolts.

#38 ::: Kathryn from Sunnyvale ::: (view all by) ::: December 11, 2008, 05:38 PM:

If your cold causes sinus problems (or if you get allergies), I'd recommend looking into saline sinus rinse. Studies have shown it can be quite helpful for adults. (And looking around Pubmed, it also helps kids, from this 2008 study*.) Among other benefits, it cuts down on symptoms that lead to post-cold coughs.

One can make the solution from common ingredients found around the home, or use those kits with pre-measured packets of salt/bicarbonate (good for travel and for getting the mix right (it stings if there's too much or too little salt)).

* "Conclusion: Children in the saline group showed faster resolution of some nasal symptoms during acute illness and less frequent reappearance of rhinitis subsequently."

#39 ::: Earl Cooley III ::: (view all by) ::: December 11, 2008, 05:47 PM:

One thing I was told recently is that a pneumonia vaccine lasts five years instead of the ten year I thought it did.

#40 ::: Mary Dell ::: (view all by) ::: December 11, 2008, 05:48 PM:

abi @#19: Maybe it's a bug that only affects people of Dutch ancestry?

#41 ::: Anna Feruglio Dal Dan ::: (view all by) ::: December 11, 2008, 05:52 PM:

I am never sure if what I have is a cold or a flu. I get a little bit of fever, but no upper respiratory tract symptoms, and headache, so I say, ah-ha, flu. But either I have a super-duper immune system or I catch all the really wimpy viruses because it never gets to the high fever and wish to be dead stage, or almost never.

I used to be sick all the time when I worked in my office, because we shared workstations. For the last years I had taken, like many others, to wipe my work area with antiseptic wipes. It did cut down on the number of viruses I picked up.

My standard cold-or-flu treatment is: 1gr paracetamol/acetaminophen every four hours, lots of liquids, warm bed, purring cat, silly tv. Hot Toddy probably is not curative but doesn't hurt, especially with Lagavulin in it.

#42 ::: Fiona ::: (view all by) ::: December 11, 2008, 05:58 PM:

Thank you for posting this. The flu season has on my mind too.

A couple of added points---never take aspirin with a viral illness (cold of flu) and make sure you increase your fluid intake. Coughing, sneezing, and sweating all increase your water loss. You can get dangerously dehydrated in a few hours.

As for vomiting (not caused by a cold or flu-they are respiratory illnesses)---follow the BRATT diet---bananas, rice, applesauce, tea and toast. In small amounts, as you can tolerate it. If you think you have food poisoning, be seen by a doctor. You may need IV hydration.

Your body is mostly water, and needs water to function properly. Don't fool around with serious vomiting.

Also, you won't feel like eating, so broth and soup are a great way to get fluids and some nutrition.

Stock up on easy to prepare, and easy to store stuff for the winter: Broth, soup, juice....

Abi @ 19, being enclosed on a bus/subway with lots of people is a good way to get sick, so bicycle commuting can keep you healthy---along with the benefits of exercise. being out in the cold or rain does not make you sick--you get sick from mainly viral or bacterial infections and, rarely, fungal infections.

I'm not a doctor, so make sure you get medical advice for your own specific illnesses.

#43 ::: Serge ::: (view all by) ::: December 11, 2008, 06:04 PM:

Ginger @ 15... Cold viruses are many, plentiful

Many are cold, but few are frozen, as the motto for the University of Antarctica said.

#44 ::: Mary Dell ::: (view all by) ::: December 11, 2008, 06:07 PM:

Fiona @#42: As for vomiting (not caused by a cold or flu-they are respiratory illnesses)---follow the BRATT diet---bananas, rice, applesauce, tea and toast. In small amounts, as you can tolerate it. If you think you have food poisoning, be seen by a doctor. You may need IV hydration.

Fun fact: respiratory illnesses can bring on vomiting if you have GERD or other esophageal issues. Coughing a lot can cause reflux, either of the heartburn variety or the vomiting variety. BRATT diet helps; so do athsma medicine and NSIADs.

Fun fact 2: Food poisoning generally includes diarrhea. Also true of many stomach bugs. Whereas esophagitis doesn't.

#45 ::: JennR ::: (view all by) ::: December 11, 2008, 06:09 PM:

TGIM gets a flu shot every year, when the office offers them. He gets the flu every other year. This year, he got the flu in October, three weeks before the shot. Nobody else in the house gets a shot, and I think the three of us have had the flu once (total) in the last five years.

I haven't gotten the flu for 15 years; and despite TGIM getting the flu and the teenager getting a cold and the 11yo getting a cold->bronchitis (all in October!), I'd only been sick for a week since Easter. And then I started feeling wonky, and went to see the doc. "That's not bronchitis or the flu. That's early stage bacterial pneumonia. We don't usually see it this early. You must breathe a lot." "Just a bit -- sing in a choir, play in a community band." "Ah. so you notice when function is compromised." Two rounds of antibiotics later ('call me *right away* if you have trouble breathing and I'll get you an inhaler'), the bug is gone. Still dealing with the damage though, and may wind up with a round of steroids if it doesn't go away like they think it should.

#46 ::: joann ::: (view all by) ::: December 11, 2008, 06:09 PM:

sharon #33:

Because you're wishing for flue powder?

#47 ::: Madeline ::: (view all by) ::: December 11, 2008, 06:39 PM:

Wait, so every time I thought my cold had "turned into" bronchitis, I really had the flu?

#48 ::: lohengrin ::: (view all by) ::: December 11, 2008, 06:47 PM:

@47: Highly unlikely. As was mentioned higher up in the comments, colds can also turn into bronchitis. Allergies can turn into bronchitis. Any weakness in or irritation to the respiratory system can result in bronchitis, if one is vulnerable to it.

#49 ::: lohengrin ::: (view all by) ::: December 11, 2008, 07:01 PM:

To clear up a common misconception about bronchitis: it's not a disease per se, like influenza, it's simply an inflammation of the bronchi. The -itis suffix means inflammation (tendinitis, pancreatitis, etc.), so whatever originally caused your bronchi to become inflamed and start over-producing mucus, it's still bronchitis.

#50 ::: Lee ::: (view all by) ::: December 11, 2008, 07:12 PM:

David, #5: WRT anti-virals and colds, my thinking is:
1) A cold is a known quantity. It's not going to last very long, and (barring individual medical issues) won't do lasting damage.
2) Colds are easy to treat symptomatically. A good antihistamine will get me functional, albeit not at full steam.
3) I am very dubious about throwing more drug at something than is really needed. That way lies the creation of new drug-resistant strains.

For those reasons, I'll save the Tamiflu for something worse than just a cold.

Remus, #13: No shit. Also, avoid people who work with children if at all possible. My ex was a day-care teacher with an immune system of iron. He might get the mild form of whatever was going around the center that month, but he would bring it home and I'd get the whole nine yards.

sharon, #33: That's not a bad rule of thumb. :-)

Fiona, #42: Folk wisdom says that ginger will settle an upset stomach. It may be placebo effect, but I've often found that drinking flat ginger ale, or eating a bit of candied ginger, helps when I'm feeling queasy. Also, saltine crackers (or melba toast rounds) make a good substitute for toast that can be kept next to the bed.

#51 ::: Nix ::: (view all by) ::: December 11, 2008, 07:31 PM:

Hm. Interesting. I get a simply insane number of colds (six to ten a year), and spent the first two years of my life constantly struggling with a cold verging on pneumonia.

But my colds fit most of the listed symptoms for 'flu': hyper-fatigue (for one to three days I can't do anything but sleep), sinus headaches, feverishness, coughing, joint aches, but *also* sneezing, a sore throat, and a stuffed-up nose.

When I get the flu (only a few times in my life so far), it's like that squared. It's two weeks before I'm back on my feet again, and two months before the coughs completely go away.

I read a paper a few months back that suggested that those born severely prematurely (as I was) end up missing out on part of their adaptive immune system, but I've lost the paper so I can't remember which bit is supposed to be missing. (If it was the antigen-presenting cells lining the respiratory tract, so my immune system never noticed colds until they were in full flood, that would explain everything: but I've lost the paper so that's a WAG.)

#52 ::: pixelfish ::: (view all by) ::: December 11, 2008, 07:39 PM:

Sadly, I first got the cold that was going around the office. Then I got the flu/bronchitis that my boyfriend got from his co-worker--and right after a particularly bad allergy attack. They gave me antibiotics and an inhaler last week, and I started to do better, but then as of last night I relapsed something hardcore, so now my doc has me on steroids (Goodbye, Olympic dreams! she said facetiously) and robitussin with codeine and some anti-nausea meds to boot. Whee. Basically I feel like I can breathe as long as I have hot tea and hold very still. It SUCKS.

#53 ::: David Harmon ::: (view all by) ::: December 11, 2008, 08:12 PM:

Lori Coulson:

Each year the companies making the vaccines guess at which strains will be most active in that year's flu season

Just to amplify on that, there's something like a 6-month lead time needed to manufacture the virus, and they need samples of the particular strains they want to protect against.

#54 ::: David Harmon ::: (view all by) ::: December 11, 2008, 08:23 PM:

Bah... "manufacture the virusvaccine"!

#55 ::: Fragano Ledgister ::: (view all by) ::: December 11, 2008, 08:38 PM:

Serge #43: Many are cold, but few are frozen, as the motto for the University of Antarctica said.

That's the motto of the campus in Chilean Antarctica.

#56 ::: Serge ::: (view all by) ::: December 11, 2008, 09:15 PM:

Fragano @ 55... Is it? It's been many years since my wife last wore the t-shirt - a time long ago when she had an obsession for penguins.

#57 ::: Marilee ::: (view all by) ::: December 11, 2008, 09:20 PM:

Now here's something I can use when the doctors want me to socialize more: "But when I'm home alone most of the time, I'm not exposed to viruses!"

I do get a cold every few years and it goes directly into pneumonia, so we start with antibiotics. I have lung disease already.

I haven't had flu in a very long time, but I do get the shot every year.

#58 ::: Ginger ::: (view all by) ::: December 11, 2008, 09:44 PM:

albatross @ 29: There is some protection from year to year, but influenza virus mutates so rapidly that there's going to be one that your body hasn't "seen" before. Established protection against resurgent influenza ("memory B cells") can reactivate if that virus shows up. Case in point: 1985 or 1986 outbreak of A(Taiwan)-68 (if memory serves me correctly); in that epidemic, anyone old enough to have been sick in 1968 was semi-protected against that virus in 1985-6. They'd get sick, mildly, and then get well sooner -- just as vaccinated people do every year.

Of course, we all know that vaccination is never 100% efficacious, but we all still get our flu shots. I had the flu three times in one winter, when I was an extremely-stressed out resident, and ever after I've made sure to get the vaccine.

David Harmon @ 53: There is at least a 6-month ramp-up to produce large quantities of vaccine in order to protect the population.

CDC, WHO, and other organizations meet in December or January to pick the next season's vaccine. China tends to be the origin of the next season's crop, so epidemiologic surveys of Chinese infection rates are critical. This is also the source of the potential super-flu, as you have ducks, pigs, and humans living in close proximity, sharing their viruses. Duck (or avian) influenzas do not easily infect humans, but they sometimes do infect pigs. Within the pig, they can reassort with pig influenzas, which can infect humans; or they can recombine with human influenzas.

Vague "flu-like" signs are non-specific, diagnostically speaking. Many viruses cause low-grade fevers, mild to moderate vomiting, muscle aches and pains, etc., and are neither cold nor flus -- consider SARS, as an example. In fact, you could consider Ebola, until the hemorrhaging starts, or Cercopithecine Herpesvirus 1, or Yellow Fever, or even non-viral illnesses like hepatitis, bacterial infections like Cholera, or parasitic infections like Giardia. In other words, basing a diagnosis on vague clinical signs isn't going to be productive. You need something pathognomonic, like hemorrhages, or jaundice, or cyclical fevers, or CNS signs, or non-response to antibiotics.

Diagnostic medicine is a lot like police work. You gotta find the perp, and you gotta use basic investigative skills like questioning the witnesses and gathering evidence.

Oh, on washing hands: just keep in mind that you're not going to sterilize your hands with that soap and water. Bacteria live on and in your skin. The point is to keep most of the bacteria off you, and keep them away from your face, and keep other people's germs off you. You live in a soup of microbes, and you are a big old bag of microbes, so don't worry too much about washing hands in hot water or disposing of towels. Cleanliness is certainly next to godliness, but over-cleanliness doesn't get you any closer to godliness, and chapped hands are awfully rough on your significant other.

#59 ::: Thomas Lumley ::: (view all by) ::: December 11, 2008, 09:45 PM:

David@5 re antivirals:

The antivirals that work against influenza just don't have any effect on any of the cold viruses. Tamiflu et al attach to a specific protein on the influenza virus that just isn't there on other viruses.

An antiviral that sort of works against rhinoviruses (the commonest winter colds) has been developed, but it wasn't approved by the FDA back in 2001. It needs to be taken very early, doesn't have very impressive effectiveness, and messes with the metabolism of oral contraceptives. According to Google, they are now trying again with clinical trials of an inhaled version.

There's also an antiviral for respiratory syncytial virus, which causes cold-like illnesses, but it is saved for infants with serious cases. It's not clear how effective or safe it is, either.

#60 ::: John Walton ::: (view all by) ::: December 11, 2008, 10:00 PM:

Jim, my whole family came down with the flu here in the UK in October-time, a week before we were scheduled to get our flu jabs. It seemed from our experience -- and from anecdotal discussions with friends and acquaintances -- that this year's flu is "a long one that comes and goes". Is there any medical reason why a particular year's flu would act differently than another year's?

#61 ::: Ginger ::: (view all by) ::: December 11, 2008, 10:11 PM:

John Walton @ 60: Yes, there is. Each season's selection of viruses is different, genetically-speaking, which is why your body responds to it as a brand-new pathogen. More virulent versions of influenza will lead to more secondary opportunistic infections, which is perceived as "a long one that comes and goes". Not only that, but there's more than one virus circulating, so you may well be getting sick with different influenza variants in sequence.

#62 ::: heresiarch ::: (view all by) ::: December 11, 2008, 10:16 PM:

Oh, so that's what I had last week. When the fatigue hit, I just thought it was my body complaining about waking up before the sun.

Kathryn from Sunnyvale: from the study: "Change in symptom severity measured by mean 20-Item Sino-Nasal Outcome Test (SNOT-20) score;"

SNOT score? Hee! For some reason I'm always more willing to trust a study within which the researchers demonstrate a sense of humor.

#63 ::: CHip ::: (view all by) ::: December 11, 2008, 10:25 PM:

Lee@50, wrt answer to Fiona: it hasn't been a folktale since ~1981. Lancet published a study involving ginger and the tilting/spinning chair used (IIRC) for astronaut training (the one that will eventually make you hurl unless there is something wrong with your semicircular canals). I have the citation (from back when I was working with NIH's Elhill search system), but not on this computer; will try to remember to post from there. Salient point was that powdered ginger was not effective -- which should be a pointer to the active element but I haven't read of anyone taking the next step.

#64 ::: Ginger ::: (view all by) ::: December 11, 2008, 10:31 PM:

On a lighter note, I have to admit that I have vertigo, so fresh Ginger isn't the key part either.

On the gripping hand, ginger has been used for thousands of years for GI related problems, and seems to be effective, so I would definitely keep it in mind.

#65 ::: Calton Bolick ::: (view all by) ::: December 11, 2008, 10:48 PM:

Great, apparently I've had the flu for the last few days. Is it too late for Tamiflu?

#66 ::: John Walton ::: (view all by) ::: December 11, 2008, 11:12 PM:

Ginger @61 and @64: Curses! I was hoping to get to the grated ginger joke. (With actual lemon and proper honey, mmm.)

#67 ::: B. Durbin ::: (view all by) ::: December 11, 2008, 11:46 PM:

If you're wondering what to call the "stomach flu" that isn't actually a flu, "rotavirus" is one of the primary illnesses that affect children with "stomach flu." Adults are more likely to have a robust enough immune system to avoid it, though as my husband and his co-workers can attest, that doesn't mean you'll avoid it entirely. But they give infants a vaccine now, so Gareth was unscathed. (Yay!)

Children are more likely to vomit with regular flu because their immune systems are not as robust. Poor little ones.

One of the better layman-term explanations of flus, flu shots, and whatnot is actually in Connie Willis' Doomsday Book. If I understand correctly, one of her daughters is an epidemiologist, one who studies epidemics, so she has a handy resource for disease transmission information. The upshot is the flu virus has antigens on its surface, and your immune system detects and reacts to those. The antigens mutate every few months, two or three times a year. A flu shot is designed with a particular antigen combination— you're fully protected against that. You're partially to mostly protected to nearby mutations.

The reason that they're worried about zoonosis— cross-species disease jumps— is because when an avian virus and a human virus get together in a pig, for example, they can do a sort of antigen crossbreed and come up with a wide mutation, and wide mutations can kill people, because you don't have any protection at all from flu shots or from previous years' flus.

The 1918-1919 flu is thought to have been so deadly to healthy young people (instead of the more usual weak or elderly) because it induced a particular over-reaction of the immune system that inflamed the lungs. Nasty stuff.

Incidentally, I thought I got mild colds for years until somebody explained to me that I had pollen allergies and just wasn't paying attention.

#68 ::: janetl ::: (view all by) ::: December 12, 2008, 02:07 AM:

Kathryn from Sunnyvale at #38
saline sinus rinse... stings if there's too much or too little salt

"Stings" wasn't my experience. I used a neti pot for a cold, and found it helpful and not uncomfortable. It sat in the back of the cupboard for a year or so before I needed it again. When I pulled it out, I'd lost the little slip of paper with the instructions on the amount of salt, but thought I remembered it. I didn't. Yowzah! Turned out I was using half as much as I should. When I doubled the salt, all was well.
It definitely was not a "sting". More like getting hit in the face with a 2x4.
For the ceramic put that I have, it's 1/4 teaspoon of natural salt (I use kosher salt).

#69 ::: Serge ::: (view all by) ::: December 12, 2008, 06:14 AM:

Ginger @ 64... fresh Ginger isn't the key part either

Being fresh again?
We just can't take you anywhere without your misbehaving.

#70 ::: Martin Wisse ::: (view all by) ::: December 12, 2008, 07:27 AM:

Treatment: flu and cold


Especially not with the coughing in the face.

#71 ::: inge ::: (view all by) ::: December 12, 2008, 07:36 AM:

Bronchitis threatening to become pneumonia is not a common complication of the cold? That surprises me because IME it is the second most common one(after sinusitis, which seems to be less of a complication and more a standard component of a cold). OK, plural of anecdote and all that, but still: really?

#72 ::: Neil Willcox ::: (view all by) ::: December 12, 2008, 07:51 AM:

sharon @33, joann @ 46; flu being short for influEnza if you have occasion to type both you might carry on with an e for both.

Or maybe you are thinking of a flue.

#73 ::: Roy G. Ovrebo ::: (view all by) ::: December 12, 2008, 08:18 AM:

Ginger @ 58: 1985 or 1986 outbreak of A(Taiwan)-68 (if memory serves me correctly); in that epidemic, anyone old enough to have been sick in 1968 was semi-protected against that virus in 1985-6.

Tied into:

B. Durbin @ 67: The 1918-1919 flu is thought to have been so deadly to healthy young people (instead of the more usual weak or elderly) because it induced a particular over-reaction of the immune system that inflamed the lungs. Nasty stuff.

I've also seen a theory that the reason older people survived the Spanish flu was that they'd already survived a related strain in the 1860s or 70s...

Myself, I had a cold last week. Bad enough that I regretted going to work, coughing and sneezing and a touch of fever on the first day. As soon as I start running a fever, I get aches and pains everywhere - the clincher for me is when moving my eyes gets painful. Not this time, though.

Haven't had the flu for years and years. (Knock on wood)

#74 ::: Leva Cygnet ::: (view all by) ::: December 12, 2008, 08:39 AM:

Trivia time, on the topic of gastro symptoms and flu: H5N1 avian influenza manifests with gastro symptoms in humans -- apparently pretty dramatic ones. Has to do with what receptors the virus prefers to latch onto.

Apparently one of the ways they tell H5N1 from ordinary flu (in the early stages before people start seizing and bleeding out and showing other fun symptoms) is if a person has a positive flu test and is barfing, it's time to put them in quarantine.

#75 ::: Carrie S. ::: (view all by) ::: December 12, 2008, 08:46 AM:

I had the flu for, as far as I can tell, the first time ever this past May. I had my first hint of symptoms Friday night, realized I was really sick Saturday, and was well enough to go to work by Thursday.

My fever never quite got to my personal "go get a febrifuge" limit, which was 103, but then I spent quite a lot of time drinking iced herbal tea. And I slept on the couch so as not to infect my boyfriend (he'd have let me have the bed, but the couch is not long enough for him to stretch out, as he is tall).

I got the flu shot this year, mostly because I live with a diabetic; fortunately he managed to get one too. Made my arm ache for three days, otherwise no ill effects.

lohengrin @#49: To clear up a common misconception about bronchitis: it's not a disease per se, like influenza, it's simply an inflammation of the bronchi.

Yeah--two winters ago I gave myself bronchitis by biking when it was too cold.

#76 ::: CN ::: (view all by) ::: December 12, 2008, 09:03 AM:

Interesting to note, then, that the supply of flu vaccine is very low just now.

My wife is in the medical field, and she and her colleagues have been trying to obtain it for a month or more, only to be told by the suppliers that they don't have any to send.

#77 ::: Ginger ::: (view all by) ::: December 12, 2008, 09:04 AM:

Serge @ 69: I know! Isn't it grate?

#78 ::: Lila ::: (view all by) ::: December 12, 2008, 09:09 AM:

Apparently there's an actual lab test for the flu. At least, that's what my doctor told me. But maybe he just likes assigning nurses to jam a swab up my nose and out the back of my sinuses into my brain. Ouch (and I tested positive).

#79 ::: Lila ::: (view all by) ::: December 12, 2008, 09:18 AM:

(Clarification: that was last year. This year, so far so good--I hope they did a better job this year of picking the combo of viruses to go into the vaccine.)

#80 ::: dcb ::: (view all by) ::: December 12, 2008, 09:29 AM:

Fiona @ 42

Never give aspirin to children under 14 years old (some authorities now say 19 years old) with a cold, 'flu or any other viral illness, due to the connection with Reye's syndrome.

I don't see any reason not to take it as an adult, if it works for you.

Please look up how much acetaminophen (paracetamol) is in your various cold/'flu remedies before you get ill - you need to be able to calculate and avoid an overdose (e.g. if your sachets to make up a soothing drink to sip to combat cold symptoms contain 1,000 mg paracetamol, you don't want to also take two paracetamol tablets - take a couple of ibuprofen instead). This is particularly important if you're small (I've said it before: if I took eight standard paracetamol at one time that could be enough to kill me if I was unlucky).

#81 ::: inge ::: (view all by) ::: December 12, 2008, 10:13 AM:

Nix @51: This does not say anything about the theory, but colds from hell are not limited to the prematurely born. I used to have the same effects: Colds lasting three weeks to three months, going through 150 tissues a day for a week, nosebleeds, headaches, eyes swollen half-shut, fatigue, queasy stomach, sinusitis, bronchitis, the whole nine yards. My father joked that on any given day I was more likely to have a cold than not. Had the flu only twice, though.

And then two years ago it just stopped. I have had a two-day case of the sniffles since then, and one case up upset stomach (likely migraine-related) but no cold, no flu, no stomach bug, no nothing.
No idea what changed, or more correctly, a whole lot of things changed and I have no idea which was responsible.

Martin @70 -- Word. Unfortunately it's not only people too macho to stay in bed when they are sick, but bosses and collegues who demand that one appears in the workplace and starts an epidemic...

#82 ::: Iain Coleman ::: (view all by) ::: December 12, 2008, 10:15 AM:

If you do have flu, it's probably not a good idea to curl up on the sofa and watch Survivors.

#83 ::: Magenta Griffith ::: (view all by) ::: December 12, 2008, 10:29 AM:

I discovered another possible cause of vomiting with an upper respiratory infection. I have a history of ear infections. Four weeks ago, I woke up so dizzy I could not get out of bed without help. I had a cup of tea and threw up. I never throw up except from motion sickness. I finally figured it out, after ruling out food poisoning, that my middle ears were out of whack. Decongestants helped, but I spent the day sitting up, trying to to stay as still as possible. It took me more than two weeks to get over whatever this was, but it probably wasn't flu, since I never had a fever.

And yes, I had a flu shot. I always get one.

#84 ::: Serge ::: (view all by) ::: December 12, 2008, 10:53 AM:

Did you know that the French word for 'flu' is 'grippe', and that it is 'rhume' for 'cold'?

#85 ::: albatross ::: (view all by) ::: December 12, 2008, 11:09 AM:

Serge: What are you grippeing about now?

Ginger: Thanks, that makes sense.

#86 ::: Joy ::: (view all by) ::: December 12, 2008, 11:56 AM:

The difference between a cold and the flu: I can function with a cold (though not necessarily *happily*); with the flu, I'm flat in bed for the week. The problem is for me that their prodromal stages are exactly alike and *exactly* the same as a mild allergy attack (sudden onset of lots of uncontrollable sneezing, plenty of energy) so I can inadvertently infect a lot of people well before I realize I'm ill if I'm not careful. It usually takes about 12 hours to progress to where I can tell if I have the flu.

I still can't always tell the difference between a cold and lingering allergy attack.

#87 ::: joann ::: (view all by) ::: December 12, 2008, 12:28 PM:

Neil Wilcox #72:

I was attempting to make a pun about Rowling's Floo Powder (wishing one were out of the flu-affected region via magical means), but misspelled it. Which actually means Rowling misspelled it.

#88 ::: joann ::: (view all by) ::: December 12, 2008, 12:31 PM:

It's easy for me to tell the difference between a cold and the flu, although I suspect it won't work for anyone else. Odd neurological tic: if it's itching about 1 cm down and out from the left corner of my mouth, it's a cold. Damifino why/how.

#89 ::: Fragano Ledgister ::: (view all by) ::: December 12, 2008, 12:32 PM:

Serge #84: Get a grippe and stay in the rhume.

#90 ::: Serge ::: (view all by) ::: December 12, 2008, 12:47 PM:

Fragano @ 89... stay in the rhume

I'd rather be a flugitive.

#91 ::: Serge ::: (view all by) ::: December 12, 2008, 12:55 PM:

albatross @ 85... Luckily, no French publisher ever released John Le Carré's "The Spy Who Came in from the Cold" as John the Square's "L'espion qui venait du rhume".

#92 ::: Marci Kiser ::: (view all by) ::: December 12, 2008, 05:13 PM:

It's probably also worth mentioning that flu is often diagnosed in people with meningitis, as many of the symptoms are similar. Often the differential for meningitis will include a stiff neck/back pain (though vomiting in the toilet all night from flu can certainly cause this too) and light sensitivity. Don't be shy if you even think you're having those symptoms!

#93 ::: Nix ::: (view all by) ::: December 12, 2008, 06:36 PM:

Inge@#81, my recollection of the lost paper is that it's not *severity* that's aggravated by being premature, it's *frequency*. Everything else I've read says that when you're adult, you should get one to three colds a year: the six to twelve frequency is supposed to be children only.

Except it isn't.

My employer moans, but what can I do? Not use the train? Good luck getting into work that way... I actually had to explain to one boss the germ theory of disease and that if you came in with an infectious disease you'd give it to everyone else, and, yes, colds *were* infectious diseases. God knows what he thought caused them: miasmas perhaps.

(Three-week-long colds seems horrendous, though. I'm luckier: I catch a lot but I kill them as fast as everyone else, one to three days and it's gone.)

#94 ::: Ginger ::: (view all by) ::: December 12, 2008, 07:23 PM:

dcb @ 80: You beat me to it. That's one of the hidden dangers of over-the-counter cold medicines, particularly the all-in-one combinations. Everyone should be aware of the dangers. Whenever possible, make your own combination instead of swigging combo drugs; that way you can monitor your acetaminophen/paracetamol intake and take appropriate amounts.

Ian @ 82: Oddly enough, when I'm sick I prefer to watch cooking shows, although not any by Sandra Lee. Something about the homey-ness and lack of drama, perhaps. I started doing it when I was very ill with mono about 14 years ago, and had absolutely no appetite whatsoever.

Magenta @ 83: Influenza infections can also trigger vertigo, as happened to me. That winter with the three bouts of influenza left me with a permanent case of vertigo, enhanced, no doubt, by my familial history of vertigo. I didn't have any before that winter, and now it's a low-grade permanent fixture.

Serge @ 84: Better to have un rhume than la rage, n'est-ce pas?

joann@88: I had a similar itch with the early signs of mono, only on my upper right arm. Once I developed neutralizing antibodies and eliminated the infection, the itch went away.

#95 ::: Serge ::: (view all by) ::: December 12, 2008, 07:43 PM:

Ginger @ 94... Better to have un rhume than la rage

Definitely. (For those who are wondering, in this context 'rage' is the French word for rabies.

#96 ::: Lee ::: (view all by) ::: December 13, 2008, 01:00 AM:

Ginger, #58: Cue Weird Al's "Germs"...

dcb, #90: Tangentially, acetaminophen is also highly toxic to cats. IOW, if you have a cat living with you and you drop a Tylenol tablet, find it.

#97 ::: Kathryn from Sunnyvale ::: (view all by) ::: December 13, 2008, 04:15 AM:

If you have a cold and are going to fly, double-check that the decongestant you plan to carry will in fact work for you.

In the U.S., any over-the-counter cold medication has phenylephrine*. I tested it ahead of flying, and even at the max dose it did nothing for me. "Just before landing" would've been a bad time to find that out. I always carry the real stuff (unless flying to a country where it isn't allowed).

* To get pseudoephedrine now requires your drivers license and a background check.

#98 ::: dcb ::: (view all by) ::: December 13, 2008, 08:36 AM:

Lee @ 96: Definately. The cat I saw with paracetamol/acetaminophen poisoning while still a student had blue-black mucous membranes ("the cat seemed to have a bit of a cold so I gave it half a paracetamol then when my son came hope he gave it half a paracetamol")!!!. We got hold of some Parvolex (antidote) from the local children's hospital and put the cat in a makeshift oxygen tent. It did turn pink again. A week later it was yellow (liver damage); looked a bit less yellow a couple of weeks after that, but I don't know if it survived since the owners stopped bringing it back (and didn't pay the bill).

#99 ::: Mez ::: (view all by) ::: December 13, 2008, 11:20 AM:

Had a weird thing some weeks back. Could have been stomach bug I heard others had, food poisoning, or some kind of allergy (which I've never had before), or maybe a combination.

Lots of nausea, vomiting & diarrhoea – not that unusual – except that it lingered for about 3-4 weeks, and when I was sick enough to vomit, I got very itchy, then came up in a hot pink lumpy rash (hives?) in patches. This kind of symptom virtually never happens to me with anything; no known allergies. Red itchy mosquito bites is about all. As I improved, still vomited sometimes but without the rash.

Checked with oncologists and nurses, and it's not known as an effect of anything I'm on, so it remains a mystery. Perhaps it was a virus or food poisoning, and my metabolism/immune system is so bashed about by disease and drugs that there were strange reactions. (Still have damaged nerves from Hand-Foot Syndrome, for instance.)

#100 ::: Lizzy L ::: (view all by) ::: December 13, 2008, 11:53 AM:

A bad cold can also lead to tinnitis, ringing in the ears, which can be very disturbing. Some years ago I took an airplane while I was suffering with a bad cold: despite taking decongestants, I ended up with tinnitis, which has since more or less subsided, but it took years. The initial stages of the condition were very unpleasant.

Given all the nasty things that can happen when one flies with a cold/flu/respiratory illness, perhaps one shouldn't. That's my current thinking, anyway: assuming I have any choice, if I have a cold, I don't get on the plane.

#101 ::: Shana ::: (view all by) ::: December 13, 2008, 01:51 PM:

A cold with a broken nose is even less fun than usual.


#102 ::: Fiona ::: (view all by) ::: December 13, 2008, 01:59 PM:

dcb @ 80,

adults can develop Reye's syndrome--a complication of taking aspirin with a viral infection, although is is very uncommon. If you are not taking aspirin for another reason, such as prescribed by your health care provider, skip the aspirin for treating symptoms of a viral infection and go with a different type on over-the-counter med such as Tylenol.

Lila @ 78, there is indeed a test to confirm the flu. There is a verified case in MN, and the it is a strain covered by this year's shot.

It's not to late to get your shot, folks.

#103 ::: debcha ::: (view all by) ::: December 13, 2008, 02:17 PM:

Lee (#96): IOW, if you have a cat living with you and you drop a Tylenol tablet, find it.

You have or know cats that voluntarily ingest pills? All my experiences with trying to give my cats pills go rather more like this.

#104 ::: Carrie S. ::: (view all by) ::: December 13, 2008, 02:22 PM:

The only problem cats usually have with ingesting pills is that the humans want them to, in my experience. Most cats happily eat anything they find on the floor...

#105 ::: Bruce Cohen (SpeakerToManagers) ::: (view all by) ::: December 13, 2008, 03:20 PM:

I've been using the saline wash on my nose for about 8 or 10 years now, whenever I get seriously congested from either a cold or allergies. This has resulted in my no longer getting sinus infections every winter; an outcome devoutly to be wished, since there's just nothing quite like having a severe sinus headache which triggers a migraine. Except maybe Trigeminal Neuralgia, and I've avoided that so far.

I don't bother measuring, I just throw a rough amount of salt and a dash of baking soda into a glass, fill the glass with hot water, and stir. If it doesn't sting and leave a revolting taste in my mouth, I know I'm not doing it right. Note that this is a wash, not a spray. The doctor who first told me about the saline wash says that the sprays are pretty near useless, because the object of the exercise is to get rid of the mass of mucous with all of its bacteria, and leave the open sinus cavity inhospitable to more bacteria.

#106 ::: Mary Aileen ::: (view all by) ::: December 13, 2008, 03:37 PM:

Bruce Cohen (105): I use a sinus rinse with the premeasured packets that Kathryn mentioned. It doesn't sting at all, unless I get the water too hot (ouch) or forget to put the salt in (OWWWW!). Are you sure you're doing it right?

I used to get a sinus infection at least every other month. Since I've been using the rinse regularly, that's dropped to once or twice a year at most. Well worth it, in my experience.

#107 ::: James D. Macdonald ::: (view all by) ::: December 13, 2008, 03:42 PM:

Instructions for using a neti pot. (Note: I've never personally tried.)

#108 ::: janetl ::: (view all by) ::: December 13, 2008, 04:34 PM:

James D. Macdonald @ #107:
Those instructions are good, until you get to the note at the end: "may wish to use only half the amount of recommended salt the first few times you use your neti pot until you become more accustomed to the process". I recommend sticking to the 1/4 teaspoon amount.
I think using a neti pot helps me get over a cold faster. Some people attribute more powers to them, such as curing respiratory allergies. As a hayfever sniveler myself, I'm sad to say that the neti pot didn't help with that.

#109 ::: dcb ::: (view all by) ::: December 13, 2008, 04:46 PM:

Fiona @102

Skip the Tylenol (paracetamol/acetaminophen). Go straight to ibuprofen - less risk of overdose and liver damage.

In my opinion, the risk of Reye's syndrome in an adult taking aspirin with a viral infection is much less than the risk of inadvertent paracetamol overdose due to mixing Tylenol and over-the-counter cold remedies and waking up confused about when you had your last dose.

#110 ::: Earl Cooley III ::: (view all by) ::: December 13, 2008, 05:03 PM:

So a neti pot would be useful training to resist the effects of waterboarding, right? Drowning via neti pot or losing one's balance and smashing the noggin on the sink would be an ignominious way to go to the great beyond.

#111 ::: Lizzy L ::: (view all by) ::: December 13, 2008, 05:14 PM:

My doctor, who works for the Kaiser system here in CA, comments that Kaiser is expecting the flu cases to amp up bigtime in January. Evidently they are not seeing many flu cases this month.

I know that those of you who are advising other people to avoid acetaminophen because it might cause liver damage mean well: my understanding is that, assuming you have a healthy liver to begin with, a moderate amount of acetaminophen is as safe as a moderate amount of aspirin and/or ibuprofen.

When I get a cold Tylenol and Zicam is all I can take. I'm allergic to aspirin and ibuprofen. I can't take Sudafed or similar drugs: blood pressure issues. The Zicam at least allows me to breathe.

#112 ::: dcb ::: (view all by) ::: December 13, 2008, 05:48 PM:

Lizzy L @ 111

It isn't people taking a moderate amount of acetaminophen/paracetamol we're worried about - you're right, that's as safe as a moderate amount of a NSAID (non-steroidal anti-inflammatory drug) such as aspirin or ibuprofen or safer - less risk of gastric ulceration. The problem is the following, in combination:
1) it gets included in a lot of over-the-counter cold remedies and people don't realise it's there (I call this "hidden paracetamol").
2) Overdose starting at as little as eight 500 mg tablets taken at once by someone of about 50 kg could cause fatal liver damage (I calculated this for myself at 48 kg, some years ago. Forgive me if I'm slightly off with the numbers, but it's about right).
3) The signs of overdose are not immediately evident, and by the time they're present, severe liver damage can have started.
4) Because of (1) and (2), it could be quite easy to reach OD - take an OTC cold remedy (1000 mg paracetamol) plus two x 500 mg tablets. Go to sleep. Wake after an hour thinking it's much later. repeat - maybe take an extra paracetamol 'cos you feel so lousy... If you're of low body weight and unlucky, that could be serious liver damage.
5) Because it's marketed as being "safe for kids" (while aspirin isn't anymore due to the link with Reye's syndrome) people think its "safe".

We're not saying don't take the stuff (it's given to small children all the time) - just be aware how much you're taking - and keep it away from cats because their liver really can't cope with it - even if you scaled the dose down to fit the body weight.

For some context (ignore if too technical): a USA study: "Acetaminophen-induced acute liver failure: results of a United States multicenter, prospective study. Larson AM, Polson J, Fontana RJ, Davern TJ, Lalani E, Hynan LS, Reisch JS, Schiødt FV, Ostapowicz G, Shakil AO, Lee WM; Acute Liver Failure Study Group. Hepatology. 2005 Dec;42(6):1364-72. found acetaminophen poisoning to be the leading cause of acute liver toxicity, with unintentional overdose acounting for 48% of cases - a higher proportion than the confirmed suicide attempts (44%). "In the unintentional group, 38% took two or more acetaminophen preparations simultaneously, and 63% used narcotic-containing compounds.

#113 ::: Julia Jones ::: (view all by) ::: December 13, 2008, 06:21 PM:

This is the time of year that the news in the UK used to start talking about the dangers of accidental paracetemol overdose through not realising what was in various cold remedies -- because there were several cases every year, sometimes fatal. The stuff is safe for most people in a normal therapeutic dose, but the margin between that and the dose where Bad Things happen is a lot smaller than I feel comfortable with.

#114 ::: Marilee ::: (view all by) ::: December 13, 2008, 07:30 PM:

Lizzy L, #111, my first kidney failure was from a small amount of ibuprofen. My nephrologists say 2% of anybody who ever takes ibuprofen (or other NSAIDS) gets some amount of kidney damage. (I have to put NSAIDS under allergies because nobody has a "can't have" category.) I can only take a very limited amount of acetaminophen because one of the meds the doctors tried during the first renal failure damaged my liver.

#115 ::: Ame ::: (view all by) ::: December 13, 2008, 07:48 PM:

*has just finished reading The Stand, runs and hides from this post and all like it*

#116 ::: P J Evans ::: (view all by) ::: December 13, 2008, 08:36 PM:

Why I take simple antihistamines and simple decongestants. If I'm going to mix and match, I want to know what I'm taking.

#117 ::: Ginger ::: (view all by) ::: December 13, 2008, 09:53 PM:

Fiona @ 102: As dcb mentions further down, Reyes Syndrome is much less of a risk in adults. Acetaminophen (or paracetamol, or APAP) is not an NSAID, and does not treat fevers as well as NSAIDs do. It is primarily a pain reliever, and the efficacy of this varies. If it works for you, then take it. However, if you consume alcohol, reconsider your APAP intake, as it can induce an acute hepatic failure.

The problem is, as dcb and I have both said, many over-the-counter medicines include large amounts of APAP, and when you start combining those with the tablets, you very quickly get into an overdose, and that will also kill your liver. It's what happens to cats, only they get it sooner. The cat liver cannot detoxify APAP for very long, as it runs out of glutathione.

debcha @ 103: You're right, most cats don't voluntarily ingest pills. The danger with APAP is too great to leave it lying around in a house with a cat. As for the joys of pilling cats, I once had a cat with whom I had to wrestle, and it would take me two or three consecutive tries to succeed at the task. I'm pretty good at pilling cats, and he was difficult -- not mean, just difficult. As soon as the pill hit the back of his mouth, he horked it right out.

Marilee @ 114: There are a small number of people who do have adverse reactions to any NSAIDs, unfortunately.

Ame @115: I remember reading that book in a cold sweat.

PJ @ 116: that's the idea -- know what you're putting in and in which amounts. It's much safer to take a simple decongestant or expectorant, and an NSAID or pain reliever. By the way, if you're looking to get rid of mucous congestion, consider taking an expectorant rather than a decongestant. Expectorants loosen up mucous which makes it easier to get rid of. This is mainly guaifenesin, so not everyone can use it, but if medically appropriate, then I recommend it.

#118 ::: Melissa Mead ::: (view all by) ::: December 13, 2008, 10:30 PM:

What's the danger of guaifenesin?

I have autoimmune cirrhosis AND a history of GI bleed, so I avoid almost all OTC meds, but I'd thought that Robitussin was safe...

#119 ::: Lee ::: (view all by) ::: December 13, 2008, 10:31 PM:

debcha, #103: But that's when you're trying to get the cat to take a pill. If they just find one on the floor, that's an entirely different thing; any small object on the floor is a potential cat toy, and a lot of them will be tested as potential cat snacks as well.

#120 ::: Ginger ::: (view all by) ::: December 13, 2008, 10:48 PM:

Guaifenesin should not be used in children (See Medline Plus); otherwise it's considered to be fairly safe, with a wide margin between safe doses and toxic doses. You do need to make sure to drink plenty of water while using it, as the effect is better when you've got water for the expectoration. It's rapidly metabolized and excreted in the urine. The only common listed "adverse effects" are nausea and vomiting; rash and urticaria are rare (and probably related to the other compounds in the medication).

#121 ::: Lizzy L ::: (view all by) ::: December 13, 2008, 11:22 PM:

Dear God, who takes 8 500 mg tablets of Tylenol (APAP, whatever) at once? No, that's a rhetorical question, please don't answer it.

By the way, Teresa, thank you for the motivational posters. I particularly appreciated the caption of poster #2: In everything you do, try not to piss off the giant fucking gorilla.

Words to live by...

#122 ::: Melissa Mead ::: (view all by) ::: December 13, 2008, 11:24 PM:

re: #120

Thank you.

#123 ::: albatross ::: (view all by) ::: December 14, 2008, 12:08 AM:

Also, please do not feed the giant f--king gorilla more than ten bottles of Extra Strength Tylenol, as it will fry his liver.

#124 ::: Soon Lee ::: (view all by) ::: December 14, 2008, 12:52 AM:

Steve C @34:
In the southern hemisphere where Christmas is celebrated in summer, the main cold/flu season is still in the winter.

We've had a bad year for flu this winter just past. The incidence was higher than the year before, and anecdotally, people who got sick felt worse; had a personal first of a 'flu' turning into pneumonia. If the same strains are making their way round to the northern winter, getting a flu vaccine might be *a good idea*.

#125 ::: Bruce Cohen (SpeakerToManagers) ::: (view all by) ::: December 14, 2008, 02:01 AM:

Lizzy L @ 121

Oh, come on, it was early humans' willingness to hunt down giant fucking animals* that got us where we are now. --- We're where? Creek? Paddle? Climate change? OK, maybe we should re-evaluate that hunting business. Who's got a time machine? ---

* I'll stake a Mammoth against a 500 pound gorilla any day.

#126 ::: Kathryn from Sunnyvale ::: (view all by) ::: December 14, 2008, 03:20 AM:

Bruce Cohen @105,

I'd go with measuring the salt: all the benefits, none of the burn. At the right concentration and temperature your sinuses won't have any negative reaction--even without baking soda*--making it easier to do right when a sinus infection starts up.

* My allergist had told me to start with just the salt, and then try it with a pinch of baking soda to see if that improved on salt-alone.

#127 ::: Charlie Stross ::: (view all by) ::: December 14, 2008, 05:24 AM:

dcb @98: I'm always baffled by people who don't seem to realize that, other pharmacological issues aside, feeding a human-sized dose of some drug to an animal with 5% of a human's body mass is going to give the animal a 20-fold overdose.

(All discussion of feline metabolic quirks -- such as paracetamol intolerance -- aside, this one goes for all pets: human meds are intended for a mammal with body mass in the 50-120Kg range, so pilling a 15Kg dog or a 4Kg cat with a human-sized tablet except under veterinary direction is ... not advisable.)

As for paracetamol/acetaminophen, if I'm not mistaken it kills more people in the UK every year than heroin and cocaine combined, by a considerable margin. Were it up to me, I'd ban it as an OTC medication except in combination with N-acetylcysteine.

#128 ::: dcb ::: (view all by) ::: December 14, 2008, 06:23 AM:

Charlie Stross @ 127 - It baffles me as well - like with the aforementioned cat (adult human: 2 tablets every 6 hours; so what do they give the cat? 1/2 tablet, twice within an hour or so - does not compute). I suppose too many people (a) anthropomorphise so much they forget the size difference; (b) don't do the calculations; (c) don't think. Mostly (c)...

Regarding banning it, they can't, not having taken aspirin away as a pain reliever for children due to the Reye's syndrome risk. I do wish they [talking UK here, folks] hadn't limited the number of aspirin and ibuprofen sold OTC at the same time as they limited paracetamol. Gives the wrong message (that they are all equally dangerous).

Lizzy L @ 121 - Like we said, it's mainly not realising what's got paracetamol in it. Together with the "One cold remedy good, three cold remedies better!" and "Recommended to be taken every six hours - must work better if taken every three hours!" mentality

Leading cause of acute liver failure in both the USA and UK.

#129 ::: Charlie Stross ::: (view all by) ::: December 14, 2008, 11:43 AM:

dcb: there is a suitable alternative painkiller (albeit not antipyretic) -- good therapeutic margin, works at all dosage levels, 100% effective antidote available, dirt cheap, long proven track record -- except for political reasons morphine and her sisters aren't allowed to be sold over the counter any more. Gaah.

#130 ::: dcb ::: (view all by) ::: December 14, 2008, 12:16 PM:

Charlie Stross @ 129

Agree. And there are still some doctors (hopefully a dying breed, pun intended) who refuse to prescribe diamorphine to terminally ill patients "because it's addictive"...

#131 ::: Summer Storms ::: (view all by) ::: December 14, 2008, 12:51 PM:

Ginger @ 120: Actually, according to your link, guaifenesin can be used safely in children over the age of 2, provided the correct dosage is strictly adhered to.

#132 ::: Julia Jones ::: (view all by) ::: December 14, 2008, 02:05 PM:

Charlie @129: Want to get me started on what the US attitude to anything poppy-derived looks like when you're from the UK and are used to being able to get low dosages of a range of opiates without a prescription, in combination with a variety of NSAIDs and not just the liver-killer?

#133 ::: Thomas Lumley ::: (view all by) ::: December 14, 2008, 02:18 PM:

Charlie Stross@127

Were it up to me, I'd ban it as an OTC medication except in combination with N-acetylcysteine.

IIRC there was a British patent for a product that combined paracetamol with methionine (more palatable than N-acetyl cysteine). It never got off the ground, though.

#134 ::: Joyce Reynolds-Ward ::: (view all by) ::: December 14, 2008, 02:25 PM:

Julia @ 132--

Especially since poppy-derived stuff also works nicely to dry up your sinuses as well as kill the pain from cold/flu.

I do have to say, though, that if you have asthma and present to Kaiser with a coughing upper respiratory infection, they hand over the Robitussin A/C without a lot of flak. It's improved over the years, though. Used to have to sign away the first-born--now it's just "Asthmatic? Have a cold? Coughing? Hack for me, please. Eww. Sounds bad. Here's your cough syrup."

It's saved me from bronchitis for a long time. Then again, I'm a teacher and I have a Crohn's Disease patient who gets Remicade who lives in my house, so that might explain the promptness with which I get the syrup.

#135 ::: Fiona ::: (view all by) ::: December 14, 2008, 03:01 PM:

dcb @109 and Ginger @ 117. I am not advocating Tylenol as much as warning against aspirin. There is a small, but very real, incidence of Reye's syndrome in adults. One reason it is rarely seen is due to the prevalent use of other over-the-counter NSAID's that are not aspirin.

I would strongly suggest that for either the cold or the flu, people limit all over-the-counter medications. It is always a good idea to read the ingredients of everything you take.

If you are otherwise healthy, something for fever/muscle aches--the smallest dose that works for you, and something to treat the upper respiratory symptoms that DOES NOT have any NSAID's--such as a nose spray, throat spray, or cough drops and ride it out. A healthy person's body can do an amazing job healing its self. The less unnecessary stuff we put in our bodies the better.

The saline nasal rinse is great. So are warm fluids to drink and a warm shower to unstuff the nose and soothe the muscle aches. Remember that sleep is your friend. Your body heals while it sleeps.

It should go without saying, but NEVER take someone elses prescription medication. NEVER use antibiotics that are "left over" from a previous illness. Antibiotics should all be taken, unless there is a specific instruction not to. Old prescription medications should NEVER be kept, unless they are taken regularly to treat a chronic

I hope everyone stays healthy this winter.

#136 ::: John Walton ::: (view all by) ::: December 14, 2008, 04:00 PM:

Julia @ 132 on nothing with codeine being available OTC in the USA: It works in the other direction with naproxen, US brand name Aleve, which is presciption-only in the UK. I do enough walking around the South West Coast Path that you would have to pry my little bottle of generic Aleve out of my cold dead fingers.

#137 ::: dcb ::: (view all by) ::: December 14, 2008, 04:48 PM:

Fiona @ 135. It's about relative risks and informed choices. The risk of an adult getting Reye's syndrome from taking aspirin with a viral infection is very small. However, if I wake up and I feel lousy and generally "virally" and I have work to do, I may go back into bed for an hour and see if it goes away. If it doesn't I generally make an informed choice: I take aspirin or ibuprofen (depending on various factors), get up and get the work done (at home, not exposing anyone else. I don't just take NSAIDs all the time - if I have neck tension and a headache coming on, and there is someone to give me a neck and shoulder massage or the heated wheat bag relaxes the muscles, fine. But if those don't prevent the headache and I need to be able to function - then better living through pharmacology.

#138 ::: Kip W ::: (view all by) ::: December 14, 2008, 05:25 PM:

Actually, pneumonia for me. I don't remember being offered a choice, but there it is, since Monday.

#139 ::: Julia Jones ::: (view all by) ::: December 14, 2008, 05:25 PM:

John Walton @136: it's not just that it's prescription-only, it's the attitude you get when you ask for a prescription. Fortunately my dental surgery were very big on proper pain control and routinely offered scripts for whatever they thought necessary. But my doctor's surgery was a different matter -- and I have several chronic medical problems where occasional use of low doses of codeine is extremely helpful. :-/

#140 ::: Raphael ::: (view all by) ::: December 14, 2008, 06:02 PM:

Charlie Stross @127, I'm always baffled by people who don't seem to realize that, other pharmacological issues aside, feeding a human-sized dose of some drug to an animal with 5% of a human's body mass is going to give the animal a 20-fold overdose.

(All discussion of feline metabolic quirks -- such as paracetamol intolerance -- aside, this one goes for all pets: human meds are intended for a mammal with body mass in the 50-120Kg range, so pilling a 15Kg dog or a 4Kg cat with a human-sized tablet except under veterinary direction is ... not advisable.)

Could it have something to do with people mentally dividing the universe into "good stuff" and "bad stuff"? I guess when we do that, it gets kind of difficult to grasp that something we've already filed under "good stuff" can have bad effects. Kind of related to that, there's the way believers in alternative medicine seem to think that whatever treatments they believe in have all kinds of good effects without having any bad side effects, and that any treatment that has side effects can't possibly have any good effects.

#141 ::: Terry Karney ::: (view all by) ::: December 14, 2008, 08:37 PM:

re coughing: When I was last in Ukraine I developed a nasty cough (actually, it started in London, now that I think on it). The medic was saying the only thing which really worked they didn't have (codeine, which I loathe. The other medic said, no, we have something which works just as well.

Boom, I had a whole lot of 25mg benadryl. Stopped that cough in its tracks.

#142 ::: P J Evans ::: (view all by) ::: December 14, 2008, 08:52 PM:

Or the belief that 'organic'/'natural' means 'not harmful'. I see that one a lot.

#143 ::: Melissa Mead ::: (view all by) ::: December 14, 2008, 09:21 PM:

re: #135

How should one dispose of antibiotics that one was instructed to stop taking?

#144 ::: Joel Polowin ::: (view all by) ::: December 14, 2008, 10:27 PM:

How should one dispose of antibiotics that one was instructed to stop taking?

Probably best to find out if there's some system for collecting unused pharmaceuticals in your area. There's a growing problem of such substances dumped into toilets, and getting through waste-water treatment and affecting organisms downstream.

#145 ::: Ginger ::: (view all by) ::: December 14, 2008, 10:27 PM:

Melissa Mead @ 143: I'd ask my doctor if I could drop off the expired meds for disposal. Otherwise, I'd double bag them and place it in the garbage.

Summer Storms @ 131: Yes, and I hope that parents of small children would adhere strictly to the listed dosages.

As we've been discussing, some people seem to think if a little is good, a lot is better. My suggestion is always start low; that way I can repeat the dose or increase the next dose.

PJ @142: the recent commercials about the "safety" of HFCS are based on that belief, but as I pointed out in a conversation one night, ethanol is also made from corn, and you certainly don't want to ingest too much of that. I've heard the "natural is better" for years, but my mother the chemist trained me early on the fallacy of that concept.

#146 ::: Lee ::: (view all by) ::: December 14, 2008, 11:12 PM:

P J Evans, #142: You'll probably enjoy this, then. It's not our most popular sticker, but it definitely has its audience.

Tangentially: I have occasional problems with excess stomach gas, requiring treatment with Pepcid or equivalent. One time it got so bad that I went to the doctor about it; she told me that taking two Pepcid tablets at once (the recommended dosage is one) is the equivalent of a prescription-level dose, and suggested that I try that for relief first before filling the (significantly more expensive) scrip she gave me. It worked.

#147 ::: Summer Storms ::: (view all by) ::: December 14, 2008, 11:36 PM:

Ginger @ 145: Ah, but what you'd actually said was that it ought not to be used at all in children. There's a world of difference between "use only as directed" and "do not use, period."

#148 ::: Ginger ::: (view all by) ::: December 15, 2008, 09:05 AM:

Summer Storms @ 147: Point taken.

#149 ::: Lori Coulson ::: (view all by) ::: December 15, 2008, 10:53 AM:

Charlie Stross @127: The only OTC medicines used on the dogs in our home is Benadryl and low-dose aspirin. The cats I wouldn't begin to try to medicate -- they've got the wonkiest drug reactions, and it's too easy to kill them whilst trying to be kind.

The Benadryl has only been used when one of the dogs is stung by a bee. Most dogs learn not to bother bees after one experience. (Only the Shelties seem to like to chase insects, the Japanese Chin ignores most other living beings.) So far every Sheltie we've had has gone one round with a honeybee and lost...

The Chin gets one low-dose aspirin a day for arthritis of the spine. When that no longer does the job, we'll move him up to Rimadyl (something I'm holding off as long as possible as Chins seem to have liver issues).

#150 ::: Marna Nightingale ::: (view all by) ::: December 15, 2008, 12:54 PM:

Brown Betty has made some Useful and Interesting additions to this post, here.

#151 ::: dcb ::: (view all by) ::: December 15, 2008, 12:57 PM:

Melissa Mead @ 143 How should one dispose of antibiotics that one was instructed to stop taking?

In the UK, take them back to the pharmacy for disposal. Probably similar arrangements in other countries?

Lori Coulson @ 149

My family's old German Shepherd used to eat bees and wasps. Then shake his head: "hot!". Never stopped him...

#152 ::: Bruce Cohen (SpeakerToManagers) ::: (view all by) ::: December 15, 2008, 01:49 PM:

Ginger @ 145

Part of that attitude is that so many people are at least numerically challenged, if not completely innumerate. So the difference between, say, 5% and 50% is opaque to them. Likewise the difference between 1 part per billion and 1 part per thousand. Binary comparisons like "present/absent" they can understand, but when they have to compare relative amounts they get lost.

Another part is that Western civilization has tended to emphasize dichotomies as opposed to spectra. It's either Good or Evil, there's no gray area in between. That makes people think in terms of "good drugs" and "bad drugs"; if a medication with a side-effect that's dangerous gets enough publicity, most people will just automatically label it a "bad drug" without further thought. And unfortunately, those labels are sticky; people rarely relabel things.

#153 ::: Fragano Ledgister ::: (view all by) ::: December 15, 2008, 05:21 PM:

Bruce Cohen (SpeakerToManagers) #125: I suppose that giant fucking animals are easier to hunt than giant animals not so engaged.

#154 ::: Ginger ::: (view all by) ::: December 15, 2008, 07:48 PM:

Bruce Cohen @ 152: Which is part of what makes aspirin* so special. If it had to be assessed today, it would not be an over-the-counter drug, not so easily. It's got a lot of unwanted effects, some of which are benign and some of which are not so benign -- depending on why you need it in the first place. (I expect that no one would consider permanent tinnitus to be anything positive.)

It's what happened to the COX-2 inhibitors that suddenly demonstrated a rare complication in some people (of heart disease and heart failure); if you have chronic severe pain and you need celecoxib, nothing else will do the job and you might not care about the rare adverse effect. I loved how all the people who weren't taking it were so worried about it, and yet they weren't aware of the dangers of common things like dihydrogen monoxide, for example.

I mean, who needs this powerful oxidizing agent, a known danger to small children and even healthy adults?

*Which we should really call ASA, as "aspirin" was a brand name owned by a German company. We're the only country that calls it aspirin.

#155 ::: Epacris ::: (view all by) ::: December 16, 2008, 01:29 AM:

Ginger @154: We're the only country that calls it aspirin.

It's widely & commonly called 'aspirin' (sometimes 'Disprin', a brand name, here) in Australia. IANB, but acetylsalicylic acid does seem to be aspirin in the UK too. Other English-speaking countries may have different common names, tho.

#156 ::: SeanH ::: (view all by) ::: December 16, 2008, 01:56 AM:

re: aspirin, nobody seems to take it in the UK. The generic painkiller is paracetamol (Wikipedia tells me it's "acetaminophen" in the USA?) or ibuprofen (I prefer ibuprofen, most anti-cold stuff contains paracetamol, I keep both around so that I can take two paracetamol in the event that some pain isn't managed by two ibuprofen). I've never seen anything listing aspirin as an active ingredient, but I haven't been looking.

#157 ::: Marilee ::: (view all by) ::: December 16, 2008, 02:12 AM:

Melissa, #143, my city asks that with any unused meds, you put coffee grounds or used cat litter (or similar yucky things) in the bottle, put the cap back on, duct tape it, and put it in the trash.

#158 ::: Soon Lee ::: (view all by) ::: December 16, 2008, 02:18 AM:

Kip W @138:
Pneumonia is no fun. Get well soon.

#159 ::: dcb ::: (view all by) ::: December 16, 2008, 04:31 AM:

SeanH @ 156

re: aspirin, nobody seems to take it in the UK Yes we do! And we call it aspirin (we're less shy of using brand names as general nouns over here).

Seriously, since the Reye's-syndrome-in-children scare, people have been "taught" that paracetamol is "safe" and aspirin is not. But lots of older people take low-dose aspirin (75 mg/day) regularly (reduced risk of heart attack and stroke, due to anti-platelet clotting effects). It's also good to take before flying to reduce the risk of DVT - as I was instructed by my parents, who are doctors (I'm a veterinarian; I'm not allowed to treat my own species!).

I tend to take aspirin if I have a headache. If I've got really bad pain or think I may need more than one medication I'll take ibuprofen, and then, if absolutely necessary, add paracetamol on top (reluctantly because at less than 50 kg bodyweight I'm really aware of the low overdose limit). I'll also use ibuprofen if I'm looking for the anti-inflammatory rather than analgesic effects (ibuprofen works better for me than aspirin for that, and paracetamol of course is not an anti-inflammatory). And if it's really bad and I need extra anti-inflammatory effects (sacro-iliac joint strain comes to mind), diclofenac is a wonderful thing.

Cheweing up the aspirin or letting it dissolve in a mouthful of warm water, then gargling with it before swallowing does seem to help a sore throat. Of course, I'm the only person I know who doesn't really dislike the taste of aspirin.

#160 ::: albatross ::: (view all by) ::: December 16, 2008, 12:40 PM:

Bruce #152:

I wonder how much of that innumeracy is bad teaching, and how much is native (lack of) talent. I helped a friend of mine make it through her algebra class, when she went to college after many years working. She simply had never learned the rules for dealing with fractions (adding, multiplying, dividing, etc.). She is not stupid, it didn't take her long to get them, but she had somehow never learned them, despite taking (I think) at least two or three years of mandatory math classes in high school. That looks like a school failure to me.

Also, adult medicines never seem to have dosing by weight anywhere on them. Thus, the apparent dose for a 250 lb man (me) or a 125 lb woman (my mom, if she gained some weight) is the same. I didn't learn about dosing measured in mg/kg until I was at least in college (not in any class, just in random reading or conversation or something, and I'm not sure exactly when). Once you've seen it, it's pretty obvious, but it does seem like the sort of thing it would have been nice to have someone tell you.

I've read several places that there's a pretty well-established correlation between IQ and life expectancy. One possible explanation for this is biological (whatever genetic or environmental stuff messed up the development of your brain also messed up a lot of other stuff), but another is simply about the complexity of making good health decisions. If the doctor's instructions are just too complicated for you to understand, it's quite possible that you just do the wrong thing and mess yourself up further. To the extent that the second explanation holds, making medical directions and OTC medications and such easier to use (harder to screw yourself over with) might have a big positive impact on a lot of people.

#161 ::: Lori Coulson ::: (view all by) ::: December 16, 2008, 01:56 PM:

dcb @151: Wow, a bee-eating dog! The reason we gave the Shelties Benadryl was an attempt to head an allergic response off at the pass.

Every time this has happened, the Sheltie in question has been a 4 to 6 month old puppy. Not knowing if dogs can be allergic to bee venom, we erred on the side of caution. (Catching the puppy to extract the stinger from nose/mouth provides a good deal of exercise.)

Fortunately, pediatric versions of Benadryl give dose by weight, making it easy to calculate what to give a 10 to 12 pound puppy...

One of the Chin breeders I know, who is also a physician, has a list of human OTC meds that are safe for dogs, and again she gives dose by weight.

#162 ::: Julia Jones ::: (view all by) ::: December 16, 2008, 02:53 PM:

British and aspirin user, but I suspect that in this I count as Australian. My painkiller of choice is a dispersible codeine/aspirin tablet which is only available in pharmacies but does not require a prescription. Mostly because if I want a painkiller at all, it's generally bad enough that I want codeine, and I prefer aspirin for the NSAID bit of it. I'll use ibuprofen if I have a specific need for an anti-inflammatory, but for general pain I find aspirin's better. I never voluntarily use paracetamol and prefer not to have paracetamol in the house, but then I know what a nasty drug it is in even very low accidental overdose.

Over the last few years I've found it much easier to find aspirin-without-the-poppy-juice in a UK pharmacy than in a Californian one.

#163 ::: Bill Stewart ::: (view all by) ::: December 16, 2008, 05:28 PM:

Try homeopathic flu remedies. (No, really, stop laughing and pointing, I'm serious!)

Homeopathy has evolved from its origins as an incorrect overhyped hypothesis to a bogus quack theory backed up by 200 years of trial and error that, while generally done without benefit of the scientific method, nonetheless did try lots of things and reject some of the errors. Homeopathy didn't catch on to the Germ Theory of Disease, so it's not something I'd use to treat the causes of anything, but when you're talking about influenza or colds, you already know the causes, modern medicine doesn't have much useful to cure them (except possibly Tamiflu), and what you're trying to achieve is to make the symptoms go away, so a quack product that helps your symptoms is just fine.

"Alpha CF" is a homeopathic remedy that I've found works fairly well for flu symptoms; oscillo-whatever is another popular one that has some effect on me but not as much. By "works fairly well", I mean "takes me from 'feeling really really lousy and wanting to hide in bed' to 'still sick but at least vaguely human and able to think clearly'", and it's absolutely worthwhile. It's a tablet that you chew, as opposed to one of those stereotypical liquids that's so dilute as to not contain any molecules of the original medicine. There are side effects - one of the herbs in it is ipecac, in doses that I notice but are still much milder than the flu symptoms.

As far as Aspirin vs. Acetaminophen goes, the reason US hospitals almost exclusively use the latter is that many people are allergic to aspirin, and almost nobody's allergic to acetaminophen, so they use the latter unless it's contraindicated (e.g. kidney problems.)

#164 ::: Karen ::: (view all by) ::: December 16, 2008, 06:05 PM:

Anyone else worrying about resistance developing to the antiviral medication Tamiflu? From the CDC flu website: "Since October 1, 2008, 46 influenza A (H1N1), seven influenza A (H3N2), and 15 influenza B viruses from 15 states have been tested for antiviral resistance; however, 63% of the viruses tested were from only two states. Forty-five of 46 influenza A (H1N1) viruses tested were resistant to oseltamivir; while all 46 viruses were sensitive to zanamivir. All influenza A (H3N2) and B viruses tested were sensitive to oseltamivir and zanamivir." (Oseltamivir=Tamiflu; zanamivir=Relenza, which shouldn't be used in folks with asthma or COPD)

We might be going back to chicken soup and acetaminophen.

I'm also having fun this season comparing the CDC flu maps to the Google flu trends. Unpredicted side effects of search engines, yea.

#165 ::: CHip ::: (view all by) ::: December 16, 2008, 10:13 PM:

wrt the is-ginger-an-antinauseant, the reference promised several days ago. This actually came from Biosis via SDC Orbit, not from Elhill as I'd remembered. I'll let someone more familiar with medical abstracts translate if they wish as it has been a long time since I was anywhere near that field.

AN - BA74-063657
SO - LANCET (LANCA), 1 (8273). 1982., P. 655-657.
AB - The effects of the powdered rhizome of Zingiber officinale on the
symptoms of motion sickness were compared with those of
dimenhydrinate and placebo in 36 men and women who reported high
susceptibility to motion sickness. Motion sickness was induced by
placing the blindfolded subject in a tilted rotating chair.
Measurements of perceived degree of gastrointestinal distress
were reported every 15 s for up to 6 min by means of
psychophysical methods. Z. officinale was apparently superior to
dimenhydrinate in reducing motion sickness.

#166 ::: Snausages ::: (view all by) ::: December 16, 2008, 11:29 PM:

What about the feeding and the starving, and why am I the first to note the absence of advice about this advice?

#167 ::: Summer Storms ::: (view all by) ::: December 16, 2008, 11:36 PM:

Okay, which of you bums sneezed on me through teh intartubes? I suddenly have the mother of all head colds, with sneezing, stuffiness, and generalized grossness. And someone's going to pay.

Or not.

#168 ::: Marilee ::: (view all by) ::: December 17, 2008, 12:11 AM:

albatross, #160, not all drugs have to have the dosage changed for weight, and not everybody reacts in the standard way to drugs.

#169 ::: janetl ::: (view all by) ::: December 17, 2008, 12:15 AM:

Marilee @ #168: "not everybody reacts in the standard way to drugs". That's for sure! I didn't sleep well on a morphine IV.

#170 ::: abi ::: (view all by) ::: December 17, 2008, 04:54 AM:

Sigh. Riding to work every day* notwithstanding, I appear to have a mild case of the flu.


* which, I suspect, builds my general health and thus my resistance to disease. I know fine well that I can't get an illness purely by being wet and cold, but I had expected the immune-system stress of those conditions to outweigh the good of the fresh air and exercise.

#171 ::: Schizohedron ::: (view all by) ::: December 23, 2008, 02:47 PM:

I "woke up" this morning feeling like I'd spent the night in a human-sized clothes dryer. And I use quotes, because fever dreams kept me from achieving deep sleep. When I got my thoughts together, this was the page I knew I needed to check . . . at least once I felt confident enough to walk to the laptop. (Once my fevers get past a certain point, I've been known to pass out during physical exertion as simple as walking.) I feel fairly confident that this bug is a flu virus that somehow got around the vaccine I had back in November, and the first bug I've had since I began getting the shot in 2002.

During my last flu, I used the recovery time to blast through the first 2 seasons of The Sopranos. Now I've got Netflix to nurse me back to health. Hmmmm . . . Deadwood or The Wire?

#172 ::: Rikibeth ::: (view all by) ::: January 01, 2009, 12:49 PM:

Cough, body aches, and 99.2 when my baseline is usually 97.6 or so. Happy new year, flu virus!

#173 ::: Marilee ::: (view all by) ::: January 06, 2009, 12:10 AM:

Rikibeth, I don't know how I caught it from you all the way down here! Really, I just have the beginning of symptoms and since other things are wrong with me, maybe it's not the flu. (I keep giving myself a chimney.)

#174 ::: nerdycellist ::: (view all by) ::: February 03, 2009, 03:06 PM:

Well, it seems my roommate's come down with Type A Influenza. The onset of her symptoms seemed to be Sunday afternoon. So far, I'm OK (knock wood.) I called my health care provider to inquire about a vaccine so I might avoid getting the flu and the nurse who answered the phone told me "... there's no such thing..." and suggested I wash my hands frequently (check) and that my roommate and I not "share spoons". (uh, check.)

My questions are: is the nurse lying or should I get a second opinion? The CDC's website indicates that it takes up to two weeks for the vaccine to build up the antibodies - would an antiviral be appropriate? And if I haven't come down with any symptoms after two and a half days, can I just continue my hand washing regimen and not worry about it?

#176 ::: James D. Macdonald ::: (view all by) ::: November 04, 2010, 01:17 PM:

Everyone got their flu shots, right?

#177 ::: joann ::: (view all by) ::: November 04, 2010, 01:38 PM:

Yes, Jim, even though it took an hour to accomplish this. Warning to others: Walgreen's is not entirely set up for shots; was it stupid of me to stand in the wrong line because it never would have occurred to me that a user-generated shot request is the same as a "prescription drop-off"?

#178 ::: Fade Manley ::: (view all by) ::: November 04, 2010, 05:40 PM:

Got my flu shot! For the first time ever, actually; apparently what I needed as incentive to get around to doing it was a lecture from a friend with a weak immune system who can't leave the house during the worst of flu season, if too many people don't get shot.

#179 ::: Rikibeth ::: (view all by) ::: November 04, 2010, 11:58 PM:

Got mine Tuesday, feeling like it was almost as much a civic duty as going to the polls.

The teenager has had flu the last two years running. Pharmacy walk-ins won't take anyone under 18, so the appointment with the family doctor has been duly made (thanks, Mark). I am NOT having the kid miss two weeks of school AGAIN; the grades this year are GOOD so far, and I'd like them to stay that way.

#180 ::: Lori Coulson ::: (view all by) ::: November 05, 2010, 11:58 AM:

Talked to my doctor, who said, "Albumin is albumin, under NO circumstances are you to get a flu shot. If they come up with one not cultured in eggs, I'll let you know."

And he still hasn't been able to find out what the pneumonia vaccine is cultured in...

Please, everyone who can, get your flu shot!


#181 ::: Earl Cooley III ::: (view all by) ::: November 05, 2010, 12:27 PM:

Lori Coulson @180, I've seen the term "chicken protein" used, perhaps as a way to avoid the explicit mention of albumin.

#182 ::: fidelio ::: (view all by) ::: November 08, 2010, 12:14 PM:

If you can handle the flu shot but haven't had it yet, Lysol is offering added incentive. Except of course, where prohibited by law, &c.

#183 ::: Rikibeth ::: (view all by) ::: November 13, 2010, 02:56 PM:

Well, that was interesting: I think I just experienced my inoculated body shaking off a flu virus. I was feeling tired and unwell yesterday afternoon, and I napped. After the nap, I felt not-hungry and feverish, with chills, and a little bit of congestion. Also a few minor coughs. I took a decongestant and some ibuprofen and went to bed in warm layers. Woke up two hours later drenched in sweat, changed to a T-shirt, went back to sleep. This morning, slept late, but after breakfast and a shower, felt fine.

Is that right, for a post-shot reaction to exposure? Or was this something else I shook off?

#184 ::: Mary Aileen ::: (view all by) ::: November 13, 2010, 03:11 PM:

Rikibeth (183): I had almost exactly that set of symptoms a few weeks ago: tired, feverish, chills, then much better in the morning and completely well by the following day. I thought at first that I was coming down with the flu, despite having had the flu shot in late September, so I was quite relieved when it passed off so quickly.

#185 ::: Clifton Royston ::: (view all by) ::: November 13, 2010, 05:37 PM:

Yep, whole family got ours by last month.

#186 ::: Thomas ::: (view all by) ::: November 13, 2010, 08:55 PM:

Lori Coulson #180:

And he still hasn't been able to find out what the pneumonia vaccine is cultured in...

The pneumococcal vaccine shouldn't need to be cultured in anything -- viruses need living cells to grow in, but Strep. pneumoniae doesn't. The CDC website on contraindications does not list egg allergy for the pneumococcal vaccine (but does for influenza and a bunch of other viral vaccines).

#187 ::: Sherrie from Neti Pot Newbie's Guide ::: (view all by) ::: January 31, 2011, 01:23 AM:

I swear by the neti pot. It's a real life-saver right before bedtime when I have a cold, because the nasal irrigation process helps keep me from sniffling, snoring, and generally making a pitiful spectacle of myself.

A quick note about salt in your neti pot: As a few others have commented, salt really IS a must. Any articles that suggest skipping or reducing the salt "for comfort" aren't doing neti pot users any favors. (Seriously, ouch.) And remember, the salt must be pure. No iodine, no anti-caking agents, and for heaven's sake, no orange coloring. For an in-depth look at what kinds of salt you will AND won't want to use in your neti pot, here's a fairly comprehensive neti pot salt guide.

#188 ::: Lee sees on-topic spam ::: (view all by) ::: January 31, 2011, 02:27 AM:

#187 is relevant, but commercial. Moderators, it's your call.

#189 ::: James D. Macdonald ::: (view all by) ::: January 31, 2011, 02:37 AM:

It amuses me to leave it.

#190 ::: Naomi Parkhurst sees spam ::: (view all by) ::: July 30, 2011, 06:23 PM:

a plain URL having nothing to do with the conversation.

#191 ::: Jim Macdonald ::: (view all by) ::: March 21, 2012, 12:21 AM:

On the one hand, no links to anything, and more-or-less on topic.

On the other hand, 90+ identical copies out on the Web.

So out it goes.

#192 ::: Helen ::: (view all by) ::: January 12, 2013, 07:06 PM:

There's a certain unfortunate loop of events that seems to keep going around and around in Australia, judging by the conversations I hear at my workplace (plus news reports I've read):

Person gets a cold.
Person visits GP, often because it's mandated for his/her sick leave, not because you need the GP for a common cold
Person informs GP that he/she has "the flu". In Australia, no one ever thinks they have a common cold. It's always FLU.
Person demands antibiotics.
GP says that antibiotics are not prescribed for colds.
Person becomes truculent. GIVE ME THE ANTIBIOTICS.
GP finally gives the person antibiotics to shut them up and make them go away.
(You will be regaled with anecdotes about how the crool GP tried to deny the sick person their PROPER antibiotics but was convinced by LOGIC in the end.)
Person takes the antibiotics until they feel better, without finishing the full course.

Superbugs are now a terrible problem in our hospitals and doctors are working with an ever-diminishing number of antibiotics which actually work. Surprised?

#193 ::: Jim Macdonald ::: (view all by) ::: January 12, 2013, 08:17 PM:

That's without even getting into the side-effects of antibiotics (some of which can be pretty spectacular, others being merely miserable).

But yeah, we've been breeding superbugs and the day of antibiotics may well be over.

(Also: Neither colds nor flu are affected by antibiotics anyway. Though if you get the secondary bacterial infections that are the real killers with flu you'll wish that antibiotics still worked as well as they used to.)

BTW, both sunlight and humidity can slow down the flu virus, so keeping the blinds open and using a humidifier may help.

#194 ::: Nicole J. LeBoeuf-Little ::: (view all by) ::: February 25, 2014, 02:57 AM:

It's that time again. Happy new year.

We're not yet out of February, but I've been sick with "I think it's another cold" four separate times now since it became 2014. Not the same experience each time; the first two were more sinus-heavy from the get-go while the latter two started with a cough and only hit sinus congestion city towards the end.

One correspondent has given me her "from personal experience" advice to disinfect my toothbrush with chlorine bleach, or simply replace it, after a cold; otherwise I risk reinfecting myself.

While replacing one's toothbrush often is a great idea, I'm flummoxed; I thought any viral infection was a one-shot deal, after which one's immune system will recognize that particular critter and zap it good. For this reason, I had thought, you can't actually volleyball a particular cold virus back and forth between family members. Or between yourself and your toothbrush.

Is it that a cold virus mutates so rapidly that you *can* reinfect yourself? Or that some viruses we simply don't develop immunity to? Or -- and I'm not discounting this possibility -- is my correspondent simply wrong?

Not that it can *hurt* anything to disinfect or replace my toothbrush, mind you.

Meanwhile, 12-hour pseudophedrine and 12-hour Mucinex DM Extra Strength are staples in the household. Better living through science, I say. And through quarantining myself as much as feasible through at least the first three or four days of symptoms.

I would really like to get my flu shot, but I think I'm supposed to not be actively sick when I go get it. I would like to remain Not Actively Sick for more than a week at a time, thank you please and kindly?

#195 ::: Ginger ::: (view all by) ::: February 25, 2014, 08:54 AM:

Nicole @194: Part of the confusion may stem from the fact that there is not a single "cold virus", but rather a group of viruses which cause similar clinical signs. Having one viral infection can weaken your local immune system, making you slightly more susceptible to the next infectious organism, but it's not necessarily the same infectious organism each time you have a cold. Many times, bacterial infections follow viral infections, and you get a series of up-and-down clinical signs.

The influenza viruses mutate easily, in two separate paths, so those can indeed infect you more than once.

Other microbes can hang out on toothbrushes, but most of those are the normal flora and fauna of the oral cavity, and are usually commensals (i.e., we live in harmony), so I wouldn't worry about those.

I'm sorry that you're having repeated problems -- I think there's a lot of that going around this winter, and it's no fun at all to keep getting sick. Good luck getting a break so you can catch your flu shot!

#196 ::: Nicole J. LeBoeuf-Little ::: (view all by) ::: February 25, 2014, 01:43 PM:

Thanks for the confirmation and the good wishes, Ginger.

All the stuff about the "common cold" being symptoms caused by any one of a number of viral infections sounds familiar, but I had not thought about how one viral infection makes you more susceptible to the next by weakening the immune system.

I'm pretty sure that what I'm getting whammied by isn't influenza. Can so-called "cold viruses" mutate that quickly as well?

Prior to my correspondent's advice, I'd been assuming that I'm just in the way of multiple contagion vectors. We had a bunch of friends in from out of town all at once, followed the next month by my husband's birthday party, interspersed with role playing game sessions, all of which packed our relatively small home with a large amount of human traffic.

Then on top of that, I play roller derby these days, which is a contact sport involving a particularly intense level of closeness (and, as a recent study shows, microbial sharing) between both teammates and opponents. Add to this that many of them are mothers with small children, and it's no surprise everyone's getting sick on and off this season. And it doesn't help that there's perceived pressue, in the form of "make your minimum attendance through February or you don't get rostered for the March 29th bout," for me and my teammates to show up and practice despite being sick.

There was recently a push in our league to take some time after each practice to clean up around the track. Turns out I'm inconveniently fearless about picking up and throwing away others' used snotty tissues. I'm trying to stay equally conscientious about washing my hands to make up for it. Disposable latex gloves might not be a bad idea.

#197 ::: Nicole J. LeBoeuf-Little ::: (view all by) ::: February 25, 2014, 01:49 PM:

Sorry - just reread your post (why yes I *can* read, but I sometimes focus disproportionately on some bits of a post rather than others)... Sounds like you're saying it's less likely to be the same cold-causing viruses (rapidly mutating or not) as it is to be bacteria moving in where the virus preceding it left the immune system weak.

Which sounds like all the more good reason to stay home and away from extraneous human contact throughout the duration of symptoms--not just to prevent passing it to others, but to prevent picking up new crud while my susceptibility is temporarily increased.

#198 ::: Ginger ::: (view all by) ::: February 25, 2014, 02:24 PM:

Nicole @ 196-7: No worries, I often do the same thing (read too fast).

There are some viruses which are better at wreaking havoc, and sometimes you just get a particularly virulent strain of a virus (or both), and then you're really helpless against anything else that comes along, whether bacterial, viral, rickettsial, fungal, parasitic, or other. I suspect you're right about the sources of the infections. Think of it this way: next season, your immune system should be *this much* stronger, at least for some microbes. Our immune system did evolve in a soup of microbes, and you're giving it an excellent workout. Until then, may you have plenty of good soup, soft tissues, hot beverages, and comfortable pillows to soothe your rest.

#199 ::: Nicole J. LeBoeuf-Little ::: (view all by) ::: February 27, 2014, 07:35 PM:

You are very kind. I wish the same to you, as and when necessary.

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