The overwhelming majority of calls I get, wanting to be seen for waking up “sick,” or “coming down with something” are some variation of a normal viral illness This is the typical time frame:
Day 1-2: feeling a little off. You may be more tired than normal. Maybe your throat is more scratchy, nose is more itchy, but it’s really easy to miss if you’re busy, or there is some other explanation.
Day 3: I’m normally called on this day. Today you feel pretty bad and you have known you haven’t felt like yourself for a couple of days. You are starting to really have the common symptoms, may be feeling a little achy, but less so than the flu, and you have some more intense fatigue today. Now is when you definitely have some sort of runny nose or congestion or sore throat or cough–something to let you know you’re sick.
Day 4: Today is definitely worse. Honestly, no matter what I do on day 3, it’s going to be worse. You feel like crap. There’s mucus everywhere. Sorry.
Day 5: If we do everything right, this is the day the systemic symptoms should start to improve (meaning if you ran a fever, it should stop, you should have fewer body aches, be a little less tired, etc), but if it’s going to move into your chest, it will start to do so today if it hasn’t already.
Day 6 and beyond: you will be coughing but you should be improving overall. If you get worse systemically at this point, it’s time to call your doctor. You likely need an antibiotic. However, remember, the cough can hang around for a while and be QUITE annoying.
Prevention:
How do we prevent the common cold? Wash your hands. Wipe down your surfaces. Eat a healthy diet. Get plenty of rest. Pay attention to your body. What I have found is that if I can catch myself in day 1 or 2 when I’m just feeling more run down, I can keep myself from really hitting the sick of day 3 if I 1. Rest, 2. High dose C, 3. Zinc lozenges, 4. Elderberry Syrup. I can’t find any evidence to say that this works for everyone. It works for me.
Treatment:
You missed your window of prevention and you’re in day 3? Ride it out. There is no medicine that’s going to kill a virus. That being said, vitamin c, zinc, and elderberry are very promising for shortening the duration of a viral illness, again assuming no kidney, liver, or metabolism issues (so make sure you check with your personal doctor before use). I also tend strongly advocate for treating your symptoms, because untreated mucus symptoms are the biggest cause of bacterial infections in my completely subjective opinion. I like to be able to prevent the need for antibiotics, so I give my patients the run-down on what to use to dry it up and keep what’s in there rinsed out or flowing out. See the post here. Mainly with a virus, you gotta just suck it up, and ride it out. Get some REST!! As a society, we highly undervalue it, and it’s so important to our recovery. And remember, the annoying cough can last for up to 1 month, but it shouldn’t be associated with fever, chills, night sweats, or shortness of breath. And generally, your docs may have a prescription up their sleeves for this annoying cough if you ask.
Secondary Bacterial Infections
Understand that it will normally take 10-14 days for a bacterial infection to develop after a common cold if it’s going to happen. ENT studies have shown it takes at least 14 days for bacterial sinus infections to develop, so even if you’re have classic sinus infection symptoms, it’s likely from a non-bacterial cause if it’s prior to 14 days. It just takes that long for enough bacteria to grow to be causing an infection. Before this, you likely don’t need antibiotics unless you have some kind of special risk factor.
At this point, I normally want to see my patients. I want to make sure you aren’t more sick than you think, and I want to localize the infection to make sure I pick the best antibiotic for your infection. All antibiotics are not created equal, so please don’t use the last antibiotics you had for the infection you might have right now unless you’ve received the okay from your physician.