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The Cold: the Dangerfield of Illnesses

Posted on: Tuesday, 21 February 2006, 12:00 CST

By Kevin Lamb

First off, the phrase "just a cold" sure betrays some misplaced priorities, doesn't it? A cold makes people feel miserable, disrupts their sleep after already tiring them out, has no cure and can mask or morph into serious problems.

Dismissing it reflexively shows how entrenched is our growing tendency to blame illnesses on their victims and to sacrifice our health for money, whether our own or someone else's.

But having said that, we do spend a lot of money on cold remedies that range from useless to harmful. Tylenol's active ingredient is associated with more than half the U.S. cases of acute liver failure. Over-the-counter cough medicines do little but delay diagnoses of possibly fatal pneumonia or whooping cough. Improper antibiotic use breeds mushrooming numbers of both exotic flesh- eating bacterial infections and everyday allergies.

Most coughs go away on their own, said the researchers for the American College of Chest Physicians, which recommended last month against over-the-counter cough medicine for coughs caused by colds. As Dr. Sydney Spiesel wrote in Slate magazine online, any illness with 100 remedies doesn't have any very good ones, but the blanket recommendation ignores the countless ways any drug can affect different people.

Chicken soup works better, though, and of course is safer unless someone leaves the chicken on the counter all night. Studies suggest its nutrients enhance the immune system, and nothing beats fluids for clearing out respiratory gunk. Honey also helps, by shielding the respiratory system from things that cause coughing. Even a shot of whiskey can help us sleep through nighttime coughs.

Help with sleep probably explains why the one type of over-the- counter drug that works on coughing with colds is not a cough medicine. It's the older antihistamines, like Benadryl, which have lost favor because they cause drowsiness.

But anyone taking cold medicines needs to total up the acetaminophen. Tylenol is one of more than 100 over-thecounter products with acetaminophen, which contributed to poisoning more than 113,000 U.S. patients last year. Some were suicide attempts, but people often take too much acetaminophen, or take it for too long or with the wrong combinations, especially alcohol, said Dr. Guy Neff of the University of Cincinnati Academic Health Center.

Neff is a liver-transplant surgeon who sees the horrible effects of overdoses. Check all your medicine levels, he said. Never take more than 4,000 milligrams (eight extra-strength Tylenol tablets) a day, never take it longer than five days and never mix it with alcohol.

Colds usually go away on their own, but only doctors can tell if the cough is really from bronchitis, pneumonia, asthma, even severe heartburn or worse. Always see a doctor for shortness of breath, or coughs that persist three weeks or bring up blood or thick and discolored phlegm. And remember the first signs of liver damage are yellowing eyes or abdominal pain or bloating.

Don't demand antibiotics, though. They're as useless on cold and flu viruses as wrapping your arm in a bandage. Their many side effects include disrupting the beneficial bacteria that make up one- third of our intestinal weight. Besides being crucial for digestion, those gut bacteria protect us from asthma and allergies.

Even worse, the overuse of antibiotics has started breeding strains of bacteria they no longer can kill. Rates of drug- resistant pneumonia and urinary infections are ballooning, as are serious digestive infections from C. diff and various staph infections, including the flesh-eater.

One way to avoid drug-resistant infections is by taking the whole prescription, even after all symptoms are gone. Unfinished antibiotics leave surviving bacteria that can adapt and survive the next round. Antibacterial soaps and tissues have similar effects, even though many doctors' offices use them. They weed out the weakest bacteria, and research shows they don't reduce illness.

Our immune systems fend off germs all the time without our noticing. They can handle most colds and bacterial infections with the help of sleep, liquids and hand washing with normal soap. Like colds, medicines aren't trivial just because they're common.

Contact health and medical writer Kevin Lamb at klamb@DaytonDailyNews.com or 225-2129. His column appears every other Tuesday.

Online: DaytonDailyNews.com/health

Source: Dayton Daily News

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