Sunday, 19 November 2017

How

WELCOME to my first contribution to this new fortnightly column. I am a GP working at the Hart Surgery in Henley and my hope is that, through these regular articles, my colleagues and I can bring a bit of a local feel to the wider health issues at large.

To that end, I would encourage any feedback or suggestions for subject matter and we will do our best to cover as much as we can (providing it is vaguely interesting and of a medical nature).

My first topic concerns the dreaded “common cold”. I suspect that if I came up with a truly effective way to “get rid” of a cold, I could comfortably afford to buy one of those massive yachts you see cruising on the Thames during the Henley Festival. However, that would involve me succeeding where many others have failed.

In order to explore the reasons for this lack of success, it would be useful to clarify exactly what we mean by the term “common cold”.

Colds tend to manifest themselves in a variety of ways but generally one might expect one or more of the following symptoms: blocked or runny nose; sore throat; headaches; coughing and sneezing; high temperatures (above 37.5C for a child and above 38C for an adult); muscle aches; pressure in your ears and face.

Colds are caused by viruses, so antibiotics will not work against them. The viruses responsible enter your nose and throat and affect the inner linings of your upper respiratory tract.

When they do, a lucky 25 per cent of people may not get any symptoms at all but if you are in the unlucky 75 per cent then you have your immune system to blame for what happens next. As the viruses are detected, all sorts of inflammatory mediators flock to your upper respiratory tract and cause your blood vessels and mucous glands to leak fluid, hence the runny nose.

You’ll notice I refer to viruses in the plural and herein lies the biggest problem when it comes to any kind of treatment.

Rather than just one virus doing all of the damage, there are actually about 200 types that are thought to produce this clinical picture we refer to lovingly as a cold — and those are just the ones we know about.

Of these, one group called the rhinoviruses (“rhin” from the ancient Greek meaning “nose”) constitute about half of known causative agents — by far the largest group of culprits.

This sheer variety has been the biggest roadblock in finding a definitive cure simply because, in reality, we are trying to treat not one condition but many that fall under the same umbrella.

Aside from the economic impact (more than 33 per cent of absences from work in 2016 were down to a “minor illness” such as a cold), you might argue that, due to the ultimately harmless nature of these self-limiting (but extremely annoying) infections, research may be best directed elsewhere.

However, there has been a great deal of time and effort invested into seeking a definitive solution. The Medical Research Council opened the Common Cold Unit on an old military base near Salisbury in 1946, just one of several examples around the world of research into this common ailment. As part of this, thousands of volunteers were deliberately infected with colds over the years to help in the search for a cure.

Though it closed in 1989 without succeeding in its primary mission, the unit did manage to come up with all sorts of treatments for the symptoms of colds — many of which we find in our pharmacies today.

Over the years, those working on the cold have shifted their lines of enquiry to focus ever more on the development of a vaccine that might give someone immunity in order to prevent colds from developing in the first place.

Though not as appealing for the drug companies as an outright cure, most bodies currently working on the common cold seem to accept that finding a vaccine is the only realistic way to proceed.

So, in answer to the question how do you get rid of a cold, the short answer might be you can’t. However, there are ways to make yourself feel a bit better while your body fights it off:

Paracetamol and ibuprofen: These help with the fever and aching.

Decongestants, e.g. pseudoephedrine (comes in nasal sprays or tablet form): These shrink the blood vessels in the mucous membranes, reducing those secretions and blocked noses.

Rest and sleep: This is self-explanatory.

Drink plenty of water: This is important to prevent dehydration. (Your normal fluid intake should be between six and eight glasses a day even when well).

Gargle salt water: This will soothe the throat.

Remember, antibiotics do not work for a cold. What’s more, if you have the above symptoms, you do not need to see a GP. Speaking to your pharmacist is your best bet.

Having said that, if your symptoms don’t improve after three weeks, or your symptoms suddenly worsen, then it’s time to come and see us. Likewise, visit us if your temperature is so high that you start shaking, you’re finding it hard to breathe, you’re experiencing chest pain or you have a long-term condition or a weakened immune system.

Hopefully, this has been helpful but, as I mentioned at the beginning, feel free to get in touch with any feedback or suggestions on future topics.

I would like to point out an excellent resource which many are unaware of — www.nhs.uk — NHS choices. This should be the first place you check if you have any medical queries.

In the meantime, if I do come up with a cure, I will of course let you know.

Next time: The problem with antibiotics.

If you have a suggestion for a subject for the doctors, please write to: An apple a day, Henley Standard, Caxton House, 1 Station Road, Henley, RG9 1AD or
send an email to: doctor@henleystandard.co.uk

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