Have you had the spring cough yet? If not, think yourself lucky, just about
everyone else has had it. And it isn’t one of those coughs which goes away in a
couple of days, patients are saying it takes at least a couple of weeks. Or even
longer.
There are many reasons for epidemics such as these, and most
occur with the change of seasons, hot to cold, cold to wet and so forth, but
with the vast majority, the common carrier of the bug is the human race. This
time we can’t blame an innocent mosquito!
Yes, we are the ones who go to work and spread our germs to
the office, exploding an aerosol of potentially debilitating diseases into the
air, every time we cough. This is the commonest way of transferring the bugs, by
what we call droplet infection. Every droplet capable of carrying thousands of
microbes, each one looking for another human to infect. You. Or even me. In our
household, my young son brought it home from school, passing it on to his elder
sister and now to me. Thank you so much, Evan.
The latest bout has been a form of URTI, which is our acronym
for Upper Respiratory Tract Infection. This is inflammation of the bronchus,
that part of your breathing tube to the lungs before it splits to become the
right and left bronchus. The medical name is therefore “Bronchitis”. The clue is
in the ending - “itis” which generally means inflammation and / or infection.
Thus you can get Appendicitis (inflammation of the Appendix) and Pharyngitis
(inflammation of the pharynx), Laryngitis (inflammation of the larynx) etc.,
etc.; you get the picture.
Infection and irritation of the breathing tubes is, as we
said in the beginning, very common. The most usual predisposing cause is,
however, our old friend cigarette smoking! If you don’t believe that cigarette
smoke is irritating, try letting cigarette smoke waft into your eyes and see how
they will sting and water. Your sinuses and bronchi do just the same! Once the
irritation begins, the mucous lining becomes swollen, and it becomes easier for
the germs to take a hold.
With Bronchitis, it generally begins as a slight irritation
deep in the back of your throat. There can be some soreness as well, even on
swallowing. Unchecked this develops into a ‘productive’ cough, with loads of
thick, tenacious gunk being coughed up, which we refer to as ‘sputum’.
One of the signs and symptoms your doctor will want to know
is, “What color is your sputum?” This gives us a chance to see if your cough is
from an irritation or infection. If you are bringing up large lumps of yellow or
green glue then you have an infection, but if the mucous is clear then you
probably do not harbor a nasty bacterium in your throat, but an equally nasty
virus. If however, the sputum is red and bloodstained then you may have burst a
little blood vessel in the throat - or of course, this could be an early sign of
lung cancer but don’t panic yet!
If the sputum you are coughing up is thick, green and gooey,
this is fairly suspicious of a bacterial infection, and sometimes we will
attempt to “grow” the bug to identify it. No, this is not for germ warfare, it
is just so that we can feed the bug some different antibiotics to see which ones
exterminate the bug best. This is a much more accurate way of choosing the
correct antibiotic, than selecting ones by the pretty color they are on the
pharmacist’s shelves. And I don’t go along with trotting down to local pharmacy
and getting “some antibiotics”. That’s how we end up with antibiotic resistance.
If you have gone over a week and your cough is showing no
sign of letting up then it really is time to line up with all the other coughers
at the outpatients department. Just make sure you can describe the color of your
sputum!
Remember that if you are a smoker, the chances of the cough
lasting longer are much higher, as well as your being more likely to catch the
cough from someone else.
