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Caring for Sore Throats

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One of the most common reasons for patients to visit their doctor is the common sore throat.  For many years after the age of antibiotics began over a half-century ago, most doctors reached for Penicillin or Sulfa drugs, and most patients expected this prescription to be the “miracle” cure.  Which it might well be, if the underlying organism is a strep bacteria, and not a virus. 

However, times are changing, and so are bacteria.  

No longer will the common antibiotics guarantee complete recovery, even if the infection is purely bacterial.   In fact, the overuse of antibiotics has been not only in doctors offices, but in the food industry.  Mass-produced  livestock, such as  cattle, pork, chickens,  and even fish are kept in unnaturally close quarters, where they are basically bumping into each other, or the perimeters of their cages/fences. If they show superficial infections, they will not pass inspection.  So rather than have more space around each animal, it turns out to be a lot cheaper to dump antibiotics in with the feed.   This even shows up in eggs and milk in areas where this practice is not regulated. 

As a consequence, the bacteria are so used to antibiotics that they frankly are not impressed; and the infections are mutating with such speed that we cannot make new families of antibiotics fast enough. 

So with this as background, you will not be surprised when your doctor today is much less likely to dole out these medications.   Even if you have green or yellow discharge from your nose or in the back of your throat, and even if you have bright red tonsils the size of golf balls.

Instead of reaching for the prescription pad, doctors now will suggest a throat swab to test for strep, before prescribing any antibiotics.  This can be done as an instant test (which may be an extra charge, depending on your insurance), or as the kind that takes two days for the lab to report.  Over 80% of the time (in my practice) these are negative for any treatable bacteria, meaning the infection is caused by an untreatable virus.

So how do we deal with these painful viral episodes?  Here are a few tips that may help:

  1. Consider holding back on dairy products for a few days.  Milk products in many people will have an effect (not an actual allergy) to thicken mucus.   That’s why singers never drink warm milk between songs.  As soon as the mucus clears, you can happily resume your favourite milk, cheeses, or ice creams.  If milk does no such thing to you, don’t worry about this step.
  2. Grandmother’s Chicken Soup: turns out to be an excellent choice to help thin mucous discharge from the nose, throat, and airways.  Keep a few boxes of chicken stock handy, or use boullion cubes to fill your mug with a nice hot drink.  Remember to rehydrate your body with water.  Lemon and honey can prove soothing in a mug of hot water, as can herbal teas or ice water. 
  3. Saline gargles: Do NOT use commercial mouthwashes more than a few times a day, or you can change the pH, as well as the  ecosystem in the mouth, and end up with a fungal infection, with a  blue or white tongue.  If you have a really sore throat, including swollen tonsils, you need to gargle a lot, even hourly.  The best way is to use saline, stirring a few spoonful’s into a half-glass of warm water, until no more will dissolve.   Gargle as long as you can with the first mouthful, then spit it out, and repeat a couple more times.  You can immediately take a swig of something tastier, so you don’t need to endure the salt for long. 
  4. Treat symptoms with off-the-shelf medicines.  For fever, sinusitis, and pains, something like an ibuprofen or aspirin based cold/sinus pill will help. 

If the above is not working, go back and see your doctor.  Even if it turns out that your case is caused by a bacteria that will respond to an antibiotic, the above steps are still very useful.

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