The common cold season is upon us, and, each year, millions of us become afflicted.
Colds are caused by more than 200 varieties of viruses and should only last about 5-8 days as these viruses are usually rapidly killed by our bodies’ immune systems. Unfortunately, in many cases, the damage caused by poorly managed colds permits the growth of bacteria that cause sinus and ear infections which drag on for weeks.
Most of us receive little guidance about how to manage our colds or those of our children in order to end these illnesses quickly. Internet searches for common cold treatments yield advice such as drinking lots of fluids and getting lots of sleep. No one can argue with this general advice, but it will not keep you or your children comfortable or your noses clean, clear, open, and dry. Unruly, lingering colds do lead to sinus and ear infections that often require oral antibiotics.
There is a better game plan for weathering colds that has been time-tested on thousands of children and their parents. A strategy that requires no prescription medications and mainly relies on agents applied to the nasal linings rather than taken orally. The method is as simple as ABCDE and is contained in 6 simple tips: FIVE things that you should do and ONE thing that you should avoid.
This ABCDE Program involves four ingredients that you take or give your child three times a day during the week of a cold. You begin the program immediately at the first signs of a common cold: nasal congestion, runny nose, sneezing, and some sniffling. The fifth step of the ABCDE program offers a set of ingredients that’s helpful for managing lingering “colds.”
One tip that applies throughout this process: DO NOT BLOW YOUR NOSE. The nose is an air intake and not a horn or a sewer outlet for snot. When you blow your nose, you force infected material up into the sinuses and the ears.
Now, onto the program:
The ABCDE Program is easy to follow. At the first sign of a cold, you begin four daily treatments: morning, mid-day, afternoon, and evening. Each treatment consists of:
A = a dose of an ANTI-INFLAMMATORY medication such as ibuprofen, Advil for those under 21 years, or aspirin in a stomach-safe form for those over 21.
- Flickr/Mike Mozart
This assumes that it is safe for you or your child to consume these common pain and fever killing medications. They are available in liquid form for infants and toddlers, in chewable form for children, and in tablet form for a adolescents and adults. It is NEVER safe for persons under 21 to consume aspirin due to its association with the deadly Reye’s Syndrome.
Ibuprofen and aspirin, both NSAIDS, neutralize many of the effects of cold viruses on your nasal and throat linings reducing not only congestion and mucus drainage but also suppressing sneezing and coughing.
B = instillation of a BACTERIA-KILLING topical triple-antibiotic ointment such as NeosporinTM or a store brand equivalent.
This can be placed on the tip of a finger and rubbed inside the nostril. For babies, a Q-tip may be coated with the ointment and rolled around inside. It is amazing, though at what young ages infants find that their nostrils are an ideal receptacle for their fingertips. The triple-antibiotic ointment suppresses bacterial growth and eliminates crusting thus reducing intranasal swelling and eliminating the bacteria that could lead to later nasal, sinus, and ear infections.
C = a spray of CLEANSING, CHASING saline mist from an aerosol canister
- Simply Saline
You can find these saline mist sprays, such as SimplySalineTM, OceanTM, Little Remedies for NosesTM, or store brands at any pharmacy. This puff of saline chases the antibiotic ointment back through the nose while cleansing the nasal cavities.
D = DECONGESTANTS are the heart of the ABCD program as they are the agents that open the nasal airway and reduce the flow of nasal secretions, allowing you and your child to breathe freely and stop sniffing and coughing.
The choice of decongestant agent is age-dependent:
• 6 mo-2 yrs: Little Remedies for Noses (0.125% phenylephrine HCL)
• 2-6 yrs: Mild Neo Synephrine Nasal Spray (0.25% phenylephrine HCL)
• 6 yrs-adult: Afrin Nasal Spray (oxymetazoline HCL 0.05%)
Which medications to use, and how to use them
The common wisdom is that you cannot use these medications for more than 3 days or a dire fate will befall you. You will allegedly become addicted to the medication.
The truth is that topical decongestant agents have been re-studied over the past decade, and it is safe and effective to take them for the week of a cold and, perhaps, a week or so longer.
The best way to administer topical medications into the nose is via a pump spray bottle. Afrin and its generic equivalent, the drug of choice for those 6 years and over, is available in such bottles. Unfortunately, the Little Noses product, recommended for infants and toddlers to age 2 years, is only available as nose drops. Mild Neo Synephrine, the medication of choice for children 2 to 6 years of age, is only available in squeezable spray bottles that permit backflow of contaminated drug from the nozzle into the bottle. Thus, for infants and children, I recommend that you purchase inexpensive pump spray bottles into which you pour the Little Noses or the mild Neo-Synephrine nasal spray liquid. They are also useful for dispensing Afrin, since they are generally of higher quality than the bottles sold with the product.
The pump spray bottles are sold in batches of 6 for a reasonable price. Often the cost of shipping is higher than the produce price itself. These may be found here.
Often, during the first days of a cold more decongestion horsepower is necessary. That calls for the use of SudafedTM, available in liquid for younger children, in tiny pills for older children, and in extended release pills for adolescents and adults. This oral medication may be used once to three times a day as needed. The sign that it is necessary is cough due to post-nasal drip.
Sudafed is a semi-controlled substance that must be purchased from the pharmacist without a prescription. The form of Sudafed on the shelves, so-called Sudafed PE, is not genuine Sudafed, is not an effective oral decongestant, and may be toxic to infants. Don’t buy Sudafed PE in any form. Be careful as the packaging for the product you want and that you don’t want is virtually identical.
E = EXIT MEDICATIONS, to finish off those lingering colds
Some individuals have incredibly drippy noses that continue running despite the absence of congestion during the middle and toward the end of the cold. For those patients, I recommend the use of exit medications.
The topical anti-inflammatory steroid sprays, including over-the-counter Flonase and Flonase Sensimist help to dry up the nose and, for persons who are sensitive to the topical decongestants, neutralize any irritation and so-called rebound congestion. Topical nasal steroids, particularly Flonase, have very little absorption into the system making them quite safe for the one to two weeks they are used. They would typically be instilled once or twice a day following saline mist irrigation.
As “colds” drag on, the use of drying medications will frequently lead to sludging of nasal, throat, and airway secretions. This frequently leads to cough. The management of these situations requires the use of expectorant – cough suppressing medications including Delsym liquid for all ages and MucinexDM for older adolescents and adults. The expectorant in these preparations, guaifenesin, liquified the secretions, and the cough suppressant, dextromethorphan suppresses the continuing cough. These medications are given once or twice a day.
So, in conclusion, at the first sign of a common cold, you should use the four ABCD Program agents three times a day. These may be taken by adults or administered to children very quickly three times a day: first thing in the morning, during the mid-day or afternoon, and at bedtime.
The program agents are:AforAnti-inflammatory (Advil),BforBacteria-killing (NeosporinTM or triple-antibiotic ointment),Cforcleansing and chasing, D for discongestants, and E for exit medications.
Don’t forget to follow the final all-important tip, which is really a commandment: NO NOSE BLOWING. Remember, you can “play” the common cold like a virtuoso musician. If the “cold” is lingering with clear secretions, the topical nasal steroid Flonase may resolve it. The cough is ongoing, an expectorant-cough suppressant would be useful. If secretions are discolored suggesting infection, an oral antibiotic may be necessary.