sick this winter? mystery solved
this month i’m working at NBC in the medical center they have for their employees. NBC and Universal are one company, and they have their own fully-staffed medical center for their workers around the world, from the SNL grips to the CEO. the medical director here has taken me under her wing, and she is awesome, not only because she’s young and super fun to hang out with, but also because she is teaching me the ABCs of medicine, which ironically med school hasn’t.
in med school you learn about patients who are so sick they need to be in a hospital. at a place like Columbia this means they each have about 8 things wrong with them, like obesity, and obstructive lung disease, and heart failure, and liver failure, and maybe some weird infection because their immune system is surpressed because they had a transplant of some kind, so there’s like, a fungus ball growing in their brains and that’s why they have a headache. fungus balls or weird tumors or rare bacterial infections are NOT why most people get headaches. but as a result of my highbrow education, when a friend tells me they have a headache, those are the first things i think of. it’s embarrassing but honestly when people ask me what to do about headaches, or sore throats, or sprained knees, it’s sometimes a stretch for me to tell them what’s wrong and what to do about it.
this is why this month at NBC medical is great. i’m finally learning some of the basics. and while i’m at it, i think that it’s important not just for doctors and nurses to have the basics, but for you to have them too, so you can take better care of yourself. and so your own body isn’t some strange robot-entity you lost the user’s manual to. so with that, here are some bits on winter’s worst, strep and flu! strep and flu are the big winter bugs.
strep and flu both make you feel especially crappy, but there are big differences between them, starting with what they’re made of. strep (ie streptococcus) is a bacteria, and the flu (ie influenza) is a virus. one of my patients the other day, who is one of my favorite SNL guys, asked me, what’s the difference between bacteria and viruses? at the time i didn’t have a good answer, but i thought about it more and here are the differences that i think matter to you.
both viruses and bacteria can cause disease. but bacteria are 100x bigger than viruses, and unlike viruses they can thrive for long periods of time outside your body, like in the faucet or on the fridge handle. once they get in your body they live between your cells, not inside your cells. most important of all bacteria have teeny tiny internal organs, and these organs are the reason anti-biotics work - the drugs go in and jam up bacterial guts in various ways, so the bacteria get sick and die and mopped up by your immune system.
viruses, on the other hand, are way smaller than bacteria. in this way they’re more fragile, but in another way they’re hardier because they can hide - viruses literally live inside your cells. also, viruses don’t have internal organs, so anti-biotics don’t work. the only way your body can get rid of them is by killing the cells they’ve set up house in. lastly, viruses can’t live on surfaces like the bathroom doorknob all by themselves - they have to be inside you or your liquids to survive. so for instance, the way you get the flu is literally by inhaling somebody’s sneeze drops. really. the virus is in the drops. this also explains how HIV is transmitted in body fluids like blood, but not from touching someone who has it or their stuff.
unfortunately when it comes to a virus as catchy as the flu, some people don’t wash their hands after they cough or sneeze into them, and then they go slime the bathroom doorknob, and if you are unlucky enough to get there in time you get the virus-loaded drops on your hands and then you go and touch your face or bite your nails or grab the mouth of your kleen canteen and get the flu that way. all great reasons to cough into your elbow and sneeze into a tissue instead of using your hands as a hanky, and to wash your hands a lot.
if you really need more than than, check out this explanation
what does this mean for you? well, in terms of what bacteria do to you, i think of it this way - they cause crud. by crud i mean pus and mucous and the nasty greeny-yellow stuff you cough up when you have bronchitis or sinusitis and the stuff that weeps out of an infected cut or a zit and the white junk that sits on your tonsils when you have strep throat. ick. i saw the nastiest tonsil the other day… this poor girl. it was this red swollen wet blob in her throat covered in white goo bits. yuck. (that photo isn’t her)
viruses cause lots of different diseases, from flu to measles to HIV. but when it comes to the winter bugs like the flu and the common cold, think fever, aches, clear stuff coming out of your nose, and dry cough. essentially, if you’re not snoting out or coughing up yellow/green stuff, your doctor isn’t giving you antibiotics. or at least they aren’t supposed to.
STREP! do you have strep throat? these are the 4 things you should have. 1. sore throat, 2. fever, 3. swollen glands, 4. NO cough. the biggest tip off is the sore throat is happens all of a sudden, like it’s really bad and out of the blue. if you’re coughing a lot or super congested and your throat hurts from post-nasal drip, you probably don’t have strep throat, and you probably don’t need antibiotics.
what strep can unfortunately do too is close off the tubes leading to your ears, from all the swelling in your throat, and so your ears may pop or feel full, and this may go away when things calm down. if your ears really hurt, or are draining something out of them, then they may actually be infected. either way get checked out!
FLU! do you have the flu? you should feel super tired and achy, like bodyachy and headachy, and definitely have fever and chills. maybe a runny nose, maybe not. your doctor can’t do anything for you, but if you’re on your deathbed and worried you have swine flu and you’re a kid or pregnant or really old, go in.
A COLD! do you have a cold? you probably don’t need this post for this, but just in case - stuffy runny nose, dry cough, maybe a headache, maybe a mild fever. basically flu light.
for the last two, all you can do is take care of yourself. lots of sleep and soup and juice and tylenol for fever and steam showers to soothe your nose and sudafed to open things up. you will be fine. wash your hands. for strep, you need anti-biotics, so go see a doctor right away and get a culture.
if you’re really really not sure, go see a doctor but hopefully reading this demystified some stuff.