Health Matters Blog

Upper Respiratory Issues Part 1: Head Colds

By John Todd, APRN, FNP

We’re deep in the season for head colds, chest colds, and flu and if you haven’t gotten a flu-shot, it’s not too late. Getting a flu shot reduces a person’s likelihood of needing to visit an Emergency Department by 50% during that flu season.

As a Family Nurse Practitioner, I note the weather changing from autumn to winter by the respiratory conditions that patients bring to the office. There’s that moment in the fall that we feel in our sinuses and lungs as the trees shed their leaves. Some of us barely feel it; some develop a sore throat with post-nasal drip; others develop a seasonally predictable sinusitis or bronchitis. Smokers often have the toughest time. There are things we can do to help sinuses do their job well and to help our respiratory system stay healthy.

John Todd, APRN

John Todd, APRN

Sore Throat: I think we all start to notice “something coming on” when getting a sore throat. I suggest using a gentle and safe antibacterial rinse immediately. It’s nothing fancy or expensive, just gargle four times daily with warm salty water – approximately ½ teaspoon of salt in four ounces of water. This should taste saltier than seawater and is both anti-inflammatory and antibacterial. You don’t have to have the salty taste linger: it’s ok to rinse and gargle with plain water afterwards. Oh, and I don’t recommend hydrogen peroxide, which can irritate tissues that are already sore.

What we call our “sinuses”, medically known as the paranasal sinuses, are the four pairs of air spaces located at the front of our head: behind our cheeks, deep in our nose, behind our eyes, and (the smallest ones) in our forehead. Sinuses are air spaces lined with glands that produce thin, watery mucus. When healthy, our sinuses have a layer of watery mucus throughout. We need our sinuses to produce thin mucus just as we need our saliva glands to moisturize our tongue, mouth and throat.

Healthy respiratory tracts from our sinuses to our lungs are lined with tiny short hairs called cilia that help move the mucus around, preventing it from clinging. If you’re a nonsmoker, your mucus probably moves around well naturally. Smoke a pack of cigarettes a day for more than five years, and those irritated mucous membranes can easily dry out, making the thick mucus much harder to clear away.

When someone says, “I’m having a lot of sinus trouble,” it usually means that the mucus has become thick and clinging due to allergies, virus, or irritants like ash or dust. The mucus has started to block the sinus opening, resulting in pressure behind the cheeks and eyes, deep in the nose, and in the forehead. Inevitably some of this sinus drainage travels to the back of the throat as post-nasal drip. It’s no longer thin and watery—we’re then calling it phlegm, pus, “crud,” or “green junk.”

Some patients have become accustomed to asking for antibiotics whenever they develop this thick, pressurized, persisting sinus congestion. From a medical perspective, we have come to understand that most head cold sinus congestion will resolve over 5–7 days regardless of antibiotics. Ongoing sinus congestion, which I refer to as sub-acute sinusitis, can cause a worrisome and persisting sinus pressure with thick, clinging mucus, including post-nasal drip.

For people seeking rescue from a head cold or lingering sinus congestion, I first recommend hydration and rest. Drink plenty of water to thin out your mucus and get plenty of sleep. Don’t spread the cold around – wash your hands frequently and consider taking time off work BEFORE your colleagues are made ill with your head cold. Speaking of transmission; if you have to sneeze; sneeze into the crook of your elbow, not into your hands.

There are a number of twice-a-day techniques that can help open up and reset the sinuses while helping to get that crud cleared out over several days. Check with your medical provider or pharmacist about mucus thinners, saline nasal rinses or nasal sprays. You may not be aware of this, but nasal sprays work best for the sinuses when you lean over the bottle and aim the spray toward the back of the head – that’s not how they show you on TV!

Next week – Part 2: Chest Colds. When is it okay to suppress a cough?

John Todd is a Family Nurse Practitioner with Putney Family Healthcare and Brattleboro Internal Medicine, members of the BMH Physician Group. He can be reached at 802-387-5581 or 802-257-2611