Is it just a cold, or something more serious?
DEAR DR. DONOHUE: You'll think I'm an overprotective, helicopter mom, but I am never at ease when one of my three young children has what I think is just a cold. I have no idea if they need to see a doctor for something that could be more important. Can you give me some pointers on how to tell a simple cold from something that requires medical treatment? -- J.K.
ANSWER: Your question isn't silly. Most people wonder if their cold symptoms are indicative of something more serious, but they don't want to run to a doctor unless they are.
Adults can have as many as four colds a year. Children have even more, and older people have fewer. Older people are more immune to cold viruses because they have been exposed to many of them during their lives. They have developed antibodies and are somewhat immune. Young children, who have had less experience with cold viruses, are not as immune.
Rhinoviruses constitute a large viral family that is the most frequent cause of colds. There are more than 100 different strains of this viral family. That's one reason it has been so frustrating trying to develop a cold vaccine.
Typical symptoms of a common cold are dripping nose, sneezing, a mild cough, nasal congestion and a raw, slightly sore throat. One of the most important signs separating a cold from a more dangerous respiratory infection is the lack of a fever. A cold lasts from four to nine days. People usually stay somewhat active with a cold, and that includes kids.
Influenza, on the other hand, always produces a fever. Its cough is hacking and quite constant. Muscle pain and headache are present. People with the flu, including children, are not active. They want to lie down and forget about the rest of the world.
DEAR DR. DONOHUE: I am an 86-year-old woman with a swallowing problem. Food catches in my throat and makes me cough. An hour to two later, it dislodges and finds its way back into my mouth. It smells bad.
My doctor has looked into my mouth and throat, and says he sees nothing wrong. He advises me to eat only soft foods and to drink lots of water when I eat. I'm convinced something is wrong. What do you think is going on? -- B.W.
ANSWER: Your complaint has the trappings of Zenker's diverticulum. It's a pouch that has formed in the back of the throat. People with a Zenker's diverticulum have great difficulty swallowing due to the kinds of symptoms you describe. Liquids go down with ease; solids don't. The Zenker's diverticulum entraps them and ejects them later -- most of the time.
A diagnosis is made by having a person like you swallow some barium and then have an X-ray taken. The barium finds its way into the diverticulum. Doctors with special scopes also can uncover one.
You need to see an ear, nose and throat doctor.
DEAR DR. DONOHUE: I felt a lump in my right breast. My doctor examined it and sent me to a surgeon, who ordered a mammogram. After the mammogram, he did a breast biopsy. The report said I had a fibroadenoma. The surgeon said it isn't cancer, but wants me to have a repeat mammogram in three months. Why? -- E.D.
ANSWER: Fibroadenomas are not cancer. The lump they produce feels rubbery and can be moved around with ease. Cancers are usually hard and fixed in place.
The follow-up mammogram was ordered to be absolutely certain that the lump is not changing, something that should give you even greater assurance than you now have.
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Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.
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