I debated putting this in MPSIMS, but I really am curious so it goes here…
two weeks ago I went out and as part of the festivities smoked approximately 1.5 packs of cigarettes in about 3-4 hours… I woke up the next morning (sunday) without any noticeable effects, except some slight dehydration (to be expected… again on monday no ill effects, so I thought i was in the clear. Then monday night my throat started to get moderately sore. A cold had been circulating throughout my friends so i figured I was getting a cold. Then beginning tuesday all the way through this thursday (about 10 days) I had what was without a doubt the worst sore throat i’ve ever experienced.
Any time I tried to swallow (even just my own saliva) I received excruciating pain. It was impossible to eat anything. Any time I took a bite and tried to swallow my eyes would fill up with tears with the pain (even stuff like yogurt). I couldn’t even drink water without wincing with every sip. I tried choloroseptic spray, a regiment of 800mg ibuprofen every 8 hours, cough syrup… anything i could get my hands on… NOTHING stopped the absolutely awful pain. I went to the campus health center and the nurse told me i just had a cold (no strep) and to drink water and wait it out… I tried to explain that I couldn’t drink water or eat anything and she said “I’m sure its uncomfortable but just do it”
Finally after 10 days of complete incapacitation, it wore off and now I have the classic cold symptoms of scratchy throat, lots of phlegm (real wet cough), and runny nose (which suddenly doesn’t seem so bad after putting up with that shit for a week and a half)
I’ve had colds before, and remember sore throats, but never in my wildest dreams could imagine anything that bad or associate it with a cold… so what the hell was it? Was it just the really bad beginning to a standard cold? Was it related to the tobacco binge the weekend before (why did it wait 4 days)? Or was it some 3rd party infection that just opened me up for a subsequent cold?
somebody will be along with a more informed answer in a moment, but I’d think that the excess smoking could have irritated your mucous membranes (more than normal, that is) and left you more vulnerable to infection (including maybe a secondary bacterial infection).
Important but gross question: what color is the phlegm and/or snot? Is is thin and runny, or thick?
If it’s clear or white, you probably have a viral infection, in which case the doctor can’t really prescribe anything that will help you. If it’s yellow, green, tan, or some other funky color it’s probably a bacterial infection. In that case, antibiotics should help.
Sorry Holly, phlegm color is not really a reliable guide to whether something’s a bacterial infection or not.
Kage it would have been nice if they had tested for strep, but your symptoms do sound consistant with a lot of nasty viral throat and upper respiratory infections (note that I did not say ‘just a cold’). The severity and duration of a sore throat is not a good indicator of whether it’s strep or not.
Strep throat is typified by severe throat pain, swollen submandibular glands (we’re talking marble-sized in most cases), headache, nausea, and fever, generally over 101.5 degrees. There is generally no significant cough or congestion associated with it. A rapid strep test can confirm the diagnosis in 30 minutes, a strep culture in 1 or 2 days.
Viral infections, such as adenovirus, rhinovirus, and countless others can cause the very same symptoms, as can the Epstein-Barr virus, which causes mono.
I don’t know how smoking fit into the picture, other than by inflaming your pharyngeal tissue and knocking back it’s defense mechanisms.
I tell my patients that if their symptoms are not clearing in 2 1/2 to 3 weeks (after strep has been ruled out), to come back for a recheck.
She did test me for strep, didn’t find anything… Also I didn’t have any of those other symptoms you described, just excruciating sore throat… and now it’s more standard symptoms of a cold…
What sort of thing might I want to look out for in case its mono? I’ve heard things like “tired all the time”, but as a college student, I’m always tired all the time…
I used to get something like this twice a year or so (still do, depending on where I live)-- it would look like I had a terrible cold for weeks (doctors would say it looked like strep and bronchitis at the same time, although I had neither when tested-- incredibly sore throat, couldn’t sleep at night because of irritation in breathing, endless sinuitis, bleeding gums, etc) and it turned out that I was having very bad allergies to something (although I had been certain I did not have any allergies, until a doc put me on claritin to make sure). That could be a possibility.
I’ve just had the very same thing, although my sore throat was markedly less severe than the one you describe. I have been a veritable phlegm factory but I shut it down with comtrex. I am feeling better now. I hope you are, too. Definitely very strange.
I respectfully beg to differ, doc. No, it’s not a precisely reliable guide (if it was, sputum cultures would never be necessary) but it does give a good indication. After caring for ventilated patients for a while, I was able to pretty accurately guess the infective organism by the quality of the sputum. Thick, tan secretions always prompted the concerned pulmonologist to order a culture. Often, the doc would immediately start a course of antibiotics based upon sputum appearance alone so that treatment could begin before the lab results came back.
If sputum color and consistency weren’t important, there would be no need for the doc to constantly quiz me: “What color are the secretions? Quantity? Thick or thin? Blood streaks?” etc. in addition to asking for my assessment of breath sounds, ABG’s, vent settings, and so on.
Or maybe my nursing school really sucked badly, the hospital where I worked sucked badly, and all the doctors who work there are morons, too. I wouldn’t rule it out.
That’s certainly true for vent patients, and respiratory patients who you know are bringing up actual sputum, Holly. 99% of the ambulatory patients who I see daily and who complain of bringing up “phlegm” are just coughing up stuff that’s come down from the nasopharynx. Over the years they’ve brought me lovely samples of what they’ve hacked up, and I’ve cultured them, and they always come up “normal oral flora”. Nasal passage and sinus secretions differ significantly from pulmonary secretions.
In short, you are correct, if the sample in question is actually coming from the lungs, and I am correct if the sample is coming from the nasopharynx. In your line of work, most of what you see is actually sputum, while most of what I see, to put it technically, is “snot”.
A blessing on all nurses, especially critical care nurses!
kaje, mono is generally associated with a prolonged sore throat (often greater than two weeks), and very swollen glands under the jawline, and so much fatigue that one may sleep 18+ hours a day. Also fever is common. The spleen and liver may become enlarged, and in cases of mono hepatitis, jaundice, or yellowing of the whites of the eyes may occur. The blood test for mono generally doesn’t even become positive for it until the symptoms have been present at least two weeks.
If you fit this description, or aren’t sure, ask your health care provider (I hate being called a provider) about it.
No, it’s not a precisely reliable guide (if it was, sputum cultures would never be necessary) but it does give a good indication. After caring for ventilated patients for a while, I was able to pretty accurately guess the infective organism by the quality of the sputum. Thick, tan secretions always prompted the concerned pulmonologist to order a culture. Often, the doc would immediately start a course of antibiotics based upon sputum appearance alone so that treatment could begin before the lab results came back.