When Your Cold is Not a Cold

June 12, 2009

In our current age of economic recession and flu epidemics, experiencing hoarseness or a sore throat can conjure up worst-case scenarios. What I’ve noticed in more recent months is that more and more people with these two symptoms are coming in concerned about throat or lung cancer. If you feel a lump in your throat, the word lump itself can cause feelings of stress or anxiety. If you’re a smoker or a past smoker, the situation is even worse.

The other day a man came in complaining of an itchy, scratchy throat 4 days prior, with loss of his voice the next day. He didn’t have any other viral symptoms such as fever, chills, or muscle aches. Upon further questioning, he normally eats dinner early, but the night before all this happened, he went out to eat dinner late and also had some drinks.

Here’s the explanation to the sequence: Because of his upper airway anatomy, he was predisposed to acid reflux at night due to occasional obstructions and arousals. I talk about who may be predisposed and why this occurs in my book, Sleep, Interrupted. During an obstruction, vacuum forces can suction up small amounts of stomach juices into the throat, leading to various throat symptoms such as scratchiness, pain, hoarseness, post-nasal drip, lump sensation, and chronic cough. More often than not, doctors will give oral antibiotics in this situation, "just in case."

Many typical "colds" start of with a scratchy or sore throat, with no other viral symptoms. Later, it can "travel" up into the nose and sinuses, leading to nasal congestion and sinusitis. What’s happening here is that there was an initial episode of acid reflux, which first irritates the throat, leading to more swelling and congestion, aggravating the vicious cycle. It’s also been shown that your normal stomach contents (acid, bile, digestive enzymes, bacteria) can travel up into your nose and ears. Chronic inflammation can predispose any part of the body to true viral or bacterial infections.

The typical fevers, chills and sweats that are seen in this situation may suggest a viral infection, but you can also have all these symptoms from an involuntary nervous system reaction, which is called vasomotor symptoms. This happens when your involuntary nervous system becomes imbalanced due to a sudden change in your sleep-breathing status.

Even if you start off with allergies or a runny nose from a cold, eventually, the tongue will collapse more and perpetuate this vicious cycle.

So the next time you have a sore throat and are convinced that you have an infection, think again. In many cases, you’ll find that either you must have eaten late or drank alcohol the previous night. If not, then you may have a true cold. But since it’s been shown that having colored nasal mucous of throat phlegm does not necessarily mean you have a bacterial infection, things are not always what it seems.

How do your typical "colds" begin? I’d like to know.

Written by Steven Park · Filed Under Blog | Leave a Comment

Swine Flu Hullabaloo

June 10, 2009

I don’t mean to diminish the seriousness of our current flu epidemic, but I wanted to voice my opinion on this matter. As I wrote in my last blog, both my sons came down with severe flu symptoms over the weekend. They went to the pediatrician on Saturday morning, who basically told my wife that they had the flu and all they needed to do was to to stay well hydrated and give it time to go away. Needless to say, this infection has affected nearly every school (and parents) in dramatic ways. The good news is that my older son Jonas felt well enough to go on his end of the year class trip on Monday. My younger son Devin was feeling much better yesterday, but was not completely well enough to go to school today. Fortunately, my 4 month old Brennan hasn’t been affected…yet.

Officials do note that even if what my sons have is the Swine flu, it’s no worse than the typical flu that comes around this time of the year. What has made it worse, however, if the extreme state of panic and fear that the press has invoked, on top of the bad state of the economy. Stress can definitely make you more susceptible to infections, but not in the way that you think.

It’s known that in sudden stressful situations, your immune system is heightened, so you’re less prone to getting an infection. This makes sense since if you’re injured in battle, your immune system has to be on overdrive to heal all your wounds and prevent infection. Once the stress is gone, then your immune system goes back down to normal, but not without dipping below normal for a short while. This if the period when people get sick after an intensely stressful event. This also explains why people sometimes get sick on vacations when you’re more relaxed.

But if you have prolonged chronic stress, your immune system never comes back to normal. Your cortisol level (the stress hormone) is constantly elevated, and you’re going to be more prone to various kinds of infections.

I describe the sleep-breathing continuum in my book, Sleep, Interrupted, where your ability (or inability) to breathe properly at night while sleeping is directly proportional to how severe your symptoms will be if you catch any infection. The more narrow your upper breathing passageways, the same amount of inflammation that wouldn’t bother someone with larger airways will trigger a self-perpetuating cycle, leading to chronic or prolonged symptoms. So the more narrow your airways, the longer and more severe your flu symptoms, along with more secondary complications.

How about you? Do you get over colds or the flu very quickly, or does it usually last a long time?

Written by Steven Park · Filed Under Blog | Leave a Comment

My Adventure with Swine Flu(?) and Soybean Sprout Soup

June 7, 2009

Traditional Korean culture states that you should eat soybean sprout soup to fight a cold. My wife had just bought some soybean sprouts for my two sons, Jonas and Devin, who had just come down with severe flu-like symptoms (along with half their classmates). Unexpectedly, my older son Jonas was feeling well enough to attend his 4th grade graduation recital on Saturday. That left me taking care of my other son Devin, who was still very sick, and our 4 month old, Brennan.

Although I had dabbled in Korean cooking in the past, I had never made soybean spout soup. It’s always been a comfort food that my mother and my wife would make for me whenever I was sick. So with my wife gone, I decided to try making it. I couldn’t find it in any of our Korean cookbooks, since it’s such a simple ordinary recipe. I ended up Googling it and found a great Youtube video by Maangchi. She’s a middle aged Korean woman with a thick accent, but thoroughly entertaining, and definitely educational. I made my first soybean sprout soup without any trouble, and my son ate it with some rice. The next day, he was feeling well enough to go fishing later in the day.

After watching another few dozen videos on Maangchi’s site, I now have a new desire to start learning to cook Korean. One man from Germany commented on her website that he lost 92 pounds in 18 months eating only Korean food!

Along these lines, one frequent question that I get from patients is how I manage to stay so thin in my middle years. Even when I’m not exercising, I don’t gain much weight at all. My honest opinion is that a long as I eat at least one Korean meal every day (preferably dinner and lunch, if possible), I don’t gain any weight. I have to admit that I do eat quite a bit of pasta and take out food, but as long as one or more meal per day is Korean, I’m fine. When I’m able to run at least 2-3 times per week, I feel great.

Besides chicken soup, do you have any other traditional recipes handed down through your family that helps with colds?

Next time, I’ll tell you my take on the recent Swine Flu epidemic.

Written by Steven Park · Filed Under Blog | 3 Comments