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I have been uo and around today and feeli like I am coming

out of the upper respiratory...
I have been uo and around today and feeli like I am coming out of the upper respiratory virus that lasted so far 14 days. Is it normal to feel muscle fatigue in arms? I tried to fold towels and could barely hold my arms up. I also feek very weak all over. I was reading about viruses and I read where viruses dont usually go more than 10 days
If you go over 10 days it must be bacterial and you should have antibiotics. I was never given any antibiotic and am concerned of complications do you think mine was viral since fever stayed low grade
.can virus last 14 days?
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Answered in 12 minutes by:
2/6/2016
Anthony Bray, MD
Category: Medical
Satisfied Customers: 10,341
Experience: 14 years experience in the field of Family Practice
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Hello again!

Yes of course a virus can last well beyond 10 days !! It depends on the culprit ...the specific infection ....many cold viruses may tend to clearcor improve in under 10 days but many may not improve as fast ...

Mono for example may last many weeks or be recurrent or chronic in some cases ....

It is not too uncommon to see muscle soreness with a viral infection and some sense of feeling weak as you recover is not that unusual

As long as you are getting better ...that is the main thing !! Our immune system is the main defense 's infection. Bacterial infections may have more bad potential than the more typical viral infection ( hence with antibiotics we are much less likely to die at a young age due to pneumonia than say 100 or more years ago!!

Still either recover from an upper respiratory infection is still recovery and that would not generally be much different as to recovery from a Bacterial or viral illness .....

Of you recover then your immune system is winning and that is the main thing at this point ....

The 10 days is a rough guide as to a doctor judging whether to start an antibiotic or not ....

About 80 percent of respiratory infections tend to be viral in nature and when this is the case you do not have benefit from an antibiotic

As long as your infection is now clearing then you would not seem to need an antibiotic now....

The more serious and lasting an illness may be then having some sense of weakness is common though

I hope that this is helpful for you

Let me know if you have further questions or concerns

Best Regards!

Anthony Bray MD

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Customer reply replied 1 year ago
Does being on an antibiotic during a long virus decreade the risk of a secondary bacterial infection from taking hold. How common is secondary pnemonia after something like this? I just get worried because i have autoimmine issues

Hello again,

No not really ...an antibiotic would not guarantee you protection from a secondary infection. The timing and possible pathogens are key to this question though.in some cases say if you were to have influenza then as you recover you would have a period of increased susceptibility say about 7- 10 days from start of that illness....common secondary bacterial pathogen may be streptococcus pneumoniae....so if we knew who and WHEN as to that roller coaster sequence then in such a case YES an antibiotic at the right time could be VERY VALUABLE !!

I have seen cases of bacterial pneumonia follow the flu.....

Now with more common viral illness you need to hold back and let your own inmune system work...overdoing antibiotics may just lead to bacteria resistant to most or in some cases all antibiotics ( highly resistant bacteria such as Pseudomonas may be selected out ....that could be even WORSE than giving NO ANTIBIOTICS .....

So it is not so simple a decision as to when to treat with an antibiotic 's holding back....

Blood counts can help.....

Tests such as sputum cultures may be helpful but it isn't too practical to test everyone with cold symptoms in the winter as such ( ends up being well over half of us !!)

So we aim for empiric treatment based on clinical clues much of the time --- fever / prolonged symptoms / signs of bronchitis or sinus infection / culture when symptoms call for it --- etc

It is a judgment call as to when to use antibiotics but try to hold back and not overuse them for the 80 percent viral infection cases ....

I hope that this helps and makes sense ...

It helps to treat a specific bacterial infection with the right antibiotic but it can cause problems to throw the wrong antibiotic at the wrong time ....

Example is the yeast infection ...common secondary complication of antibiotic treatment . similar to yeast we at times see adverse infections occur ....so care is needed ....culture guided treatment is best when that is feasible ....

I hope that this is helpful for you

Best Regards!

Anthony Bray MD

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PS please feel welcome to ask further questions as may be helpful for you !! Please do remember to give positive rating on this thread---

Thank you very much !!

Take Care !

Anthony Bray MD

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Customer reply replied 1 year ago
Is someone such as myself with a history of autoimmune issues susceptible to bacterial secondary pnemonia? Also do most of the people you have known to end up with this respond to treatment.

Hello again ,

No not unless you are on immunosuppresamt treatment ....If that is the case then yes you would be more susceptible to infections in general ....

It would depend largely on your treatment .....

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Customer reply replied 1 year ago
Ok. I am just incredibly weak today. I was most of the day doing a few things around the house. Really rough time walking up the stairs. A little winded and lack of strength. I have never been this sicknfor so long. Worse virus I have had.

Hello again,

Well I hope that you steadily feel better !

Keep an eye on symptoms ...recheck if you should have certain concerns such as new cough -- pain with deep breath or cough. Fever ...let me know if I may be of further help!

Take care! Feel better soon !

Anthony Bray, MD
Category: Medical
Satisfied Customers: 10,341
Experience: 14 years experience in the field of Family Practice
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Customer reply replied 1 year ago
I was thinking of getting some Robitussin DM over the counter for this cough. Coughed a straight 6 hours last night. No relief and no sleep. My dr. says he doesn't like to suppress cough because it keeps me from coughing up the phlegm. I just have to get some sleep. Does Robitussin DM have both a suppressant and an expectorant together? How do these 2 work together? Do you think this would be okay? Also what about vicks vapor rub? Strong smells usually bother me so I wasn't sure if I could tolerate this one? Would a humidifier be good? Would you recommend steam or cool mist?

Hello again,

Yes Robitussin DM is fine and should be helpful for you. It has a mild suppresant (dextromethorphan) and an expectorant ( guafenesin ) it will not prevent you from coughing if you need to clear your airways -- it merely takes the edge off of excessive cough . it does help to loosen mucus and helps you to clear airways .

I hope that this is helpful for you

Let me know if you have further questions or concerns

Best Regards!

Anthony Bray MD

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Customer reply replied 1 year ago
What if i really dont need the expectorant part. I dont feel like i have chest congestion. Is it still ok to take?

Hello,

Yes it is fine to take. The expectorant is quite harmless. No expected side effects from that... It is fine to take say Robitussin DM even if it is just a dry cough...

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Customer reply replied 1 year ago
Does an expectorate thin mucous out in lungs or throat area. Sometimes I feel mucous deep in throat but too thick to get up. Does it also help this.

Hello again,

Yes an expectorant helps to thin out mucus to its more normal thin and close to water state in which we are not generally aware of it.. this is true for BOTH the bronchial passages and the sinuses and throat...

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Customer reply replied 1 year ago
Hi Dr Bray.
As you know wed went to ent dr. Said I had some swelling down in my throat where drs couldnt see. So throat was much better Thurs and fri to the point I thought i was out of the woods. Last night started having pain again on the right side of my throat when swallowing but this time i felt the swelling and it was gagging me. I ate a few crackers to see if they go down and they did. Took chewable advil which made my throat burn. Took tylenol. Made pain better but still feel this swelling sensation when I swallow. No fever. Breathing fine. Coughed up a little thick yellow mucous this morning. Not much. Why am I having this? Was going to er but thought no use if ent dr is not there on weekend. Just feel like it gags me. What ever this is it is below site view when dr looks in throat. Everytime I try to cough up phelgm this morning swelling in throat feels worse. I definitely have swelling deep.

Hello again,

It sounds that you may be experiencing this late onset gradual worsening that to me is sounding more suspicuis probably for a secondary bacterial infection...since you have been thought to have had a vial illness and that was clearing but you are now having a second rise of more sore throat and getting more productive cough it seems I think it more likely that you may benefit from an antibiotic ....

It is fine to treat pain with Tylenol / cough and perhaps post - nasal drainage with Robitussin DM / sore throat with Chloroseptic as options

Re-evaluation soon may be helpful and it does not HAVE to be an ENT ....another doctor may or may not think that you would benefit from an antibiotic now ...that is increasingly my feeling as you describe the progression today but another doctor may well have different opinion on this point ....

If this is ongoing in the sense of worsening then I would advise follow up ( ENT -- primary care-- urgent care -- private office if possible preferred I think but ER if you feel to really need assistence....

I hope that this is helpful for you

I hope that you feel better soon

Best Regards!

Anthony Bray MD

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Customer reply replied 1 year ago
Where would the secondary infection be coming from? My only main symptom is this sense of swelling deep in throat. Coughing intensity has improved. Just coughed up al little phlegm today but everyting is centered around the swelling and no fever

When you get certain viral infections the tissues and mucus membranes may be compromised and not protect as well from bacteria that are already commonly in the area ...some bacteria of the mouth for example are more capable of bening pathogens ( invading susceptible tissue and causing problems such as bronchitis for example ) This is common pattern with influenza but less so with common cold .....

I hope that this is helpful for you and makes sense

Let me know if you have further questions

Take care!

Anthony Bray MD

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Customer reply replied 1 year ago
do you think the swelling deep in the throat that only ENT could is bacterial possibly? Would I have a fever?
Customer reply replied 1 year ago
When ever i talk swelling makes me gag
Customer reply replied 1 year ago
What is the area behind the tonsils that cant be seen upon exam. That is where swelling is. Do you think this can wait til tomorrow. Dont know if I should go to ER. Breathing seems to be okay. Food going down. Just gags me a little.

Hello again -

Several folds and pockets that can't be seen on routine oral exam. Tonsils have pockets which may accumulate pieces of food and bacteria at times ( white / cream colored clumps at times seem.) gargles may at times help to dislodge these ....

If you should develop an abscess of tonsil or just behind it then we might see swelling of tonsil but the underlying abscess could not be determined in routine exam....

Ulcers of lower aspect of posterior pharynx could be VERY painful ...

The scope procedure should have identified if that were the case however. .

Fever may occur with more serious infections but this depends on the person's age ( children run fever more easily ) type bacteria ( group A strep causes fever but many bacteria do not do much )

Most sinus infections would not ...

Tonsillitis may but enlarged tonsils more chronic often not ...

Bronchitis more often no fever // pneumonia yes usually Fever

Fever defined as temp above 99.9 ...( 98.6 plus or minus 1.3 degree normal range )

If you have ongoing pattern of increased pain of throat or increased cough then I would advise follow up ..

If me I would try to avoid the ER as your source of care ...IT is there if you really need access however

Continue gargles salt water or Listerine

Chloroseptic

Robitussin DM or similar

Tylenol ( ok to add or alternate ALEVE and that may be of help )

I tend to think that you are getting into more prolonged illness and symptoms more likely to benefit from antibiotic courese ..

I hope that this is helpful for you

Let me know if you have further questions or concerns

Take Care!

Anthony Bray MD

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Customer reply replied 1 year ago
The thing is the swelling and pain tend to move around. It was on both sides. Now just on right. I have a strange history with ebv virus. Very sick with symptoms for about 4 years in my late 20s. My tests throughout the years would show reactivation. I am beginning to wander if I am experiencing a reactivation which would explain the throat swelling. I wander if the cold virus caused ebv to reactivate. Fever is 99.1. When it gets to 99.1 I get achey.
Customer reply replied 1 year ago
I also have chronic inflammatory response. That could be causing this to hang on

Hello again,

Well I think that you will do better to do your best to DOWNPLAY your symptoms and not focus on them so much ( as best that you can)

It is very easy for people to magnify their symptoms ...

( yes even though I'm a doctor I HATE being sick myself too!!)

Try not to worry as much and give it more time through this weekend

If you truly should have an infection in need of an antibiotic then I think it will declare itself more in the next 2 to 3 days

If you trend better during this time then probably best to not treat or overtreat potentially with antibiotics

Inflammation affecting the back of throat and lower structures closer to the vocal cords is not rare or strange really ..this is a common occurrence ....

The temp 99.1 is not remarkable ( even if a bit high for you this itself would not be a concern )

It is normal to see fluctuations of body temp and 99.1 is not a TRUE FEVER ( even if it unusual for you)

If early week comes and you see temperature greater than 100.4 or very sore throat or productive cough getting worse then I would think you have more chance to benefit from evaluation and treatment ....

Common to get aches with wide variety of illness ...that isn't very specific if a symptom....

I hope that this is helpful for you

Let me know if you have further questions or concerns

Take Care!

Anthony Bray MD

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Customer reply replied 1 year ago
Went to see dr. My normal dr was out sick so I saw someone new. One thing he noticed was my cbc from last week white count was 9.9. Normal range up to 10. That seem to stand out to him. He ran it again today since almost a week has passed. If it is above 10 he will prescribe antibiotics. My questionbis can you have bacterial infection amd number not go past 10? He wanted me to try flonaise. He thought when the flonaise runs down my throat the ateroid in it may reduce the swelling in my throat that is far back. My question is I dont have much congestion. Will this irritate my nose at all if I dont need it for the nose?

Hello again -

1) yes it is Possible to have a bacterial infection with the WBC still below 10 ...the doctor seems to be looking for evidence of worsening infection that may be more suggestive of bacterial infection

2) Flonase tends to be low in side effects especially with short term use

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Customer reply replied 1 year ago
my cbc was 10.1. Would you treat for antibiotic with that number? Also my platelet count which normally runs in 247. Last week rose to 347 and this test shows it to be 418 now. Normal range is up to 400. What would cause my platelet count to go up
Customer reply replied 1 year ago
Also can viral infections also cause 10.1
Customer reply replied 1 year ago
Also my lymphocytes went down to 19. Normal is 20. And neutraphils went up 62 last week 68 now. Cut off 71

Hello again,

The shift of neutrophils vs lymphocytes is the main clue to distinguish viral vs bacterial infection

With your total WBC at 10.1 PLUS LOWER lymphocytes then that DOES SUGGEST BACTERIAL INFECTION---

So yes I think you warrant treatment with an antibiotic now

Platelet count may go up due to inflammation

I hope that this is helpful for you

Best Regards ---

Anthony Bray MD

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Customer reply replied 1 year ago
Where does the infection come from?. No strep. No pnemonia ear or sinus infecrion. Fever normal to low grade. How does dr know which antibiotic to use if nothing to culture. How do they know what to target?

Hello again,

There is not a single day that passes that you do not have millions of bacteria in the mouth and mucus membranes ....most of these represent NORMAL FLORA >> some bacteria can disrupt and start to invade tissues though ...this an INFECTION....this is of course a common occurrence ....a person may typically run through 3 or so respiratory infections in a given year ....

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