The Cold vs. the Flu: Dr. Aversa Explains on KOMO News Radio

Sound Family Medicine’s Medical Director, Dr. Marc Aversa, helped answer the question that many of us tend to ask this time of the year – do I have the cold or the flu? In his interview during KOMO Radio’s “Health Talk” segment, he explained to listeners how to determine the difference and what to do to find some relief.

Below is an audio clip as well as the transcript of the interview which aired December 10th, 2016.

KOMO News Radio Interview Transcript

Host: Alright, we’re back with our first segment with IRG Physical Therapy’s Health Talk along with Shannon O’Kelley and I’m Tom Hutyler and our first guest today is Dr. Marc Aversa, family medicine physician and medical director at Sound Family Medicine. We’re going to talk a little about the cases of the cold and the flu that invariably start to creep in at this time of this year. Shannon, you know all about it. It’s stuff you guys don’t generally deal with as you deal more in physical therapy but people around this time of the year can be exacerbated by the cold and the flu you just don’t feel good – no fun at all.

Let’s hear from Shannon O’Kelley and Dr. Marc Aversa.

Shannon: Dr. Aversa, welcome how are you doing?

Dr. Aversa: I’m doing great. good morning.

Shannon: Good morning and thanks for joining us. It’s a great day. We’re talking about my favorite subject, or my favorite subject to avoid and that’s cold and flu. And we’re in that season – the cold and flu season. So, before we start talking and getting into the cold and flu – what is it and how do we treat it – tell us about your practice. Your medical director at SFM?

Dr. Aversa: That’s correct. I work in the Puyallup office down there. We have a few other locations – one in BL and one out towards graham. I’ve been there 17 years.

Shannon: 17 years? Being a practicing physician and also the medical director, you wear several hats then, don’t you?

Dr. Aversa: I do. Yes.

Shannon: And that hat includes being the clinical but also you have this business aspect of your practice and you and I both know that healthcare is changing. That pendulum is swinging so you’re probably pretty busy.

Dr. Aversa: Yeah, we keep busy. [smiles]

Shannon: Nice, nice. How did you get interested in family medicine?

Dr. Aversa: That’s a good question. I knew I wanted to be a doctor from an early age but didn’t know what I wanted to do probably until I was in college. In college I realized that getting to know people over time and being able to use the power of that relationship to affect change is probably one of the more powerful things I could do.

Shannon: So, as a family physician, I’ve always thought it’s a great practice and it’s a great business to be in because you develop relationships with the family and that’s why they call it family medicine but you’re seeing kids at a young age and you’re seeing people progressing through life even into geriatrics so you cover and treat a large spectrum of patients.

Dr. Aversa: We do, yeah. We take care of people throughout their life. A good number of the doctors in our practice deliver babies and I do that as well. Unlike, I think a lot of family doctors these days, there’s a good number of us who still work in the hospital and take care of people when they’re sick in the hospital. We do a lot.

Shannon: Do you have a favorite part of your practice? An area that you really like to work in?

Dr. Aversa: Delivering babies is always a lot of fun.

Shannon: That sounds like fun.

Dr. Aversa: It’s one of the best things you can be a part of. It’s a miracle, really.

Shannon: It is a miracle. Hey, let’s talk about babies and let’s talk about as babies grow up and they go to daycare and they go to school. I was a parent and I remember the days my kids would come home with these infections and you wonder is this a cold? A virus? Bacteria? So, let’s start by talking about the cold vs. the flu because we’re in that season.

Dr. Aversa: Yes. Flu, I think a lot of people even with flu can be a little confused because this time of year a lot of people come in saying “Oh, I’ve got the flu” and they’re talking about a stomach virus – they’ve got a little bit of vomiting, some diarrhea and maybe a fever. That’s a stomach virus and people call it the stomach flu but it’s different than the flu which is influenza which is a chest infection where people get high fevers and a cough and a lot of muscle aches and they’re really quite a bit more sick with influenza usually than with people call the flue or the cold.

Shannon: And with influenza, the flu, it’s normally a virus. My understanding that it’s a virus.

Dr. Aversa: Influenza is a virus. Yes.

Shannon: If you get that chest congestion and that nasal congestion, do you normally have a running nose and are you producing fluid through the nose and coughing? I mean sometimes you talk about fluid and bacteria and the cause of that bacteria.

Dr. Aversa: Well yeah, we don’t usually use fluid so much as an indicator of bacterial vs virus anymore. Really, most of my patients when I see someone with influenza they usually don’t have a lot of nasal congestion or running nose. They usually are feeling it more in their chest.

Shannon: Good point. Now, is that the #1 difference you can describe to our listeners? If I’m sick, how do I know? I guess is the question is – is it a cold or is it the flu?

Dr. Aversa: With colds people are usually miserable and they’re feeling under the weather. When people come in with influenza a lot of them look like they were just hit by a truck. You walk into the room and you say wow, this person’s feeling really sick and they are having a hard time doing most of what they need to do just in the day to get through it. Whereas with a cold it’s, you know, kinda hard to work but they can manage.

Shannon: So we were talking about various symptoms and various causes of the symptoms. Particularly we’re talking about a virus vs. bacteria or flu vs. the common cold. What about this fever thing?

Dr. Aversa: Fever is part of what makes you feel miserable. It makes your muscles ache and people with influenza usually hurt a lot as opposed to the cold where they might just be a little achy here and there but the fever with influenza just tends to hurt people more especially adults. Kids, maybe not quite as much.

Shannon: Is it common to have a fever with the common cold or, generally speaking, the fever is related to flu?

Dr. Aversa: You can see a fever with both. I think more commonly we’ll see higher fevers with influenza than with a cold. We’ll see more of that illness reaction with influenza. It’s definitely a more severe illness. It’s something that, I think, a lot of people don’t realize but it’s a top 10 cause of death in this country every year. We see people sometimes get really sick even though most people who get it weather it and it’s just crummy and hard to do something for a week or two.

Shannon: Right, tell our listeners: your body creates a fever, there’s a reason why you have a fever, your body is reacting to something. Can you walk us through that fever process?

Dr. Aversa: Well the idea of the fever that we think of physiologically is that your body’s immune system is trying to fight something off and to make the environment in your body a little less hospitable for the infection. It’s a little more complicated than that and there is a lot that goes on in the immune system in terms of what a fever is but it is partly to make it miserable for the virus and for you.

Shannon: Yeah, your body is just trying to get rid of the virus. It’s fighting that virus. When should a fever be of concern?

Dr. Aversa: I think we normally aim to manage the symptoms of the fever. So using Tylenol or ibuprofen to help with the symptoms of the fever is pretty reasonable. But, the idea that the fever itself is the problem probably is no longer our thinking. We sometimes have heard of people putting their child in an ice bath or something like that to get rid of the fever and that’s probably not helpful.

Shannon: That’s kind of a myth. Hey, you know what we’re going to do right now? We’re going to put you on the family physician hot seat. Are you ready?

Dr. Aversa: Ready.

Shannon: I mean, we’re talking about probably a billion dollar a year industry is these over the counter remedies for colds and flus. Let’s talk about what you recommend. Give me the good old family physician – I’ve got the flu; I’ve got the cold – what do you recommend?

Dr. Aversa: I like to look at what the main problem is that you’re experiencing is and try to figure out is there something you can treat? If you’ve got nasal congestion from a cold, for example, saline nose spray or decongestant might be appropriate. I tend to lean more towards the saline nose spray because the decongestants make me feel a little shaky and miserable. If someone’s got a fever? Tylenol or Motrin. They help the fever but I try not to use the combination products because I just think you’re just as likely to feel terrible from the side effects of those three or four things in a product.

Shannon: Ok, as we wrap up what do you think about vitamin c, high doses of vitamin c when you’re sick? I’ve heard that, I mean, I think my dad did that. What do you think about that?

Dr. Aversa: Linus Pauling came up with an idea that vitamin c would be a great thing for fighting off illness and he was brilliant, I mean he won two noble prizes but he was wrong. Studies have shown it doesn’t help at all.

Shannon: Now I know. Great information. Thanks for your time.