Is my sore throat a strep throat?
DEAR DR. DONOHUE: What makes a strep throat something special? Is it more serious than other sore throats? How do you tell if it is strep throat? — L.W.
ANSWER: Almost half of all sore throats are caused by viruses. Treating those sore throats with antibiotics does no good but plenty of harm. It wastes money and contributes to the rise of resistant bacteria. Viral sore throats don’t usually raise body temperature above 101 F (38 C). They make people feel bad, but not so bad that they cannot swallow. Reddened eyes point to a viral infection, and cough is common with such an infection. Simple treatments get a person through a viral sore throat: warm tea with honey to soothe the throat, and Tylenol for pain.
Strep throat demands attention. Antibiotics cure strep throats, lessen the number of sick days, prevent spread and, most importantly, avert rheumatic fever. Strep throats have a sudden onset and make it quite difficult to swallow anything. Neck nodes enlarge and are tender. Fever usually is higher than it is with a viral sore throat. Headaches are common, but a cough is uncommon. Quick office tests often can detect a strep throat. If they can’t, the doctor sends a throat swab for culture of the strep germ. Penicillin is the treatment.
Rheumatic fever deserves a few words. Although it isn’t seen as often as it once was, it is still with us and it still causes great trouble. It’s a consequence of an untreated strep throat. It attacks heart valves and leaves them permanently deformed. It also can cause temporary joint swelling and pain; a red rash; small, painless beneath-the-skin bumps called nodules; and uncontrollable movements of the arms and legs. All of these resolve. Admittedly, rheumatic fever happens only to a small percentage of untreated strep throat patients, but the heart consequences are so great that treatment is extremely important.
Some people call every sore throat a strep throat; those people are wrong.
DEAR DR. DONOHUE: With all the talk about hand-washing to avoid the flu, how about alcohol wipes? Do they do a better job than soap and water? I like them because of their convenience. You don’t have to run to a restroom for a sink. — J.K.
ANSWER: Alcohol wipes are convenient. They do a great job of elimination germs that cling to the hands and fingers. The answer is: Definitely, use them.
Soap and water also do an excellent job. The water used for cleaning the hands doesn’t have to be hot. Tepid water is just as good, and prevents the hands from drying out from overheated water. The washing time should be 20 seconds or longer, the time it takes to sing the first verse of the “Happy Birthday” song twice. Dry the hands with a disposable towel, or let them air dry.
Which of the two is better? That’s a tough call. You’ll get protection from either.
DEAR DR. DONOHUE: I have always had 15 pounds of unwanted weight. My friend tells me that the reason I can’t lose it is the fact that I drink three to five Diet Cokes a day. I drink them to keep from gaining weight. I am very active and walk every day at a fast pace. The Cokes are always my first drink after the walk. Can they make you gain weight? — S.A.
ANSWER: Diet drinks have no calories. It’s impossible to gain weight without taking in more calories than usual.
However, one study has implicated diet drinks as a factor in weight gain. For me, the argument is less than persuasive. It says that although the drinks don’t add weight by themselves, they encourage the drinker to overindulge in other, calorie-dense foods. The sweet tastes of the artificially sweetened drinks make a person crave more calories. I find this hard to believe.
Five diet drinks a day is a bit overboard. Because they are acidic, diet drinks can erode tooth enamel. Cut down on the number you drink. And you can reduce the threat to your teeth by drinking with a straw and by swishing out your mouth with water after you have drunk one.
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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