Chief complaint: The patient, who is a physician, awakened today with persistent sore throat, and now with a feeling of slight dizziness, weakness and muscle aches. Sore throat started on the return from Arizona 2 days ago. Patient had been exposed to several others with upper respiratory tract / viral syndrome symptoms while at a conference. Not prone to frequent infections, however has noticed some association between air travel and such syndromes. Echinacea (Nature Made) was immediately started, at a dose of about 1500 mg daily (250 mg every 3-4 hours), along with 1000 mg of vitamin C in the form of "Emergen-C", as well as chicken soup (lovingly home-made).
The dilemma: Your patient isn't too worried about the infection itself, as he's healthy and isn't prone to nor does he have a history of worrisome infections. His main concern is . . . should he go to work?
The process: This is a tough one for Doctor J. He knows what his mother would say - "honey, you need to take care of yourself!" He imagines his other colleagues toughing it out. He hems, he haws, he takes his temperature - that's helpful, it is 100 - still not quite enough. Finally, the answer comes in the form of a question: "If this were someone else - one of your colleagues - what would you advise them?" Easy - stay home, take care of yourself, you take care of people all the time.
The resolution: After calling and having patients cancelled for the day, and writing a contrite e-mail to colleagues (likely unnecessary but I couldn't help myself), I felt worse and worse for several hours. Temperature went up a wee bit, and down to normal since mid-afternoon with only ibuprofen in the mid-morning. Have continued the echinacea, which I'll do for the next several days. Usually I advise that patients not return to usual activities until they have a full day of improvement. In this regard, alas, I will not heed my own advise, and I will return in the morning. Hope that's OK with you.