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Too Sick To Work?

The alarm's buzzing ... but something's not right. You're sniffly, sneezy ... queasy. You have a common cold. Or is it something worse? Should you drag yourself to work? Or spend the day in front of the tube?

"Presenteeism" — going to work when you're sick — is as contagious as the flu. Millions of Americans are doing it. By one estimate, upwards of 75 percent head to work with the common cold or other problems.

Sure, sick employees keep the computer warm. But research shows that people sick with the common cold are not very productive. In fact, their lost productivity accounts for up to 60 percent of employer health costs — more than if they'd taken a sick day.

So you wake up with a common cold or some other ailment that's getting you down. What should you do?

To help you decide, Sharon Horesh, MD, instructor of clinical medicine at Emory University School of Medicine in Atlanta, gives her advice.

Just keep this in mind: "There's no antibiotic that can get rid of the common cold or flu or stomach virus," Horesh tells WebMD. "That's my pet peeve ... antibiotics only work with a bacterial infection ... bacterial bronchitis, pneumonia, strep throat, earache, pink eye."

Also, be careful about which medications you take for the common cold, says Nathan Segall, MD, a private practice allergy specialist in Atlanta.

The overwhelming majority reach for over-the-counter antihistamines, he says. But beware: Even if it's a so-called "non-sedating antihistamine" it could cause sleepiness and mental fogging, says Segall. "Some individuals will be more likely to have these side effects than others will."

That turns into a double-whammy: The common cold itself will affect your ability to concentrate because of clogged nasal passages and headache. Add a bit of drowsiness (whether it's from the pills or from difficulty sleeping). Pretty soon, you're making mistakes at the keyboard, barking at co-workers, generally feeling miserable. Even if it's just the common cold, maybe you should have called in sick.

To keep it from happening again, here's a checklist of symptoms that help you determine if you have a common cold or something else:


  • If you are sniffling — but not achy, not feverish — it's probably allergies. Get to work!
  • Sniffling, achy, tired, fever? You're coming down with the common cold or the flu. You are contagious in those first days. You are miserable, face it. You're not going to get much done at work. Also, you will recover quicker from the common cold or flu if you get some rest, says Horesh.
Chills, Sweats
  • If your clothes are getting drenched, you likely have a fever. (A warm forehead is a very low-grade fever or nothing at all.) When you have a fever, stay home — you're contagious! It's likely flu or, yes, the common cold. Drink fluids. Stay away from work until you feel better, Horesh advises.
  • If you have a fever plus white patches on your tonsils (say "ah"), it may be strep throat. It's highly contagious. You may need an antibiotic. See a doctor!
  • If it's a tickle in the throat or it feels like postnasal drip, the cough is probably from allergies or the common cold. Unless you've got other common cold symptoms, such as aches or fever, get to work!
  • If the cough feels deep, makes you short of breath, and brings up green mucus, it's likely more than the common cold — perhaps bronchitis or pneumonia, according to Horesh. See a doctor!
  • If your ear really hurts, if you can't hear well, you may have an ear infection. That's not contagious. Congestion from a common cold can also leave your ear in pain. You need to see a doctor to see which it is. You may need an antibiotic. Ear infections usually don't go away on their own, she says.
  • If your eyes are bright red, if there's creamy white stuff in the corners, if your eyelashes are getting matted, that's likely pinkeye, which is highly contagious. Don't go to work. See a doctor for an antibiotic. It's another infection that needs antibiotic help, Horesh tells WebMD.
Sinus Pain
  • Pain around the eyes, top of the forehead, the cheekbones, even the top of your teeth are signs of a sinus infection, but it could be a common cold. Call in sick and see a doctor to see if you need an antibiotic. Next day, you'll likely be able to get yourself to work since sinus infections aren't typically contagious, Horesh advises.
Tummy Problems
  • A stomach virus — nausea, vomiting, watery diarrhea, aches, low-grade fever — can lay you low for several days. For 24-48 hours, you'll be absolutely miserable. It can take up to five days to recover. Drink lots of fluids, especially water, so you don't get dehydrated, says Horesh.
  • For the first day or two, fluids and soup should be your diet. Then it's soft solids like mashed potatoes, applesauce, Jell-O, toast, and bananas. Slowly get into solid foods like meat. If you eat solid food too early, it just upsets your stomach more.
  • With food poisoning, vomiting and diarrhea usually occur six to 12 hours after you eat. The time frame is helpful for distinguishing it from a stomach virus. With food poisoning, once you vomit, you feel better.
  • Rule of Thumb: If you can hold down food, you can go into work.
  • Go to work if you sit at a computer all day. But if you're on your feet, you will have more swelling, so wait until you can walk with little discomfort. An Ace bandage will give support to an ankle so you won't re-injure it, Horesh advises. Anti-inflammatory pain relievers help most people, even if they're not in a lot of pain, because they reduce swelling; take it with food so your stomach isn't irritated.
  • An ice pack is a good way to reduce swelling without risking stomach problems.
  • Though headaches can be caused by things like the common cold, if you can't tolerate noise or light, you likely have a migraine and shouldn't be at work, says Horesh. If you haven't seen a doctor for your migraines, make an appointment. There's no point in suffering with them. There are drugs you can take for migraines that start working within the hour and shorten the migraine's duration.
Poison Ivy
  • This shouldn't keep you at home (unless your eyes are swollen shut). If the rash is still oozing, it's still very contagious. Wear clothes that cover it. Wash your hands frequently. If the rash is on your hands, avoid handshakes, she says.
  • If you share any office equipment — keyboard, phone — make sure it's washed after you use it. Of course, that advice holds for any infectious illness, whether it's poison ivy or the common cold, Horesh tells WebMD.

SOURCES: Sharon Horesh, MD, instructor of clinical medicine, Emory University School of Medicine, Atlanta. Nathan Segall, MD, allergy specialist, Atlanta.

By Jeanie Lerche Davis
Reviewed by Michael W. Smith, MD
© 2004, WebMD Inc. All rights reserved

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