Enoch Choi, MD  
Male, 46
Palo Alto, CA

Specialties: Family Medicine

Interests: sinusitis, Migraine, Low back pain
Palo Alto Medical Foundation
Urgent Care
Palo Alto, CA
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Is It the Common Cold Or Something More Serious?

Mar 13, 2009 - 31 comments

Common colds










swine flu



On Tuesday Mar 17, 2009, 03:00PM (EST) I'll be on a webchat answering questions about colds and flu:


Can you tell the difference between the common cold and the flu? How about bacterial infections such as bronchitis or pneumonia? According to the CDC, flu activity is just starting to pick up in the U.S. and could continue into April or May. As an Urgent Care physician at Palo Alto Medical Foundation, I see dozens of these viral and bacterial illnesses every day and I'll be available to answer your questions live at March 17, 2009 3:00PM EST. Join me to learn about the flu vaccine, antivirals, antibiotics, and alternative preventative measures such as humidifiers, saline drops and sprays, herbal supplements, and honey and find out whether these treatments are suitable for children, the elderly and other high-risk groups.

This has been an unusual year in that the flu has been picking up in the last few weeks, and will last into early summer.  The symptoms of influenza include cough, sore throat, runny or stuffy nose, and fever. Other common symptoms are chills, headache, muscle aches, fatigue (a tired feeling), and loss of appetite.   Fortunately, this year, there's plenty of vaccine and you'll have protection as soon as a week after getting your shot.  They flu shot covers the flu virus strain very well this year.  The shot is a better choice, since it's been hard to find Relenza, the antiviral medication that this year's strain is sensitive to.  Tamiflu has been so overused that this year's flu strain is resistant to it - meaning it won't help you if you took it.  This is important because in a minority of cases, the flu can lead to death from complications of pneumonia.

The common cold has less severe symptoms than the flu.  It's more likely to have the the symptoms of cough, sore throat, runny or stuffy nose, and fever without the chills, headache, muscle aches, extreme fatigue (a tired feeling), and loss of appetite.  It gets better with time.

A bacterial infection such as bronchitis, sinusitis, or pneumonia is suspected when you have a persistent fever (>100.4 deg F), and copious pus in your bronchi, sinuses, or lungs, which can be heard by a doctor on examination.  Other signs such as facial pain radiating to your teeth or rapid breathing with shortness of breath can help with diagnosis.

No matter if viral or bacterial, there are over the counter remedies that help: humidifiers, saline drops and sprays, nasal rinses, and herbal remedies.

I'll be happy to chat more about this with you!

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572651 tn?1530999357
by Lulu54, Mar 13, 2009
Hi Dr. Choi,
We're excited to see you do this first MedHelp chat.  Those of us over at the MS forum have been passing the flu bug around - well, I know we're not really sharing, but it seems our members all over this country have been struck with it the past 2-3 weeks.  The CDC could gather lots of samples from our group.

I would guess a big question that will be posed is if there is anything that can be done to tame this variation of the flu quickly to prevent MS patients from experiencing exacerbations or true relapses.  The other debate we constantly have is how long to wait before calling our doctor for treatment.

Thanks again for agreeing to be the first - it should be good.

My best,
MS forum Co-cl

242516 tn?1368223905
by Enoch Choi, MDBlank, Mar 13, 2009
Thanks for rooting for me!

To tame this variation of the flu quickly to prevent MS patients from experiencing exacerbations or true relapses the best way is to not get it at all - get immunized.  

How long to wait before calling our doctor for treatment, has something to do with how to tame this variation of the flu quickly as well. If you're seen by your doc within 48 hours of start of symptoms Relenza can help (or 2nd choice: tamiflu + either of amantadine or rimantadine).

Hope to hear from you tuesday!

168348 tn?1379357075
by ChitChatNine, Mar 14, 2009
I'll be there for certain!  Thanks for taking time from your busy schedule to help us learn about this!  Interesting to note that many on the thyroid community get symptoms in and around their thyroid with illness.  Not sure if it's just swelling, I think some get actual pain, and some actually have thyroiditis that flares with illness, too, I think.

We'll let our members on Thyroid know about this exciting Webchat and see you Tuesday!

co-cl thyroid

Avatar universal
by ravana, Mar 14, 2009
what about fever,sorethtroat,maliase????

Avatar universal
by clayton007, Mar 16, 2009
What about have had this since Dec.as well as my wife.Never have been this sick this long,and so many others as well.to this date I,ve seen no Cure from any doctor.

242516 tn?1368223905
by Enoch Choi, MDBlank, Mar 16, 2009
Ravana:   fever, sore throat and malaise are common with colds & flu

clayton007: you & your wife should be checked and consider a chest xray, pertussis screen and consider trial of inhalers (possibly steroids). probably not antibiotics if you've had mild symptoms for almost 4 months...

Avatar universal
by clayton007, Mar 16, 2009
Thanks Doc,
  We'll ckeck in with the our doc.

389974 tn?1331015242
by swampcritter, Mar 17, 2009
Swampy says -- Please don't cough on your computer during this chat. We don't want Dr Choi to get sick :)

Avatar universal
by sweetfudge, Mar 17, 2009
Hi  Doc Choi, I have always had probs with non stop sneezing and running nose and stuffy too. at times i feel i have no energy at all. not to mention strange feeling like my head is going to pop.sinus and alergy med. don't alway work. i recently had a baby and i think my symptoms have gotten worse.
what do you think?

168348 tn?1379357075
by ChitChatNine, Mar 17, 2009
GREAT Webchat Dr. Choi!  I learned a lot!

Here's the link to the archives from the wechat with Dr. Choi:   http://www.medhelp.org/health_chats/archive/2

One question I have is about taking the supplement Emergen-C .. you mention if one decides to use this product,  take <3 grams a day to reduce risk of side effect of kidney stones

I am a member on our MSK (Medullary Sponge Kidney) Community and am prone to calicum oxalate kidney stones.  What part of the supplement increases risk for kidney stones .. the Vitamin C or the Calcium?  Also what does 3 grams equal since it's listed on the packet for Emergen-C in mg's .. I'm not good at the conversion.  

Thanks -- I'll be certain to fwd this info to our MSK and Kidney Disorder communities to share with them along with the link to the archives!


572651 tn?1530999357
by Lulu54, Mar 17, 2009
Dr Choi,
Wonderful chat - I just read the transcripts and picked up quite a bit I didn't know. Unfortunately my plans to particpate live went by the wayside thanks for my husband having a heart attack this weekend! He's fine and will be home tomorrow - but it was quite the adventure.

Anyway, I wanted to tell you how refreshing it is to read those of you experts who have a sense of humor and share a bit of your personal life too with the readers here.  

My best,
MS Forum

242516 tn?1368223905
by Enoch Choi, MDBlank, Mar 17, 2009
ChitChatNine, the vit C precipitates out into stones i think.  3000mg is 3 g.

LGK54, so sorry for your husband's heart attack!  I always like to share my own life with my patients, and keep it lighthearted...

Avatar universal
by patricia190283, Mar 17, 2009
I have three children that and two of us adults that have had the stomache virus but continue to have times of stomache upset or vomiting and rash and at times of diariah could it be a bacteria cause also the gas is released quite a bit
please help a single mom to know what to do.

242516 tn?1368223905
by Enoch Choi, MDBlank, Mar 17, 2009
bacteria is a rare cause of intermittent abdominal pain, vomiting, gas, and rash.

it usually passes on it's own

if it doesn't, see your doc!

242516 tn?1368223905
by Enoch Choi, MDBlank, Mar 17, 2009
uh.  i said it's not likely bacteria.  what's your question?

Avatar universal
by reddincali, Mar 18, 2009
Dr. Choi,

I keep getting 'sick' with sore throat, running/dripping nose, chest congestion, low grade fever.  I've been sick 5 times in the last 6 months.  I have allergies and asthma.  I workout 4 days a week 1 1/2 each time, eat fairly heathy, wash my hands constiantly and yet I still get sick!  I just want my life back. :(

242516 tn?1368223905
by Enoch Choi, MDBlank, Mar 18, 2009
please ask your question in a forum...

Avatar universal
by Terrie_TTC, Mar 19, 2009
ummm...lets see, I had a headache, I've been feeling more fatigued, runny nose, took me hours to sneeze, like i had to sneeze but I couldnt from 10 am then i finaaly sneezed around 1pm, it was horrible. To top it off, im on pms. It could be my allergies, but im not so sure because i never have the urge to sneeze for hours... what do you think?

Avatar universal
by stanko87, Mar 20, 2009
Hi Dr. Choi, I have asthma and allergies and am living in a College dorm that is on the older side and doesn't seem to have very good circulation. I have a headache, mild chills (sometimes I feel warm though), a deep asthma cough (taking advair and salbutamol), constipation, poor appetite today and mild dizziness and I am also puking at times (mostly yesterday, it is very liquidy). Could this be caused by the dorm or more specically something in the dorm?

242516 tn?1368223905
by Enoch Choi, MDBlank, Mar 20, 2009
Terrie_TTC and stanko87 please ask your questions in a forum

Avatar universal
by jeffrinava, Mar 21, 2009
Have migraine , but know about that. Developed  about 10 mths< 1 yr yr ago an achy allover "feel like a flu is starting to come on" but it stayed and stayed--never went on to develop a flu or other  higher level  symptoms  just -tired,--mild fever  99.9 -100 F or so by mid afternoon 9I checked it out on occasion) , but nothing  else except achy muscles joints, and stiffness.  Worse on barometric change--rainy, humid--hot or cold--humidity--was sleeping with 2 heating pads (one upper body --one at my feet)--so achy -- at times my husband would notice I was not standing up straight--I told him--I just "hurt all over" ibuprofen helped, but it is hard on the tummy-so I gave that up and I was taking LA  opioid  since 2000  related to complicated  migraine (refractory to usual meds for prevention---used them for 14 yrs before we went this route and mig. not rebound) but I wonder what this would have felt like had I not had this pain med  on board  

Well, this lasted  almost 7-8 mths. Woke up  2 mths ago and felt great.. and have felt fine ever since. I seemed to notice  a little less achiness  starting  about 3 mths back, but then all of a sudden--no achiness--not tired--still have migraine and that has gotten much better  with tx of course , but this felt entirely different thna migraine related stuff--did not seem to be aura -related or mig. related at all.

. Can  a nonspecific virus --maybe that causes this feeling  last this long? There was one time--way back in the late 1990s when I felt the same way (but only for 4 mths or so)---and then it went away. Had not thought about this  past episode of almost the same feeling until  the  latest. One may have nothing to do w/ the other (oh, do not take statins or any other thing that has muscle aches, etc  associated with it). My FP just thought it was early OA--stiffness etc, in jointsand I did not really pursue the issue  once he said most likely OA--but why  would this  just vanish if it were OA or and arthropathy or related to soft tissue problems?  Many Thanks. I'm really glad its gone. But it just seems odd. I was never really worried once told it was OA--but to suddenly vanish--seems odd. Again.Thanks.

242516 tn?1368223905
by Enoch Choi, MDBlank, Mar 21, 2009
jeffrinava please enter your question in a forum

389974 tn?1331015242
by swampcritter, Mar 24, 2009
Here is the most recent influenza update from the MMWR:


Thanks for spending the time to do the chat, Dr Choi!

Avatar universal
by kshavp, May 11, 2010
About 2 years ago all of a sudden I had a bad gas problem in reguards to burping. The gas buildup in my stomach actually made me feel like I was having a heart attack, I had a severe cheat pain on my left side - to the point where my left arm was tingeling.  However, I found that when I started to burp a lot the pain went away.  However now the side of my chest had a throbing pain.  I went to my doctor and he said the severe gas caused the discomfort and I somehow pulled a muscle on the side of my chest.  He gave me some anti-inflamatory's and the pain went away.  Now almost two years later the same problem came back.  The gas preasure pulled that muscle again. I'm wondering if you ever heard of this kind of discomfort from gas pain and what it might be.  It does seem that whenever I feel like I having a heart attack that simply releasing the built up gas by burping makes it go away.  It also seems that I get light headed every now and then but my blood presure has always been good, but I think that might be dehydration.

Avatar universal
by ryan258, Jun 20, 2010
Hi, I am 26 years old. Up until this time last year, well april, I was healthy. I weighed 175lbs and I was attending the local gym 3 or more times a week religiously.   At that time (april) I began to get "hot flashes", Where I would have to sit in front of a fan or turn on my car to cool down before I would black out or vomit I then went camping and had a bad experience.  I had a (spelling) seaser and it felt like all the blood was leaving my arms and legs and going to the middle of my ribs.. Like right where they end in the middle.  That lasted 6 hours of me on the ground. I was put in a shower because I was freezing, but I was sweating real bad. Eventually the blood made its way back after an ambulance was called.  Ever since I have been having bad hot flashes still. I had rapid weight loss in sept where i went from 17 down to 135lbs, where I am currently holding. I can not eat normal food or it just comes up. I have discovered ginger tea with real honey to keep me hydrated and i make a non-stop supply of whole wheat banana muffins which stay down and dont constipate me too bad.  I have been on that exact diet for months now. I have been thru the cancer clinic with no answer and am on rabaprazole for heartburn. Which seems like it just helps me not throw up as much.   I am seeing the gasterologist in sept. Does this sound familiar to anyone? I am tired of waking up in hospital, with no answers and an iv in my arm to help get me hydrated. Please help.
Thank you

Avatar universal
by mrsjackson1996, Dec 18, 2012
what would cause my boyfriend to cough up blood, ears bleeding, head hurts, stomach pains, losing hair, body sore, tired all time time, weak , his body being very hot but hes freezing, not eating like normal, throwing up, and its been going on for a month we carried him to the doctor they said it was flu but were worried its something way more than this .... i'm worried to death that it could be cancer.. please help us please i'm begging you :( .....

535822 tn?1443976780
by margypops, Dec 20, 2012
Dr Choi, May I ask what your opinion is regarding the chem trails and the program 'Project Cloverleaf' many people seem to be getting sick with similar symptoms perhaps not as extreme as the above post.I do not see doctors addressing this possibility at all. The project bombards us almost every day with known toxins as part of their weatherisation program..If you would care to there is a video out there called "What on earth are they Spraying " be glad to hear your opinion ...thank you

Avatar universal
by jsmile, Sep 04, 2015
I'm not sure if this thread is still active but I'm currently a breastfeeding mom my of a 4 1/2month boy. Yesterday I woke up with a sore throat and sneezing. Today the same thing but also a stuffy nose,headache, forceable belching and shortness of breath(after a sneeze) what should I do? What can I take seeing the fact that I breastfeed?

Avatar universal
by traceylanddd, Nov 24, 2015
Omg.. I have been online all night..
My teeth are falling apart..  I practice good hygiene and to look at me you would think I had braces as a kid and have beautiful teeth
I am well educated, but I do drink..beer is my drink of choice.
My research on line has led me to believe that my inhalers may be causing my rapid tooth decay.  I have COPD.. was diagnosed with asthma at age 17.. am now 47.. been on Ventolin since 17, Spiriva and Advair for approx 20 yrs.
I have used Beclaforte, symbicorte, flovent.. which have all been replaced by the above .  I have repeatedly been prescribed PREDNISONE.. which I know is a dangerous drug.. but due to the fact that I am a social smoker and have normal outside allergies.. and have now .. in the last 3 yrs added bee stings to that list..am now suffering from severe tooth decay. I take vitamins, eat pretty healthy, I brush my teeth regularly.. sometimes 3 times because of the gaps and chips because of the pain when food gets stuck between them.  My teeth are now falling apart, rotting, breaking... Why????????  what can I do or not do... I am not ready for dentures... They look nice in the front. .. but they are falling apart!!!!!  Can you help.. I need some solid medical advice. Thx

16508544 tn?1448649854
by SickofDox, Nov 27, 2015
Check to see if there is some class action lawsuit against the manufacturers of the inhaler med, but I suspect Prednisone as it is hard on the bones.
I'm from Wisconsin and I've never met a regular beer drinker with good dental hygiene who's teeth were cracking away. Take calcium and vitamin D3. When was the last time you had your blood levels drawn? If there is a lab called Theranos in your state you can get lab results and draws on your own thin dime and cheap. Face it-- You will need veneers or total implants. Having teeth to chew properly and ear raw fruits and vegetables is essential to your physical health. Having a nice smile is essential to your emotional health. If you are well educated then hopefully you have the income to supplement your dental procedures. And for heaven's sake, do whatever you can to stop smoking socially! Tell your buddies that it is gross and walk away. Just look up the list of things that it does to your body and 2ndhanders.

Avatar universal
by Vendetta2016, May 02, 2016
No thanks on the  poisonous flu shot that contains more bad ingredients then good as well as mercury , oh let's not question the motives ,greed of the pharmaceuticals and trust medical peers! the dumbing down of Docile people!

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