A Day by Day Look at Flu Symptoms

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Day "0"

Dinner party
You can spread the flu before you know you have it. Thomas Barwick/Stone/Getty Images

This is a fictional story to illustrate the progress and effects of the flu. This is a tale of how things can go wrong and is not a blueprint for good management.

The flu affects different people in different ways. Not everyone who gets it will have the same symptoms.

Although the virus will not affect everyone in the same way, we will look at some of the most common ways it affects someone on a day by day basis so you'll be prepared and know what to expect if you or a family member gets it.

Day "0"

This is the day before any symptoms appear. Today, "Emily", who is 27, is feeling fine. She is attending a birthday party, having dinner with friends and unknowingly spreading the virus around. The day before her symptoms appear, Emily is already contagious.

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Flu Day 1

A woman sick in bed. Photo © Stockbyte/Getty

Today, Emily woke up feeling miserable. She is now running a fever, has a cough and a sore throat. These are the most common symptoms of the flu. Unfortunately, Emily also has asthma, which puts her at higher risk for complications from this flu. Today, she needs to call her health care provider to ask if she needs to start taking Tamiflu.

Unfortunately, Emily does not have health insurance or a primary care physician. She decides to wait and see how she feels tomorrow to decide if it is worth spending the money on a visit to the doctor.

How to Find a Doctor

If you do not have any conditions which place you at high risk for complications from the flu, you may not need treatment with an antiviral medication. 

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Flu Day 2

Coughing. Photo © George Doyle/Getty

In her second day with the flu, Emily was up most of the night coughing and her fast-acting inhaler didn't help much with her asthma symptoms. She is feeling miserable and says that even her eyelids hurt. She is still running a fever of 102 and finds it difficult to get out of bed.

Because she isn't feeling any better, Emily decides it's worth the money to go see a doctor today. She goes to a walk-in urgent care clinic where she is diagnosed with a flu-like illness -- likely influenza -- even though no test was performed.

Unfortunately, even though she is considered high risk, the health care provider who sees her does not prescribe her any antiviral medication and sends her home with cough medication instead. Antiviral medications are most effective if started within the first 48 hours of symptoms.

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Flu Day 3

Relenza, an antiviral medication to treat or prevent the flu. Photo © GlaxoSmithKline

On her third day with flu symptoms, Emily is still feeling exhausted, her throat is hurting and she still has a fever. Her cough is not really improving even though she has been taking cough medication. After talking to her friends who are health care professionals, she decides to go to a different walk-in clinic where she is finally prescribed an antiviral medication, Relenza.

Although Relenza is effective against the flu, it is an inhaled medication and is not recommended for people with asthma or other lung diseases because it can make their symptoms worse. Emily does not know this (although the person who prescribed it to her should have) and she starts taking it. Overnight, her cough gets even worse and she feels like it is getting more difficult to breathe.

When to See a Doctor for a Cough

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Flu Day 4

Tamiflu packages. Justin Sullivan/Getty Images News

On Emily's fourth day with flu, her cough still isn't getting any better. Her fever has come down and she isn't feeling quite as achy though. After talking to her friend who is a nurse, she calls the clinic where she was seen yesterday and finally speaks with someone who agrees that she should be taking Tamiflu instead of Relenza because of her asthma. Unfortunately, the pharmacy does not have any Tamiflu in stock so she will have to wait until tomorrow to get it.

Many people start to feel better by their fourth day with the flu. Emily is having a more difficult time recovering from the virus because she has asthma. She also learns that a friend of hers who was at the birthday party with her the day before her symptoms began is now sick as well. People with the flu may be contagious anywhere between the day before to seven days after their symptoms appear.

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Flu Day 5

Teenage girl coughing. Arthur Tilley/The Image Bank/Getty Images

On day 5 of her flu infection, the pharmacy calls to let Emily know that her Tamiflu is finally ready. Unfortunately, it is likely too late in the illness for it to make a difference for her. She was not able to take it within 24 to 48 hours of the onset of her symptoms and because it is quite expensive and she does not have health insurance, Emily decides not to get the medication.

She is actually starting to feel better anyway - her fever is gone and her cough is getting better. She is still staying at home because she doesn't want to expose anyone else to her illness.

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Flu Day 6

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Should you exercise when you don't feel well?. MjDigitalArt/E+/Getty Images

On her sixth day with H1N1 swine flu, Emily is still feeling tired but she is breathing easier and her fever is gone. She decides that she wants to get back into her routine and goes out for a jog. Her body isn't fully recovered from the virus though, so she doesn't make it far before she has to come back home.

Should You Exercise When You Are Sick?

Emily comes home and takes a nap and is feeling OK when she wakes up so she decides to go out to dinner with some friends.

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Flu Day 7

Sick woman in bed
Returning symptoms after feeling better is a sign of a secondary infection. Svetlana Braun/E+/Getty Images

When Emily wakes up on day 7 of her H1N1 swine flu infection she is feeling well. She goes to visit her family and believes she has recovered from the illness.

Later in the evening, she starts to feel run down and then develops another high fever and starts vomiting. She is also experiencing chest pain and her cough returns.

Although the flu is mild for most people, some individuals develop complications or secondary infections. If you start to feel better (like Emily did) and then suddenly get sick again, you should see your health care provider to determine if you have another infection, especially if you are considered high risk.

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Flu Day 8

X-ray of lungs showing left lower lobe pneumonia. Centers for Disease Control and Prevention

On Emily's eighth day with flu, she is experiencing a painful cough and a fever. She is very frustrated because she thought she was better, but now she is sick again and unable to go to work or school.

Finally, after another few days with the cough, fever and vomiting, Emily makes a trip to the emergency room because she just can't take it anymore. She is diagnosed with lobar pneumonia after x-rays are taken. She is given a prescription for antibiotics and sent home. She finally starts to feel better after another two to three days.

While Emily's story isn't typical for everyone -- and is definitely not an example of good quality care -- it is a look at what can happen when you get influenza.

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