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Old 07-25-2006, 07:04 PM   #1
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Chronic/gagging cough

Hi everyone~

I'm desperately looking for answers. Long story short I went to my Dr with a cough that I've had for about 3 months. She treated me for everything from Sinus infection, to allergies and asthma. I have never had allergies before, nor have I had asthma. The only thing that got rid of my cough was an oral steroid, but the cough came back after a week of being off the steroid. I was finally refered to an ENT who looked down my throat with a camera and said he saw signs of acid reflux and he put me on Prevacid twice a day. This seems to be helping some. My cough is a deep cough which leads to gagging, dry heaving and 2 times I've gotten sick. I haven't read anything on LPR that mentions such a gagging cough. I realize everyone is different and symptoms can be different but was wondering if anyone else has this. I cough that hard because it's the only thing that gets rid of the burning I feel in my throat. My ENT said it would take 6-8 weeks for my throat to heal, but how can it heal if I can't stop the coughing and gagging? I work in customer service and I'm on the phone for 8 hours a day. My job is very stressful, which I understand doesn't help reflux. I'm 36 years old and have never had such problems so I am totally thrown by this. I had a chest xray which came back normal.
I've been reading these posts for a couple weeks and wish you all well and pray for the answers you are looking for. I will not rest until I find answers for myself. Thanks for listening.

 
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Old 07-26-2006, 07:55 AM   #2
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Re: Chronic/gagging cough

A severe and unrelenting cough is indeed one of the 2 major symptoms of LPR. Your symptoms are exactly the same as mine were before I was diagnosed and treated. You are on the right path with a PPI twice a day, but if Prevacid doesn't work, try Nexium, 40 mg, 2x per day, taken at the same time, for a total of 80 mg in the morning. This is the regimen that worked 100% for me. I've been on it for 4 years now.

 
Old 07-26-2006, 01:54 PM   #3
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Re: Chronic/gagging cough

I know it is hard for you. I work in a job where I have to talk all day, too.
I have been out of work since 6/25/06 with this coughing LPR. Hope I can return soon and hope they "hold" the job for me, but who knows, this could return at anytime and I would not be able to work/talk again. I know how frustrated you are, because I am too. You know that if we STRESS over it, it will only make things worse.

You are in my thoughts!! Hang in there.

 
Old 07-26-2006, 06:49 PM   #4
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Re: Chronic/gagging cough

Thank you for the replys. My ENT said to give the Prevacid 2 weeks and if there was NO change at all, then he wants me to see a pulmonologist to check my lungs. Just to make sure nothing is being missed. I will also talk to him about Nexium if my cough doesn't start to disappear soon.

aswander....how long did it take for you to see your cough going away? I'm just curious to know what kind of time line I should follow. How long do I give each drug before moving on to the next one that may or may not be my answer. I appreciate any answers/advice you can give me.

Sandy Beach...You hang in there too! I hope they hold your job for you. I try not to let the stress of work get to me, but that's easier said than done sometimes. Besides job stress, there's the stress of everyone hearing you cough and gag at your desk which only makes the stress level higher.

Thanks again for the help! I am so glad I found this board. If nothing else, I am with people that understand my total frustration with this.

 
Old 07-26-2006, 07:06 PM   #5
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Re: Chronic/gagging cough

ASantee,

Everyone here has had very individual responses to the PPIs, but for the most part, they have been somewhat helpful or very helpful. There are also individuals that dont' respond and noone knows why. Possibilites for non-responders include bile reflux and a chromosomal problem that is related to neuropathy and nerve problems.

But - you seem to have classic LPR with the really bad cough and hopefully it will respond to double dosage PPI therapy. Since response is so variable, it's hard to give you a specific timeframe to judge your progress by, but my best estimate is about 30 days. I think that by 30 days you should notice a significant difference.

I had LPR for 6 months without a diagnosis. For 4 of those months, I had been placed on 40 mg of Nexium per day (1 pill) which did nothing, and LPR was never mentioned. I just had a local ENT who noticed "some reflux". At 7 months, I found a much better ENT who diagnosed me and had me take 2 Nexiums together (80 mg) at her office. For the first time in 6 months, I stopped coughing in about 30 minutes. Just stopping the coughing was a major improvement, so I often say that my major leap was on the first day. Still, it took about 2-3 weaks for the runny nose and sinusitis-like condition to fully go away.

I was wondering if you cough at night? A lot of LPR patients feel best when lying down, treated or untreated.

I've personally tried Prilosec OTC and Protonix for short periods after starting the Nexium. Neither of those other drugs worked for me and I went back on the Nexium. I haven't been tempted to switch around at all in the last 2 years as it's hard to imagine feeling better than I do.

However, I do take an occasional Zegrid before bed when I have breakthrough reflux.

Give the Prevacid a chance - it might work. For some reason, most people here seem to be placed on Prevacid by their doctors first. It seems to be very very popular with the MDs.

However, if one PPI doesn't work for you, just move on to the next. Try each one if you have to at the double dosage level because PPIs are the best treatment out there for LPR. Lifestyle changes that I found important as well include not drinking soda, eating smaller meals, cutting out fried foods and fatty meats, and limiting chocolate. But I love food and eat everything at some point.

I hate to say this - but your job may be the cause of the problem - if you really have to talk 8 hours a day. Many singers get LPR - because they are overusing their vocal cords and larynx. You may be overusing your larynx in your job.

 
Old 07-26-2006, 09:18 PM   #6
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Re: Chronic/gagging cough

ASantee,
You are not alone. I have had a chronic cough for several years--the gagging (sometimes vomiting), dry, can't catch your breath, pulling rib muscles kind of coughing. Last year it lasted for 4 months before I got it under control and this year it was about 3 1/2 months. In general there are four things that cause a chronic cough
  1. allergies
  2. asthma
  3. post nasal drip
  4. acid reflux
It sounds like your doctor has been treating you for all of these items. Unfortunately for me, I actually have all of the above. It has taken trying various combinations of medications before I could get the cough under control. For me, when one of the items flares up it tends to set off the others so getting it under control is sometimes frustrating. For example: when I get a sinus infection it sets off my asthma which in turn sets off more acid reflux problems. I just have to keep telling myself that we will hit upon the right combination of things that work and watch what triggers an episode (if there is a noticible trigger) so I can avoid it. Currently I have been cough free since mid April (after a cough that began in January). My current course of treatment is: Prevacid 2x/day, Advair 500/50, Allegra, Singulair, Flonase and Astelin. I am also following a low acid diet and trying to avoid allergy and asthma triggers.

The other thing that can cause a chronic cough--it is actually nicknamed "The 100 Day Cough"-- is Pertussis (Whopping Cough). In adults, it can be difficult to catch your breath, but you don't usually hear the "whoop" that you hear in children. The cases of Pertussis have gone way up in the last several years. In my area it went up over 400% last year. Recent research has shown that the immunizations we received as children are not effective past pre-teen ages. There are new vaccines, but so far most insurances are not covering it for adults. Last year I had blood testing and nasal testing but both came back inconclusive--I was never sure what was causing the cough. After my multiple visits to the doctor last year between January and June I came to think I had a sinus infection (started it all), cold weather and bad air asthma flare up, indoor allergies, reflux flare up (definitely had the symptoms), a viral infection, Pertussis and the flu. I was miserable. (I have never missed a day of work or school for illnesses until this episode.) Ironically EVERY one of these items had a symptom of a chronic cough.

I hope I didn't scare you, but you should have some hope. When I found the treatment that worked for me I was nervous because I knew the cough would return, but it hasn't returned yet.

I will keep my fingers crossed for you.

Signed: Cough free since April.

 
Old 07-27-2006, 12:48 AM   #7
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Re: Chronic/gagging cough

hi there, this is Carol

I've been going thru the same stuff--coughing till I bring up copious amounts of phlem andd then also vomit my food. I will be seeing my Gastro specialist.been to neurologist as cough can also come as a side effect from certain meds.

Codine is a great part of T3. If you have any, take l or two and you may be able to settle down for the night. I am also going to a lung specialist who did a broncoscopy and got a biopsy. He found our I have a chronic lu ng inflammation and put me on 25ml of prednesone for l month then 4 pills for 2 weeks, thenn 5, then 2.

I may have to thru an open lung procedure to rule out cancer and some other things as the sample taken during a broncoscopy is quite small,

Perhaps you have asthma that needs to be treated.

Definately a lung specialist for you along with Pulmonary testing that can be arranged for him

Just found out today, I may have sleep apnea which would keep me gasping for air and coughing. That will mean going to bed with oxygen.

Sleep apnea has been known to cause stroke and heart attack because the body becomes so used to strain for oxygen.

 
Old 07-27-2006, 07:23 PM   #8
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Re: Chronic/gagging cough

I do cough a lot when I lay down, almost soon after I always seem to have a huge episode. Seems to be the worst when I lay on my left side for some reason. That's the side most of my sore throat pain has been for the last 3 months so I guess that has something to do with it. I'm starting to see a pattern of me coughing most in the evenings and at night. To top it all off, I've got some sort of pain in my middle to side of my back. I'm guessing I pulled/strained something while coughing.

I'm on vacation next week, I'm hoping being away from the stresses of work will do something good for me. I hope to reply very soon and sign my posts like others here as "cough free since......" Wish me luck!!

 
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