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Old 01-17-2013, 07:27 PM   #1
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Worn out from constant coughing--long post

I am getting so incredibly tired of continually coughing. I've been coughing since September, but it has been worse the last few weeks. I literally spent over half of my day today coughing. I'm not talking about a gentle cough either. While my cough is dry, it is harsh. It goes on and on and I can't catch my breath. At times, I end up gagging or actually bringing up my breakfast the coughing is so forceful.

I've been coughing so long, my core muscles are tired (although they get a good workout ) and my bladder keeps getting more and more unhappy. My shoulders and neck have gotten so very tight too. I end up leaning over a lot when I cough because it is the most helpful position to help me get my breath back.

I'm not really wheezy now. My peak flow between coughing is actually between 300-400. My Pulmonologist doesn't want me on Prednisone unless I get to about 200. I've been using my nebulizer morning and night and inhaler in between. I'm on Dulera 200, Pulmicort, Singulair and Xolair. I've also been using Promethazine DM cough syrup as needed since December 31. I can't take it while I work during the day though because it does slow me down. I've tried tessalon perle and it doesn't do much for me.

I have a history of acid reflux triggering my asthma and a cough in general. I had a 24 hour pH test last month though and it came back normal. I had an upper endoscopy then also and it came back normal. I'm on Dexilant 60 and Zantac though.

Allergies have triggered my coughing at times, but my allergies are fully under control at this time. I've been on 5 1/2 years of weekly immunotherapy and the Xolair has boosted the effectiveness of the shots as well for the last 2 1/2 years.

I've had pertussis in the past and this doesn't feel the same.

I've been living with extremely cold weather and horrible nasty air inversions for the majority of the time since Christmas. The red air quality is supposed to last at least into next week. Both cold air and pollution are asthma triggers. I wear a double layer fleece mask and scarf when I go outside.

I do live in a dry climate, but have been using humidifiers and trying to drink lots of water to stay hydrated.

I'd consider taking time off work to visit family in a warmer climate, but I've missed 3 weeks of work since Thanksgiving for wrist surgery and a bout of flu over New Years.

I keep feeling like I should be going back to the doctor. I'm not sure there is anything more they can do for me though unless my peak flow actually drops significantly. My Pulmonologist told me a month ago that I knew what was causing my problems and I was already doing it and to see him in 3 months. My ENT/allergist helped me out last October, but I don't feel the throat rawness that I had then, just very dry. I had a normal chest x-ray then. I had a follow-up GI appointment that the doctor cancelled, but the assistant who called gave me my test results which were all normal. I'm not sure he would have much to offer. My Primary Care Provider added the Pulmicort and refilled my Promethazine 2 weeks ago. My lungs didn't sound too bad then though. I'm not sure who I would even follow-up with.

I just know I'm miserable and supposedly doing "everything right". I know nobody out there is an expert, but any suggestions would be really really welcome.
Thanks,
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Last edited by MountainReader; 01-17-2013 at 08:43 PM.

 
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Old 01-18-2013, 01:41 AM   #2
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Re: Worn out from constant coughing--long post

I can't believe your pulm will not give you the prednisone. I have had that exact same condition on several occasions and the only thing that would help is the pred. And lots of water.

Maybe it's time to get a new pulm.

 
Old 01-18-2013, 08:21 AM   #3
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Re: Worn out from constant coughing--long post

You have my complete sympathy, I have been there myself. My asthma manifests mainly with cough, although I do get wheezy and sob at times. But if I am just coughing, my peak flows are actually normally pretty good. When I get coughing non stop like you describe for more than a day or 2, prednisone is the only thing that will stop me. I have tried waiting and waiting to see if I can stop it myself, but if it doesn't subside pretty quickly, I always start a round of pred. My allergist told me that when I am coughing non stop like that, I should never let it go more than 2 days before calling him for a course of pred. I think that the coughing further irritates the already supremely irritated lungs and it is just not going to go away with help at this point. Is your dr refusing to give you pred for some other medical reason, or does he just not believe that you should get it without a low pf? I know that there are a lot of harmful side effects, but I always wondered how much damage we inflict on our bodies with that type of coughing. It really can't be good for us. I, like you have gagged, cracked a rib gotten pulled muscles etc. I would imagine that it increases the bp, heart rate etc., and think that all of that needs to be weighed against the dangers of a short burst of prednisone. Have you had one of your coughing attacks in your drs office any time recently? That's what happened that finally got the attention of my dr that my problem was more serious than just some random cough. If you haven't done that, try it, might work! I really think that your instincts are right, you have to see one of your drs. If they won't help, then I would say to try another, unless there is some other strong reason why they won't give you the pred. I hope that you are back to normal soon, I know too well how miserable you must feel.

 
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Old 01-18-2013, 09:43 AM   #4
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Re: Worn out from constant coughing--long post

I don't have any suggestions but I just wanted to say I'm sorry for all that you are going through and hang in there. It has to get better eventually, right? It sounds like you are really doing everything you can. I hope you find some relief soon.

 
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Old 01-18-2013, 05:43 PM   #5
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Re: Worn out from constant coughing--long post

Thank you for your responses.

You all bring up good points on the Prednisone.

As with Sue, at times my coughing is horrible and I struggle to breathe while coughing but at the "calm" times in between my peak flow isn't that bad. (300-400) Right now, my peak flow isn't that bad. A few months ago, it was much much worse.

I actually called my primary care today. They offered to refill my cough medicine again. He is willing to prescribe me Prednisone as soon as I request. I don't even have to go in, he said I could just call. I'm trying to avoid that if I can. My Pulmonologist is worried about having me take it too much, especially because the Prednisone can cause acid reflux to flare. I've had major acid reflux issues in the past and don't want a flare there compounding things even worse. For me, the acid comes up in a gaseous form and irritates my lungs. I even end up aspirating it at times. It also irritates my throat causing me to cough even more. It really is a viscious cycle.

I understand the doc thing. I've coughed plenty like this in front of my PCP, ENT and GI doc over the years. Most recently, a couple weeks ago. Unfortunately I've never been able to get into see my Pulmonologist when I'm actually in a flare. I've had some coughing at times, but it is far from my worst. Most of the time I'm pretty healthy. It usually takes 4-5 months to get in to see him. All of the Pulmonologists in my area are like that. You can bet that when I am bad that I initiate some coughing though. It takes very little to start the coughing. In fact, usually when they listen to the lungs and ask me to take a deep breath that is all it takes.
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Old 01-22-2013, 01:22 PM   #6
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Re: Worn out from constant coughing--long post

Hi Mountainreader

I can totally sympathize with the coughing and not wanting to go on prednisone
because it has so many side effects. I have acid reflux quite bad so I can understand.

I find it very difficult this week because it is very cold and a windchill on top of it.
The temperatures where I live tend to go up and down quite abit even in the winter. I use a neck warmer but I find it hard to breathe with something over
my nose and or mouth. I just cannot wait for spring.

I have one suggestion that works for me is heat on my chest which I use to ease the pain and tightness and it might help with the coughing.
I find a hot drink like tea with lemon and or honey may give temporary relief.
You may have tried these things already.

Good luck.

 
Old 01-22-2013, 07:41 PM   #7
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Re: Worn out from constant coughing--long post

I'm not usually a hot tea drinker, but I've been doing the hot tea, same as you. It is nice in the evenings.

I think you are getting some of the weather now that I've had out west. I've been in the single digits with a high usually in the teens for most of the days since Christmas. We are finally supposed to get up to the 30's this weekend. l'm looking forward to finally getting above freezing, even if just by a bit. I'm also looking forward to this nasty nasty air clearing out.

I don't get the wind chill as bad here as you do. I grew up with some bad windchills so I'm thankful for that. The cold temps are bad enough. This is the 3rd coldest January in our state's history.

I found a good fleece d loop mask that I've been using. I agree with breathing into something being a problem. It can be uncomfortable at times. I know it is critical to keep that cold air from my lungs so I keep wearing it. I also wear scarves, but they don't stay up as well.

Good luck getting through the weather this week.
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Old 02-02-2013, 03:38 PM   #8
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Re: Worn out from constant coughing--long post

So, I'm finally going a couple hours at times between coughs. It depends on what I'm doing though. I hope this means I'm starting on the road to being cough free.

January weather report here:

*22 days of "red" UNHEALTHY air quality. Worst air quality in the country.
* several other days in moderate air quality
* average high temperature was 19 degrees for the month (We had a warm front come through over the last couple days of the month and we made it up above freezing. Otherwise we were averaging a high of 16 degrees.)

Two of my worst triggers are cold air and polluted air.

We had several snow storms come through (a couple feet of snow in the valleys) and our air cleared out last week, but now the inversion is setting back in and we are in moderate air quality heading towards unhealthy again.

The sad thing is that the rest of the year it is georgeous here with all of the mountains. After months like this, it makes me wonder if I should seriously consider moving. I know that I'll end up with new allergy and asthma triggers in other places though.

I've had the cough since September, but I've really been worn down since Christmas when our inversion set in. Ironically, despite the "warmer" air in the 30's, better air quality and better breathing, I still don't have my energy back. I know it takes time, but this worries me. Things seem much worse this year than in past years and I've been through it a lot.

I know I haven't been performing my best at work. It is hard to multitask when you are constantly worn down.

I've been to my PCP (multiple times), ENT, Gastroenterologist and Pulmonologist and all agree I'm doing everything possible to address my breathing and coughing problems right now. I see my Pulmonologist again in a couple months. How long should I continue to put up with this? I'm not sure where else I should turn or if other treatments are even an option. My budget is very tight right now because I've been having to pay for a recent surgery and PT appointments, in addition to all of my other dr visits so I have to really consider when I need to visit the doctors again since my last few visits haven't resulted in any actual treatments when I leave.

Thanks for listening.
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Old 02-02-2013, 08:22 PM   #9
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Re: Worn out from constant coughing--long post

Have you tried the Cheratussin cough syrup? It really knocks mine out. I had to resort to it this past week with this viral bronchitis I've had. The coughing was about to do me in and I needed some sleep. Works wonders for me.

 
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Old 02-02-2013, 08:35 PM   #10
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Re: Worn out from constant coughing--long post

Thanks.

I've been taking Promethazine (Phenegren) DM pretty regularly since December. I've filled 3 prescriptions since January.
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Old 04-20-2013, 06:04 PM   #11
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Re: Worn out from constant coughing--long post

Next time ask your doctor for Tussionex , it's got hydrocodone in it and it's works my cough/bark (which has been mistaken for whooping cough since age 3 and I'm in my
40's now), it's super strong though but I find if I have that then I can actually sleep for a few hours...which helps

 
Old 04-20-2013, 08:00 PM   #12
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Re: Worn out from constant coughing--long post

Really sorry you are having this issue. The only thing that works for me when I get the cough that won't go away is Cherutussin. I'm on my second scrip this year and it's the only thing that let's me sleep. Two bouts of viral bronchitis and the pollen season from Hades are about to drive me off the deep end too. Hope you get resolution soon.

 
Old 04-22-2013, 09:17 PM   #13
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Re: Worn out from constant coughing--long post

Thanks for the advice.

Tussionex is actually probably the only the only cough medicine that really gives me some 'quiet time' in my coughing. Unfortunately, it really makes me drowsey and I can't work while taking it. Even just taking it at night, I was known to sleep through 2 loud alarms. Not good at that.

So, my cough lasted from September through Mid-February. I finally had a follow-up visit with my Pulmonologist a couple weeks ago. I mentioned to him that my PCP had reviewed my records and pointed out that I have a long history of starting visits to him in early October through the winter and my cough seems seasonal (aside from wildfire air in the summers). He agrees I have asthma, but still thinks that reflux is my worst coughing trigger. If it is primarily reflux, I don't think I would have so many years of seasonal type symptoms. I know winter inversions and cold air are both major asthma triggers. Either way, other than regular visits with him, I don't have any other treatment options at this point. I really really want to keep from having another year like this last one again. It is frustrating either way.

The good news is that I'm cough free with good PFT's right now.
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Old 04-22-2013, 09:21 PM   #14
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Re: Worn out from constant coughing--long post

Engineer,

I actually had Whooping Cough about 5 years ago. The coughing this year was almost the same. At one point, I questioned if I had contracted it again. Yes, I did get immunized for it last year when my insurance finally covered it.

I can certainly relate with the constant issue though. Even when we know better, it can still get the best of us sometimes when we get so run down.
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