Does this sound like LPR?

[bikesing]

I'm approaching wit's end! I'm looking for opinions. Here are the symptoms:

- It all started one morning, Nov 1. I woke up to coughing and right side tightness. We had 2 humidifiers on in the room and there was so much humidity, there was a cloud in the room. My wife coughed for one day.

- This was Weds morn. The prior Sunday I mixed up 10 bags of concrete to pour a cement pad. It was a windy day and there was some cement dust in the air that I may have breathed in but I was fine until weds morn.

- Since then I've had a dry cough every day and a sense on the right side of tightness/very mild pain that I also feel when eating. It feels as if my right bronchial tube or esophagus are affected.

- I've been to the Dr twice re this. They seem to focus on the cough and not the esophagus. They prescribed an inhaler (Maxiar) and clariten the first teim. This did nothing. The second time ( a week ago) he said it was adult pertussis (whooping cough) and gave me an antibiotic (zithromax) and sent me for a chest xray. Since I have not gotten a call yet on the xray I presume it was clear. The antibiotic has not changed anything.

- My anxiety level is very high. I've had (by process of elimination) esophageal spasm (mild) diagnosed many times before because of right sided chest pain. Had many stress tests, etc. and it always goes away (after months!) when I settle down regarding it. This is very similar except for the cough.

- My sleep is not affected and sleeping does not make the cough worse. It's more of a feeling of a tickle which makes me want to cough.

- I sing in the choir at church and cantor and can sing for hours and be ok. I also can walk 2-3 miles and ride my bike and be ok.

- I've always been a throat clearer especially in the morning. This can be very annoying.

- Work stress was very high when this started and I was under a lot of pressure.

- My anxiety now is the cough sensation. If it's from the cement dust, how long will things take to calm down? If it's LPR, does this come and go? I've read re use of Nexium - are there OTC drugs that I can try?

Thanks so much!!

Tom

[Ol'Line Rebel]

Sounds like it could be either. Have any doctors told you it's probably because of the dust? Did you specifically state you were ever concerned about the cement incident, or even having reflux?

LPR certainly can cause a variety of symptoms up at the throat level, or anything related to the throat (we have to worry about inhaling acid/anything too!).

I hope you can find out!

[MountainReader]

It sounds like your areas of concern are on the right track. I am not sure of any really effective OTC meds though. My best recommendation is to find a doc you trust and keep visiting until you have figured out what the underlying problem is. There is always the possibility you have more than one thing triggering your cough. I have had chronic coughs also and I can share some of what I learned througout the ordeals.

My doc informed me that there are 4 main causes of chronic coughs: asthma, acid reflux, allergies, post nasal drip. Pertussis will also cause a chronic cough.

In the past two years I have battled various chronic coughs and I have had to use the process of elimination and testing to figure out the causes. I have asthma, allergies, acid reflux and at one point I was diagnosed with Pertussis as well. One of the worst times of my life was when I had a sinus infection as well as aggrevated asthma, acid reflux problems and Pertussis at the same time. Just as I was healing from those, I also got the flu. My cough lasted from the end of January until about mid-June. (I had 9 doctors visits in the first two months trying to figure out what was going on.)

My primary symptom for all of these conditions was a chronic cough. At times the coughing was bad enough that I couldn't catch my breath and I had aching muscles in my stomach and ribs. My right side was the worst also.

I have asthma that is treated with 3 meds year-round. My primary triggers are allergens, cold air, polluted air and inhaled chemicals. When triggered, the asthma cough can last for quite a while for me.

For the reflux (LPR), my main symptom is just the chronic cough. I don't have any heartburn. Single dose PPI's weren't much help for me. I had a PH test to confirm the presence of acid and was placed on Prevacid 2x/day. This (and watching my diet) has been a miracle treatment for me.

I had Pertussis about 1 1/2 years ago. I had both a blood test and a special nasal swab test done to confirm the diagnosis. Pertussis has the nickname of the "100 Day Cough." Even after I had been treated with the antibiotics, the residual cough lasted about 4 miserable months. I knew I had been immunized against this and was extremely surprised with this diagnosis. I have since found out that the immunizations don't last into adulthood and there is a new vaccine available for adults.

I thought the coughing would never end, but one day I was suddenly cough free.

Good luck finding your answers.

[bikesing]

Wow, thanks for the very detailed reply! I'm most curious about the 100 day cough or pertussis. My cough isn't really bad, but I just get this feeling of needing to cough which is totally non-productive and only occasionally. More annoying is the fact that it's totally on the right side and feels like it's associated with my esophagus. The chest xray was totally negative and clear, which was good news. I still wonder what role stress and anxiety plays. The Dr. said to give it another month so maybe he thinks it's the pertussis thing. I'll try to be patient. I really don't think it's asthma. However, this eveing I went and had dinner with a friend in a restaurant and he always wants to sit in the bar side where it's smoky. Well, the cough and right side annoyance become noticeable to me then. Now the question is whether my anxiety about that caused it or not.

Thanks again!
Tom

[MountainReader]

Bikesing, my chest x-rays came back clear as well. My cough is always non-productive.

If you continue to have concerns and don't think it is asthma, you may need to consider seeing an ENT or a Gastrointerologist.