Cough w/flem

My father is 70 years old and has been having this horrible cough for several months now.  He is a Diabetic, takes insulin twice a day, is on blood pressure medicines, uses albuteral in his breathing machine-4 times a day and uses the CPAP at night.  Every morning he has a terrible cough and it continues throughout the day-just more so in the AM.  He is constantly coughing up flem (phlegm).  He has tried several cough medicines, nothing seems to help.  His doctor has not been successful in getting it to loosen up.  I am looking to see if you have any helpful suggestions, new direction to take etc...I am concerned more now because when he coughs he gets coughing so hard and the flem (phlegm) is so thick it actually makes him choke.  He has been blacking out on occasion when he gets coughing/choking.  Any advise you could give me would be appreciated.    Thank You.

[National Jewish]

The onset of a chronic cough at age 70 is worrisome.  Your father should have a chest X-ray and a culture of his phlegm.  He should also have sputum cytology, and a blood count, to look for signs of infection.  If the recommended tests do not reveal a cause of his cough he should have an evaluation of his upper airways and sinuses.  If this is negative, he may require a bronchoscopy.  The cough you describe could originate anywhere in his respiratory system, from the sinuses (post-nasal drip) on down.  It could be caused by infection, a tumor or even by aspiration of a foreign body, such as food.

It is important for a new-onset, chronic cough that persists for months be thoroughly evaluated, especially when the person is elderly and even more so if there is a history of cigarette smoking.

[RTFLY]

Why is your father coughing? Is he getting over an infection or is he/was he a smoker? How is your fathers diet? I ask because, is this a man that will drink water and lots of it? Water is the best expectorant we know of. Is the phlegm discolored at all?  If your dad was or is a smoker, that could certainly explain his cough and morning phlegm production. But if this has only been going on for a few months, that is why I ask if he recently may have quit smoking or had a recent infection. There is a drug that is called Mucomyst(acetylcysteine)that can be combined with Ventolin(albuterol sulfate) in a nebulizer. Mucomyst is a mucolytic that acts to thin out secretions that are exceptionally thick. Maybe ask your fathers doctor about this drug and see if this may help your dad. Again, water is the best. If your dad can tolerate drinking more water, then see if that helps loosen things up(if your dad isn't on fluid restrictions). If not, see the doctor and find out if mucomyst may help your dad. I hope all goes well...take care.
                                                JCI RRT RCP

[pjcag]

I have chronic bronchitis and allergies. I was having the same problem...not so severe though. After many meds, he has me on an expectorant twice a day and (as you can see on an earlier post) atrovent since I was using Albuterol and it didnt help. Atrovent is anti inflammatory. Also as the other poster said, water, water, water. Tea doesnt count as caffiene can make it worse. Since using the Atrovent and drinking minimum of 64oz water for last 3 days, it seems like a miracle..hardly any plelgm at all.

[Concerned lady]

To follow up on all the good suggestions made, I hope your father will soon be seen by (at least):

--a good Pulmonologist (lung doc) to find out what's causing the cough & phlegm,

--a good ENT (Ear, nose & throat doc), also to find causes of the cough & phlegm,

--a good GI (Gastro-intestinal doc), in case the cough & phlegm are partially caused by gastric reflux,

--the doctor who prescribed the insulin for the diabetes,

--the doctor who prescribed the blood pressure medication,

And I encourage you to make sure that these docs talk to eachother, so each one knows what the others discovered, when they speak to and examine and test your father.

Bring your ideas and the others' suggestions to these docs & see what they think is going on.

I wish your father the best. I hope he gets correctly diagnosed and treated soon!