Persistent cough could it be serious?

[rdd]

Over a month ago I started with a cough - it is somewhat productive, though mostly clear to white in color.  When the cough didn't clear I went to see our family doctor who said that my lungs sounded clear and that it was probably from a combination of liggering irriation from a cold and seasonal allergies.  

After another few weeks and the cough hadn't cleared I went back to see our doctor and again he said that my lungs sounded clear.  I told him it feel like it was settled in the center of my chest (mid to base of my trachea maybe).  He percribed a cycle of Zythromax in case it might be bacterial.  

The round of antibiotics was just finished and the cough is still hanging around.  I have been trying to take allegra or claritin to see what might help if it is all allergy related, but neither seem to make it stop.  

I am getting a little concerned as I used to do environmental inspections and there was always a risk for exposure to industrial chemicals - though this did seem to start with a cold that my children got also (though their coughs have mostly cleared up already.  

Curious what my next step should be, or if I should stay on the antihistamines to see if they might clear it up over a week or so of continual use.  Thanks for any suggestions.

[National Jewish]

Generally a cough caused by a cold lasts for several weeks.  If it were simply a virus, it would have started to get better by now.  In most cases if this were a bacterial infection alone, the Zithromax® (azithromycin) would have worked.  Even though the cold is gone, sometimes the cough lingers for 3 to 6 months because the cold has caused irritation of the airways of the lungs.  This irritation is similar to the way asthma effects the airways of the lungs.  However the irritation from the cold will eventually clear up without treatment.  When this irritation is treated with an inhaled steroid, which is used to treat asthma, it often clears more quickly.  If this is getting worse or is not getting better, I would suggest seeing your doctor and having a chest x-ray done.

Irritation of the airways of the lungs could also be due to an allergy or ongoing exposure to an irritant, such as pollution or smoke.  Antihistamines, like Allegra® (fexofenadine) and Claritin® (loratadine), should help if allergy is the cause.  Also an ongoing cough can be a side effect of a group of medicines used to treat high blood pressure called angiotensin converting enzyme (ACE) inhibitors.  In a person who has a normal chest x-ray and who doesn’t smoke the other common causes of cough are postnasal drip, gastroesophageal reflux disease (GERD), and asthma.

[rushabure]

Hello

You have described a condition that I exactly have, and also similar steps I have taken. Could somebody out there help??

[AndyRRT]

I think whats most important here is getting an accurate history on you. If you have experienced this type of cought in past seasons, or even over a period of years, this could very well be a chronic bronchitis. However, if this coughing is all together new, further diagnostic are needed. The fact that you have worked with industrial chemicals poses serious risk. Continue to observe your sputum production and pay particularly close attention to the color, consistancy, volume, and smell. Have you ever noticed any blood in your sputum? Any time you cough something up, don't swallow it right away. Be sure to look at it.

Make sure your physician knows about your work history and any other possible exposures you may have had. If he continues to be passive with your symptoms, don't hesitate to seek a second opinion.


Andy, RRT,CPFT

[AndyRRT]

Just some further notes on what exactly a cough is. A cough is generated by one of the 5 airway reflexes. The oropharyngeal, pharyngeal, laryngeal, tracheal, and carinal reflexes. The cough reflex is one of the body's best defense mechanisms. Irritations, pollutants, or an obstruction in the airways activates this reflex. A cough is basically a rush of air that helps clear debris from the airways in your lungs. In other words, if it doesn't belong there, the body wants to get rid of it.

A cough is more helpful if it is producing and expelling something, such as yellowish pus. This kind of cough is termed "productive" and usually should NOT be suppressed by drugs. Minor irritations in the throat can start the cough reflex, even though normal mucus/spittle are the only material to be expelled. (This is called a "dry" cough.)

Mucus from the nasal passages can drain into the throat and lungs (post-nasal drip) and trigger the cough reflex. Such coughs are also not helpful and may be treated with cough suppressants. I have seen the nurse that posts here comment several times on post nasal drip. You might want to take a look at a few of her posts and see what she has to say.

-Andy, RRT,CPFT

[Concerned lady]

I agree with Andy. Have you seen a Pulmonologist (lung doc) yet? You can telephone a LUNG LINE nurse, at 1-800-222-LUNG(5864) to get more advice. If possible, you could be seen at Nat'l Jewish, where they have a very good department of Environmental & Occupational Health.

You may have more hidden toxins/irritants in your home, etc., that you can find and remove, or avoid. Might you have a mold problem?

Overly dry air can be remedied with a warm mist vaporizer. Some air cleaners can be helpful, if irritating particles are in your air.

Gastric reflux can also cause chronic cough, and can cause post nasal drip.

There are lots of possible causes for your cough, and I agree that you should see some specialist docs to help get an accurate diagnosis. Good luck to you.

Concerned lady
<a href=http://cantbreathesuspectvcd.com>http://cantbreathesuspectvcd.com</a>

[RTFLY]

Since I live in an area notorius for allergy sufferers I can empathize with you.
If you want to really pursue this issue you could request to your doctor to have a chest x-ray done as well as getting some blood work completed. Your history is important and since you did not mention it in your story, I will assume that you don not smoke. If you have not been running fevers and the color of your sputum is clear, it may be just allergies.
Zithromax (azithromycin) is given in a dose pack that is usually five days long and it can most often knock out the common respiratory infections. There is also a newer three day dose pack that you may have taken.
If you are still concerned,  go back to see your physician. Take caution in taking antibiotics for small colds that may be attributed to virus' or allergies. Antibitoics will not do anything for these symptoms. I hope all works out for you. Take care and be well...
                                          J.C.I., BS RRT

[firestorm]

I also have had a productive cough for about 3 to 4 weeks now and have gone to my Dr. twice and they have not taken an Xray since they don't hear any lung sounds when they listen with the steth. and I continue coughing and now I feel very sick.  I just realized I work with a chemical that is always in the room with me and opened all day but that to discard it we must wear a splash proof mask and put in approp. containers yet I breate that all day and I just started my new job about 2 months ago.  I wonder if this could be the same type thing for me as well.  I wish you well.  Take care.  Youre not alone.

[[e-mail]]

Obviously I am well on the way to being a dead man!!

The cough is persistant, both day and night, and productive, giving a pale, diaphanous, grey couloured (non yellow) type of mucus.

I've had all the usual cough remedies (both prescribed and other), with absolutely no change in circumstances.

I gave up smoking 8 months ago after being a 45 a day man for 45 years.

I wonder could this possibly be a continued clearing of the lungs after such sustained damage?

OK, I was wrong!!!! But what then is it?

The reason I gave up the evil weed was that I was getting very distinct heart pains (I guess you could call it Angina).

After only weeks off the fags, I was clear of all pain, and despite the depression brought on by the Zyban, i have had no major symptoms (pain/discomfort) except for this lingering bloody (actually not bloody) cough!!!

It is really annoying that colleauges are saying to me get something done about that hacking cough, where when I was a smoker, I suffered no such ridicule! (And the rub is) I did not cough so much as i do now!!!

Any ideas???

[[e-mail]]

**** You!""!"!"

[[e-mail]]

**** You!""!"!"

[[e-mail]]

**** You!""!"!"

[re1sheets]

A related discussion, persistant cough was started.