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Son constantly coughing
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Son constantly coughing

My son is 13 years old and is coughing every 15-30 seconds a loud violent cough.  He has had this cough now for four weeks.  It occurred back at the end of September for close to three weeks and was treated with his asthma medications (prednisone, Albuterol Inhaler, Flovent, Zyrtrec) and it finally went away.  It came back almost four weeks ago but much worse than before.  I am not exaggerating when I say he is coughing every 15-30 seconds, he is.  He can manage to fall asleep for a few hours at night but is woken up by it or it takes him hours to fall asleep at night.  We have been to the ER, Urgent Care, Primary Doctor, and an ENT.  First they said it was his asthma but once we realized none of the usual medications (listed above plus antibiotics this time) did not help at all they said it was probably whooping cough.  Pertussis test was done but came back negative.  A neck and chest X-Rays were done, nothing.  We have tried every cough medicine/home treatment you can name and they are not even taking the edge off.  We went to an ENT today and he was just as baffled.  He did a scope and said throat and vocal cords were normal.  Ears were squeaky clean.  We left today so discourage because it took two weeks to even see him and now he is referring us to a Pulmonary Doctor, who knows how long that will take.  Has anyone heard of this before?  My heart is breaking for my son.  He is miserable.  The cough sounds like there is a seal stuck in his throat but like I said pertussis was negative.  The only thing I did see on the internet was that Zyrtec can cause a cough, anyone hear of it causing this type of cough?  
Tags: cough, violent cough, Zyrtec, chronic cough
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Avatar_f_tn
  I really feel for you and your son!  I wish you guys all the best during this, the happiest and yet somehow the sickest time of the year.  
  
  I was diagnosed with asthma at age 9 or so, and it was bad all through my childhood.  I hope that your visit to the pulmonary doctor will be revealing - it's important to see if you can figure out what your triggers for asthma are (mine were always allergens like mold, ragweed, or cedar, and other common things like cat dander, dust mites; getting sick, intense exercise, changes in the weather -humidity, barometric pressure, cold fronts- any combo of these could be, well, frustrating...).  

  If you're not already, during the "bad times" of the year (typically from September/October to February) try charting how his lungs are doing with a Peak Flow Meter.  They can give you a heads-up real fast if something is going on so you can take action.  You might also ask the doc about if he needs an at home nebulizer for breathing treatments (great for the extra sick times of the year and emergencies).  

  Someone might refer you to an allergist at some point...  For me and my brother (similar problems -- I joke we have terrible DNA) it took a few years to get us on a good regime, and at some point, one of my doctors determined that my middle school, which I had just started, was infested with mold, and that was the cause of a great deal of my problems.  So if something new is going on with him, don't forget to check out the environments he spends the most time in.  If someplace is new or something has changed, it might be worth investigating.  I don't want to make you panic though.  The school wasn't condemned or anything - my allergy was just high enough to warrant changing schools.  And some of the other teachers and students who had mold allergies were able to put two and two together as well, and get some help.

  I'm wondering about his other symptoms -- is he having chest pain at all that is different from the asthma, or just sore from coughing?  There are, unfortunately, a couple of things it could be that won't really show up on X-Ray (however, I'm not a doctor, this is just me and my experience).  The first one I think of, because I got it at around the same age, although it came with coughing and an incredible amount of chest pain, is pleurisy.  Not a very popular diagnosis anymore, and typically only found in "old people," it is an inflammation of the pleura, or the tissue that surrounds the lining of the lungs.  It's very unpleasant, and also results in that dry "barking" cough.  That kind of cough is very distinctive, and although it sounds (and feels!) very bad, I am generally grateful to have a dry cough rather than a productive or "wet" cough.

  The things I can think to recommend maybe to help during the night are a vaporizer or humidifier (ask your doctor which type is preferred), and sipping warm water or tea if you really get going (just try to avoid dairy if you are having any mucus, as it can thicken it up pretty quick).  Asthmatics worst time of day tends to be between 2 AM and 5 AM, I had a doctor tell me one time, and based on my experience -- especially when sick -- it's very true.  Bedtimes are the worst!  Extra pillows can help, or if there is some way you can sleep in a recliner that is great too.  

  As far as the Zyrtec causing a cough, I haven't heard of that firsthand, but you might ask your pulmonary doc about Singulair -- it's a once daily preventative tablet for allergies and asthma.  I've been on and off it a few times and it is a good med.  My brother, whose asthma is worse than mine, has been on it for years.  I know there are a lot of new asthma meds out there, both for acute use and preventative, so hopefully you'll find something that works well for you guys.    

  Sadly, this time of year, for asthmatics, the cough is the last thing to go away when we get over being sick, and in my experience and in my family it has sometimes lingered for months.  It seems like the years we were better prepared for the season going in, the better we did, and the less the cough lingered.  I'm learning a lesson (again) this year -- I've been off my preventative meds for maybe two years, and after being sick over Christmas, catching a secondary infection, and a cough that won't quit, I'm ready to go live in my shower, which is the only place I get relief.  

  I hope that your visit is worth it, and that your son can get some sleep.  Take your questions for the doc, your "list of demands" so to speak, and don't leave until you are satisfied!  
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Thanks for your reply!   Alot of what you said makes sense and we've done alot of it.  He's been on Singular now for about 2-3 years.  I am going to ask for an allergist referral, he definitley needs that.  We just started charting with the Peak Flow Meter a few months ago, lung function right now is very good.  We do have a home nebulizer.  I have him use that right now because I feel like I have to do SOMETHING but it's not even taking the edge off.  In the past, it's cleared his breathing but like I said his breathing is not really being affected right now.  No chest tightness, no wheezing, etc.  Just sore throat from all the coughing.  We used the vaporizers (cool and warm alternating) for about three weeks.  Finally stopped using it last week because it just wasn't helping.  He said they were too loud in his bedroom.   I want to thank you again Kristin for taking the time and replying.  I will definitely pursue some of the things  you mentioned.  
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Avatar_f_tn
  Oh gosh!  It sounds like you guys are super on top of things.  Keep up the good work!  Asthma can be quite the saboteur.  And your poor guy -- middle school is exciting enough without all this going on!
  
  It might be time to break out the cough meds; I'm guessing he's had Tessalon Perles, in my experience they work great for quelling a more severe cough.  If it's really bad, or you want something to take at night to help him sleep  -- cause that's where you really miss out with the perpetual coughing, you don't sleep and your body can't heal -- ask your doc about Robitussin AC or Tussionex.  The last two do contain opiates to use as an anti-tussive, and can be dangerous if misused or taken with contraindicated medications, or if his asthma were under poor control.  I personally, have used Tussionex for bad nights on and off through the years and it's very effective (just be aware that it's an Extended Release med, and can take a bit to work at first -- a mistake that made for a very sleepy and nauseous day).  When and if to introduce opiates is a tough call, but sometimes you get to that breaking point.  And ultimately it's up to your family and your doctors.  
  
  I wish you all the best -- I know the caregiver role is not easy.  Happy New Year to you and your family, and I hope it brings y'all happiness and health, and no more coughing!  
    
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