unrelenting cough

I've had an uncontrollable cough for the past 3 weeks.  The 1st week my doctor diagnosed it as parainfluenza (croup) and said to let it run its course.  It was accompanied by congestion and I also lost my voice.  The cough is significanly worse at night- so I can't get much sleep.  I have attacks where I can't stop coughing for several minutes.  I've since been given one cough med after another.  Now I'm on hydrocodone with guaifenesin, but it's only marginally working to control the cough.  I've also developed a very severe pain in my left rib area below my breast.  I'm sure this is from the intensity of my coughing, but the pain is turning into another problem all together.  

Still, my cough doesn't seem to be improving. Am I just being hasty, or should I be recovering by now?  My voice is back, and I'm less congested- but the cough just won't go away.  I asked my doctor if it was pertussis, and he said it was highly unlikely because I've had my series of immunizations as a child.  I'm 32 years old, in good health, just had a baby 6 months ago, and have never smoked.  Any advice would be helpful.

[National Jewish]

It is possible for a cough caused by a virus to last for several weeks.  Since your cough is not improving, I would suggest seeing your doctor.  Generally if it were simply a virus, your cough would not be nearly this severe and it would have started to get better.  It is possible that the virus has irritated the airways of your lungs and this is now causing your cough.

Pertussis can happen in adults, even those who have been vaccinated.  The symptoms that you have experienced could certainly happen with pertussis.  Having a blood test to check your pertussis level or titer would tell if you are still protected by your series of immunizations that you had as a child.

To know for sure if this is due to a lung problem you will need to have testing done.  A good place to start is with a chest x-ray.  A pulmonologist would be the type of specialist to identify a lung problem and the best treatment.

Another consideration would be postnasal drip.  This is drainage from the nose and sinuses dripping down the back of the throat.  There could be several reasons for this drainage.  One is an allergic reaction to inhaling something.  A second reason is a non-allergic, non-infectious inflammation in the sinuses that can linger after a cold.  A third reason is chronic sinusitis.  Postnasal drip can cause coughing as a result of irritation of the throat and lungs.  Typically this is worse at night when you lay down to sleep.  You may experience the postnasal drip as congestion or a constant feeling of phlegm at the back of your throat and this can affect your voice.  As long as you are not on a fluid restriction you should be drinking 6 to 8 8-ounce glasses of non-caffeine non-alcoholic fluid daily.  This will thin the phlegm so that it moves more easily.  A nasal wash helps remove phlegm from the nose and sinuses.  This can temporarily reduce the postnasal drip and lessen the cough.  A prescription nasal steroid spray decreases nasal swelling and phlegm production.  This may prevent the postnasal drip and coughing.  To get the most out of a nasal steroid spray use it after doing a nasal wash.  A nasal steroid spray does not provide immediate relief of symptoms.  It may require several weeks of routine use to become effective.  Please read our Nasal Wash MedFact at http://www.nationaljewish.org/medfacts/nasal.html for more information about this technique.  Share this information with your doctor to see if you would benefit from this daily treatment.

[Concerned lady]

You can telephone the LUNG LINE and speak with a LUNG LINE nurse at Nat'l Jewish, by calling 1-800-222-LUNG(5864), between 8am & 4:30pm, Mountain time, to get some good advice about what to do now.

Adult Pertussis (whooping cough) is more common than previously thought, and people can and do get it, even if they were vaccinated as children. There's a blood test that you can ask for, that can tell you whether you do have Adult Pertussis or not. If you do have Adult Pertussis, there are antibiotics that can help treat it.

Some viruses can cause residual coughing, and sometimes, can even cause gastric reflux, which can also result in coughing. There are treatments for gastric reflux, which should lessen coughing, if reflux is a factor.

There may be other factors contributing to cough, like indoor air pollution, dry air, etc.

You could ask your doctor (and also ask a LUNG LINE nurse) to refer you to a specialist, like a Pulmonologist (lung specialist doc), to help you find out for sure what you have.

My husband and I thought very highly of Nat'l Jewish, when we needed help with getting diagnosed several years ago.

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

[Sebastians Mom]

Perhaps a bronchodilator might help. This is an asthma medication but can also be used to treat bronchitis, etc. Sounds like it might be the virus du jour. My whole family had it this month and let me tell you...it is a lasting problem. But it's definitely something your Doctor should pursue. If you are having coughing fits like that it's possible you are wheezing which means you are not getting enough air. If your Doctor poo-poo's it, seek another opinion!

[Mrs. Miller]

Been coughing for 9 months.  Been to allergists and regular doctor.  Have had chest x-rays and sinus x-rays.  I've been given shots (cortisone and adrenalin), and several antibiotics.
In June I coughed so hard I had a compressed fracture of the 8th vertebra.  Surgery was done to correct it (Kyphoplasty).  The cough continues, and now the pain is in my hip and lower back area.  If I'm not coughing, it doesn't hurt.  A cough and I can feel the pain pulling from those areas.

I do not have osteoporosis, bone density scan and MRIs say no.  The doctors feel possibly I'm allergic to one of my medications as I have many allergies and asthma.  I take Brethine, Uniphyl, Zenstoretic (blood pressure), catapres blood pressure), Celebrex, Synthroid and Nexium.  Could any of these cause a cough?

I take over the counter Triaminic to help the cough, plus cold/sinus tablets which seem to offer temporary help.  This pain is interrupting my otherwise active life!  I'm 67.

[WilliamBill]

Last winter my wife had terrible cough for 2 months which led to rib pain. The Dr. xrayed and found her with 5 broken ribs!!!! Ouch. It cleared slowly and eventually she got well. (This was during the SARS scare and she was never tested.

[bashfulsue]

A related discussion, Rib & back pain was started.