11th July 2006
This is my first post and I apologise upfront for the length of it – I have had a cough for over four years and I am desperate for advice so want to make sure I give all the necessary information. I hope someone will spare the time to read it and give me some advice.
I have had common allergies since I was about 18 years old (I am now 45) – pollen, grasses, house dust mites and pet hair (cats in particular), etc. At that time I had skin test followed by three years of weekly desensitising injections.
A few years later I was diagnosed with perennial rhinitis and mild asthma triggered by the allergies. The sign that things were getting worse was always a cough. I have always had a runny nose (not the dripping kind though!) and post nasal drip causing catarrh – I’ve coughed up phlegm every morning for as long as I can remember.
Generally everything was kept under control by taking antihistamines, using nasal sprays, and inhalers (initially relievers and later preventers). Over the years I can remember being prescribed beconase and becotide, flixonase and flixotide, terfenadine and fexofenadine – there may have been some others that I can’t remember now.
However, I have had an almost constant cough for over four years now and am desperate to get it sorted as the medications are no longer working.
The cough is trying to clear my throat and chest. Sometimes it is dry, other times small bits of phlegm are coughed up (except I’ve always coughed up larger bits of phlegm every morning – the longer I sleep, the more phlegm comes up – now that I sleep less, I’m bring up less phlegm in the morning).
I now sometimes cough to the point of being sick, have strained muscles and now have stress incontinence. My husband and I are sleeping permanently in separate bedrooms so he can get a reasonable night’s sleep as I wake to cough two or three times at night. I can’t remember the last time I slept through the night, even if I take something to help me sleep.
I first went to my doctor about the cough in August 2003 when I came back from our annual holiday and realised that I had been coughing for more than a year (i.e. since the last annual holiday) and she referred me for lung tests.
Over the next 6 months I saw several specialists. I was initially referred to general medicine specialist who prescribed anti reflux medication (just in case, as I have no symptoms) and referred me for the lung tests. These established I have very good lung function and am not asthmatic – despite being prescribed inhalers for years before.
The chest specialist referred me to an ENT specialist who said my nasal passages and sinuses are clear. He prescribed a number of different nasal sprays.
During this time I was prescribed Rynacrom (Sodium cromoglicate), Rhinolast (azelastine hydrochloride), Nasonex (mometasone), codeine/pholcodine linctus and ranitidine – that’s all I can remember.
Nothing has relieved the cough, although the codeine and pholcodine linctus helps, but not for long and obviously I can’t take it every time I cough.
The ENT specialist said they couldn’t suggest any other treatment and I would have to live with it.
So I did some research on the internet and read that a cough like mine might have more than one cause, so I though that I would try a combination of allergy and anti-reflux medication using over the counter medication. I also bought an air filter/purifier and anti-allergy bedding for my bedroom.
So I tried ranitidine (first thing in the morning and last thing at night) with beconase nasal spray (first thing in the morning and last thing at night), loratadine or cetirizine antihistamines (one a day tablets) and codeine/pholcodine linctus up to the dosage limit. I also used my asthma reliever (as that was still in date) as a last resort sometimes, as that helped more than anything else.
The cough did not improve but it was often relieved by my asthma reliever with codeine/pholcodine linctus.
By this time my cough was being remarked upon by family friends and work colleagues and I could see people cringing when I coughed. At work colleagues were often remarking on how long I had had the cough - I was aware that it was irritating them, so in the end I was going into the ladies toilets to have a good cough or use my asthma reliever. I would even have to leave meetings or ask callers if I could ring them back. I gave up a stressful job in 2004 and I have worked on six month contracts since but the cough has continued.
In 2005, when my asthma relievers eventually ran out I went back to my doctor to ask her to renew the prescription and also give me a prescription for the over the counter medications as they were costing a lot of money. I had not seen her since she referred me to the hospital in 2003.
She really did not want to give me an inhaler as my records now showed I did not have asthma, but I persevered telling her it was the only thing that really helped and she agreed in the end – I’m sure she wanted me out of her office! She did not prescribe ranitidine, she gave me lansoprazole orodispersible gastro-resistant tablets. I felt so awkward and uncomfortable that when the tablets ran out I went back to buying over the counter.
Eventually the cough started to cause stress incontinence and I started to get severe muscle pain over my ribs under my right breast when I bent over. The pain would not occur when I coughed but out of the blue if I bent over. To stop the pain I would sit or stand up straight breath deeply and slowly for a few minutes and it would gradually subside.
So about six months ago I thought I would go back to my doctor again. I saw a locum and he told me the reason why the inhaler helped even though I did not have asthma, was that my throat was going into spasms when I coughed and the inhaler would relieve the spasms. He also prescribed different antihistamines - desloratadine for day time use and chlorphenamine maleate for night time use. He also told me not to worry about the sound of my cough irritating my family, friends and work colleagues – easy to say when I can literately see people cringing. The new antihistamines did not improve the cough.
So I went back to self medication. At the moment I am taking –
Loratadine (one in the morning)
Chlorphenamine maleate (two at night)
Ranitidine (one in the morning and at night)
Psuedoephedrine hydrochloride (up to 4 a day)
I drink water and suck throat sweets constantly to try to keep my throat moist. I go through a packet of blackcurrant olbas oil pastilles a day, even though you should not take more than 8 in 24 hours. I try to alternate then with Tunes or Throaties. My bottom teeth are crumbling away, but I’ll do whatever it takes now to stop the cough.
About a month ago I gave up my job and started working from home and the final straw came last week.
I bent over and the pain under my breast started - but this time it would not go away. It kept coming and going, getting stronger each time. The slow deep breaths did not work and I began sweating heavily. I was lying down trying to breathe holding under my right breast where the pain was. I was on my own I was really scared, I began to think that maybe I was having a heart attack, even though the pain was not over my heart and in the end I did something I have never done in my life – I dialled 999 for an ambulance. I was terrified and thought I might be dying. As I waited for the ambulance the pain started to subside, then came again and subsided again. The ambulance came and the paramedics quickly established that my heart was ok and my blood pressure was fine too. I was so relieved I was crying but at the same time felt a complete idiot, even though they were fantastic saying I had done the right thing. They offered to take me to hospital but I just wanted them to go, so they gave me paperwork to take to my doctor to get checked out again, suggesting some possibilities for the pain such as gall bladder problems.
I saw my doctor the following morning and explained what had happened. She was pretty sure that I had strained the cartilage between my ribs and told me to take ibroprofen (one in the morning and at night). As a safety precaution she referred me for a gall bladder x-ray. I feel sure she is right, that the pain was caused by strained cartilage between my ribs. But I think strained cartilage was caused the cough – and she made no reference to that. I think she should have thought about what caused the strained cartilage in the first place.
My GP is very nice but I no longer have faith in her. I’m unable to change doctors because of a local policy stating practices will not accept patients from other local practices (I live in the UK by the way). My husband reckons that she must be near retirement age so we may get a change of doctor that way.
What I am looking for (apart from a miracle cure) is some other suggestions for self treatment, bearing in mind I’m in the UK. Can anybody offer me any advice?
Kind regards
BuddyBonthenet
I have had common allergies since I was about 18 years old (I am now 45) – pollen, grasses, house dust mites and pet hair (cats in particular), etc. At that time I had skin test followed by three years of weekly desensitising injections.
A few years later I was diagnosed with perennial rhinitis and mild asthma triggered by the allergies. The sign that things were getting worse was always a cough. I have always had a runny nose (not the dripping kind though!) and post nasal drip causing catarrh – I’ve coughed up phlegm every morning for as long as I can remember.
Generally everything was kept under control by taking antihistamines, using nasal sprays, and inhalers (initially relievers and later preventers). Over the years I can remember being prescribed beconase and becotide, flixonase and flixotide, terfenadine and fexofenadine – there may have been some others that I can’t remember now.
However, I have had an almost constant cough for over four years now and am desperate to get it sorted as the medications are no longer working.
The cough is trying to clear my throat and chest. Sometimes it is dry, other times small bits of phlegm are coughed up (except I’ve always coughed up larger bits of phlegm every morning – the longer I sleep, the more phlegm comes up – now that I sleep less, I’m bring up less phlegm in the morning).
I now sometimes cough to the point of being sick, have strained muscles and now have stress incontinence. My husband and I are sleeping permanently in separate bedrooms so he can get a reasonable night’s sleep as I wake to cough two or three times at night. I can’t remember the last time I slept through the night, even if I take something to help me sleep.
I first went to my doctor about the cough in August 2003 when I came back from our annual holiday and realised that I had been coughing for more than a year (i.e. since the last annual holiday) and she referred me for lung tests.
Over the next 6 months I saw several specialists. I was initially referred to general medicine specialist who prescribed anti reflux medication (just in case, as I have no symptoms) and referred me for the lung tests. These established I have very good lung function and am not asthmatic – despite being prescribed inhalers for years before.
The chest specialist referred me to an ENT specialist who said my nasal passages and sinuses are clear. He prescribed a number of different nasal sprays.
During this time I was prescribed Rynacrom (Sodium cromoglicate), Rhinolast (azelastine hydrochloride), Nasonex (mometasone), codeine/pholcodine linctus and ranitidine – that’s all I can remember.
Nothing has relieved the cough, although the codeine and pholcodine linctus helps, but not for long and obviously I can’t take it every time I cough.
The ENT specialist said they couldn’t suggest any other treatment and I would have to live with it.
So I did some research on the internet and read that a cough like mine might have more than one cause, so I though that I would try a combination of allergy and anti-reflux medication using over the counter medication. I also bought an air filter/purifier and anti-allergy bedding for my bedroom.
So I tried ranitidine (first thing in the morning and last thing at night) with beconase nasal spray (first thing in the morning and last thing at night), loratadine or cetirizine antihistamines (one a day tablets) and codeine/pholcodine linctus up to the dosage limit. I also used my asthma reliever (as that was still in date) as a last resort sometimes, as that helped more than anything else.
The cough did not improve but it was often relieved by my asthma reliever with codeine/pholcodine linctus.
By this time my cough was being remarked upon by family friends and work colleagues and I could see people cringing when I coughed. At work colleagues were often remarking on how long I had had the cough - I was aware that it was irritating them, so in the end I was going into the ladies toilets to have a good cough or use my asthma reliever. I would even have to leave meetings or ask callers if I could ring them back. I gave up a stressful job in 2004 and I have worked on six month contracts since but the cough has continued.
In 2005, when my asthma relievers eventually ran out I went back to my doctor to ask her to renew the prescription and also give me a prescription for the over the counter medications as they were costing a lot of money. I had not seen her since she referred me to the hospital in 2003.
She really did not want to give me an inhaler as my records now showed I did not have asthma, but I persevered telling her it was the only thing that really helped and she agreed in the end – I’m sure she wanted me out of her office! She did not prescribe ranitidine, she gave me lansoprazole orodispersible gastro-resistant tablets. I felt so awkward and uncomfortable that when the tablets ran out I went back to buying over the counter.
Eventually the cough started to cause stress incontinence and I started to get severe muscle pain over my ribs under my right breast when I bent over. The pain would not occur when I coughed but out of the blue if I bent over. To stop the pain I would sit or stand up straight breath deeply and slowly for a few minutes and it would gradually subside.
So about six months ago I thought I would go back to my doctor again. I saw a locum and he told me the reason why the inhaler helped even though I did not have asthma, was that my throat was going into spasms when I coughed and the inhaler would relieve the spasms. He also prescribed different antihistamines - desloratadine for day time use and chlorphenamine maleate for night time use. He also told me not to worry about the sound of my cough irritating my family, friends and work colleagues – easy to say when I can literately see people cringing. The new antihistamines did not improve the cough.
So I went back to self medication. At the moment I am taking –
Loratadine (one in the morning)
Chlorphenamine maleate (two at night)
Ranitidine (one in the morning and at night)
Psuedoephedrine hydrochloride (up to 4 a day)
I drink water and suck throat sweets constantly to try to keep my throat moist. I go through a packet of blackcurrant olbas oil pastilles a day, even though you should not take more than 8 in 24 hours. I try to alternate then with Tunes or Throaties. My bottom teeth are crumbling away, but I’ll do whatever it takes now to stop the cough.
About a month ago I gave up my job and started working from home and the final straw came last week.
I bent over and the pain under my breast started - but this time it would not go away. It kept coming and going, getting stronger each time. The slow deep breaths did not work and I began sweating heavily. I was lying down trying to breathe holding under my right breast where the pain was. I was on my own I was really scared, I began to think that maybe I was having a heart attack, even though the pain was not over my heart and in the end I did something I have never done in my life – I dialled 999 for an ambulance. I was terrified and thought I might be dying. As I waited for the ambulance the pain started to subside, then came again and subsided again. The ambulance came and the paramedics quickly established that my heart was ok and my blood pressure was fine too. I was so relieved I was crying but at the same time felt a complete idiot, even though they were fantastic saying I had done the right thing. They offered to take me to hospital but I just wanted them to go, so they gave me paperwork to take to my doctor to get checked out again, suggesting some possibilities for the pain such as gall bladder problems.
I saw my doctor the following morning and explained what had happened. She was pretty sure that I had strained the cartilage between my ribs and told me to take ibroprofen (one in the morning and at night). As a safety precaution she referred me for a gall bladder x-ray. I feel sure she is right, that the pain was caused by strained cartilage between my ribs. But I think strained cartilage was caused the cough – and she made no reference to that. I think she should have thought about what caused the strained cartilage in the first place.
My GP is very nice but I no longer have faith in her. I’m unable to change doctors because of a local policy stating practices will not accept patients from other local practices (I live in the UK by the way). My husband reckons that she must be near retirement age so we may get a change of doctor that way.
What I am looking for (apart from a miracle cure) is some other suggestions for self treatment, bearing in mind I’m in the UK. Can anybody offer me any advice?
Kind regards
BuddyBonthenet