A forum for people who suffer from chronic or persistent coughs to share ideas... these don't have any sort of official approval so you try any of them out at your own risk. I've consigned some of the more unusual ones I received to the Oddities bin on the left. I've also listed very simple remedies separately. If you're a sufferer, good luck, and please report back by commenting on the particular posting if you find success. Or just comment to the most recent posting and I will pick it up.

Friday, January 18, 2013

News update

Visiting my blog for the first time in a while I notice it's just over a year since I was last on the radio!!!

Anyway, quite a few interesting posts recently under that topic...

From my point of view, yesterday I had my first, long-awaited, appointment with a Speech & Language Therapist.  The theory seems to be this... from all the various investigations I've had over the years, there isn't an identifiable cause/reason for the cough, but my "throat has developed an overall heightened sensitivity, so I cough more easily and intensely."  What I need to do is break the habit  and learn to control the cough: if I can reduce the number of times I cough it should reduce the overall sensitivity.

What the approach boils down to, apart from some odd face-pulling exercises which I think may be a bit token, is that I have to stop myself from coughing or clearing my throat by sipping water repeatedly until the urge goes, combining it with taking small sniffs and breathing out through the nose - so sips and sniffs!

I tried it when I woke at 4am this morning and it did seem to work, to an extent - I still coughed, but nowhere near as much as usual, and I wasn't racked with it and exhausted by the end of it ... I even went back to sleep.

Early days yet, I'll report back in a couple of weeks time.


NickP said...

Just want to repost this from Dawn64, which was a comment (edited) on the Update blog below...

Hi Nick, I've had a cough for at least 4 years. It started as a dry cough but over time my body seemed to try to protect my throat by producing more mucous.

The medics seemed to think the whole thing was down to acid reflux - I had the dreaded camera down the throat test in 2010 which seemed to confirm a faulty valve was allowing stomach acid into my oesophagus so I was put on Lansoprazole to control the stomach acid. So, the acid was under control but there was no improvement with the cough,which just seemed to get worse and worse.


The specialist I saw had a working theory that chronic cough can be a post viral effect - the cough reflex nerves in my throat have been permanently changed and are now hyper sensitive (a bit like when people still feel a burning sensation in their skin after a bout of shingles has gone). So, any medication would need to "turn down" the sensitivity of my nerve endings.

The good news is that the current medication is making a real difference - slow release morphine sulphate 5mg twice daily. I was put on it for 2 weeks followed by 2 weeks without before returning to the clinic for a follow-up. I was worried about feeling drowsy or "woolly" but the dose is so low that the only side effect is an occasional dry mouth. After 2 weeks I was convinced it was helping - my work colleagues agreed they'd hardly noticed me coughing in the second week. Doing without for the next 2 weeks only convinced me that he morphine was making a real difference as the cough returned to its full horror by the time I returned to the clinic.

I'm now being prescribed a continuous supply for the next 3 months until my next check up when it will probably just be continued if it's still going ok.

I still cough but less often and less violently - instead of the cough escalating until I almost vomit, I just cough once or twice. The space in between coughing is also more relaxed, less raw. As a result my whole body feels more relaxed and I am sleeping better. The mucous in my throat is also reduced - whether that is directly due to the morphine (which sometimes causes a dry mouth) or whether the reduction of sensitivity has led to less production, I don't know. I only really noticed how bad it was when I came off the morphine for the 2 week break, as the mucous came back almost immediately.

Fingers crossed the morphine will carry on working and I can start living again.

Nick writes: If my SLT approach doesn't achieve the desired result, I think I'll be going to back to Wythenshawe to ask for morphine again - it's really the only thing that's worked for me in the past.

Ling said...

Hi Nick, my name is Ling and I am from Singapore. I was googling on chronic cough and chances upon your website. My mom is currently facing this chronic cough issue. I have never encounter someone who coughs so frequently in a day. She could stil be up awake in wee hours coughing non stop and this has caused much distress to the whole family as well as to herself. She has tried TCM, western medication and went for x rays (nothing found), various doctors diagnose her situation was windpipe allergy. Would like to seek your kind advice on any medications or household remedies she could take to alleviate her cough situation. Thanks in advance!

Anonymous said...

Just found your blog. I have had my cough for 14 months so far and I have been in dispair about the condition. I have had all the tests and my GP is no longer interested. At least they have ruled out taking unnecessary medication. Increase in asthma medication included ingredient that aggravated cough. Acid reflux medication made me feel ill (like Dawn64 I have faulty valve but had further test where inplant in gullet monitors acid levels over 24 hours and proved this was not the cause)Heart specialist discovered I had high blood pressure (possibly aggravated by worry and cough) and medication for this and statins possibly aggravate cough but may save my life!Worse thing is pains in chest and burning sensation in inflamed windpipe. I am about to try course of antihistamine. Does anyone know anyone who has got better!

Colin said...

Hi Nick
Like many others I have had a cough for a long time (20-30 years). I have seen consultants in Slough, Manchester & Chesterfield.
The Consultant Physician has just written to my doctors saying the following. "His new complaint is that over the last year or so he has been getting episodes of cough syncope i.e. episodes of feeling dizzy and blacking out whilst having one of his coughing fits, however he does not describe any new respiratory symptoms from the point of view of sputum production, chest pain, shortness of breath, fever or weight loss.

In the past he has tried multiple treatments and had multiple investigations. From a respiratory point of view he has had trials of inhalers including Qvar and Salbutamol. A bronchosopy which was normal with no evidence of malignant cells, a CT scan of the chest which was normal and lung function tests which showed neither obstructive or restrictive deficit.

From a reflux point of view he has tried multiple courses of proton pump inhibitor therapy in the form of Lansoprazole which have not helped and from an ENT point of view he has seen by one of the ENT consultants who did a laryngoscopy and suggested that he see the speech and language therapy and try Beconase spray for what appears to be a very hypersensitive laryngeal moucosal area which was evident during the laryngoscopy by the fact that he needed local anaesthetic to be able to go on with the procedure and have multiple very significant bouts of coughing fits during the the that the area was touched.

The working diagnosis for this chap is that he obviously has a hypersensitivity to the back of the larynx which is normal for him."

At the top of the letter in the ACTION BOX is No action.

Best regards


Thomas Snell said...

My coughing has stopped. I coughed for years and have gone through the usual tests (allergy, Tuberculosis, acid reflux, COPD, post nasal drip, etc). Been treated with Zantac (ranitidine), pulmicort, symbicort and a plethora of other inhalers...none which worked. Nothing was able to get rid of that little tickle in the back of my throat. What has changed now? Milk...or rather the lack of it. My son is currently going through an elimination diet for food allergy testing and one of the foods tested is all things dairy. I have adopted part of his diet by proxy and since I have eliminated cows milk from my diet, I have not coughed since. I now substitute rice milk for cooking and even drinking, non-dairy creamer in my coffee. I have now slimmed down a little as part of my belly was bloating (a little of it is beer...but we all need to live a little). Now down a few pounds more energy, sleeping better and most importantly have not coughed in over a month. I am not saying this is an answer for everyone but worked wonders for me. Thomas Snell (Ottawa, Canada)

Gilamarth Neithan said...

Greetings All,

First I must say I am happy to have found this site. It was from an older article I stumbled across from the DailyOnline. In any case, it's nice knowing I'm not completely along here.

I'm well into my 8th year of going thru this and until this past week all medical professionals except for my primary care PA-C held the opinion that the condition was purely psychosomatic. This unfortunately included the speech therapist. While the idea of learning to control the cough was fine by itself, the therapist unfortunately made the mistake of pushing the mental “triggers” of the cough more so than the physical nature.

Perhaps had the treatment been based on a physical effort rather than mental it may have been more beneficial, but even trying the physical exercises had no effect on my coughing.

With finally knowing that this, while rare, is a real physical based condition, perhaps now I may have more progress to make with at least easing the symptoms. Luckily, my primary physician I work with has fully agreed that the condition is real and purely physical despite what the “experts” suggest. I'm hopeful in the next couple of weeks to confirm that I do indeed have a hypersensitive cough reflex and can at least put an end to the hunt for a “mental” cure.

I'm glad to hear that there is some relief at least for you with the speech therapy. Any progress made by any of us can always potentially get closer to at least managing our symptoms better. Even if it doesn't work for me, the fact that it's helping you or anyone else get's us one step closer to at least understanding what's going on a bit better.

On a last note before I head out, I've heard from Professor Woodcock that there a few things medically that may help us all currently in the trial phase, which makes it 3-4 years at the earliest. Which I imagine will be a lot longer for myself even if things go well with the trials as I'm overseas on the West Coast of the US. Trying to convince the doctors over here that something not already in their books could still be a real physical condition is hard enough, let alone convincing them to prescribe a medication for it lol.

In any case, please keep us updated on the speech therapy progress. If something is at least helping I may be able to try again, with a different therapist that can at least agree to treat this as a physical condition even if they personally believe it's mental.

Good luck to all and keep the spirits up. I am all too familiar myself with the limitations and stigmatization that goes along with a chronic cough from physical to social. It's all about adapting and knowing that we're not alone with this.


Amanda Clerke said...

Hello. Not terribly computer savvy so hope I am going about this correctly.
I too have a cough that usually starts every year with a cold . It begins as a regular cold that appears to be resolving after about 10 days .within 24 hrs it turns a corner and becomes a hacking mostly non- productive cough that lasts on average 6 months of every year.
I have tried everything from steroid tabs,inhalants, bronchodilators , herbal solutions ,homeopathy , codeine etc etc. I am now on PPI s . don't think I have silent reflux but I am willing to try anything. I have a deviated septum and polyps for which I use Nasonex and take antihistamines. I really am unaware of a post nasal drip although I have been told I had this in the past . I think the meds are dealing with this.
Interestingly I don't cough at night ( except at the beg of the cold). I always cough in the car , when I move around or when feelin stressed although I feel this is all secondary to the fact that whenever I get a cold it turns into this shocking 6 months hacking thing .
Currently I am trying a new asthma inhalant Qvar 100 m. I have never found any asthma meds to help and my spiro tests are always good .
I have said to doctors for years I feel as if I have a hyper response to any cold I get. I have recently gotten rid of all gas heaters not flued . On a very very personnel level I was recently in an elevator where someone broke wind ...... I honestly nearly died . My chest closed up ,I started barking and felt as though I had just swallowed acid . I am sure the perpetrator though it was complete overkill but that is how sensitive my bronchus are. Should mention lungs and X-rays always clear.
Any thoughts??? Ideas??? Would love to have just a regular cold like everyone else that just resolves normally.

NickP said...

The SLT didn't work for me I'm afraid. I've discussed going back on morphine with my consultant, but he's suggested I should have another bronchoscopy first, to check if anything is visible in there as the cause. Cough very troublesome at the moment - gets me down.

Meanwhile, lots of posts to moderate......

NickP said...

Just a quick response to Gil's post on July 5. I may have mentoned this elsewhere on the blog - I had a call from Prof Woodcock one day .. oh, well over a year ago now - saying that he wanted me to take part in a trial of a new drug (or new use of an old drug) and he was very optimistic about it helping someone like me. But when I spoke the following day to a researcher to sign up for it, I mentioned that I gave up smoking 20 years ago, she said that ruled me out of the test! I was gutted. But maybe there's hope just around the corner.
I liked the tone of your message Gil, thanks. We all need to keep our spirits up.

Sheila said...

I had a terrible chronic cough for as long as I can remember. It devastated my life. 8weeks ago I stop eating wheat products. I have not coughed since!!!!!! I am free. That,s how I feel!!!

Alicia Kean said...

Ive had a chronic cough for 6 yrs. I have had many test and seen many doctors. Like everyone with a chronic cough doctors test for allergies, asthma, reflux, sinus etc and everything came back ok. I have also tried prednizone for a month or so which didn't work. live on chewing gum and halls and at times in find it hard to breath Bc I cough so much. Over the years ive come to realize that I go through bouts of depression and anxiety. Dealing with that and my chronic cough has been dibilitating. My doctor decided to give me Adavan bc of my so called panic attacks bc I felt I couldn't breath and guess what....my cough of 6 years is gone!! Completly gone!! If you are expeirencing depression, anxiety, panic, stress, which is very common with everyone having such crazy busy lives...you may have the chronic cough bc it's ur bodies way of telling you it can't cope. I hope I'm helping someone with this suggestion. It doesn't hurt to try. It. My doctor now has me on Zoloft...it's a long term drug to help one deal with stress, anxiety, depression etc and my cough is still gone. !!!!

Anonymous said...

Hey nick. I have had this cough off and in for about 5 years. Before the cough started I always just made a noise with my throat. The cough usually lasts about a year and starts back in couple months. Last year I went an entire year without coughing. I even talked about how I wasn't coughing and I still had no erge. I have figured it out. Its deffinetly a habit cough, but its caused by stimulants. Looking back on it now it all makes since, I use to be a wild child and loved taking speed. I took one addepex one time and coughed for 8 months. I done math once and the cough cane back. Even pain pills trigured it. Well when I grew up and quit messing around it stooped. Hell I forgot all about it. I need to loose some weight so I got on adepex and yup the damn cough is back. I quit taking it as soon as it came back. Now its just a waiting game. Also caffeine will do it. Stimulants causes it but it'll still take a while to get it gone. I also have been to clinics and all kinda stuff. I'm about to go see a shrink but first I'm gonna try a hipnotist. I've seen people quit smoking after being hypnotized. One thing is for sure when this thing is gone i will never take anything to start it lol. I don't cough in my sleep if I'm played back relaxing I can control it after practice lol. But as soon as I get to working r anything to get me moving r excited I cough like crazy. Mine is constant. Like every secound. I'll keep you updates.

Anonymous said...

Nick this is Jeff I'm the guy that just posted about stimulants. I just read some more of your comments. I sure hope u get rid of it but I really believe there is no since in talking to doctors. Something irrated you and caused you to start and that caused you inside to get irratated and now you can't stop just like me. I have spent hundreds before I realized its a mind thing.

Anonymous said...

Google phsycogenis disorder cough, tic cough, self hiptnotism for cough. Sorry I posted so much. Hope this helps

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