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I am getting so incredibly tired of continually coughing. I've been coughing since September, but it has been worse the last few weeks. I literally spent over half of my day today coughing. I'm not talking about a gentle cough either. While my cough is dry, it is harsh. It goes on and on and I can't catch my breath. At times, I end up gagging or actually bringing up my breakfast the coughing is so forceful.

I've been coughing so long, my core muscles are tired (although they get a good workout ;)) and my bladder keeps getting more and more unhappy. My shoulders and neck have gotten so very tight too. I end up leaning over a lot when I cough because it is the most helpful position to help me get my breath back.

I'm not really wheezy now. My peak flow between coughing is actually between 300-400. My Pulmonologist doesn't want me on Prednisone unless I get to about 200. I've been using my nebulizer morning and night and inhaler in between. I'm on Dulera 200, Pulmicort, Singulair and Xolair. I've also been using Promethazine DM cough syrup as needed since December 31. I can't take it while I work during the day though because it does slow me down. I've tried tessalon perle and it doesn't do much for me.

I have a history of acid reflux triggering my asthma and a cough in general. I had a 24 hour pH test last month though and it came back normal. I had an upper endoscopy then also and it came back normal. I'm on Dexilant 60 and Zantac though.

Allergies have triggered my coughing at times, but my allergies are fully under control at this time. I've been on 5 1/2 years of weekly immunotherapy and the Xolair has boosted the effectiveness of the shots as well for the last 2 1/2 years.

I've had pertussis in the past and this doesn't feel the same.

I've been living with extremely cold weather and horrible nasty air inversions for the majority of the time since Christmas. The red air quality is supposed to last at least into next week. Both cold air and pollution are asthma triggers. I wear a double layer fleece mask and scarf when I go outside.

I do live in a dry climate, but have been using humidifiers and trying to drink lots of water to stay hydrated.

I'd consider taking time off work to visit family in a warmer climate, but I've missed 3 weeks of work since Thanksgiving for wrist surgery and a bout of flu over New Years.

I keep feeling like I should be going back to the doctor. I'm not sure there is anything more they can do for me though unless my peak flow actually drops significantly. My Pulmonologist told me a month ago that I knew what was causing my problems and I was already doing it and to see him in 3 months. My ENT/allergist helped me out last October, but I don't feel the throat rawness that I had then, just very dry. I had a normal chest x-ray then. I had a follow-up GI appointment that the doctor cancelled, but the assistant who called gave me my test results which were all normal. I'm not sure he would have much to offer. My Primary Care Provider added the Pulmicort and refilled my Promethazine 2 weeks ago. My lungs didn't sound too bad then though. I'm not sure who I would even follow-up with.

I just know I'm miserable and supposedly doing "everything right". [COLOR="Red"][B]I know nobody out there is an expert, but any suggestions would be really really welcome.[/B][/COLOR]

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