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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]
Thanks,
MountainReader
You have my complete sympathy, I have been there myself. My asthma manifests mainly with cough, although I do get wheezy and sob at times. But if I am just coughing, my peak flows are actually normally pretty good. When I get coughing non stop like you describe for more than a day or 2, prednisone is the only thing that will stop me. I have tried waiting and waiting to see if I can stop it myself, but if it doesn't subside pretty quickly, I always start a round of pred. My allergist told me that when I am coughing non stop like that, I should never let it go more than 2 days before calling him for a course of pred. I think that the coughing further irritates the already supremely irritated lungs and it is just not going to go away with help at this point. Is your dr refusing to give you pred for some other medical reason, or does he just not believe that you should get it without a low pf? I know that there are a lot of harmful side effects, but I always wondered how much damage we inflict on our bodies with that type of coughing. It really can't be good for us. I, like you have gagged, cracked a rib gotten pulled muscles etc. I would imagine that it increases the bp, heart rate etc., and think that all of that needs to be weighed against the dangers of a short burst of prednisone. Have you had one of your coughing attacks in your drs office any time recently? That's what happened that finally got the attention of my dr that my problem was more serious than just some random cough. If you haven't done that, try it, might work! I really think that your instincts are right, you have to see one of your drs. If they won't help, then I would say to try another, unless there is some other strong reason why they won't give you the pred. I hope that you are back to normal soon, I know too well how miserable you must feel.
Thank you for your responses.

You all bring up good points on the Prednisone.

As with Sue, at times my coughing is horrible and I struggle to breathe while coughing but at the "calm" times in between my peak flow isn't that bad. (300-400) Right now, my peak flow isn't that bad. A few months ago, it was much much worse.

I actually called my primary care today. They offered to refill my cough medicine again. He is willing to prescribe me Prednisone as soon as I request. I don't even have to go in, he said I could just call. I'm trying to avoid that if I can. My Pulmonologist is worried about having me take it too much, especially because the Prednisone can cause acid reflux to flare. I've had major acid reflux issues in the past and don't want a flare there compounding things even worse. For me, the acid comes up in a gaseous form and irritates my lungs. I even end up aspirating it at times. It also irritates my throat causing me to cough even more. It really is a viscious cycle.

I understand the doc thing. I've coughed plenty like this in front of my PCP, ENT and GI doc over the years. Most recently, a couple weeks ago. Unfortunately I've never been able to get into see my Pulmonologist when I'm actually in a flare. I've had some coughing at times, but it is far from my worst. Most of the time I'm pretty healthy. It usually takes 4-5 months to get in to see him. All of the Pulmonologists in my area are like that. You can bet that when I am bad that I initiate some coughing though. It takes very little to start the coughing. In fact, usually when they listen to the lungs and ask me to take a deep breath that is all it takes.





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