Can't Get Rid of that COUGH?

This time of year especially, coughs seem to stick around forever. Here in Austin, the culprit may be seasonal allergies, but overall the major cause of persistent coughs is viral upper respiratory infections- from both simple "colds" and the big, bad flu. With these infections, after you get past the headaches, and stuffy nose part, you find yourself coughing- often up to SIX WEEKS after the initial illness. Sometimes it's a minor "clear your throat" type of cough, while other times, it's the crazy fits of coughing that keep you from sleeping.

Is there anything that can be done for a cough that wont go away? Yes, but a cough does NOT mean you definitely need an antibiotic- in fact, typically, you do NOT. However, a cough that is not managed with over the counter medicines should be addressed by your physician. Coughing all day long at school or work (or keeping up your spouse with coughing all night) is NOT a good plan!

What can your doctor do? First of all, she does need to rule out any secondary infection such as a pneumonia. If you are a week into your symptoms, and suddenly you feel a ton worse and develop a fever, this might be a bacterial infection setting up shop AFTER the virus cleared the way past your body's defenses. For this scenario, yes, you need an antibiotic. More commonly, though, you may have developed some over-reactive airways and may benefit from some inhalers or other asthma-style of medicines. A prescription cough syrup used at night may help with the nighttime exacerbations, and your doctor can remind you of some traditional home remedies such as cool mist humidifiers that may help. Finally, sometimes a cough comes from other sources, such as acid reflux or sinus drainage, which require different treatments.

BOTTOM LINE: See your doctor to evaluate coughs that get worse after a respiratory illness, or that wont go away- don't expect antibiotics, but know there are other treatment options!!

Can't stop coughing?

Cough, cough, cough...argh! Is there any point in seeing your doctor when all you have is a left-over cough after an upper respiratory infection? YES! While it is rare that you will need antibiotics, there are other medications that your doctor may recommend to help you quiet that cough.

Often, after a viral infection, we are left with a cough. Untreated, that cough might last up to six weeks. Frequently, it is worse at night and may keep you (or your spouse) from sleeping- which adds fatigue and grumpiness to the picture. At a minimum, your doctor may choose to prescribe a narcotic cough syrup (assuming the OTC dextromethorphan-containing products are not working) so that you and your loved ones can get some rest.

Additionally, it is very common to develop a transient asthma-type of reaction in your lungs after a cold. We call this reactive airways, and the extra mucus production as well as spasm can lead to some wheezing and/or cough. The good news is that this is not a permanent change, AND we can use a couple different types of inhalers to improve your cough and shortness of breath.

Traditional home remedies such as cool mist humidifiers and topical menthol products can also provide good symptomatic relief.

If you have a cold, then seem to recover, and then get broad-sided with an intense cough and fever a week later, you may indeed need an antibiotic because you have become secondarily infected. In this case, an antibiotic may be recommended, but the mainstay of treatment will still include rest, fluids, and over the counter cough suppressants such as dextromethorphan, which is designated "DM" in most combination cold products.

BOTTOM LINE: Got a tickling cough? Use OTC meds and hydration. Stuck with a nagging, lingering cough? Go see your doctor for some extra help, but don't expect antibiotics.

Cough, cough, cough...

Well, it was bound to happen- can't blog about the flu twice and not end up with it, right? Did I get it from our daughters? Doubtful, with the time frame. The incubation period for H1N1 is 1-7 days, typically in the first 4 days. But we're exposed at work (obviously, they come to see us!), the grocery store, and everywhere else. And yes, I wash my hands obsessively! How bad was my case? It's all relative, of course, but I would say "moderate" as I was wiped out in bed for 3 days with 102* fever, headache, body aches, sore throat and the COUGH from BEYOND!! Unfortunately the timing was such that I was speaking at the AAFP (American Academy of Family Physicians) the week following my illness, and though the fever was long gone, the cough only got WORSE! Of course, since I was surrounded with over 4000 other physicians, I was privy to many opinions and suggestions, and I'll tell you, I tried them ALL (with thanks to my peers, especially for the unique home-made concoctions, although sadly, nothing was a miracle cure that I can pass on to you.)
So, what do you do with a cough that wont go away? This is the point of today's blog. "Cough" makes the top ten list every year for reasons to visit your doctor. After many upper respiratory viruses, coughs will linger... for up to SIX weeks! A cough does NOT mean you definitely need an antibiotic- in fact, typically, you do NOT. However, a cough that is not managed with over the counter medicines should be addressed by your physician. Coughing all day long at school or work (or keeping up your spouse with coughing all night) is NOT a good plan!
What can your doctor do? First of all, they do need to rule out any secondary infection such as a pneumonia. More commonly, you may have developed some over-reactive airways and may benefit from some inhalers or other asthma-style of medicines. A prescription cough syrup used at night may help with the nighttime exacerbations, and your doctor can remind you of some traditional home remedies such as cool mist humidifiers that may help. Finally, sometimes a cough comes from other sources, such as acid reflux or sinus drainage, which require different treatments.
BOTTOM LINE: See your doctor to evaluate coughs that get worse after a respiratory illness, or that wont go away- don't expect antibiotics, but know there are other treatment options!!