Hi,
I am very concerned about my Wife. I first noticed a persistent cough last February, and it has been getting steadily worse since. I first noticed it during the day, but she usually coughs first thing in the morning. She is 59 years old, a 40 pack-year smoker. For the first 6 months, it was just during the day, but starting in August, she was also coughing at night. It appears to me to be a non-productive cough, as I have never seen her swallow after a coughing fit. Now the coughing fits occur every 20 min, or so during a bad day, but after a few days this will subside to once an hour or more, on a less severe day. She does regular clearing of her throat, but this is much like my own. (I believe I have sub-clinical chronic bronchitis). I have not noticed any significant shortness of breath, nor wheezing. Also she is a late onset insulin-dependant diabetic. She will absolutely not go to the doctor, as I believe she suffers from a classic neurosis regarding cancer, and death, stemming form a childhood incident regarding a step-grandmother who died of cancer in the home.
I have done a lot of reading on the net, and here are my thoughts, which I present for your comments.
1. It does not present like chronic bronchitis, since it did not appear seasonally, as a lingering cough from a cold, gradually increasing in duration until it lasted for 3 months of more in at least two successive years.
2. It did not present like emphysema, for which I read the first symptoms are usually shortness of breath, and wheezing, followed by a cough in the later stages.
3. Likewise, It does not present like asthma
4. My Son has GERD and this is also different, being a productive cough, and associated with heartburn (though I read this is not always a symptom) It seems unlikely to me that she would suddenly develop GERD at 59, but I don’t really know.
5. I guess it could be caused by post-nasal drip, but would this account for the progression in severity of her cough? She has no obvious sinusitis.
6. She has no other symptoms that might suggest congestive heart failure.
7. I thought TB as unlikely, based on local occurance, and likelihood of contact
8. I guess it could be cystic fibrosis, but I know very little about this.
9. I know there are quite a few other possibilities, such as sarcoidosis, bronchiectasis, thoracic enurism, etc, but I guess these are less likely than Cancer
10. It seems to me that the cause is most likely lung cancer. She has not complained of chest pains, and has not reported to me any hemoptsis. She has lost no noticable weight, and seems to be eating normally. She does occasionally complain of a headache in the upper neck, but this could be due to stress. I have noticed very recently a very slight change in her mental state, (momentary confusion, uncharacteristic lack of reason), but this is very slight, and could be due to stress (she recently lost her father, and our newborn grandson is blind), rather than a metastatic tumor.
I am a person for whom security is based on knowledge and understanding, and I realize I am grasping at straws, and that even doctors, relying on multiple tests, may be uncertain of the exact cause of chronic cough, and must experiment.
Is there any validity to me reasoning?
Thanks,
John