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Charlie's Coughing His Head Off


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Charlie has been coughing much worse in the last few days. We saw his rad. onc. on Friday and he prescribed Tessalan Pearles to supplement the inhaler and cough medicine he was already on. It seemed to work really well on Friday night and Sat. On Sun. his cough seemed to get much worse and has continued today. When I got home from work I realized he had a runny nose--that maybe it is post nasal drip. He took a pain pill and I gave him sudafed for congestion. He just took another pain pill. He can only keep from coughing if he is sitting up. It doesn't seem to be a productive cough--he isn't coughing up anything--just coughing uncontrollably. Any advice or suggestions or observations? I even had him chew gum like Ry had suggested to someone awhile back.

I called and got him an appointment with the pulmonologist for Wed. afternoon. He is really miserable. Thanks for listening. Don't know what to think or do other than what we've already done.

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This is what I could find. I will post more if I find more. If it gets too bad I would take Charlie into the Dr./ER just to be safe and get him some relief.


Chronic dry coughs are usually caused by irritation from cigarette smoke, environmental irritants, allergies, postnasal drip, or asthma. Several chronic lung diseases also cause a dry, hacking cough. Some people cough out of habit for no clear reason.

Less common causes of a dry cough include:

Gastric reflux. Usually you will also have other symptoms, such as heartburn, burning in the throat, or increased saliva.

Whooping cough (pertussis).


A swallowed or inhaled object.

Mycoplasma pneumonia.

Side effects of angiotensin-converting enzyme (ACE) inhibitors. Examples of ACE inhibitors include captopril (such as Capoten), enalapril maleate (such as Vasotec), and lisinopril (such as Prinivil, Zestril, Zestoretic).

Viral illnesses, which may occur frequently, such as the common cold, or rarely, such as sudden acute respiratory syndrome (SARS).

A health professional can evaluate your symptoms and recommend appropriate treatment.


Non-productive coughs

A non-productive cough is dry and does not produce sputum. A dry, hacking cough may develop toward the end of a cold or after exposure to an irritant, such as dust or smoke. There are many causes of a non-productive cough, such as:

Viral illnesses.

After a common cold, a dry cough may last several weeks longer than other symptoms and often gets worse at night.

Severe acute respiratory syndrome (SARS) is a newly identified respiratory illness that infected people in parts of Asia, North America, and Europe in early 2003. The main symptoms of SARS are a fever higher than 38°C (100.4°F), a dry cough, shortness of breath, and difficulty breathing.

Bronchospasm. A non-productive cough, particularly at night, may indicate spasms in the bronchial tubes (bronchospasm) caused by irritation.

Allergies. Frequent sneezing is also a common symptom of allergic rhinitis.

Medications called ACE inhibitors that are used to control high blood pressure. Examples of ACE inhibitors include captopril (Capoten), enalapril maleate (Vasotec), and lisinopril (Prinivil, Zestril, or Zestoretic).

Exposure to dust, fumes, and chemicals in the work environment.

Asthma. A chronic dry cough may be a sign of mild asthma. Other symptoms may include wheezing, shortness of breath, or a feeling of tightness in the chest. For more information, see the topic Asthma.

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Here are some answers I found from other health professional websites.


The dry coughing could be due to either a healing process of a respiratory infection or a continued chronic sinusitis. Sinus inflammation is a common cause of coughing that increases at night. Often a CT scan of the sinuses during these episodes shows significant sinus involvement. This may clear up with a 3-week course of antibiotics along with a short course of oral steroids.

Without a further evaluation of you and some tests, it is difficult to make a better guess of what is going on.


Over-the-counter cough suppressants (antitussives) can provide relief. They're especially helpful if your cough is bothersome or keeps you awake at night. Cough suppressants are available in medications you take by mouth (such as Robitussin DM syrup) and chest rubs you apply to your skin (Vicks VapoRub).

Many oral cough suppressants contain the active ingredient dextromethorphan. It works on the cough center in the brain and calms the urge to cough. Although most people tolerate it well, it can cause drowsiness and stomach upset. It may cause a serious interaction with a class of prescription medicines called monoamine oxidase inhibitors (MAOIs). If you take phenelzine (brand name Nardil), tranylcypromine (Parnate), selegiline (Eldepryl), or any other MAOI, don't take a product that contains dextromethorphan.

Chest rubs often contain anesthetic or numbing agents called camphor or menthol. Vapors you inhale from chest rubs may numb the throat and relieve cough. Be sure to use a chest rub externally, and don't ingest it.

See your health care provider if your cough lasts for more than one week, or if you also have a fever, rash, or headache.


Whether dry or productive, a cough may last for weeks because of persistent irritation of mucous membranes.

Symptom relief

Drink plenty of fluids.

Moist air.

Inhale steam from a vaporizer, or via a hot shower, to help loosen chest congestion.

Cough drops, lozenges, hard candies.

By keeping your throat moist, these products help relieve the dry cough that often accompanies a scratchy or tickly throat.

Cough suppressants.

Since a productive cough serves a useful function, it is best not to suppress it. However, if a cough is dry, irritates your throat, or keep your awake, a cough suppressant may help. For a tight cough, look for an expectorant

Stop smoking.

Smoking irritates mucous membranes and will make a cough worse.


from drgreene.com

You need to stop a nonproductive cough because excessive dry coughing can cause hoarseness and throat irritation. Nonproductive coughs need an antitussive to stop the coughing. Dextromethorphan is the most common OTC antitussive. Cough medicines with the initials DM have dextromethorphan in the ingredients, such as Robitussin® DM. Antitussives are also included in throat lozenges.

You should also note whether your cough medicine is indicated for day or night time use. Night time cough medicines usually contain the active ingredient diphenhydramine, which may cause drowsiness.

Hope some of this helps you and Charlie.


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Tina--Might want to ask the doctor about Hydromet (Hydrocodone W/ Homatropine Syrup) for the cough? Does not make one sleepy either. I had a bad cough for a couple of weeks and was surprised how fast it worked--tried over the counter, did not clear it up at all. My doctor did give me an X-ray to see if it was pneumonia and it was not. Just a thought. Hope this helps. Rich

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My brother Mark had the same cough as Charlie's..He was fine sitting up then when he tried to sleep it would keep him up all night..We thought of allergies, dust, pillow cases washed in Tide, etc..He told his Oncologist and was also given Hydromet,plus every other cough medicine there was.. Nothing helped him..We took him to the ER for XRays, he was developing pneumonia..Just a precaution, I would get Charlie to the Dr., or at least call him and tell him about this recent cough..

Hope this helps..


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Tina...If I were you, I think I would get Charlie checked out rather than waiting for his appointment. First of all, it would give both of you some comfort from this nagging cough and second it could catch something else that might be going on...like pneumonia. Not to scare you but I do think I would have him checked out before Wednesday...just in case. I know you guys must have your heat on now. When I lived in Tennessee and had to use the heat it would always make the air very dry and I would cough a lot. Maybe you need a humidifier? Anyway...saying prayers and hoping for good news.

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Thanks everyone! A special thanks to you, Katie for doing all the research for me. He is now running a fever of 100.5. I called and got his appointment moved up to this afternoon with the pulmonologist. The onc's office is going to check his blood, then he will get an x-ray, then see the pulm. Please keep your prayers going. I will be asking about the Hydromet and I'm sure they will give him antibiotics. Thanks again.

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I just saw this and I'm really glad you are getting Charlie checked out today. A cough in a cancer patient can be from so many things. I do hope you get some quick answers and solutions. I was going to suggest another possibility not on the list.. oh heck I'll throw it out there anyway...... Mike had a dry non productive cough due to pneumonitis (caused by radiation and or chemo) a while back.. but it was also accompanied by the sudden onset of shortness of breath. In that case high doses of prednisone are used to reduce inflammation and the cough slowly improved. Will be looking for your update and praying for a simple solution.



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Just got home. The dr. is taking a shotgun approach, which is just fine with us. He gave him a steroid shot and a prescription for prednisone along with antibiotics and allergy medicine. On my way to the pharmacy now. Talk later. Thanks for all the support and prayers! You'll are the greatest!

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Hi Tina..

Like the shotgun approach. Not messing around.

Yep. Could be so much with us... including effusion or even congestive heart failure. Trust me, I learned the hard way. If it still does not clear up, be persistant.

I am, unfortunately, experienced beyond belief in this department.

Cindi o'h

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The dr. is very thorough. He said it could even be an Ace inhibitor he is on for blood pressure. Not likely with him having been on it a long time...but, he wants to cut it out next if he is still having problems. You never know with all the meds., infections, cancer, etc. Sorry you have to know so much about it. Is your R. T. making a difference yet?

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Thanks, Tina.

Hoping that it is one of the three that Charlie is going through. If he isn't better, I know that you will go back for advice.

Yes. I the pulm. rehab. seems to be helping. I think I will start a thread on this. I wish I would have known that this was possible 3 years ago. I don't think that I would have deteriorated as much as I have if I had gone through this program back then.

Best of luck, you'll.

How is that college girl doing???

love, Cindi o'h

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