As I mentioned in my last post, I wanted to share with you my chronic cough journey in case you or a loved one have been struggling, and not having any luck making the cough go away.
A chronic cough is any cough lasting longer than 6 – 8 weeks. When I started out to write this, I was going to document the whole process. The more I got into the weeds, I realized it was a pretty boring story. You would probably nod off or more likely, delete or click off, so I’ve cut out all of the extras, and got to the meat of this journey.
In late April after having a mild cold, my cough turned into a dry cough both day and night. My throat would be dry, and I had to cough. I would swallow including drinking lots of water, try to talk myself out of the cough, but nothing would stop me from coughing, as I said often, coughing my guts out. It wasn’t a regular cough. With this cough every time I tried to eat, I coughed. And it wasn’t just a little coughing, I would cough so hard I was sure my chest was going to explode. I couldn’t eat anything that was solid or hard such as bread. And I had to eat real slow.
In addition to the problems with eating, I couldn’t talk. On those rare times if I could talk for a short period of time, it would take so much effort. But even then, it wouldn’t take long to have a full blown coughing episode.
I could not sleep in bed without coughing. I tried a wedge pillow which didn’t work, so I ended up for months sleeping in my recliner in my studio. Well, I will say I “tried” to sleep. If I got to sleep, I would only sleep a couple hours and then I’d wake up coughing. Needless to say, without much sleep I’m not a happy camper, and what made it worse is I saw no end in sight.
Here are the medicine and procedures I tried:
- Robitussin DM
- Tessalon Pearls (benzonatate)
- Protonics 20 and then 40
- Promethazone DM cough syrup – Didn’t help
- Asked my doc for Codeine. She agreed and prescribed Guaifen Codeine. I finally got some relief at night, but was concerned I’d get addicted. My doctor refilled it twice.
- Chest Xray – was normal
- Video Stroboscope – my vocal cords were fine
- Endoscopy – didn’t show anything
- Speech Therapy – 2 months/ twice a week (I thought my ENT was crazy to suggest it.) It did help, but what we were doing was working on the symptoms, and not getting to the root of the problem. I learned tools to help prevent a full blown coughing episode (which worked a little) but again, we weren’t working on the root cause of the coughing.
Now we are into August and I wasn’t much better. I might have some good days, but my nights were pretty awful. At the end of August I had a followup appointment with my ENT. I told him nothing was working. He said he had an idea. He wanted me to read a book, and started to tell me about the author, Dr. Jamie Koufman. I was so excited when he started talking because it was her book, Dropping Acid, that helped me years ago when I was having such a hard time with my Silent Gerd. Here is a post I wrote in 2011 about it.
I immediately felt hopeful. He wanted me to try her recipe for getting rid of my chronic cough. I ordered the book, and began taking the first drug, Elavil, an antidepressant. Within the first week, my coughing at night eased up a bit. After two weeks on Elavil, Gabapentin, a drug usually used for seizures, was added. With both drugs now, I was doing pretty good. I was still coughing but the extreme episodes were occurring less frequent. It’s recommended that a second dose of Gabapentin be added if coughing doesn’t stop, but when I added the second dose (I tried this twice) I ended up having scalp itching. So I just continued on the two meds.
According to her book, Dr Koufman said to continue the medicine even after the coughing stops because it might return. She said it might take several months before a patient can quit. She also said this regiment of drugs worked on 75% of her patients. I was sure hoping I’d be part of that 75%!
In mid October when I went back to my ENT, and I wasn’t coughing much, he said I could taper off whenever I wanted to but to start with the Gabapentin. I was completely off both drugs by Thanksgiving. So I was on those drugs for a total of three months.
As my coughing spells started to be less frequent, and eventually going away, I still had the fear when I got in bed. (Now I was able to sleep in bed.) I immediately started getting nervous. I was sure the cough was coming back. I still struggle with that fear, and keep a glass of water on the table next to my bed. Everywhere I go, I still carry my water glass, although now I can leave it in the car, instead of bringing it with me. One thing I thought about today as I was writing this, that it’s not an effort to talk anymore. That struggle is gone too.
I hate taking any medicine so taking all of these things over the eight months was not something I wanted to do. But it got to the point that I was up for taking anything that would bring me relief. Dr Koufmann writes in her book that some of her patients have had chronic cough for 10 years. I can’t imagine having this for that long. However, before I started on her medications, I was feeling pretty hopeless thinking I’d have to deal with this for the rest of my life.
So my reason for writing this is to let you know there is help out there. My medical doctor did not know anything about Dr. Koufman. I would still be coughing if it wasn’t for Dr Palmer, my ENT, suggesting this treatment. Here is the Chronic Cough Index that’s in her book to help the reader determine whether it a Reflux or Neurogenic cough. Mine was both. However, I used the meds for the neurogenic cough. According to Dr. Koufman, “neurogenic simply means “of or relating to a nerve,” and in the case of a neurogenic cough, it is the vagus nerve that is out of whack.” She has a lot of good information on her website.
So I’ve been off of the drugs and no neurogenic coughing for over a month. I did get a cold shortly after Thanksgiving and was coughing, but it wasn’t the same. This is a different kind of cough. I’m still nervous that it will come back, but so far, so good.
I wanted to add that if you have a chronic cough, it might not act like mine. You may be able to sleep at night, and maybe your episodes are not as often as mine, if at all, but it’s worth checking out Dr. Koufmann’s information.
Now to get back to creating, and looking forward to a much better 2023. Happy New Year Everyone!