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Progressive cough with blood streak, wheezing and choking, fever. Taken Glycerin, Guifasen. Good remedy ?

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HI. I am a 32 year old male in the UK, and I have a cough. I am ~5'8" and ~13 stone (I know). I am a bus driver, so meeting lots of people all the time, and my shift pattern changes weekly and have been doing a lot of overtime of late. I also eat irregularly (but plentifully, hence 13 stone), struggle to go to bed early and get very little exercise - I was going to start cycling to work (3 miles - 1/2 hour each way), but the cough has put that on hold for the time being. I do not smoke (but was exposed to a lot of unfiltered pipe smoke in enclosed rooms as a child), and drink small amounts very infrequently (due to driving for a living). No one else in my house smokes, and I have not been in a smoky environment for at least the last 10 years. Also, i have never been able to run very far (60 metres) without getting severely out of breath.

The cough - started about 3 weeks ago, maybe longer. No other really noticeable symptoms. I wasn't really coughing anything up, and what I was coughing up was clear, although thicker than normal saliva. The cough got progressively worse. I started choking when coughing, with the occasional loud gasping/wheeze. One morning (about 2 weeks into the cough) I coughed up a small amount of blood streaked clear liquid, accompanied by the choking, gasping and wheezing - the blood only happened once. During this period I had tried several over the counter cough mixtures including Glycerin, Guifasen and Liqurice and Squill Tincture.

I made an appointment with my doctor, after a brief examination he said I had a very slight temperature and probably HAD had a virus, and was left with an upper Amoxycillin, 500mg 3 times a day for 1 week. I finished this course on 2 days ago. Towards the end of the course of antibiotics I developed a very runny nose. This has also cleared up. Yesterday, I started producing excess saliva, so much so I was spitting it out regularly. Today saliva production is still excessive, but not as bad. But I still have the cough, Fits are few and far between, but very hard.and I am still choking.

To say this is annoying is an understatement. We have been experiencing abnormally high temperatures for this time of year (October) in the UK, and I would like to shake this before the cold hits as it is forecast to hit hard. Plus I would like to start cycling, but cannot whilst I am coughing like this.
Posted Mon, 30 Apr 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sujeet N Charugulla 23 minutes later
Hello and thanks for your query.

I shall make an effort to provide you with good professional recommendations specific to your questions.

I understand the sequence of events for your cough situation has got you concerned.

Reading your history, the 3 week cough with white sputum and the solitary blood expectoration, considering the childhood exposure to unfiltered pipe smoke atop the wheezing and your continued choking - I would like to rule out another point apart from the doctor. And its good that you have already finished that course of amoxycillin which would have killed any bacteria lurking around in the upper traact.

What I am hinting to in here is - obviously after a Chest X-Ray, I want you to be sure your Lower Respiratory Tract is also clear and normal. As sometimes that can be the real source of infection. And Amoxycillin would not kill bacteria there. You would need an antibiotic more powerful than that.

On the Chest Xray the focus of the consolidation would become clear for you, and rationally the lurking symptoms that you have right now, in spite of the initial good treatment your doctor gave you, can be explained better.

You should be fine after the entire infection clears up. One more thing, gasping can also be due to your 13 stone weight as you are already aware, so this aspect needs consideration in here. As sometimes, your compromised lungs due to the infection would have undergone the strain to accommodate the excess needs of your body during cycling etc. So, go easy and work on a long term weight loss regime. A qualified trainer might help.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you and I shall be glad to answer any further apprehensions.

Above answer was peer-reviewed by
Follow-up: Progressive cough with blood streak, wheezing and choking, fever. Taken Glycerin, Guifasen. Good remedy ? 2 hours later
Thank you for your reply.

I know searching for information on the internet regarding medical matters can lead to mis-information. But a lot of things I have been reading point towards maybe an irritation of the throat and possibly post-nasal-drip brought on by excess stomach acid.

I have in the past suffered from bloating, the odd bit of acrid fluid (bile?) brought up on occasion and the odd bit of heartburn. But not very often and nothing that has every kept me awake at night despite the fact I have poor diet, and irregular eating times.

Do you think there is anything in this, or do you think it is more likely that it is a lower infection.

Many thanks.
Answered by Dr. Sujeet N Charugulla 5 hours later
Thanks for the follow up.

These set of symptoms certainly point to problems in the gut apart from the lungs. But, I do not think you are having the lung symptoms because of the gut reasons. Yes, they could be added problems in not relieving the coughing due to the post nasal drip aggravated by the reflux of acid from the stomach into the throat.

Try, regular diet times/not reclining an hour atleast after meals/cutting on tea,coffee/ over the counter remedies for heartburn for a couple of days like antacid chewable tablets, liquids.

If persistent, you would need prescription tablets to neutralize the acid from a doctor. As that could mean a Gastro-Oesophageal Reflux Disease, Peptic Ulcer Disease. Treatment is mostly with tablets and you should do good.

Let me know if any further queries.

Wishing you good health.

Above answer was peer-reviewed by
Follow-up: Progressive cough with blood streak, wheezing and choking, fever. Taken Glycerin, Guifasen. Good remedy ? 19 hours later
Thank you once again for your reply, very insightful.

I have yet to see my GP, but things thankfully seem to be on the mend. I forgot to mention in my last reply that whilst coughing / choking &c., I was also wretching(sp?) - I felt like I was trying to vomit, but nothing was happening.

Anyway, this morning I had a coughing fit with all above symptoms, but not as bad as ones that gone before. What I coughed up was not much, mainly clear although streaked with a tiny amount of yellowy-green stuff (pretty normal as far as I am concerned). However, there appeared to be 3 dark spots in it. I took a cotton bud and as best as I could, fished out one of the dark spots. Unfortunately I was rushing for work so I only hastily examined it and forgot to take a picture. To me it looked like it /could/ have been a seed casing. And I had walked through a /cloud/ of seed a couple of weeks ago (cannot remember if it was before or after cough started though). I am not saying these were seed casings, but whatever, I have coughed far less since.

I do now have some other symptoms though. I have what feels like a prickly rather than tickly throat - not really surpised there is soreness after all that coughing though. But also the dangly thing at the back of my throat (uvula?) is swollen. I did take some photo's of this as best I could with my camera-phone...




Again, I have tried to do my own research into this - and this is something I have had before and usually goes away withing 12-48 hours. I have read that this is often (but not only) caused by stress and dehydration. I am also a big snorer which I am sure won't help.

I have upped my fluid intake - mainly room temperature water, taken some Ibuprofen and suck the occasional Strepsils (2,4-Dichlorobenzyl alcohol 1.2mg & Amylmetacresol 0.6mg) or Strepsils Extra (Hexylresorcinol 2.4mg).

I would like your opinion on this, but feel sure things are going in the right direction.
Answered by Dr. Sujeet N Charugulla 11 hours later
Thanks for the reply.

I realize after viewing your upper throat pictures, yellowish-green sputum, seed casings occasionally, dark spots and all - the infection does not seem to have been reduced with Amoxycillin, and you would require further review.

The swollen uvula speaks of the infection at the moment. As you know it should reduce as the infection is controlled. And retching has been brought with the irritation of your gut mucosa with the irritant repeatedly by the sputum you have swallowed.

This is normal in persistent infections. Try warm water iodine gargling meanwhile 4-5 times a day. You should get a iodine mouth gargle solution in stores, dilute as given.

Anyway, you are right on track and your visit with the GP would certainly help you with the current situation.

Wishing you good health.

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