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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Intense Coughing Post Partial RLL, Feeling Of Lump On Throat, Cough On Deep Breathing. Disruption During Intubation Or Extubation Causing This?

I had a partial rll. The same evening I felt like there was loose skin deep in my throat. It was gone in a couple days. I was discharged on 4 days post op. I woke up 2 days later with a gagging cough which I still have 2 l/2 mos. later. I coughed so hard that I blew a qt of old blood & fluid out a stitch where the chest tube had been. Then a few days later I had another qt. removed by a pulmonologist . Each time I lost this fluid I also lost the cough for maybe 8 hrs. & it returned. A recent x-ray & ultrasound showed that I have only a couple of areas with very minimal amt. of fluid remaining. This cough has changed my life as these coughing episodes just appear at random not related to anything specific & make it impossible for me to talk & nothing I do stops them. I have gone to the ER twice & there is nothing they can do for them. I went to an ENT & was told I had LPReflux from the fluid on the lung for weeks & just the surgery in general pushing on everything. I was put on the diet & lifestyle changes to try to stop the cough so the Inflammation would hopefully improve. I take hydrocodone twice daily & benzonatate 3 times daily & recently was put on pepcid . I feel like I have a lump more on the right side of my throat just above where the collarbone comes together in the middle. This area on the right side of my throat if touched will bring on a violent coughing episode. And if I take a deep breath it also stimulates that same area resulting in coughing. My opinion of this is that something was done during either the intubation or extubation causing this? I m to have a barium swallow test in another week because when I swallow at all regardless of eating or drinking I have a sensation of a fullness in my throat. At times when I eat something it feels like it doesn t go down. I can go for several hrs. without coughing & without having a sense of swelling or fullness. What is your opinion about this coughing which causes me to become fatigued & totally frustrated.
Sat, 4 Jan 2014
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General Surgeon 's  Response
Hi. As you have rightly noticed the problem lies in the lower part of the neck. It is this area from where the phrenic nerve supplying the diaphragm goes down and the nerve supplying the vocal cord comes up. As also you have a sense of fullness in the throat. A good CT SCAN will help you to get a diagnosis and guide for further management. Of course go for Barium swallow as it may show something that the CT scan can not show. I hope this explanation helps you.
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Intense Coughing Post Partial RLL, Feeling Of Lump On Throat, Cough On Deep Breathing. Disruption During Intubation Or Extubation Causing This?

Hi. As you have rightly noticed the problem lies in the lower part of the neck. It is this area from where the phrenic nerve supplying the diaphragm goes down and the nerve supplying the vocal cord comes up. As also you have a sense of fullness in the throat. A good CT SCAN will help you to get a diagnosis and guide for further management. Of course go for Barium swallow as it may show something that the CT scan can not show. I hope this explanation helps you.