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Treatment for allergic cough - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Asthma and Allergy
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3631 Questions
User :   Hello, I am a 53 year old female flight attendant who for the last year and a half has been experiencing what I think may be chronic bronchitis. I have seen two pulmonologists and had 3 spirometry (sp?) tests, chest exrays, etc. Two of these physicians suggested COPD, and two didn't give me a for sure diagnosis. I am taking prednisone for the fourth time in this last year and a half for an unstoppable cough, heaviness and sort of burning in my lungs, and it usually happens after a long flight and when my system is weak and exposed to a different climate (I just returned from New York.....and I live on Guam). I am pretty sure this is allergy related because when I try to have a glass of wine with dinner.......I start coughing and feeling the symptoms I am assuming that it is also an irritant/trigger. I have been tested by an allergist to be highly allergic to dust mites....and it doesn't help that I live in a high humidity place.....however, I have been able to keep my allergies at bay by taking Allegra once a day and using Palanase and Verymst nasal sprays. Will you answer four questions for me if you have time? We do not have a pulmonologist on I will be anxiously awaiting your reply.
1.) Do you think there is a good chance that I have chronic bronchitis or COPD?
2.) When I take prednisone long does it take to kick in at 20mg dosage?
3.) Is it okay to take two pills in the morning rather than every 12 hours. I am having alot of trouble sleeping. And is that harder on my system to take it that way? should I just take an over the counter sleep aid.....instead? Okay that was four.....sorry.
Thank you so much for your response.
Doctor :   Hi
Doctor :   I am reding ur Q, plz wait
Doctor :   Hi
Doctor :   I am sorry for late
Doctor :   Are you there?
Doctor :   Your 1st ! 1.) Do you think there is a good chance that I have chronic bronchitis or COPD?
User :   Yes....I just didn't want to interrupt you. PLease take your time.
Doctor :   How many cigarrertes you smoke
User :   I have never smoked! And never lived with a smoker.....only 8 years of second hand smoke on the airplane.
Doctor :   Because you have cough for more than 3 months and you smoke , you have been exposed to smoke you may have COPD
User :   not to mention that we had to spray pesticides in countries like Papau New Guinea and Australia for years.
Doctor :   Ok
Doctor :   That COD is 1 possibility with second hand smoking
User :   When I have seen four different doctors and they can not give me a for sure diagnosis.....what do you think is my next steP?
Doctor :   Yes
Doctor :   COPS is 100% diagnosed when u have positive spiromtry test
Doctor :   But the diagnosis is empirical now /clinical grounds
Doctor :   It may not be 100%
User : what would you recommend that I do to figure it out for I just wait for it to get worse if it is chronic bronchitis?
Doctor :  
2. Next possibility As you are already allergic dust and use sprays ,, you cough might be due to allergic reaction
User :   OK.
Doctor :   But the Q is doea the allegins stay on the time?
Doctor :   But still that is second possibility
Doctor :   but u tested and u r positive for allergens right
User :   Right
Doctor :   ur 2nd Q 2.) When I take prednisone long does it take to kick in at 20mg dosage?
User :   Yes.
Doctor :   Prednisone work both for allergic cough and COPD
Doctor :   but it is for OPD
Doctor :   *COPD
Doctor :   it kicks in in 1 hr
Doctor :   one tan enough for day
Doctor :   it acts for 24 hrs
User :   Can an allery caused cough last for months?
Doctor :   no
Doctor :   unless the allergens last longer and u r exposed them alll the days
User :   So you think that after three pills of prednisone that I should have a major difference in my symptoms?
Doctor :   ur 3 rd ! 3.) Is it okay to take two pills in the morning rather than every 12 hours.
I am having alot of trouble sleeping. And is that harder on my system to take it that way?
Doctor :   Yes
Doctor :   YEs u ca ake 2 in AM
User :   I am exposed to allergens every my home and on the airplane.
Doctor :   *yes u can take 2 in AM
Doctor :   ok
Doctor :   So moslty that is the reason u have chronic cough
User :   But it's harder on my system if I take 2 at one time?
Doctor :   How long u use them
User :   I took one last night and 2 this morning......and I am still coughing a little and still have the feeling in my lungs and chest.
Doctor :   it may not suppress the cough
Doctor :   it will decrease the inflammation
Doctor :   to suppress cough u need to use for 7 days
Doctor :   mean while u have to use cough suppressants
Doctor :   Ur 4 th Q should I just take an over the counter sleep aid.....instead?
Doctor :   yes Benadryl bed time is good sleep aid
Doctor :   no problem with this for u
User :   Ok......and would you suggest that I do take 2 in the morning so I can sleep......or should I tough it out at one every 12 hours like is prescribed.
Doctor :   especally when u have allergy
Doctor :   Yes, usually prednisone can only be given one time
Doctor :   that is in the morning
User :   So 2 in the morning is what you would suggest.
Doctor :   iy
Doctor :   yes
User :   What would you do if anything to make sure of the diagnosis if you were me?
Doctor :   Do not take any medicines, when u r symptomatic, get the pulmonary function tests done
Doctor :   CT chest done
User :   Ok. thank you so much.
Doctor :   WHen u r not on edicines the pathology will be evident in pulmonary function tests
Doctor :   when u r getiing better, the lungs function well and the pathology is not reflected in Pulomnary function tests
User :   This is quite difficult living on Guam with no pulmonologists.........but I will try next time I have this problem.
Doctor :   u dont need Pulmonologist
Doctor :   General physican is fine
Doctor :   some body has to review the results of PFT
User :   Have you ever been to Guam????
Doctor :   No due
User :   Just a way.......but I have never been offered those tests on guam
Doctor :   I will
Doctor :   OK
User :   Do most general physicians have the abiltiy to administer the spirometry and the CT scan?
Doctor :   I understand, most doctors in rural India also do not order the tests
Doctor :   but good one will do in cities
Doctor :   Do most general physicians have the abiltiy to administer the spirometry and the CT scan? ::::: Spirometry is very simple. Yes it can be administered by any one. It is not full pulmonary function tests(PFT). Get the full PFT
Doctor :   CT chest is is done in radilogy dept
Doctor :   Docotr will not do it
Doctor :   There are technician do these?
Doctor :   Doctor will analyse the results
User :   I see. thank you very much for your help with this.
Doctor :   I do not recommend prednisonoe more then 1-15 days
User :   My prescription is for 7 days only. Hope it isn't too hard on my system since I do have
Doctor :   You can better use steroid inhalers on long term basis
User :   pre osteoporosis
Doctor :   that is right
Doctor :   short term ok'
Doctor :   OK
User :   I have been using Advair diskus whenever I have the slightest problem......but it didn't help this time.
Doctor :   Hope I cleared ur doubts?
Doctor :   Ahha
Doctor :   u did not tell me that
User :   oops.....sorry.
Doctor :   That is for COP and Asthma
Doctor :   That has two medicines
Doctor :   fluticasone+salmeterol
Doctor :   U have to use it regularly , not like when u have problem
Doctor :   any other inhalers
User :   Like for the rest of my life? Every day??? Yes, I have been using albuterol as well when I feel the need.
Doctor :   not for the rest of lif
Doctor :   eTry ising for 3 mon and watch the symptoms
Doctor :   *try using for 3 mo
User :   Ok I will......but should I be using it with the prednisone?
Doctor :   May have to use it for life long
Doctor :   when symptoms are ad
Doctor :   8bad
Doctor :   *bad
Doctor :   but give gaps in using
Doctor :   When ever u have severe cough, use both
Doctor :   and then tapper and stop Prednisone and continue Advair
User :   I thought there is a drug interaction problem there
Doctor :   No
User :   Ok then....thanks.
User :   The advair did not stop my cough the other three times that I had this problem. what do you think about that
Doctor :   If the diagnosis is COPD, Advair works
Doctor :   If the diagnosis is not COPD, we r giving it empirically
User :   What about emphysema??? My mother's father (my grandfather) died of that and he
User :   did not smoke either. He worked in a cannery.
Doctor :   Get PFT done
Doctor :   it will show it
Doctor :   COPD means bronchtis + emohysema
Doctor :   *p
User :   Ok.
Doctor :   DId I asnwer ur questions?
User :   Yes, of course I have many more but thank you so much for your time.
Doctor :   what else do u have
Doctor :   I can answer logically
Doctor :   scientifically
User :   Like if it is COPD.......should I stop my career as an airline flight attendant??? should I move to Arizona or somewhere dry?? Should I kill my cats????
Doctor :   No sweety
Doctor :   That is wrong step
User :   Good. I guess I will just wait for the next time and get the full tests and go from there.
User :   Thanks again. My other questions are probably just because it's fun to talk to you. So I should say goodbye. Namaste.
Doctor :   Namaste
Doctor :   Danyavad=Thank you
User :   Si jus mase (thank you in Chammoro.....the native Guam language). Bye!
Doctor :   where Guam
Doctor :   Is it in south
User :   Everybody asks that. It's a US territory in the middle of the Pacific Ocean about 3 hours
Doctor :   OK
User :   south of Japan......and acrossed the ocean from the Phillipines
Doctor :   Great borders
User :   am i your first patient from Guam?
Doctor :   It might be beautify pale to see
Doctor :   If u think so..
Doctor :   Yes
Doctor :   u r
User :   Yes, very tropical and hot.....kind of like India
Doctor :   I like thhe HOT though
User :   me too.......but maybe I should not live here because of my allergies. I am sure my house is full of dust mights even though I do everything possible to keep them at bay.
Doctor :   It was wonderful talking to you AAAAAAA
User :   where are you?
Doctor :   Avod dust
Doctor :   use humidifier at home
Doctor :   use curtaiins
Doctor :   india
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