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Suggest Treatment For Productive Cough

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Posted on Mon, 25 Jul 2016
Question: My 91 year old Mom started a slight cough on 6-22-16. Within a 5 days her cough was constant without producing phlegm. She still has the nagging cough on 7/8/16 and continues to hang on. She had a chest x ray on 6-27 and 7-11. Lungs were clear and no pulmonary edema. She is on duo-neb 4 times a day, symbicort 80/4.5 twice a day and recuse inhaler twice a day and Delsym OTR cough medicine every twelve hours. She has a history of COPD and reactive airway disease. Her vitals are BO 155/84 PR 85 O2 90 (96 with three deep breaths) temp normal.) We have installed expensive air purifiers in the house. She does have allergies to dust and pollen. But these whole house air purifiers should be controlling that. Inside or out side makes no difference with coughing. However, she is not exposed to the outside very often.
She has has a 22 y\o aortic pis valve with 100 % dependent on a pacemaker. Pacemaker was replaced on 6/29/16. She had some foot and ankle edema for three days that was removed easily with Lasix. Lasix has been stopped 7/8/16. She gets slightly winded easily, walking from car to house. At her 91 birthday on 1/17/16 she was unable to blow out two candles on her cake. Her daughter had to blow them out for her. She has pretty sever unrinary retention and we are working with a urologist on that but it has been slow going because they are so busy. Our objective is self catherization. Do you think this cough is viral? Or symptom of her conditions. Kidney's are fine. I live with her and am her caregiver for years. She has Hippocampal sclerois dementia. Short term memory is terrible. Long term memory very good. She is not diabetic and takes no blood pressure medication.
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Answered by Dr. Drkaushal85 (7 hours later)
Brief Answer:
Yes, possibility of viral infection is more.

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.

Since chest X-ray is normal, no need to worry for pneumonia and pulmonary edema.
She had also changes her pacemaker recently, so cardiac cause is also unlikely.
Possibility of viral upper respiratory tract infection (URTI) is more.
Viral infection usually causes secondary bacterial infection.

So along with all these drugs, you should also give her broad spectrum antibiotic like Levofloxacin or Azithromycin (these are prescription drugs so you need to obtain them from your local physician).

Another possibility is worsening of COPD. She is having breathlessness on minimal exertion and now coughing. Both of them are commonly seen with worsening of COPD.

So also get done PFT (pulmonary function test) to identify this.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother.
Thanks.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Drkaushal85

Pulmonologist

Practicing since :2008

Answered : 15005 Questions

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Suggest Treatment For Productive Cough

Brief Answer: Yes, possibility of viral infection is more. Detailed Answer: Thanks for your question on Health Care Magic. I can understand your concern. Since chest X-ray is normal, no need to worry for pneumonia and pulmonary edema. She had also changes her pacemaker recently, so cardiac cause is also unlikely. Possibility of viral upper respiratory tract infection (URTI) is more. Viral infection usually causes secondary bacterial infection. So along with all these drugs, you should also give her broad spectrum antibiotic like Levofloxacin or Azithromycin (these are prescription drugs so you need to obtain them from your local physician). Another possibility is worsening of COPD. She is having breathlessness on minimal exertion and now coughing. Both of them are commonly seen with worsening of COPD. So also get done PFT (pulmonary function test) to identify this. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.