Doctor misdiagnosed my cough for 5 months - it was the Lisinopril. How to confront him?

In My Humble Opinion
1

This could probably go in the Pit, 'cause I am FUMING, but I need some reasonable advice on how to proceed. I’m not looking for lawyer or doctor advice, but suggestions from fellow patients who’ve been through something similar.

I started seeing a new doctor about 6 months ago. Nice guy, no negative reviews online, preferred provider for my insurance. He prescribed me Lisinopril for slightly elevated blood pressure.

A month later, I’m in his office with a sucky cough and snotty nose. He tells me I have a sinus infection, prescribes me antibiotics, and I go on my way. The snot clears up but the hacking, dry cough remains. I return to his office a few weeks later about the cough. He tells me the bacterial infection obviously hasn’t exited my body, so more antibiotics and a codeine-based cough syrup.

Now the cough is severly affecting my sleep. I’m waking up in the middle of the night – several times a night. The cough syrup helps a bit, but not a lot. Another visit, and he tells me to breathe in lots of steam and use Vick’s on my chest. Another few weeks, another visit. At this point, my husband is worried that it’s something serious (my dad currently has lung cancer and my grandpa died from emphyseima – I quit smoking about 2 years ago after a 15-year habit). Again, more antibiotics and cough syrup.

Now it’s affecting my work. I break out into horrid coughing fits at work and people are afraid to sit near me. My head is throbbing from the constant coughing. My husband is panicking. I’m starting to PEE MYSELF from coughing so hard.

I go into the doctor on Monday and DEMAND a chest xray and allergy tests – I tell him he has to do SOMETHING to help cure this cough. He is hesitant to do any further tests, and tells me I should check with my insurance to see if they cover such tests. They do. Chest xray comes back negative. They draw blood for an allergy test and tell me to return this Friday (tomorrow) for the results.

Yesterday, after another sleepless night full of dry, wretching coughs, I go to Urgent Care. They do an immedaite asthma test - negative. A lung-function test - all clear. The doctor asks me what medications I’m taking. When I get to Lisiniopril, she stops me. “There’s your problem right there!” she says.

I go online to discover this is the most common complaint about Lisinopril – a dry cough. Holy fluff.

I’ve stopped the Lisinopril, but it seems that it can take up to THREE MONTHS for the cough to go away once the medication is stopped. Another 3 months of no sleep and pounding headaches.

I am so furious with my doctor. How could he not know about the coughing side effect? Why didn’t he look into it?

I’m so glad I got a second opinion. It took me WAY to long to seek one out, but I’ll chalk that up to lesson learned.

My question is – what do I say now to the original doctor? I’ve spent over $100 in co-pays on visits, plus money for all the stupid prescriptions. I want to confront him about this and ask him why he didn’t figure it out.

Would you pursue legal options? I want my money back! And I want him to apologive to me, and also somehow magically give me 5 months of sleep back. And all those night I couldn’t sing a good-night song to my baby, because I was coughing too hard – I want those nights back too.

GRRRRR.

2

Before you check into legal options, did you receive any paperwork with this medication that listed the side effects? (Maybe your pharmacy doesn’t do this, but mine prints out a lengthy list of all possible side effects, warning signs, don’t take this medicine if’s, etc., and puts it in the bag with the bottle of pills.) If you did receive this information, and didn’t read it, then that may be a problem with any possible lawsuit.

If you didn’t get this information, then tell your lawyer that, and also your doctor. (Who may have thought you did get that information.)

You have my sympathy for the sleeplessness, either way.

3

I had the same problem with that med. But my doc not only clued me in about that side affect, he reminded me and asked when I went back for a re-check on the BP. Sure enough, a dry hacking cough. Weird side effect.

4

Good point, Dendarii. Yes, I do receive paperwork on all prescriptions, and I do read through them. I just never associated the “occasoinal cough” symptom with the horrid, hacking cough that I was experiencing.

To be honest, I will likely never look into legal options about this. I don’t want to sue anyone. But I DO want to confront the doctor and demand an explanation from him about why he never looked into any other possible causes for the cough – it seems he was just stuck on the idea that I needed more and more antibiotics for an infection, and he never considered that the problem could lie elsewhere.

5

Yes cough is a side effect of that med but your cough began with a snotty nose … lisinopril does not cause that. It may be that the nose was just coincidental, happening at the same time you developed a lisinopril induced cough … but it may not be. It is very reasonable to include lisinopril cough in the differential, it may even be the likely reason, but the urgent care doc jumping to conclude that it is the cause is as much of a cognitive error as your primary’s staying anchored on the snotty nose as the cause. (And that is very likely the error he made, not not knowing about lisinopril cough, but staying anchored, focused, on the initial presentation of the cough as one that began with an apparent sinus infection. Not opening up his thought process to other considerations as the nose cleared and the cough remained or worsened. It is a common error to make.)

In any case a doctor who errs can only learn if (s)he learns of the possible error. Confronting is not useful, but getting feedback that may improve his performance in the future is. It’s how experience makes for better doctors.

6

It sounds like you had two things going on, the cought that went with your sinus infection and snotty nose and then the nagging cough that came from the Lisiniopril.

I quickly looked up Lisiniopril side effects, and the first thing I got was The most common side effect of all of the ACE inhibitor medications including Lisinopril is an annoying persistent cough. This resolves if the medication is stopped, but can take weeks or months to completely go away.

When you are prescribed a medication, it helps to be an informed consumer and patient by looking into possible side effects. It takes only a minute, but it can save you a lot of hassle.

7

You’re putting all your faith into an Urgent Care doctor who saw you for…what? 15 minutes?

By all means, change doctors if you’re unhappy with the care that your current one is providing. But don’t assume that Doctor B is correct based on nothing more than his opinion. Go off the medication to see if the symptoms alleviate, and THEN you can more safely draw conclusions.

8

It sounds like the Doc should have considered the known adverse effects more than he did, I’ll grant you that. But – and you’ll probably have to take this comment as a Devil’s Advocate sort – you really don’t know if the drug was the cause, and the only cause of your cough. It is entirely possible that your coughing spell was coincidental to your taking of the drug. In fact, you mentioned it took 3 months after discontinuing the drug before the cough went away, which tends to un-incriminate it.

No matter how much you may blame one drug for your cough, one example, one trial, one patient, isn’t enough to firmly establish the cause & effect when there were probably dozens, if not hundreds, of other factors that cannot be ruled out.

But I certainly would find another doctor.

9

That is odd that a doctor wouldn’t think that a dry cough was a side effect of an Ace inhibitor. Of course hindsight is 20/20.

This is off topic, but next time you see a doctor ask them if an ARB would be a good substitute for the lisinopril. The cough is due to a buildup of bradykinin (which builds up because the ace inhibitor blocks the ace enzyme, which breaks down bradykinin), an ARB would bypass that problem and just block the angiotensin receptor.

10

Trust me, PunditLisa, based on the post-yesterday-visit research I did about coughing and Lisinopril, it is definitely and without question the cause of the cough (especially since Doctor B jumped right on the asthma and lung-function tests that turned out negative).

I will take responsibility for not doing the proper research on the drug when I first started taking it. The cough, when initially presented to my doctor, could very well have been caused by (or partly caused by) the sinus infection, and so I understand how he could have misdiagnosed it the first few times I returned to his office.

But we are talking about 5 months of visits here. And he seemingly refused to look into other possible reasons for the cough even after the snotty nose went away. I think had he worked dilligently with me to discover another reason for the cough, we may both have stumbled upon the Lisinopril thing.

So for reals, let’s take the idea of legal action off the table. I don’t want to sue. I do certainly want to confront him about this, so at least he can has accurate information next time this happens to another one of his patients. I literally don’t know HOW to confront him. Pay for another visit and then tell him? Call him on the phone? Wait until I go in tomorrow to get the results of the allergy test and then tell him? I don’t want to make another co-pay just to tell him this!

11

You misread my OP, Musicat. The cough will NOW take three months to go away now that I’ve discontinued the drug. I am still coughing. And not sleep. And pissing myself with every hack.

And as I posted just a second ago above, there’s a very good chance the original cough WAS due to a sinus infection (or at least partly responsible). But once the sinus infection was completely gone (and after 4 rounds of antiobiotics, it surely SHOULD be gone), the cough remained for another 4 months. That’s the “bad doctor” part of this whole complaint.

I will be seeing a new doctor and will definitely get on another medication that can help with the high blood pressure.

12

I’d call his office and say you’d like to speak with your doctor. You may be asked to leave a message and then receive a call back. You don’t have to pay, for fuck’s sake. (I’m assuming you’re in the U.S.)

13

Call or write a letter. Try to phrase it in a non-angry tone, but express your disappointment that he remained focused on the initial presentation as the cause and did not consider other options as the cough persisted, such as the lisinoproil.

14

Do you really think what you’ve described rises to the level of medical malpractice? Your doctors conduct did not fall below the standard of care expected of physicians. You complained of a variety of symptoms and he attempted different treatments. The law does not require the impossible—immediate and unfalliable diagnosis—when the practice of medicine still requires more than a few judgment calls and episodes trial-and-error.

And who knows, the doctor might be glad to be rid of a patient as theatrical as you’re coming across.

15

Yes you do need to speak up about it. Make a follow up appt, be clear to the staff that the usual copay will not apply, this is a follow up to prescribed medication that is causing serious side effects. Let him explain if he cares to, and go from there, good luck, I hear your gripe.

and imho, i call BS on the sinus infection, that antibiotic probably did nothing for your common cold and nothing for your side effect.

I am so down on the whole dr/office interactions i’ve had these years, I want a customized healthcare boutique experience.

16

Bolding mine. Obviously I don’t think it rises to level of medical malpractice. I have staetd as much in my subsequent posts. And he did NOT attempt different treatments. He kept plying me with antibiotics and the same cough medicine. He did not consider that his diagnosis was incorrect.

But thanks for your helpful advice, Kimmy. I’m glad I can depend on your wise council in situations where I am upset because a doctor ignored my pleas to find another cause of the cough that has given me so much physical and emotional pain. Perhaps the next time you go for 5 months without a good night’s sleep and a bunch of instances where you piss your pants because you’re coughing so hard, I can give you similarly good advice.

17

I bet he won’t talk with you about this. You are alleging he screwed up. He has insurance to cover his ass. Any sort of admission on his part may affect his ability to defend his actions in court.

ETA: I speak from personal experience. My doctor’s lab made an error. I took medication for two weeks that made me pretty ill. A second opinion led to the finding that the first lab test was in error. My first MD told me, very politely, that his insurance company would not allow any further contact between us.

18

What I would do is politely tell him about the connection between my persistent cough and the medicine he prescribed, and get a different doctor. My confidence in this doctor would be shot.

19

Doctors aren’t pharmacologists, they often come to a conclusion and stick to it despite all evidence too. Your best bet is to stay proactive and do your own research.

I went in to the ER because of a near fatal asthma attack, well they decided I had a seizure disorder and wanted to put me on seizure meds and didn’t even treat my asthma!
I was 28 years old and never had a seizure in my life, however I had asthma since I was five.

Because you know you can’t pass out from an asthma attack, asthma doesn’t kill people or anything :rolleyes: <sarcasm

20

I would talk to your doctor about your experience in Urgent Care, the research you have done, and to tell him you have stopped taking the prescription. Ask him if there are any extenuating circumstances for why he didn’t talk to you about this evidently common and persistant side-effect, or ask you to get off of the medication himself. No need to be rude about it, and don’t make it seem like you’re scolding him or putting a “gotcha” moment on him. He’s a professional, one who obviously made a mistake, and should be treated with respect, just like how you would like to be treated if you made a mistake when trying to help someone for months (which he was doing for you). If you really feel he is incompetent, then find another physician and tell him why. That’s pretty much all you have to do.