# Doctor misdiagnosed my cough for 5 months - it was the Lisinopril. How to confront him? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [January 26, 2012, 5:17pm UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748 "2012-01-26T17:17:34Z")\ **Posts on this page:** 16\ **Page:** 3
**Author:** ![Amasia](https://avatars.discourse-cdn.com/v4/letter/a/ba9def/32.png) [@Amasia](https://boards.straightdope.com/u/Amasia)\ **Post date:** [January 27, 2012, 7:07am UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748/41 "2012-01-27T07:07:39Z")
As others have pointed out, please don’t be afraid to challenge doctors who you don’t feel comfortable with or who are not listening to your symptoms. That doesn’t mean that you should expect to walk into a doctor’s office with a demand for a certain prescription/procedure, but you have a right to be treated effectively and efficiently. Use the internet (but not too much!) and always check side effects, drug interactions ect. You are the last stop-gap on your own health. To the OP, I’m sorry about your experience and the misery you must be experiencing. Hopefully the symptoms will abate sooner than you expect. ---
**Author:** ![contradancer](https://avatars.discourse-cdn.com/v4/letter/c/9dc877/32.png) [@contradancer](https://boards.straightdope.com/u/contradancer)\ **Post date:** [January 27, 2012, 7:20am UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748/42 "2012-01-27T07:20:15Z")
From what you describe it appears that you did have some viral or bacterial infection coincidental with beginning the Lisinopril and the Doctor just kept following that line of treatment. I took a beta blocker and the cough drove me nuts, but I looked it up on the internet and found that was a common side effect. The cough went away in a couple of days. You have to realize that you are responsible for keeping yourself informed. I know you aren’t a doctor but if you have just started a medication it would be reasonable to assume that might be the cause of your cough. I hate it, but doctors have become mostly pill pushers and you have to get involved in your own treatment. ---
**Author:** ![contradancer](https://avatars.discourse-cdn.com/v4/letter/c/9dc877/32.png) [@contradancer](https://boards.straightdope.com/u/contradancer)\ **Post date:** [January 27, 2012, 7:24am UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748/43 "2012-01-27T07:24:30Z")
From what you describe it appears that you did have some viral or bacterial infection coincidental with beginning the Lisinopril and the Doctor just kept following that line of treatment. I took a BP med and the cough drove me nuts, but I looked it up on the internet and found that was a common side effect. The cough went away in a couple of days. You have to realize that you are responsible for keeping yourself informed. I know you aren’t a doctor but if you have just started a medication it would be reasonable to assume that might be the cause of your cough. I hate it, but doctors have become mostly pill pushers and you have to get involved in your own treatment. ---
**Author:** ![Becky2844](https://avatars.discourse-cdn.com/v4/letter/b/91b2a8/32.png) [@Becky2844](https://boards.straightdope.com/u/Becky2844)\ **Post date:** [January 27, 2012, 7:55am UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748/44 "2012-01-27T07:55:38Z")
Girl, I read this and just had to post. Same here, same med. Bad cough, and every time I cough I PEE myself. I’m so mad I could chew nails. The doc has changed my blood pressure pills but still, right now—weight gain, wracking cough and piss. They go thru school, get their license, hopefully get a successful practive and no longer have the time to read up on anything. The only “new” info is what they get from drug reps. Apparently any “umbrella” drug that seems to help a lot of things is primo. You HAVE to be your own advocate. Confront him/her. You’re not going to get any satisfaction; the doc is going to brush you off to your face but _hopefully_ you’ll help make them think twice the next time they prescribe for somebody else. $100 worth of bills isn’t worth Small Claims Court; you have to pay court costs which are at least $150. NEVER trust a doctor unequivicalby. Keep a notebook. They do not know everything and unless they’re a neighbor or your BIL they don’t know you. I can’t stress this enough. Not only are doctors just like you and me, they have power over life and death no matter what their level of compentancy. Question everything. Sometimes they cut off the wrong leg, much less give you a medicine that’s “for all,” but not for you. ---
**Author:** ![smaje1](https://avatars.discourse-cdn.com/v4/letter/s/e47774/32.png) [@smaje1](https://boards.straightdope.com/u/smaje1)\ **Post date:** [January 27, 2012, 10:17pm UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748/45 "2012-01-27T22:17:39Z")
Another update: I’ve been off the Lisinopril for about 3 days now. After an absolutely horrid day yesterday (I actually vomited from coughing so hard) and a rough night, I am having a much better day today. No actual coughing _fits_, just the occasional cough that I’m controlling with lots of water, a little cough syrup, and cough drops. I’m starting to feel optomistic that the cough won’t take an entire three months to disappear. But lesson learned. Next time, I won’t hesitate to stand up to my doctor and question their authoriTAY. Becky2844 – I hope your cough goes away real soon! ---
**Author:** ![Foxy40](https://avatars.discourse-cdn.com/v4/letter/f/a9a28c/32.png) [@Foxy40](https://boards.straightdope.com/u/Foxy40)\ **Post date:** [January 27, 2012, 10:36pm UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748/46 "2012-01-27T22:36:10Z")
> [@kayaker](#): > > 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. Personally, I think your doctor was an ass and that isn’t the typical reaction in a doctor/patient relationship. Obviously, if you read the thread, you know the physician did indeed speak about the issue and is working on resolving it. While I may agree with you should a death be involved, a case of chronic cough or a non permanent illness should never have a medical provider gun shy and usually does not. I have to wonder if the first doctor has extensive experience being a defendant. :dubious::dubious: ---
**Author:** ![psychobunny](https://avatars.discourse-cdn.com/v4/letter/p/54ee81/32.png) [@psychobunny](https://boards.straightdope.com/u/psychobunny)\ **Post date:** [January 27, 2012, 11:23pm UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748/47 "2012-01-27T23:23:29Z")
There’s really no excuse if a doctor truly doesn’t know that a cough is a common side effect of lisinopril but it is easy to get tunnel vision and ignore the obvious. I would hope that by the third visit at the latest your doctor would have said to just stop the lisinopril until the cough resolved. However, in a case where it is unclear whether the lisinopril is the cause, I will sometimes have people retry the medication to see if the cough comes back before forever eliminating an entire class of medications for future treatment. Usually the cough from lisinopril is an annoying dry itchy type of cough and not as severe as yours, so retrying it isn’t a big deal. Anyway, the cough is usually significantly lessened within a week. ---
**Author:** ![Foxy40](https://avatars.discourse-cdn.com/v4/letter/f/a9a28c/32.png) [@Foxy40](https://boards.straightdope.com/u/Foxy40)\ **Post date:** [January 27, 2012, 11:29pm UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748/48 "2012-01-27T23:29:49Z")
> [@psychobunny](#): > > There’s really no excuse if a doctor truly doesn’t know that a cough is a common side effect of lisinopril but it is easy to get tunnel vision and ignore the obvious. I would hope that by the third visit at the latest your doctor would have said to just stop the lisinopril until the cough resolved. However, in a case where it is unclear whether the lisinopril is the cause, I will sometimes have people retry the medication to see if the cough comes back before forever eliminating an entire class of medications for future treatment. Usually the cough from lisinopril is an annoying dry itchy type of cough and not as severe as yours, so retrying it isn’t a big deal. Anyway, the cough is usually significantly lessened within a week. I am not a doctor but what I just read, the medication has a side effect of a DRY cough. If the patient presented with a “snotty” nose and productive cough, it seems to me that assuming it wasn’t the medication wasn’t off base at all. ---
**Author:** ![smaje1](https://avatars.discourse-cdn.com/v4/letter/s/e47774/32.png) [@smaje1](https://boards.straightdope.com/u/smaje1)\ **Post date:** [January 27, 2012, 11:48pm UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748/49 "2012-01-27T23:48:48Z")
> [@Foxy40](#): > > I am not a doctor but what I just read, the medication has a side effect of a DRY cough. If the patient presented with a “snotty” nose and productive cough, it seems to me that assuming it wasn’t the medication wasn’t off base at all. To clarify, this was the timeline of events: 1. Doctor prescribed me Lisinopril. 2. Soon thereafter, I caught a bad cold (or had a sinus infection). I had a bad cough (productive) and a snotty nose. Doctor prescribed me antibiotics. 3. Snotty nose went away. Cough remained, but it was no longer a productive cough. I made a point to tell my doctor that it was now a dry cough – a tickling in the back of the throat. Doctor prescribes more antibiotics, saying that the infection must still be there. 4. I make several return visits to doctor. No more snot, but dry cough remains. Cough starts having serious negative effect on my life – loss of sleep, occasional incontinence. Despite the change in cough and the lack of snot, doctor insists it is an infection, recommends Vicks and steam to clear mucus (despite the fact that there is no muscous to clear). 5. Cough gets progressively worse. I return to doctor and demand he run tests for allergies and give me a chest xray. He does, reluctantly. \<— This part pissed me off to no end. I have good insurance that will cover these tests, but he is still reluctant to run the tests! Why? Who knows. 6. Cough is so awful that I go to Urgent Care. Doctor immediately notes connection between Lisinopril and cough. 7. I stop taking Lisinopril, and three days later, the cough which has plagued me for months starts dwindling. Success. So I can understand how the doctor was stuck on the idea that the cause of the cough was an infection. I understand how he did not immediately equate the cough with the Lisinopril. In my mind, the cough from the original cold/sinus infection and the cough from the Lisinopril started right around the same time. What riles me up is that the infection eventually went away. The mucous was gone. I was now describing to the doctor a completely different kind of cough. And yet he was adamant that the cough was the result of the infection. I don’t think he ever considered that it might be something else. Doctors are not perfect. I didn’t expect him to perform miracles. But I am disappointed that he didn’t figure out the connection between the \*later \* (dry, unproductive) cough and the medication he prescribed – a medication that is well-known for causing this exact side effect. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [January 27, 2012, 11:54pm UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748/50 "2012-01-27T23:54:21Z")
Right. At the first visit. Which is where he got anchored onto the snotty nose as the cause of the cough. But when there was no more snotty nose, no sign or complaint of post nasal drip, the holding onto that as the cause of the now persistent “hacking, dry cough” needed to be revisited, the process of thinking of a differential diagnosis formally reopened. If he had done that the lisonopril would have jumped out at him as a very likely suspect, along with bronchospasm as a possibility or even an undertreated occult pneumonia. That’s what **psychobunny** means by tunnel vision (and I have meant by “premature closure” and “anchoring error”.) On preview, as our op says. ---
**Author:** ![This\_Just\_In\_2](https://avatars.discourse-cdn.com/v4/letter/t/bbe5ce/32.png) [@This\_Just\_In\_2](https://boards.straightdope.com/u/This_Just_In_2)\ **Post date:** [January 28, 2012, 1:28am UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748/51 "2012-01-28T01:28:42Z")
It is good to hear you’re feeling better already. With the new energy from less coughing and better sleep, [you might consider other non-medicated ways to control your blood pressure.](http://www.mayoclinic.com/health/high-blood-pressure/HI00027) ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [January 28, 2012, 2:33am UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748/52 "2012-01-28T02:33:02Z")
Well yeah you do raise a very good point. If I understand correctly our op was put on this med after just one appointment documenting mild BP elevation. I’m not an internist but it on peds side we don’t label it as real until we’ve had it as a consistent finding measured at least two additional times separated by at least several weeks. And then yeah mild elevation (maybe even pre-hypertension) I would think would have the non-med approaches at least discussed and encouraged before meds and still discussed and encouraged while on meds as well. Another resource - the [DASH diet](http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf). ---
**Author:** ![bump](https://avatars.discourse-cdn.com/v4/letter/b/7c8e57/32.png) [@bump](https://boards.straightdope.com/u/bump)\ **Post date:** [January 28, 2012, 3:21pm UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748/53 "2012-01-28T15:21:33Z")
> [@Mama\_Zappa](#): > > I think that’s a ARB (like what I’m on now - Benecar). They’re _somewhat_ similar to ACEs, I gather they interrupt the cycle somewhere upstream (or downstream?) of where the ACE inhibitors do, which makes it less likely that it will have the byproducts that cause the coughing… or something. > > In my case, it felt like a tickle or an _itch_ on the _inside of my neck_. I told the doctor I was beginning to have some very weird fantasies involving a bottle brush :D. > > My doctor _also_ prescribed some codeine cough syrup - but just as a brief stopgap until I got in to see her (and it did help but obviously not a long-term solution). I’m really confused at a doctor who will offer refills of that apparently in lieu of finding out what the real problem was!! Losartan is an angiotensin-2 receptor inhibitor, which means it directly inhibits angiotensin-2, rather than the enzyme that converts it a step or two earlier in the process, which generally means that it’s more directly targeted. I actually took the Lisinopril for about 2 years before it finally gave me the cough, so it’s not always an immediate thing. ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [January 28, 2012, 3:22pm UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748/54 "2012-01-28T15:22:10Z")
> [@Foxy40](#): > > Personally, I think your doctor was an ass and that isn’t the typical reaction in a doctor/patient relationship. Obviously, if you read the thread, you know the physician did indeed speak about the issue and is working on resolving it. > > While I may agree with you should a death be involved, a case of chronic cough or a non permanent illness should never have a medical provider gun shy and usually does not. I have to wonder if the first doctor has extensive experience being a defendant. :dubious::dubious: In defense of my physician, the error that occurred was the fault of the laboratory he used. He assumed I would sue him, and he in turn would recover from the lab. He was just following the requirements of his malpractice insurance provider. BTW, I did not sue. I was so happy to find out I was healthy, I didn’t pursue court. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [January 29, 2012, 12:22pm UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748/55 "2012-01-29T12:22:58Z")
> [@smaje1](#): > > 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. You’ll just have to wait and see how long it takes for the cough to go away. It MIGHT (just MIGHT) clear up much quicker. I’ve had some bothersome side-effects with other drugs (metoprolol, a beta blocker) and when the doc told me to stop taking it, he also said it might take several weeks for the side effects to subside. Well, I felt 50% better in just 24 hours, and 90% better in another 24 hours. With any luck, just maybe your cough will clear up quickly, but you never know… YMMV ETA: Aha! Just noticed post #51 above, which remarks on you feeling better already. ---
**Author:** ![Danja](https://avatars.discourse-cdn.com/v4/letter/d/48db29/32.png) [@Danja](https://boards.straightdope.com/u/Danja)\ **Post date:** [January 29, 2012, 9:43pm UTC](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748/56 "2012-01-29T21:43:32Z")
> [@Nava](#): > > UC doctors see a much-wider variety of conditions than most others; they do things like “think of side effects” much more easily. > > Heck, I once diagnosed my mother’s elevated transaminases as having been caused by her cough syrup… the doctor knew she’d been taking it but hadn’t realized a syrup called actithiOL which stated all over the box and bottle “not for children under 12” might, just might, have some alcohol. They’ve lowered the %, but back then it was equivalent to vodka. In that case, the doctor’s reaction was: “kick me! :smack: OK, you should be fine, then, we’ll repeat the test in a month to make sure it was that and I hereby vow to be a lot more careful about excipients and side effects… damn!” A little bit off the topic of the thread, but in fairness to your doctor, I wouldn’t have expected the cough syrup to contain alcohol. It’s actiTHIOL; a thiol is like a sulfur version of an alcohol. Sorry if you’re the chemE poster and I’m explaining this for no reason. [Previous page](https://boards.straightdope.com/t/doctor-misdiagnosed-my-cough-for-5-months-it-was-the-lisinopril-how-to-confront-him/610748.md?page=2)