Medical advice solicited: troublesome cough for 3 weeks

You are not my doctor - I have some appointments lined up to get this condition investigated some more, but I thought the smart folks of the SDMB might be able to contribute some ideas or insight…

About 3 weeks ago, I developed a cough that I thought was just the start of a bout of the common cold - a few days later, I still had the cough, but not really any of the other usual symptoms of a cold

It went on for a week like that, getting slowly but steadily worse - until it got to the point where the cough would wake me up multiple times in the night, struggling to breathe with a throat full of phlegm.
I went to the doctor at that time and was thoroughly examined - a chest infection was ruled out, but the doc gave me a prescription for amoxycillin, not to be started immediately, but to be kept in case I felt that a bacterial infection was beginning.
I sat on the prescription for about a week, and the cough did worsen, including some wheezing and rattling in my breathing - so I collected the pills and began taking them.

So the exact symptoms are (sorry, some of this is gross):
[ul]
[li]nearly constant production of clear, salty phlegm - I can’t tell if it’s all originating in my sinuses or nose, but my nose is not running (in the direction of my nostrils) at all[/li][li]Sore throat[/li][li]Loss of voice (I sound like Barry White most of the time)[/li][li]Coughing fits that can sometimes escalate to trigger vomiting, or more commonly, leave me physically unable to inhale for 30 seconds or so - as if my larynx has shut completely.[/li][li]If I sniff hard (which I sometimes feel I need to, before trying to cough out an accumulation of phlegm), I sometimes smell a faint scent of ammonia[/li][/ul]

My temperature and blood pressure are normal - I am continuing the course of antibiotics to the end of the pack. I am about 2/3 of the way through the course.

If I lie flat on my back, I can get a whole night of sleep without waking up choking - if I sleep on my side or front, I get about an hour of rest before waking up in panic coughing and spluttering.

In total, it’s now been about 3 weeks since the start of this condition. In the mornings, I feel like maybe I am improving, but later in the day, things return to a poorer state.

I have more medical appointments booked, but would appreciate anyone else’s advice especially if you have experienced anything very similar.

Until the Doctor–try OTC expectorant tablets/syrup.

It’ll help with your discomfort, at least.

I have had some coughs like this. They are almost always the result of a sinus infection. Did you not get a cough suppressant along with your antibiotics? I’m kinda surprised you didn’t get a cough suppressant. I know your cough is productive, but you need to get some sleep. I have gotten decongestants, and cough suppressants along with my antibiotic-- and once when I completely lost my voice, steroids. The other meds keep the cough at bay until the antibiotics kick in, so you can rest and eat properly. They also keep the cough from irritating your throat to the point that you have bacteria re-entering the irritated tissue (or so I was told).

I have let sinus infections go, waiting to see if they were viral, to the point that they were so entrenched, I needed a very long course of antibiotics. I even had a resistant one once, that required me to take two antibiotics at once. One was a standard treatment, and one was something that isn’t really the most effective thing for sinus infections, but I’m allergic to a lot of antibiotics, so I was on a high dose of it for a week, then a low dose for three weeks. It did finally knock it out, and I had been sick a long time.

I once had a cough so bad that the doctor at the weekend clinic I went to asked if I was up-to-date on my pertussis vaccine (I more than was).

I’m generally pretty healthy, but sinus infections are my Achilles heel.

Actually, I had my tonsils and adenoids out about 17 years ago, and they have not been as bad, or frequent, but I do still get them, especially when I first started working with little kids.

The antibiotics are probably what you need, but you might need a second course. If you are still sick when you finish the first course, and you go back to the doctor, ask about cough suppressants.

Were you on Valsartin and had to change to Losartin?( there was a recent recall) For blood pressure? I think some high blood pressure meds make you cough.

It sounds like post-nasal drip is causing the cough. In other words, I’m agreeing that sinuses may be the culprit. In terms of cause, have you tried allergy medicine to see if that helps?

No - I’m not on any regular medication for any other condition.

I had a “summer cold” about a month ago which was similar. my cough wasn’t as bad as yours but I had the multi-day sore throat and productive cough, along with rales (the “rattling” noise you mention.) took about 3 weeks to get the hell out of here.

If you’d like to sleep better, try filling a mug with boiling water, add some tiger balm or Vick’s, and inhale the steam for a few minutes before going to bed. This really helps me when I have an intractable cough. Sometimes I do it a few times a day and it clears it so well I don’t need to go to the doctor. It’s old school but it will help you get a good nights sleep!

Good Luck!

Yeah, sinus infection is my guess. I had the flu, cleared up but the cough remained. Much like yours. Doc told me sinus infection and gave me antibiotics which cleared it up. Slowly.

I agree. The first thing that occurred to me is sinus infection. It’s all in your head (literally) and the cough is from the muck draining down from your sinuses. Or it could just be a particularly nasty dose of pharyngitis.

If it’s sinus related (does your face hurt?) ask your doctor about squirting saline up your nose. They sell special bottles to do it. It’s kind of unpleasant, but it does move the muck out.

I’ve been coughing the last few weeks, and the Dr. says it’s allergies. Mine isn’t keeping me awake, though, and I feel fine even though I’m producing enough snot to fill a bathtub. There are days that my wife says I sound like a heavy smoker.

The residual cough from a viral bronchitis can last 4-6 weeks. Longer if you are a smoker.

Cut out dairy products. WAG.

I recently had almost everything you described and it turns out to be asthma flare-up. Albuterol inhaler helps.

Update: I am at the hospital this morning as I coughed up blood in the night. X rays and full examination suggest nothing to worry about -more, stronger antibiotics for the sinus thing, and a recommendation to use OTC antihistamines to dry it up. The blood was just from the strain of coughing apparently.

I bet it freaked you out. Glad you’ll be ok when you throw off the infection.

Oddly, it was sort of empowering, because it escalated the process of getting me in front of an x ray machine

In the US, bronchitis is the most common cause of hemoptysis and viruses are the most common cause of bronchitis. After three weeks a course of antibiotics is warranted but don’t be surprised if they don’t help much.

It’s the ACE meds that can cause cough; lisinopril, benzapril, etc. NOT the ARBs like valsartan, losartan, etc. ACE meds do it by causing the body to produce more histamine; ARBs don’t have that side effect.

This old myth of dairy causing thickened secretions and increased cough has been well debunked. There is no link.