Tuesdays Are Your Turn – Coughing, Coughing, Dear God the COUGHING

It’s impossible, I think, to overstate the impact that asthma cough fests can have on your (read: my) emotional state. Friends and family that never see the worst of a child’s respiratory problems, that can’t join in at 2:00 in the morning for breathing treatments during the rough times, that never hear the hacking that can last all night long, will possibly never understand an asthma parent’s fairly regular bouts of insomnia. Life gets even more fun when an irritated throat combines with the flaring to result in near-constant coughing.

During my daughter’s recent fun with H1N1, I felt transported back to her earlier, uncontrolled years of interrupted sleep and midnight movies with the nebulizer. Not only did that cough plague her all day and night throughout the illness itself, but it also lingered for awhile afterwards, as both flu and asthma tend to do. Only this time, I was waking up a 10 year-old at two a.m. instead of a toddler. This time, I could ask her, “Okay, what’s your peak flow?”

Her age and my experience still don’t negate that wide-eyed, sleepless worry when she flares or gets sick, though. And sometimes, I just have to sleep. As AG has gotten older and as long as the situation meets these markers, I do what I can to minimize her cough at night:

1. She blows an acceptable level on her peak flow meter.
2. She is not struggling to breathe or breathing markedly/noticeably faster.
3. She feels no tightening in her chest.
4. She’s on regular albuterol treatments to control the flaring.
5. Her cough is not indicative of a worsening flare and she appears in no danger of respiratory distress.
6. Basically, it’s her throat that appears to generate the cough and not her lungs.
7. I’m contemplating drastic measures. (read: running away from my home)

If her breathing doesn’t meet all these criteria – and this is key – then I don’t suppress her cough because that’s her main asthma symptom. Instead, she will use her albuterol if she hasn’t, or I may end up on the 24-hour nurse hotline.

Assuming AG can breathe okay and I’m feeling desperate and she tells me it’s a throat cough rather than a lung one, or if it’s the asthma-free Steadfast Sidekick coughing instead, here’s what I do:

Daytime
Cough drops or hard candy* (although I’ve had to review usage of cough drops vs. inhaler with AG lately)
Hot drinks
Shower steam

Nighttime
Teaspoon of honey
Elevated sleeping
Sports bottle of water

What do you use?

*AG uses mentholated cough drops with no problems, but menthol CAN aggravate asthma symptoms in some people.

85 responses to “Tuesdays Are Your Turn – Coughing, Coughing, Dear God the COUGHING”

  1. kerri says:

    Elevated sleeping for the win. Seriously. That is one of the things that helps me the most all the time, especially when I’m sick. I have three (two large-ish) pillows all the time, and when I’m sick, I’ve often folded my huge body pillow in half to prop my upper body up even more.

    Personally, I find a lot of time cough drops (Halls Fruit Breezers) and stuff don’t help me at all with coughing, only with sore throats.
    Things like Advil Cold and Sinus help from time to time, but I do find surprisingly Benadryl helps sometimes during a cold to decongest my chest and sinuses a little.

    I’ve ditched most cold medicine and rely on increasing my Symbicort to 3-4 puffs twice a day instead of 2, and using my rescue inhaler has needed. I also ALWAYS use my AeroChamber when I have a cold–it helps a lot all the time, but even more when I’m repeatedly/continuously flaring if I’m sick.

  2. Danielle says:

    During the daytime, I suck on coughdrops like there’s no tomorrow but only if it’s a cold. This is only for the sanity of those around me. If it’s asthma, then the coughdrops won’t help anyway.

    At night, I only use elevated sleeping. I try not to suppress my cough at night just in case it is indicative of a worsening flare, especially now that I have no mommy to rouse me awake and say “what’s your peak flow?”

  3. Ang says:

    I don’t do anything except albuterol/steroids when it is bad. With my non-asthma kid it is so nice to go in and spread some vicks on her chest, give her some delsym (or however you spell it) cough suppresent, and go back to bed. It is so…simple. With my asthma kids I never, ever, ever give them any type of cough meds. They get Zyrtec for allergies or Benedryl because of course the allergen can aggrevate the asthma but I refuse to give them nyquil or any other meds. There have been too many nights that I have been up every 90 min nebbing. I would not with those on anyone. Not ever. I have a stack of 30 min kid shows (movies with short shows) that are dedicated to these events but if I never had to use them again… I really am bitter about asthma sometimes. Why my kids? Why is it our constant battle. We had to use the inhaler on both of them at the pumpkin patch and we had the neb backpack in the van. It is constant stress on everyone :( I really want to send my kids to asthma camp when they are older. Okay, tangent! sorry ;)

  4. Amy says:

    Okay, I edited a bit for throat/lung clarity–thanks, guys!

    Also, I added the bottle of water tip. AG ALWAYS sleeps with a sports bottle next to her bed when she’s sick, in case she wakes up with a dry throat–b/c the last thing we need is more coughing, right?

    Ang–Don’t apologize! I think we all have our bitter moments–esp. those of you with more than one asthma kid. It IS stressful and it’s terribly unfair and it’s a wonder we’ve made it through this far with our sanities intact (mostly).

  5. Elisheva says:

    Blast from the past! This is an exact description of a significant part of my childhood. My parents have three asthmatic kids, tho one was only diagnosed a few years ago and thus missed out on most of the “fun”.

    Childhood colds were always horrible for my brother and me. No cough suppressants, elevated sleeping, and pretty much round the clock neb treatments. (BTW, my love and appreciation for the Sound of Music comes from being stuck nebbing in front of it as a kid. Great movie!) One of the worst parts was that no one in school could figure out why colds would knock us out for two weeks when they barely missed any school for the same colds.

    There got to be a point, when I was 12 or 13, that my parents stopped getting up in the middle of the night for me unless it was a real emergency. I got all insulted when sometime around that age I woke my mom up in the middle of the night because I was having serious trouble breathing and was blown off. She responded with “Have you done a neb treatment yet? No? Why not? You know how to set it up by yourself. Don’t you know your father and I have to work in the morning? If you don’t feel better after that, come back.” My preteen self was very offended and taken aback by this. But looking back at it, I realize that was an important step toward independence. My parents (my mom especially) always tried to get us to take responsibility for as much of our asthma care as was age appropriate. She used to always remind us that this is something we’d be stuck doing forever, and that we won’t always be able to rely on her.

    Is AG still sick or is this a looking-back post? I’m confused. Anyway, feel better AG!

  6. Allie says:

    I use Traditional Medicinals Breathe Easy Tea in addition to my rescue inhaler – of course, not a doctor, so I don’t know all that much about the combo, other than that it makes me feel better. More so than just hot water. It does seem to open things up a bit.

  7. Carolyn says:

    My asthma girl doesn’t really cough unless something serious is going on. So we do typical treatments for her – nebs with albuteral, hypertonic saline, and pulmozyme. In addition to flovent, prednisone, antibiotics and probiotics.

    With my asthma boy, sometimes the honey will work along with a moist heating pad on his chest.

    When either of them sound like they have deep chest congestion, I have them jump on a trampoline to shake around the mucus so that they can cough it up easier. Tickling works great too!

  8. Her Grace says:

    I LOVE the trampoline idea. Might have to try that one. Also the water bottle.

    I think that H1N1 may have finally arrived at our house. Michigan’s cases rose quickly this week: 200 schools closed as of today. She came home with a sore throat and by bedtime had fever, aches, fatigue, headache.

    No cough as of yet, but I’m going to work hard tomorrow at getting her a script for tamiflu. She doesn’t have an official asthma diagnosis, but she’s needed oral steroids after the last couple of colds, so I’m concerned.

    Here’s what’s weird: Earlier this week, I had very vague symptoms, minor body aches, very mild sore throat, tired, a few digestive issues. I told my doctor at a well check, and she immediately put me on Tamiflu ( I have asthma). I blew it off (but took it anyway), because my symptoms were so mild they hardly slowed me down. But now, considering kiddo, I’m wondering. Also weird: My lungs feel today like they do after I’ve had a cold or cough — sore and minorly tight. But I never had a cough or even any shortness of breath.

    Anyway, keep your fingers crossed for us over the next week or so!

  9. Marcia says:

    Oh my, the coughing. When my son was younger he’d cough until he gagged. I’d hold my breath when he took a huge mouthful of something and then have a coughing ‘spasm.’

    How many times did I get up and watch him breathe and count the breaths per minute or to see if he looked blue or had retractions? Many, many little to no sleep nights.

    My son also has tracheomalacia so the coughing takes on a lovely honking sound when he really gets going and we have to ask him to try not to honk into the peak flow meter or when he has his lung function tests. It’s difficult for him and it’s very hard to get a good reading on the peak flow meter – we just get a vague idea.

    Ang, I too have wondered, usually in the middle of the night up with my son for yet another neb treatment, why he/we have to go through this and so many other kids don’t. I’ve been through the bitter feelings and thoughts that my son doesn’t deserve this, etc. Hang in there, it will get easier.

    Elevated or sitting up sleeping, cough drops, sipping Coke (not diet), hot chocolate do seem to help.

    Has anyone tried chest therapy to loosen the mucous?

  10. mtngirl says:

    No, we don’t use chest therapy. We don’t use cough suppressants either. My neighbor with non-asthmatic kids cannot relate at all. Our mucus managemtent consists of the standard – check the peak flow meter and do the albuterol nebulizer/rescue inhaler treatment, but we also have our kids do nasal washes/sinus rinses am/pm (using Neil Med bottles) and take plain Robitussin every four hours to thin the mucus and try to get as much of it out of their system as quickly as possible. This ususally works pretty well, but then H1N1 hit….

    My youngest, who is 5 and is at the “ractive airway disease” diagnosis stage, is still recovering from H1N1 (this the third week of school she has missed). Prior to this she was not on daily full-blown asthma meds (she was only at singulair, pulimcort flexhaler, and zyrtec). Her pediatrician would not put her on Tamiflu at day 2 when her temp hit 104, saying they weren’t prescribing it for ped. patients. They said to start rotating Motrin/Tylenol every three hours. Four days later, her temp hit 103 after trying to go 7 hours without any motrin/tylenol and she had “that cough” too. Took her the pediatrician that day. He diagnosed her with H1N1 and put her on a strong antibiotic and sent us home. The next day she could not move the peak flow meter at all. The cough was terrible at this point and I was losing my mucus mangagement battle. So I called the asthma/allergy doctor. They sent us the ER (of course its Fri afternoon) where they treated her for an acute asthma attack (no pneumonia from chest x-ray). The ER doctor then put her on prednisolone and sent us home. She then coughed up a mucus plug Sat morning. Saw the asthma dr on Mon. and she doubled the prednisolone dose. My daughter is now finally tapering off the prednisolone (day 20 of this).

    My older asthmatic daugther (8) started coming down with the cough and fever and I begged the pediatrician to put her on Tamiflu after explaining what her sister went through. He agreed to it and she had the shortest-lived cold she has ever had. The contrast was amazing and yet sad at the same time. The older daughter was reading books to her younger sister while little sis was doing the nebulizer. I just looked at them and thought “Tamiflu…no Tamiflu. And it made me mad too!

    Has anyone else experienced their pediatrician not prescribing Tamiflu for their asthmatic/pre-asthmatic kids? I feel like my younger daughter got caugth in that gray zone of the asthma diagnosis game the doctors and the insurance companies play.

    Also, at times I feel stuck between the peditrician and asthma doctor dilemma. The pediatrician manages routine health issues fine, but when the colds cross over to asthmatic complications the asthma dr. manages the medications much better than the ped. dr. But the asthma dr. doesn’t have after hours or weekend coverage. Has anyone else experienced this type of dilemma? I’m ready to start looking for a new ped dr. that handles asthma better but I’m not sure how and even if, I will find one.

  11. Mina says:

    I see many are suffering just the same as myself. Its so unfortunate that we have to go thru this.

    I have persistent day and night time cough since 3 days now. i get this kind of allergic/asthmatic symptom every october-dec.

    All i could do is to reduce the no. of coughs per hour.

    PLEASE TRY THIS : TRUST ME YOU WILL DO MUCH BETTER than you are now.
    if you are an adult, try to chew (dont crush) 2-3 whole black pepper before sleep, Its sometimes ok to keep the pepper under your gums while sleeping.

    You will MOST likely stop coughing in 5-10 mins and free of cough until an hour or even more.
    sometimes i used to chew it every 3 hrs, so the essence of pepper go into my throat and stops initiating the cough.

    Also try this:
    apply generous amount of VICKS Vaporub under your feet. and put on your socks and sleep at elevated position on a preferably leather couch/bed.

    (avoid linens/regular bed for sometime)

    hmmm.. After so many research and coughs i could comeup with these BEST suggestions only to reduce as much cough as possible.
    Hopefully someone would be benefitted.

  12. Kelley says:

    mtngirl:

    I love my daughter’s primary care dr. (he’s also mine), but he was not able to effectively treat a lot of the problems she developed last fall (walking pneumonia, spasmodic croup). Her asthma (& allergy) doc stays on top of EVERYTHING. She wants me to let her know as soon as she gets a cold, and to bring her in to do a spiro test if her cold lasts more than a couple of weeks to make sure her lung function is ok. She’s the one who ordered a GERD test to see if that was contributing to the frequent croup problems (which it was)…I would definitely recommend finding a good (or great) asthma & allergy dr. It is like night and day as far as their understaning of asthma and how everything interacts with it. Many primary, ped, etc. drs just don’t have the same experience/knowledge/expertise with asthmatics. Our life has considerably improved since we first met with her asthma doc. It is so much easier trying to manage her condition, as well as avoid complications, when you have a good dr who knows what to do when problems come up. Our asthma doc only works the regular hours too, so we go to her primary doc for non-asthma things. We are lucky, though, because the call service for her asthma doc has the on-call get back to me within 30 minutes, day/night/holidays. I know that if my AG gets the flu, that the on-call (or her regular asthma doc) will call in/fax over a Tamiflu Rx to our 24-hr pharmacy within an hour of my notifying them of her symptoms. Good luck!

  13. Amy says:

    Elisheva–I love your input from your asthmatic childhood. I’m always trying to keep track of what to expect–that’s how I ended up on your site through Kerri’s. AG had it last month, and she’s fine now. But thanks!

    Carolyn–Like Her Grace, I love the trampoline idea.

    Her Grace–Fingers crossed. Did it end up being flu?

    Marcia–We do chest PT! As I told Ang in an email earlier this week, I’ve been meaning to post about it forever.

    Mtngirl–Oh, yes, the asthma-less families will never have any idea, will they? I agree on nasal washes–they’re a godsend both for AG and me–I don’t have asthma but am very prone to sinusitis. I had no problem getting Tamiflu, but I’m wondering if it’s b/c AG got sick so early in the season.

    And I could not agree more w/Kelley. My control over AG’s health when she was younger VASTLY improved when I started taking her to a specialist right before she turned five. (ours didn’t have great hours, either) They gave me so much good, detailed information on her condition, I wish I’d taken her in sooner, like when she was first diagnosed at age 2.

  14. Katie says:

    Wow, I am new to the site. My son’s rt told me about it. I have been reading all about asthma as I feel so ignorant about it. My son is going to be 7 in a week. He had his adnoids and tonsils out last Nov. We were told he was borderline asthmatic b4 the surgery (about a yr). Once the surgery was done and healing completed he actually seems worse. He has been having a really hard time breathing this weekend. He is sometimes not registering on the peak flow meter. I find myself listening and watching his breathing. The cough is horrible and I am tryig to find thebest thing to do for him. He has a cough medicine the dr rx b/c he usually gets a nasty cough and he keeps us in it all the time. I am questioning that now that I have read more about it. I guess I just wanted to say thank you. I am learning alot and feel somewhat better and somewhat so much worse than I did an hour ago! Gotta go check his flow again.

  15. Amy says:

    Hi Katie, and welcome to the site, although I’m sorry you have to be here, too. I’m not sure how much you’ve learned about asthma so far, but coughing is the number-one symptom, not wheezing. In fact, my daughter is one of those kids that will cough and cough and cough until she’s doubled over, but we never hear her wheeze. That’s one reason it took us a loooong time to get her health under control when she was younger. Anyway, I look forward to learning more about you–please don’t be shy w/questions or comments b/c the readers here are really helpful.

  16. Smscott says:

    Oh wow, im new to the site and wish i had known about it earlier! great resource!! linked (in a roundabout way) from AsthmaInTheNews on twitter to AngryAsthmaMom, to AsthmaGirl, to here… Mom to a 4 1/2 yr old with asthma. She too had tonsils and adnoids out back in August which has seemed to help, her allergist changed her meds slightly (advair instead of flovent which has been a godsend, and adding zyrtec) but we have been SOOO lucky with her ped. hes amazing and manages asthma so well! I wanted to echo the sentiments about other parents just not “getting it”… love the supportive attitude here. For my daughter as well, she almost never has an audible wheeze, its all cough for her, like shes drowning and gasping for air.

  17. Amy says:

    Hi, and welcome! So glad you found me & I hope you’ll stick around. My daughter’s exactly the same–she’ll cough until she gags, but never wheeze.

  18. Teri says:

    Wish I didn’t need it, but since I do, I love your site. My daughter was diagnosed a couple years ago and we’re still finding our way. I’m wondering about the asthma doctors mentioned in some comments. We’ve been to an allergist and just started with a pediatric pulmonologist, but haven’t found anyone yet who seems skilled with treating asthma in kids. When you say ‘asthma doctor’, which kind of specialist are you seeing? Thanks for your help! And thank you for letting me know I’m not the only one going through a lot of this!

  19. Amy says:

    Hi Teri–My daughter doesn’t see a specialist at the moment b/c we’ve got a pretty good handle on everything to the point that her pediatrician can handle it. She doesn’t have any allergies except to dust mites, so she used to see a pediatric pulmonologist when she was younger.

    The parents I’ve talked to with allergic asthma kids, though, seem to like the allergy/asthma specialists better than ped pulmo’s, which makes sense. Hope that helps!

  20. Frankie's mom says:

    I am so heartbroken and exhausted with my daugthers viral induced asthma. A simple cold turns into two weeks missed of school, nebulizer treatments, steroids and antibiotics. I get so jealous of these kids who never miss school and it breaks my heart for my daughter who always has to catch up from all the school she’s missed. She had sinus surgery two years ago from recurring sinus infections which we thought was the culprit. It helped but just for about one year and here we are…second week of school and she’s already missing her third day of school. This really is hard to deal with and causes me great anxiety and distress for her. My heart goes out to all you asthma moms. No one seems to understand and looks at you or your kid like something is freakishly wrong with them for getting sick so often. I’m so tired of it and pray my heart out that God take this from her. That is my hope.

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