Conquering the Cough
Robert Hayden, DC, PhD, FICC
Question: A recent upper respiratory illness has left me with a residual cough. I have not had any fever for the last two weeks, but the cough really bothers me. It makes me sound sick and keeps me awake at night as well. What can I do to make sure this does not progress to pneumonia?
Coughing is a lifesaving reflex in which the body is trying to cleanse its airway. It is associated with everything from upper respiratory infections and postnasal drip to bronchitis. At this time of the year, especially with the wild fluctuations in Griffin’s temperature, we can be concerned about any respiratory illness, especially among the elderly or those whose immune systems may be compromised by other conditions.
I heard from some colleagues of mine in Arizona recently who warned that influenza has claimed several lives in that state with a very short incubation period. As of this writing (third week of January 2014), flu cases are very widespread in Georgia, and only regional cases are seen in South Carolina, Florida, Alabama, and Mississippi. It is hard to imagine being surrounded by a mild outbreak like this, but Georgia’s flu outlook is quiet so far according to the Center for Disease Control (CDC). The rest of the country is also quiet with the exception of Iowa and a couple of states in the Northeast. I would not be concerned about the specter of influenza unless you have traveled to one of the places where regional outbreaks have been recorded.
Sometimes a cough remains after even a mild upper respiratory infection. If you have no fever, you are probably not infectious and are safe to go back to work, church, school, etc.
There are several things you can do for the cough itself. First, the over-the-counter cough medications that you can get in any drugstore may be helpful. Look for guaifenesin, the active ingredient in Mucinex. You can get it in a generic form. This is a very benign drug in so far as side effects go, and it is pretty good at mobilizing secretions in the lungs. It stimulates the mucous glands in your airway so that you can cough out whatever is irritating you. This capitalizes on the lung’s ability to clean itself. The generic guaifenesin is relatively inexpensive. A dose of 600 mg ranging from 2 to 3 times daily is reasonable. Drink plenty of water with it.
Some of the liquid cough medicines contain not only guaifenesin, but dextromethorphan, which is probably the best cough suppressant you can get that does not have a narcotic in it. If you use the combination of these two over-the-counter medications, be sure to follow the directions. Dextromethorphan in massive overdoses can be hallucinogenic. When taken as directed, it can make you drowsy, so it is a good one to take at night you want to go to sleep anyway. Again, drink plenty of water while taking this medication so that your mucous membranes are well hydrated. That will help you cough out the offenders.
This brings me to something I use with patients with success. It is a simple way to open the air sacs in your lungs with things you have lying around at home. This simple treatment, when done by a licensed respiratory therapist in a hospital or clinic, is quite expensive. When you do it at home, be sure to think of me every time you save about $150.
Get a straw and a glass of water about four or 5 inches deep. Blow bubbles in the water through the straw with the straw submerged to the bottom of the glass. This will put resistance in your upper airway sufficient to open the air sacs in your lungs. In the hospital, we called this positive end expiratory pressure, or PEEP (in the hospital, we like to use acronyms so that patients don’t know what we are saying!). Opening the air sacs in this manner will increase oxygenation and put air on the other side of whatever is making you cough so that your cough is more efficient at cleaning the lung. I would do this treatment for about five minutes every four hours, especially if you are acutely sick with fever. It may well prevent the pneumonia that is the real threat to your health.
Of course, stay away from anyone who is sick within reason. If you feel you are contagious, stay away from work because your coworkers do not want this illness, either.
If this or any other illness persists, get to a physician as soon as possible. If you do not have one, or do not have insurance, call a physician’s office or talk to a nurse for advice. Feel free to call here as well and I will help you anyway I can. In the meantime, stay healthy!