2009-11-04

Cough


Cough


As we all know, the season of colds and flus is here, big time!


The H1N1 epidemic has jumped the numbers of colds and flus
to levels normally seen in the middle of winter, so it makes sense
to take a moment and think about one of the worse problems these
infections cause, cough.


Of all the problems that colds and flus cause, one could argue that 
cough is the worst.


Fever, aches, runny nose, loss of appetite, sore throats and such 
are also awful experiences, but a bad cough is especially agonizing 
for a number of reasons:
  • Coughs usually come at the end of an illness, when you are exhausted
  • A cough hurts.  It takes a lot of breath, a lot of power, and hurts
  • Coughs take longer than any other viral symptom to go away
So what is a cough, what can get rid of a cough, and when should you 
worry about a cough?


What is a Cough?


A cough is a reflex.  Just like when we hit your knee and your foot has
no choice but to bounce up, if your airway is raw and you breathe, you 
will cough.


Colds and flus cause coughs because these viral infections basically
strip the lining of the airways.  Just like a burn, the outer lining of the nose,
throat, and lung are destroyed with a cold and flu.  This makes them very 
tender, and explains why colds and flus make your nose, throat, and lungs
so sore and uncomfortable.  The raw nose hurts when it drips, and the raw
throat hurts like crazy when you swallow.


The raw trachea and lung means that every breath feels like something 
very sore is being scraped, and that leads to the cough.  If there is lots 
of mucus in the lung, the cough will be wet, and if there is not, the cough
will be dry.


What can Get Rid of a Cough?





Because it is a raw, inflamed airway that causes cough, the only thing that 
will get rid of a cough will be the healing of those sore air channels.


While you wait for that healing to take place there are some comfort measures
that often help.


Most powerfully, it turns out that every time you swallow, your whole breathing
system stops.  You can't breathe at all when you swallow.  
This means that while you swallow, you cannot cough.
And so, if you can swallow more- of anything- you will cough less.


The first thing you can do to reduce coughing is swallow more and more
often.  It can be water, or any liquid, or it can be a food that you suck on 
or swallow over time.  Anything that makes you swallow means you will not cough
while you are swallowing.


It also turns out that anything that soothes that sore airway will reduce coughing.
This includes warm, moist air, which is far less irritating than dry cold air.


And to the second thing you can do to reduce coughing is make the air
around your child warmer and wetter.  The ultimate example is the 
steamed bathroom, but a humidifier might help too.


What about drugs for cough?
For a drug to really stop coughing it would either have to kill the virus ravaging
your airways, heal the burned airways, or block the reflex to cough when air
rubs the burned airways.
No drug has yet been invented that does any of these three actions.
There are no drugs that stop coughing.


For many years, over-the-counter drug manufacturers have marketed a series 
of medicines as "cough suppressants."  These drugs include various anti-
histamines, epinephrine-related items, and a smattering of quite old
remedies that have no known biologic activity.
Study after study has demonstrated these drugs do not stop or reduce coughing, 
and yet they sell.
Finally, the FDA has recently started to ban the sale of cough suppressants to young
children.  


Cough drugs do not work, and they may cause harm, we urge you 
not to  use them.



When is a Cough something to Worry About?

As you can gather from what causes coughs, they are universal.
Every person will have many colds in their life, with no exceptions.
And so, every person will have a cough many times in their life, again, with
no exceptions.


Colds and flus last an average of 8 days, typically from 1-14 days.  Coughs 
are nearly always present in the last stages of nearly all colds and most flus.


So here are features of a cough that are NOT worrisome:
  • Part of a cold- nearly all colds have coughs
  • Appearing at the start, middle, or end of a cold or flu
  • Being wet or dry-  all coughs are wet or dry
  • Causing discomfort-  all coughs are a miserable experience
  • Being flecked with specks of blood- the irritated airway can leak a bit of blood
  • Coughing up mucus- all coughs will do this
But here is what to watch out for and call us about ASAP:
  • Having trouble, struggling, to get air in and out of your chest (not nose)
  • Seeing a lot of blood, not just a few flecks in what you cough up
  • A mild cough lasting more than 2-3 weeks.

BOTTOM LINE:
  1. Everyone gets colds, nearly all colds cause coughs
  2. Coughs result from the stripping of the lining of the trachea and lungs that viruses cause.
  3. The best cure for a cough is a healed airway.  All colds heal, so all coughs end.
  4. Coughs tend to be at their worst at the end of a cold or flu
  5. Swallowing anything blocks coughing
  6. Warm moist air is often soothing
  7. Cough medicines do not work and should not be used.
  8. The main reason to worry about a cough is if you are struggling to breathe when not coughing.


Dr. Arthur Lavin

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

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