The Agony of a Cough

The Agony of a Cough

Many troubles appear in their own season.  Allergies plague many of us every spring and fall.  This season, the season of fall and winter, the season of the school year, brings the troubles that come with colds.

And few problems that colds create can compare to the agonies suffered from having a cough.

What is a cough, how does a cold cause it to happen, what other problems besides a cold can cause a cough, when does a cough get worrisome, and what can be done to get rid of this horrible experience?

What is a cough?
A cough is a big spasm of muscles in the chest that happens whenever the lungs and their airways get irritated.

Because it takes so many muscles to create a cough, the muscles get sore, the chest hurts, the throat get sore, in not too many days of a cough people really get upset at the agony it causes, and for good reason, it is a true misery.

How does a cold cause it to happen?
After many years of thinking about just what is a cold, it appears we have an answer- a cold is a burn.


A cold is when a virus infects your nose, eyes, throat, and lungs.  When a virus infects, it really kills off the lining of what it infects.  So when you get a cold, the virus literally destroys, or burns off, the lining of your nose, throat, and lungs, and sometimes- eyes.  When the lining of your nose gets burned you get a runny nose, when its the lining of your throat you get a sore throat, but when the lining of your lungs burns off, you get a very awful thing- a cough.


Well, think about what would happen if you had a burn on your hand and someone rubbed a little sandpaper on it, Ouch!!   That's the situation with a cold in the lungs- the lining of the lung is burned away and so with every breath you are rubbing air on a burn, OUCH!!  When you hurt the lung, you cough.

Not all coughs are due to simple colds, how do you know your child's cough is from a cold?
During cold weather months, the vast majority of coughs are from colds.

But not all.  The main causes of cough all have to do with the lung or throat being bothered, and include:
viral infections (aka, colds and flus), bacterial infections (e.g., pneumonia, bronchitis, and bacterial sinus infections), allergies and asthma, and irritations (e.g., smoke).

So, if you do not have allergies or asthma, if there has been no smoke exposure, and if your illness is less than 14 days old and not getting much worse over time, the odds are overwhelming your cough is from a cold.

When is a cough worrisome?
This is a critically important question.  First of all, let's make sure we know what is meant by worrisome.

It turns out nearly all coughs are dreadful and quite bothersome.  No question there, even if your child is quite safe from the illness causing the cough, he or she can be quite irritated by coughing all the time, in fact, will almost certainly be bothered terribly by it.

But by worrisome we mean that the cough or the illness causing it might cause actual harm.

Coughs caused by simple colds almost never actually cause any harm, meaning that when the cold goes away, the child is very much like they were before the cold came, fine and unchanged.

So, if someone has a cold, how do you know the cough or the illness has changed into something that is actually potentially dangerous or harmful?

The best indicator is to see how hard it is for your child to get air in and out of their chest when they are not coughing.  Don't pay too much attention to how breathing is going in and out their nose, that is very often very difficult.  Instead, look at how much work it takes to breathe air in and out of the chest in between coughing attacks.  If someone is breathing comfortably when not coughing, it is very unlikely the cold has progressed on to something of concern.

Of course, other indicators that your child has left the world of a simple cold toward a more dangerous set of illnesses include a stiff neck, severe pain, difficulty waking up.  Notice that fever is not on that list.  Even the simplest cold causes fevers up to and including 105.8.

How do you stop or reduce coughing?
Even if you know the cough is from a simple cold, you still are faced with watching your child really suffer, a horrible place to be.  The need for a medicine that relieves coughing is real, urgent, and acute.

Only one problem, that drug is yet to be invented.

The need is so strong, so urgent, however, that many companies sell stuff claiming to stop or even reduce a cough a bit.  In March of 2011, the US FDA launched formal investigations of fraud for over 500 cold and cough remedies.   From Robitussin to Mucinex (exactly the same drug!), from Comtrex to Triminic, essentially all the over-the-counter meds in the cough and cold aisle don't really do anything,

Now, keep in mind that the placebo effect is a wonderful and powerful thing.  An astounding 30% of the time, whenever anything is administered as a medication (even salt water), it works.  It really works, pain goes away, sugar levels in diabetes go to normal, walking improves, just about any symptom will get better about 30% of the time.  And in essentially every study done on cough and cold remedies, they perform no better than salt water or other placebos.

And, that makes some sense.  If you think back to how a cold is a burn, imagine again having a burn on your hand.  What medication exists that you could take that could make that burn go away in a few minutes, or keep it from being uncomfortable if rubbed?

So, what to do?  Well, it turns out the whole breathing apparatus shuts down whenever you swallow anything.  If water or food is rolling down your throat, the lungs are closed.  During a swallow there are no breaths, and therefore, no coughs.

The more seconds per minute you swallow, the less you will cough.  That's how cough drops work, and you can offer your child the same relief by having them sip on a favorite drink, or if old enough, suck on their favorite treats.

How long is normal for a cold to cause a cough?
Colds last a lot longer than people can possibly imagine.  We would like to think our colds will be 24 hour bugs, but the average length of a cold is 8 days.

That means half of all of our colds will last longer than a week, many go on for 2-3 weeks.

And, cough is almost always the last part of a cold, and gets worse every day until the cold finally heals and ends.  That goes back to the cold being a burn.  The virus typically lands in the nose or mouth, and begins the burning there.  Like any good fire, the burn slowly progresses and eventually hits the lungs. The more lung burned, the worse the cough.

And, so, coughs often come at the end of a cold and worsen as the cold burns its way out.  Another reason they cause such agony, after being sick for a week, who can stand a cough getting worse every day for another week?  Who can resist being discouraged in that sort of setting?

But, keep in mind, the cough appearing and getting worse almost always means the end of the cough and the cold is getting closer.

In fall and winter, colds are by far the top reason for cough.  Cough is the result of irritation to the lining of the lung and/or throat, and gets worse as the cold burns its way across the throat and lungs.  No medicine has yet been invented that could make a cough better, but swallowing can interrupt coughing and that can help.  Be on the lookout for trouble breathing when not coughing as the key sign that your child has something more serious than a cold, as well as other indicators of dangerous illness like stiff neck, severe pain, and/or trouble waking up.

Our hearts go out to all of us who suffer a cold, it is truly a miserable experience.  Keep your child comfy, and know that the cold will pass.

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.

No comments:

Post a Comment