Why is my child coughing so long!

Some of you who know me pretty well know that our family has been put the the ringer the last few months with sickness.  It all started with my daughter Hannah who had a wet cough or phlegmy cough that started way back in July.  I took her to the pediatrician multiple times who said it was allergies or a virus.  She continued to cough everyday all day.  I knew it wasn’t allergies.  My husband, mother and son all have allergies, and they have never coughed everyday for months because of allergies.  I finally decided if the pediatrician wasn’t going to do anything that I would take her to an allergist to prove that it wasn’t allergies.   The allergist tested her for allergies, turns out she is mildly allergic to trees but that wasn’t what was causing the coughing.  The allergist determined Hannah had a sinus infection, that went undiagnosed for 5 months.  After a round or antibiotic and steroids the cough finally ended.

Next was my baby Noah(8 months old) who started coughing, I was ready to cry after the ordeal I went thru with Hannah.   I took him to the pediatrician who said “it’s a virus”, then a week later back to the pediatrician, “it’s a virus”, then another week went by, “it’s a virus”, then back again to the pediatrician it’s getting worse lets give him Omnicef, still not better lets’ give him breathing treatments and another round of Omnicef because I was  insisting it’s not a virus.  Still no improvement, Noah continued to get sicker and sicker and I was crying every night because I knew something was seriously wrong!  And my pediatrician kept telling me it was viral!  So in desperation I made another appointment with an allergist/immunologist praying he would have some insight.  After listening to my story the allergist/immunologist said he suspected it to be  Mycoplasma, after doing the physical exam he said Noah had pneumonia.  He didn’t have a fever which was throwing off my pediatrician .  After 10 days of Bactium, the antibiotic to treat walking pneumonia, (Mycoplasma Pneumonia), I am happy to say Noah has stopped coughing.  I am so thankful to God for leading me to the right doctor.  

I know this is going around so I hope that my story will help other moms who can’t figure out why their children are coughing!

The 3 most common causes of a cough that lasts 6 weeks or longer are postnasal drip (most commonly from allergies), asthma and gastroesophageal reflux (stomach acid coming up to the vocal cords and making him cough)–in that order. Often the history or exam guides you. For instance if there is wheezing, asthma is the likely candidate. If the lungs are clear but there is alot of snot, postnasal drip. 

The typical approach is a trial of treatment for the most likely culprit. Albuterol sometimes is helpful if you give it and you notice that for the next couple hours he coughs or wheezes less. It doesn’t do anything to make him get better faster but it does make him breath easier and wheeze and cough less until his body heals. If he is not getting better within a week or two, you can try oral steroids for 5 days or a steroid inhaler which gives the same medicine right to the longs but takes longer to work (maybe a month). Somewhere along the way a chest xray is good to get to make sure there is not a pneumonia or something unusual that might show up on xray.

For both asthma and postnasal drip from allergies, avoiding common allergens can be helpful. The most common ones are cats/hamsters, dust mites (cover mattress and wash sheets in hot water weekly) and pollen or mold.


My friend who is a doctor sent me this information.  I thought it might be helpful to someone.

My report on the American Academy of Allergy, Asthma, and Immunology"s 2011 meeting

I attended the AAAAI’s (for short!) 2011 meeting in March.  I thought this was a productive meeting for me.  This is an international meeting of allergists from around the world.

I got to investigate a number of Electronic Medical Record (EMR) systems firsthand.  This helped to crystallize my thoughts of the current status of EMR currently available.

Mannitol challenges seem to have replaced methacholine challenges to test for bronchial hyper-reactivity.  I do not see my practice using them often.

The general plenary sessions were interesting. (photo 1).  Some of the interesting topics: nanotechnology, asthma, studies on sublingual (under-the tongue) immunotherapy, safety of long-acting bronchodilating agents, food allergy, mold exposure.

There were no new medications debuting.

I spoke with allergists from around the world: Japanese, German, Turkey, Finland, Italy, and the U.S.  My conclusion: medical practices and health care systems differ widely, not only within the U.S., but in many countries.

I think there will be some subtle changes in my practice, which should improve my patient’s disease outcomes.

Incidentally, while in California, I visited the Ira F. Brilliant Center for Beethoven Studies, in the San Jose Public Library.  An ultra-fast visit is here and here.  You can see Beethoven’s hair.  A sample was used to discover that high lead levels probably contributed to his death.

The next weekend, I attended the Allergy, Asthma, and Immunology Society of South Carolina’s annual meeting.  This was a smaller scale meeting of allergists from South Carolina with 4 nationally known speakers. The topics included immunodeficiencies, EMR, drug allergies, food allergies, and occupational asthma.  The above comments apply here also.  Both meetings were intellectually stimulating and I think they will benefit my patients.

Medical Question: Pneumonia

Elaine asks: You’ve come highly recommended by quite a few author-friends and I’m hoping you can help me out with a medical question for my story.

I have a high school senior who comes down with a severe case of pneumonia weeks before her graduation. She is hospitalized in the ICU, pulls through, but doesn’t make it to graduation.

Plot wise I need her to miss the fall semester of beginning college & have her family keeping her home during the summer for extra rest while she recuperates more fully. I’d like to know if this scenario is feasible– that a case of pneumonia, if bad enough, could weaken someone enough that she’d postpone starting school in the fall and take it up again in the spring?

Jordyn says: Elaine—thanks so much for sending me your question. And thanks for the compliment! That means a lot to me.

As far as your question—there are a few issues with your scenario. In a previously healthy young adult, it wouldn’t be that feasible for her to be sick so long. Medical treatment for pneumonia is antibiotics for 5-10 days. Then maybe residual cough, easily fatigued for a couple of weeks. This is of course if it is a one-sided simple pneumonia. So, considering those factors, if she were sickened in May I would think she’d be able to attend school in the fall.

Also, people are rarely admitted to the ICU for pneumonia unless they need to be intubated on a breathing machine. So, say she had bilateral (both lungs involved) pneumonia, had to be intubated, popped a lung (called a pneumothorax), needed a chest tube, etc. Again, these might sicken her for a couple of weeks but if she’s generally healthy she should be able to overcome this, rest up for several weeks—back to school in the fall.

My suggestion would be this– give this character a chronic illness that puts her lungs in a more vulnerable state (broncho-pulmonary dysplasia, asthma, cystic fibrosis) and the pneumonia got to the point where she had to be admitted to the ICU on a ventilator and she blew a lung which complicated her situation. Considering her history of chronic disease—it would be more feasible that she’d have a long recovery time and she’d take the fall semester off.

Asthmatics on the ventilator are very hard to manage and get off and often have a complicated course. Most often, they have to be medically paralyzed and sedated. The patient is high risk for developing a pneumothorax. This would be my pick.

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Elaine Stock is a former RWA member and has presented several writing workshops. Presently involved in ACFW, she was a 2011 semi-finalist in the prestigious Genesis Contest in the contemporary fiction division. She is also active on several social networking groups. Her first short story was published on Christian Fiction Online Magazine. New to the blogging world, Elaine started a blog this past April, Everyone’s Story. Since then, the blog has been graced by an awesome international viewership that totally pings her heart. Everyone’s Story features weekly interviews and reflections from published authors, unpublished writers…and just about anyone who wants to share a motivating story with others that may lift their spirit. She has also been the guest of several other blogs, helping to further grow her presence on-line.

She and her husband make their home in an 1851 Rutland Railroad Station they painfully but lovingly restored.

That Coughing Cat, Part Two: Feline Heartworm Disease, by Dr. Laura Theobald

Heartworm disease is typically thought of as a disease affecting dogs, however cats can also be infected with heartworms. It is transmitted by mosquitoes and is reported in all of the continental United States.

Cats can show symptoms with as few as one to three adult heartworms living in the heart. These signs include coughing, difficulty breathing, vomiting, lethargy, anorexia (decreased appetite), and weight loss. There can also be acute episodes of shock and respiratory distress, as well as sudden death. On physical exam, there can sometimes be a heart murmur noted.

Diagnosis in cats is difficult when compared to dogs as the standard in-hospital testing (antigen test) that is used for dogs is not always accurate in cats. This is because cats tend to have only a few worms. A send-out test to the reference laboratory (antibody test) may be more useful, but a negative result still does not rule out heartworms. Other helpful diagnostics include radiographs (x-rays), echocardiogram (an ultrasound of the heart), complete blood count (CBC), internal organ function testing (chemistry), and fecal exam (to rule out parasites that can live in the lungs and cause coughing).

Prevention is the same as that used in dogs and includes monthly oral medications such as heartgard or trifexis, or topical solutions such as advantage multi or revolution. A six month injection called Proheart is available in dogs, but a similar product is not available in cats at this time.

Though dogs can undergo risky heartworm treatment (a series of two to three injections of a drug called immiticide to kill the heartworms in the span of a month or two), no such treatment is available in cats. Treatment is limited to monthly use of preventive medications to prevent further infestation and shorten the life of the heartworm. Supportive care includes bronchodilators to help pets breathe easier and steroids to reduce inflammation.

Written by Dr. Laura Theobald
Lap of Love Veterinary Hospice

Dr. Theobald works with Dr. Hawthorne helping families in the Charlotte North Carolina region. For more information – please see their profile page. http://www.lapoflove.com/North_Carolina_Charlotte 

Study Shows Asthma Medications Prevent Hospitalization When Used Properly

The ICU is one place you don’t want to be if you have asthma.  Research shows that available medications for asthma are highly effective in reducing hospitalizations.  SS

Inhaled Steroids Lead to Big Drop in Asthma Deaths at Texas Hospital: Study

They reduce inflammation in the lungs, improving control of asthma symptoms

TUESDAY, May 15 (HealthDay News) — Patient education and medication compliance contributed to a 74 percent drop in the number of patients with life-threatening asthma admitted to the intensive care unit at University Hospital in San Antonio, Texas, researchers report.

Their review of 30 years of hospital data focused on patients with severe asthma who didn’t respond to standard inhalers.

They found that there were 227 patients admitted to the intensive care unit (ICU) with 280 episodes of life-threatening asthma between 1980 and 2010. One patient died, but the death was from a different cause after the patient’s asthma improved, according to the team at the University of Texas Health Science Center at San Antonio.

“The main reason for the decline in cases is that more of our patients are taking their controller medications, such as inhaled corticosteroids, which reduce the amount of inflammation in the airways,” lead author Dr. Jay Peters, chief of pulmonary diseases at the Health Science Center, said in a university news release.

The researchers also found that insertion of a breathing tube, called intubation, when patients arrived in the emergency department did not lead to longer hospital stays.

“I think our methods of treating patients in the emergency department have improved so much that previous studies of issues with intubation don’t hold up anymore,” Peters said.

The study appears in the journal Respiratory Medicine.

“On the front end, this study reinforces the importance of staying on controller medications,” he said. “On the back end, it shows low mortality for patients in the medical ICU and that we don’t need to be afraid to intubate patients and place them on mechanical ventilation if necessary.”

Read more here

Nasal sinus rinses with saline solution

Before we discuss using nasal sinus rinses with saline solution, I think it would better to review the anatomy and physiology of the nose and sinuses. I’m going to try something new, using Youtube videos that I have screened, and also not reinvent the wheel. The nose normally makes some mucus: to protect the mucosal lining from being too dry; to wash off particles, allergens, viruses, and bacteria off of the mucosal lining; and to protect the mucosal lining against infections. When the mucosal lining of the nose is irritated, we call this rhinitis. If the cause is from allergies, we call this allergic rhinitis. The sinuses are bony caves branching off from the nose. Here is a good review of sinusitis. This video says almost the same thing.

Saline solution introduced into the nose and sinus cavities will wash mucus and anything in the mucus off the mucosal lining. Here is a good video demonstrating nasal rinses on Youtube for an adult and another for a child. Some prefer to use the Netipot. Either work for me. Any product that works for you and is cost-effective is an acceptable product. It’s based on personal preference. In the top 3 photos to the right, I am demonstrating what I consider to be optimal technique: head down with chin above the eyes, saline solution being squeezed gently but persistently into the upper nostril, allowing the saline to drain out the lower nostril, mouth breathing. There is no downside when done gently. The three products (Nasaline, Ayr, NeilMed) in the bottom right photos were chosen simply because I had a sample in my office.

I am frequently asked about how much saline solution to use and how often. Mucus by its very nature is sticky, like syrup. So for the saline solution to effectively loosen the mucus up, it generally takes at least 8 ounces or 240 ml per session in my experience. I habitually rinse my nose and sinuses out at least four times per day. Why? I have several reasons. First, I am exposed on a daily weekday basis to many people. Rinsing is simply good hygiene. I have a family history of allergies, plus there’s my wife with very severe allergies, and I do not want my mucosal immune system to develop allergies, so I never let the allergens build up in my nose or sinuses. Think of it as constant spring pollen cleaning. Next, I find it refreshing, like splashing cool water on your face. Finally I am exposed to patient every weekday with respiratory infections. Some of them look pretty miserable. Some of the little twerps (or to be politically correct unhappy little children) cough or sneeze point blank right in my face as I try to examine them. Whatever they have, virus or allergy or bacteria, I DON’T WANT IT. So, once I have finished their office visit, I go straight over to the bathroom for handwashing + nasal sinus rinsing.

How much saline solution is safe to use? Remember what happens when you go swimming in either a pool or the ocean. Lots of water goes up your nose. Your nose and sinuses are getting washed out very thoroughly. Think about how your nose feels after a swim. Usually it is very clear for a few hours. Why? Your nose and sinuses have most of the mucus and anything in the mucus removed. Since mucus is produced normally, the clear feeling does not last forever.

I hope this discussion tells you how I feel about nasal sinus rinsing. As my friend Linus reminded me about Chicago voters each election, they vote early and vote often. Here I recommend rinse with lots of saline and rinse often.

Help! Fish aquatic expert!?

Last week I saw these little black baby fish or whatever it is in my tank and so I set up some java moss so they could hide. They are weird and they look like fish but they are not getting bigger and they hang on to the wall sometimes. I need to know if maybe they are little fish fry from my siamese algae flying fox or if they are some kind of parasite. I can describe how they look and they are tiny and their color is black and they are shaped like a little sucking fish. They still havent grown any bigger and its been two weeks. I have no idea i searched all over on the internet and I still cant find a picture of flying fox fry so that i know how they look so now im worried!! Please if anybody knows what im talking about comment asap thank you for ur time reading this!!!

You need to pay taxes on all money you earn/receive worldwide, but I am sure that you knew that. However, you need to talk to an immigration lawyer as to whether you are allowed to work writing editorials – normally you would need another visa to cover the second job. You are only allowed to have the one job in the US under the H-1B visa rules.

Im packing today and going up to visit my mum with my 8 mth old baby. My partner and I had an argument he said im a emotional piece of junk…next day he said I pushed him to say that and if I hadnt tried talking to him he wouldnt of said it. Even I know that I didnt make him say that. I am so depressed here and there is no emotional support from him. I tried talking to him he is not interested in talking and pretends to go to sleep if I try….I asked him does he love me and want to work to make things better and we need to be solution orientated instead of tearing each other down…he says well if I am asking for something he cant do it because he feels if I ask then I am pressurising him to do it and he doesnt want to unless its something he feels like….What the??? God I am so drained and barely coping and his attitude just says to me he could care less. He came and kissed me goodbye like everything is ok??? My head is turning inside out and Im wondering if Im going crazy….I know I am very depressed and have seen doctor and have medication to take but Im thinking being with him is not good for me emotionally so maybe this time I wont return which is hard cause I feel Ive no energy left. I dont know I keep going in circles in my head.

where in michigan can i get bare solid square aluminum wire,or bare square copper with aluminum core (18-22awg) wire?and where can i get the high temp. adhesive to handle the extreme heat i intend to put through it?

We absolutely need Air Force One as a flying White House. It is an international symbol of the President of the United States, hence a reflection of this great country. The history channel is doing special on Air Force One this week — I encourage you to watch it.

the problem with microsoft word that it is related to its own filesystem i.e if you have created a file using office 2007 and trying to open it office 2003 if may not have the full feateures of the exact file so try to use the same version or upgrader version in which you have created it

Just wondering if any of you skin experts out there can slide an answer my way. I will take up swimming if it will help…