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Postviral Cough

THE LOOK I GIVE WHEN PEOPLE COUGH AND SNEEZE AROUND ME - Skeptical ...

I am so sick of this freaking cough

I've talked about this before, but as I sit here in week 4 or 5 after a cold, coughing enough so that I can't read a book to my kids without having a coughing spell, I thought it a good idea to toss out a few pearls about most coughs this time of year and hope that if you already know all of it you can share with family and friends.  And for those following this series, my gargling-to-prevent-a-cold did not work, mostly because I did a terrible job of sticking with it.

- I promise you, if I had a good cure for a cough, I would use it on myself several weeks ago.  And then I would probably sell it to you because I'd be so rich I would never have to work again.  Sadly, no such thing exists.

- Most of the time, coughing, especially this time of year, is due to upper airway cough syndrome, which is a fancy way of saying you're coughing because of something else, like postviral inflammation or post-nasal drip (even a tiny amount too small to sense can trigger coughing).

- People always say "I feel like it's moving into my chest" or "whenever I get sick it goes right to my chest".  That's because it's the normal thing to happen with an upper respiratory infection.  That is what bronchitis is.  There is no way to prevent that which I am aware of - it is the natural progression of a virus and true to the phrase "there is no cure for the common cold".

The good news is that it will get better, it just takes time.  The average cough lasts 20 days but anything under 8 weeks is still considered to be a normal "acute cough".

- Here's a list of things that might help a little bit

Avoid talking - it triggers the coughing very frequently.  And brace yourself on your knees or something if you are coughing hard so you don't strain your muscles as much.

Distract yourself - your cough reflex is like a bad itch in that you don't always have to scratch it, but it's so easy you just do it.  And like an itch, if you're scratching like crazy you're going to damage the tissue and make it worse.  Anything you can do to distract yourself from it a little bit can help.

Cough drops:  Help by numbing and lubricating the couch reflex area to make it less reactive.  Warning: if you get sugar-free ones with sorbitol, go easy, because too much sorbitol runs right through you and will have you sitting on the toilet a lot.

Hot steam:  Same idea as the cough drops.  Steam room, hot shower or bath, or holding your head over some boiling water with a towel.  There are also some things called personal steam inhalers you can get online.  Vicks Vapo Rub can help some as well.

Honey:  Some evidence that it can help kids.  OK to try for adults too.  Not totally clear how/why it works.  Try it in tea or on it's own.

Dextromethorphan (DM):  It's in basically every cough medicine out there (DayQuil, NyQuil, Robitussin & Mucinex-DM, Delsym, etc.).  Helps a little bit, not a lot.

Antihistamines:  Most of the over-the-counter nighttime medications have these in them, usually doxylamine for some reason, I think because they are using it for the sedative effect.  But Benadryl (diphenhydramine) could do the trick too.  It can be very drying if you are having a lot of drainage.  And for people over 65 can make you a little confused or cause urinary retention so they do have nasal antihistamine sprays as another option.

Past that, there are a handful of prescriptions for coughs (tessalon perles, codeine cough syrup, ipratropium inhalers), all of which have side effects and are not guaranteed to work


People usually worry about pneumonia, which is an UNCOMMON thing to happen after a cold to most healthy people.  Pneumonia means you have an infection actually inside your lung and usually comes along with high fevers, chest pains, and/or trouble breathing.  Most of the time this is due to a bacteria and less commonly from influenza - other viruses are very unlikely to cause pneumonia.  Most healthy people do not get pneumonia and usually it's more common in those with chronic medical conditions or with people as they get older (as it has also been called the Old Man's Friend).

The idea of a "walking pneumonia" is probably something that should disappear as most people who get pneumonia, are up and walking and it's really more a way of distinguishing most pneumonias from those that are related to the hospital or a healthcare facility, which typically means some more dangerous bacteria can be the cause.  Pneumonia can only be definitively diagnosed with an X-ray but sometimes a good guess can be made from a clinical exam.  This is something that generally does need antibiotics to get better and avoid any complications.

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