Constant productive cough and voice problems

I'm new to this site and am looking for some information from people more used, if that'sthe right word, to asthma.

I'm 64 and had asthma as a child, which resolved in my teens. I've always been a bit 'allergic' - nettle rash etc and I have perennial rhinitis.

I think I picked up a viral infection in July, last year, no sneezing or cough,just felt awful. Then I started to cough and clear my throat-incessantly. Went through chest x ray - clear, treatment with antibiotics and steroid sprays -Clenil,then Qvar, Ventolin, Ipratropium etc. none of which seemed to help. Spirometry inconclusive for reversability - about 7% I think. Eventually, I was referred to a consultant, who did Manitol challenge and nitric oxide test plus more spiriometry and HRCT scan, which was clear.He concluded that I had asthma, probably started by the viral whatever it was in the summer. Prescribed Prednisolone, which didn't seem to help, then Symbicort, which gave me thrush. All this time,my only symptom was a slight expiratory wheeze, with coughing, sometimes moderately productive but very hard to shift anything (sorry) and throat clearing.My voice was completely shot (I'm a TU officer and have to talk a lot in my job - very difficult meetings/hearings when you can only croak or cough!)

I changed to Seretide 250/25 + occasional ventolin + Montelukast and seemed to be getting it under control (from November to late March) with mostly quiet nights and onlythe occasional coughing during the day, although throat clearindg remained a problem.

Suddenly,it's all gone wrong - I am coughing constantly and producing gunk and the throat clearing is damaging my voice agin.I am wheezing more and feel unwell, to say the least and getting very depressed about things.

I keep asking muyself if this is really asthma or something else and I don't seem to know enough to recognize what I ought to do about it or when. My GP is helpful but is no expert and doesnt know much about asthma. My memories of asthma are of attacks as a child and I'm finding it very difficult to cope with this persistent cough,that causes paroxysms in order to shift muck out. I keep asking myself if this is a common or recognized sort of thing with asthma or should I be looking for something else. I remember how awful asthma was, as a child, and remember the night time episodes with my mother holding this giant 'puffer' with an old fashioned squeeze bulb and a face mask.

I've seen my GP today and have been prescribed amoxicillin and prednisolone, although I have no symptoms of infection, and have been told to take more ventolin, but I really am at a loss to know whether mine is a common presentation or something very odd.

I'd appreciate any advice or information from any of you, more experienced and informed.

Thanks for listening

14 Replies

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  • Hi Wildare and welcome!

    Reading through your post i'de say you've tried lots of different combinations and maybe its time your gp reffered you to a respiratory consultant as your symptoms are getting worse instead of better despite all the meds.

    A lot of the meds you've been on and are on can cause throuat problems, do you rinse your mouth out after taking your inhalers?

    Take care,

    Angie

  • Thanks, Angelica- just for reading all that!

    I am under a resp consultant and am due to see him again.He describes me as having 'mild persistent' asthma. Don't know about the mild, but it's certainly persistent! It'sthe dreadful cough that does for me and I just don't kbow how common this is.

  • The thrush is an awful problem! I have found the best way for me is to rinse my mouth out straight after using my Symbicort using salt water. I wonder if the Thrush has gone on to your lungs? If on antibiotics I can almost guarantee Thrush will be back!

    Hope you get sorted soon.

  • The cough, sore throat (and horrid phlem) are all things I suffer from too on a daily basis, more so now I'm on symbicort but also had it at times with seretide 250.

    X

  • Constant cough

    sounds like you may need to go on a daily dose of antibiotics and something like mucodyne which helps break down the gunk in your chest. I have brittle asthma, bronchiectasis and eosonophillic asthma which means I am allergic to lots of things which then overproduces the mucus in my chest. Worth asking to see a specialist at your local hospital. With regards to the thrust, always rinse your mouth after using symbicort and ask for the drops for treating the thrush in your mouth - nystatin normally works really well, hope this helps xxx Janey xxx

  • Gosh!

    Thanks to everyone for the advice and info.

    Have just seen a GP who has prescribed a week of amoxicillin and it had occurred to me to look for some longer term ones - any suggestions? Also prescribed oral prednisolone for a week and Nystan.

    I'll definitely ask for mucodyne, too. I'm seeing a consultant next week.

    I do rinse my mouth after steroids and take probiotics and Vit C to try and avoid thrush, although it does break through sometimes, despite this.

    I felt really isolated, so it's very helpful to tap into your experience and knowledge.

    Thank you so much

    Wildare

  • Looking at this post I thought I'd actually written it!

    My story is very similar. I've lived with Asthma all of my life. Then about 14 months ago I had a nasty chest infection...this was different as I noticed the phelgm was difficult to cough up..it seemed to go on and on. It then led to a horrible nasal drip with me constantly clearing my throat and phlegm every morning on my chest. I must have seen 6 different doctors and tried antibiotics etc which didnt help that much. The phlegm died down a little but i then had problems with nasal drip and medication i was given didnt really do much. I suppose over the months i got used to it, still having some phlegm on chest in mornings, although docs say it is my Asthma. However over the past 2 weeks its playing up again and the difficult to remove phlegm/loose cough is back. Went to docs yesterday and he insists it is my Asthma so he's given me Montelukast and told me to start taking anti-histamine. Im condtantly either clearing my throat or bringing up phlegm though which is horrible!

  • Paulsutt

    It certainly sounds very similar and I sympathise. Sometimes I feel so close to getting it properly under control, then, Bang! back to square one and going through it all again. Has anyone suggested long term small dose antibiotics?I'm going to ask my consultant about it.

    The coughing can be so difficult in the presence of other people, who don't realise that it's asthma and not some infectious disease!

    Best wishes

  • Azithromycin is a good daily antibiotic, but if you go onto another one for a course, you stop that one, hope you feel better soon xxx Janey xxx

  • Thanks, again, Janey

    W

  • Hi Wildare and welcome to the forum. You mentioned a constant nasal drip and this could well be Rhinitis, which is often linked with asthma. If you look on the green band at the top of this page 'All about Asthma' there is a section on rhinitis. It might be worth your asking GP for a referral to Ear Nose and Throat specialist. My son had really bad rhinitis, which was eventually helped by 2 lots of antihistamines (NeoClarityn - prescription only - and Piriton - over the counter, very effective but possible side effect of drowsiness) and nasal spray Avamys.

    Re. constant cough. My son was prescribed Phocodine, a really good cough linctus. It can be brought over the counter. By the way, have you got a Prepayment Certificate? It costs about £104 but then covers ALL your medicine, works out much cheaper than paying for each prescription if you have a lot of meds. (can also buy a 3 month certificate, or spread costs by paying in instalments).

    Doctor may have prescribed Amoxycillin even if you havent got a chest infection, because antibiotics treat inflammation, so you may find your chest is less tight after the course. Also, chest infections can be difficult to detect sometimes, and can take a hold quite quickly, so GP may be erring on the cautious side.

    Good luck and I hope you get sorted. Feel free to PM me.

  • Hi again Wildare. Thanks for your PM, I cant reply to it as you have elected not to receive PMs. Just wanted to say sorry that I missed you saying you have rhinitis in your original post. Was getting a bit mixed up I think - it's been a long day...

    It might be worth adding in Piriton - my son finds that the most effective. An allergy consultant suggested that as well as NeoClarityn. I have asthma and troublesome Exzema and find Loratadine the most effective having tried most antihistamines over the years. Piriton knocks me out but my son is ok with it.

    Having said all that, Avamys spray was the breakthrough for my son, but it's prescribed sparingly from what I have heard, because of the cost. Again, it might be worth asking your GP if you could try it.

  • Wildare, I had voice problems a few years ago with ongoing loss of voice and, as a teacher, it was problematic. My GP - who thought it could be connected to inhaled steroids - referred me to a regional speech & language therapy (SALT) team, specifically to someone trained in 'voice' problems, who not only re-taught me how to breathe properly but also how to identify and treat tension in the throat. With her help, my voice has only deserted me once in the several years since those sessions. I wonder whether your GP might be able to refer you? This person was based in Guildford, but presumably there are similar teams throughout the country.

  • Hi Wildare,

    This may be a long shot but a lot of what you describe sounds like what I went through. It turns out I have a mild hiatal hernia caused, ironically, by a severe cough I had as part of my asthma - this is slowly recovering, but it gave me severe reflux which caused me to lose my voice and need to clear my throat constantly. It's worth ruling out, in any case, as reflux and asthma can exacerbate eachother.

    As I say, I am NOT a medical professional, this is only posted based on my experience which may not be the same as yours, and it is a long shot but it's worth checking.

    Hope you feel better soon!

    Kessx

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