Major surgery and cough problems

I'm soon to have open heart surgery to replace my aortic valve (born with defect). I still get a cough from my small airways disease/type of asthma, which is tons, tons better through using Qvar, but I still cough a few times everyday. I'm concerned about the imapct of this cough postoperatively as my sternum will have been cut open and been sewn together, you can imagine coughing and how that might cause problems. The surgeon said they'd give me a ""nebuliser"". Can anyone tell me what that is ? When I looked it up it seemed to be for more deep asthma type cough. I'm thinking it wouldn't be suitable for my 'irritated' cough.

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  • Nebulisers are quite commonly used in asthma treatment in hospital. Its the same drug as in blue inhalers (usually) and so if you find salbutamol relieves your cough then the neb should help. Do you find drinking helps your cough? It may be something as simple as that which is your best solution! I'm also sure they'll make the stitches sturdy enough to survive a bit of coughing. It may be that you could just manage with throat clearing rather than full coughing which would be less impact than a cough?

  • Hi - I've never used salbutamol at all for my cough, I only use a preventer (Qvar) - this is why I'm concerned the hospital don't understand my small airways disease. My cough is set off by things like smells or cold or hot drinks, or just happens.

  • What do you mean by irritated cough? Lung irritation? Throat irritation?

    I think if you are concerned that a nebulizer is not the right solution, you need to go back to your doctor and discuss this and perhaps get referrals.

    If the cough is in the throat then perhaps it would be wise to consult with an ENT about cough suppression techniques. For example, coughing triggered by spasms in the larynx (one form of irritated cough) can be helped/avoided by swallowing (NOT throat clearing - that would actually irritate more) and certain exercises to relax the larynx. Coughs triggered by irritation from post nasal drip would be relieved by things that control the post nasal drip which in turn would depend on its cause: allergies (antihistimines), nasal inflammation (nasal steroid sprays), etc.

    If the cough is from irritated lungs, then it could well be that a nebulizer would help. But it may also be a good idea to meet with a physiotherapist before surgery. Some coughs are functional: the body needs them to clear mucus. However, there are techniques for making functional coughing gentler on the body.

  • Hi Beth,

    Thanks for this . I'm seeing my respiratory consultant on Monday to tell him what's hapening. I hope he'll be able to contact someone at the cardiac hospital where I'll be and advise them. I would say my cough is a combination of throat irritation now - I have small airways disease showing as air trapping and inflammaton in my lungs on CT and x-ray but the Qvar has mostly dealt with that. I think now my cough is due to an oversensitive cough mechanism which probably got that way through all the coughing I did when the small airways disease was bad.

  • Good you are getting to talk to your respiratory consultant.

    If you think it is due to an oversensitive cough mechanism and you feel some sort of catch/irritation/tickle in the throat before the cough, I'd consider a consult with an ENT as well - not just for the surgery, but also to get help getting rid of the cough itself. That kind of cough often is the result of a vicious cycle of irritation in the larynx: the cough irritates the larynx. The larynx triggers coughs because it is irritated. But there are things that can be done to break the cycle, give your larynx a rest, and let it heal and become less sensitive.

    I had a really bad cough last summer - although the cough originated in the lungs the force of the cough was so strong that eventually my larynx was very irritated. Everytime anything hit the back of the throat wrong , I was at risk of coughing. My ENT had some really good ideas to help suppress the cough that was a result of irritation and eventually that particular cough died out.

    Your mileage may vary and your cough might be a different cough - I just share this story to point out that some coughs can be quieted and there isn't any reason to live with this if your cough is among them.

    Good luck with your surgery.

  • Beth - that's my cough exactly ! Last year and early this year before I started Qvar and before they diagnosed small airways disease on CT scan, my cough really, really irritated my larynx and throat and now I'm left with this oversensitive reaction. I won't have time to see an ENT specialist before surgery but hopefully the respiratory consultant will give good advice to the hospital...fingers scrossed as I don't know how this type of thing works out where a person has multiple conditions.

    Thanks you !

    Good you are getting to talk to your respiratory consultant.

    If you think it is due to an oversensitive cough mechanism and you feel some sort of catch/irritation/tickle in the throat before the cough, I'd consider a consult with an ENT as well - not just for the surgery, but also to get help getting rid of the cough itself. That kind of cough often is the result of a vicious cycle of irritation in the larynx: the cough irritates the larynx. The larynx triggers coughs because it is irritated. But there are things that can be done to break the cycle, give your larynx a rest, and let it heal and become less sensitive.

    I had a really bad cough last summer - although the cough originated in the lungs the force of the cough was so strong that eventually my larynx was very irritated. Everytime anything hit the back of the throat wrong , I was at risk of coughing. My ENT had some really good ideas to help suppress the cough that was a result of irritation and eventually that particular cough died out.

    Your mileage may vary and your cough might be a different cough - I just share this story to point out that some coughs can be quieted and there isn't any reason to live with this if your cough is among them.

    Good luck with your surgery.

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