Continuing flare of cough predominant asthma - amytryptiline

[CindyID]

Hi guys, thought I'd post a quick update as it might help someone else sometime.

I have cough predominant asthma, which means coughing is my main symptom but I do sometimes wheeze when I'm really bad, and I also can get tight and short of breath.

I was discharged from hospital on 10th November after being in with this asthma flare up. It was potentially too soon and there's a whole thread about it here somewhere.

Since then, while I've had odd days where I've been slightly better, I'm basically the same now as when I came home, except my own flow has been dropping to around 50% pre neb the last few days. I've seen my respiratory team, had multiple calls with my GP, but essentially just managing at home on lots of meds and lots of salbutamol nebs, which are the only thing that stop the cough.

Except sometimes my lungs are so hyper responsive that the nebs don't work, or at least not for long.

After 4 weeks of this coughing I'm understandably exhausted. Had to call 999 this morning as cough wouldn't stop plus I was wheezing and short of breath.

Had back to back nebs and they spoke to a GP at my surgery. I'm obviously not coping being left to manage on nebs until my next respiratory appointment on the 9th. There's also an argument that they wouldn't do anything different in hospital than give me loads of nebs and I'm more comfortable/safe in my own home.

Anyway, the long and the short of it is this GP has suggested amytryptiline has been shown to help with "intractable coughs" like this, so we're trying that today. I really REALLY hope it stops this cough because I'm absolutely exhausted and have pulled muscle in both sides of my chest with it.

Has anyone else been prescribed amytryptiline for asthma cough and did it help?

Currently on fostair, spiriva respimat, pred, carbocisteine, montelukast, uniphyllin, nebs, codeine for the pulled muscles and to supress cough.

I also drink warm honey and lemon or chamomile tea literally all day, suck on packets of soothers in an attempt to calm it.

[Yatzy]

I feel for you, Cindy. I had an exacerbation this time last year, that went on for weeks, maybe flu based though I’d had the jab. Just couldn’t stop myself coughing. All cough muscles in ribs in agony. Saw GP twice, prescribed codeine for rib pain and amitriptyline for back pain, I’d pulled a lower back muscle coughing too. Also long prescription of prednisolone and antib’s, on top of my usual Seretide 250, bricanyl, and montekulast.

I lost my sense of taste and smell too and hugely fatigued, some say I had COVID early!

The amitryptyline helped me relax and sleep better, in combination with the codeine, but I only took it for a couple of weeks....didn’t like the whoozy feeling, but it helped lift all my muscle pains.

Steam helps my asthma (though I know it’s not good for some) and every time a coughing spasm started, to try to give my ribs a break, I got a kitchen bowl of very hot water (be careful!) placed it on a firm surface to prevent jerky cough movements scalding myself, and breathed the steam. If I got it soon enough, it helped, and helped me clear my lungs too. As I say, think it was flu at root, took six weeks to settle, and left me very weak.

Hope you get there soon too 💕

[CindyID in reply to Yatzy]

Wow Yatzy, maybe you did have covid, sounds awfully like it. How are you doing, are you still feeling weak now?

I've found steam can make the coughing worse, although it's so unpredictable I never know what's going to annoy these lungs next! I do constantly have a warm drink on the go though. This morning, the shower kicked off an attack, so heck knows what that was all about.

I think the amytryptiline, maybe in combination with the codeine, are helping me get more rest between coughing, and the attacks have been further apart since I started on them. Maybe they would've been anyway? Who knows?

I had a viral illness about 5/6 weeks ago that triggered this flare up. Was tested for covid but was negative. Some kind of coldy thing is a common trigger for me. Xx

[Yatzy in reply to CindyID]

Fully recovered now, thanks, but took best part of three months, all told. Glad you think your cough is reducing now....big corner turned! xx

[CindyID]

Update for anyone in a similar situation: it's early days but I do think the amytryptiline is reducing the number of coughing episodes, which in turn means less irritation from coughing. Also able to get some good rest. I'm feeling very hopeful that this'll be me turning the corner to feeling better.

[twinkly29 in reply to CindyID]

I'm glad you're getting some relief.

It sounds a bit similar to a friend's son who had received treatment for as asthma flare up a few winters ago but he was left with a lot of irritated type coughing. Having had his chest listened to and deemed to be very good, the GP suggested frequent sips of icy water to kind of break the cycle of what had seemingly become like a reflex/hyperreaction by that point - not the actual asthma causing the coughing.

[CindyID in reply to twinkly29]

Interesting, does he have cough variant asthma? My understanding is the cough in CVA is a hyperreaction and chest would sound good regardless. But if the icy water worked, that's great 👍

Hard to know for sure what exactly is going on with me, but at least something is finally helping. Was wheezy yesterday when paramedics were out so definitely some element of asthma, as I only wheeze when I'm pretty bad.

I'm just grateful to be coughing less than yesterday, and hopeful things can start to calm down now. Had a couple of decent naps today too 😴 👍

[twinkly29 in reply to CindyID]

Gosh yes the incessant coughing (I get that acutely) and lack of sleep must be a killer!

No he has quite normal style asthma (lucky him, am sure that's easier!) It was just like a residual thing that happened.

I don't know much about CVA but if you've found something that helps for certain aspects that's great - would be good if your team could actually treat the underlying asthma too!

[CindyID in reply to twinkly29]

It's a nightmare! Hoping for a chunk of good sleep tonight 🤞

Lucky him, although not lucky at all really. Hope he stays well.

There isn't much out there to research and mine is a different variation on the theme - cough predominant - so I also do get other asthma symptoms like wheeze sometimes, unlike CVA which is purely cough

Wouldn't that be great? 😀 here's hoping my referral to Exeter specialist doesn't take too long 🤞

[CindyID]

I had a brilliant idea! Had a coughing attack this morning, so before getting my neb going I recorded it. The video is very hard to watch, but really demonstrates why I find these attacks "distressing" - also clearly shows that sipping honey and lemon isn't going to help - a real suggestion from a doctor to stop an attack!

The A&E doctors, GPs and consultants only see me with a bit of a cough between attacks or after nebs. Now I can show then what I've been dealing with, 5-10 times a day, for over a month!

Strongly advise you do the same if you struggle to get people to truly understand your symptoms. Hope this helps xx