Constant Coughing

Posted by sadair20 @sadair20, Apr 8, 2023

I have recently been diagnosed with bronchiectasis and MAC. I have an appointment with ID Dr. next week.
My pulmonologist has me nebulizing with Albuterol and 3% saline 3x a day, but I can only handle 2x a day.
Airway Clearance Techniques have never been taught to me so I’m learning from online sources but basically I’m
wearing myself out and it’s not productive. I cough constantly. I mean constantly! And I feel like my esophagus is just raw. I have had these kinds of coughing episodes for decades. They usually last 2 months or so and are usually triggered by allergies or a virus. I used to think these ‘flare ups’ were asthma or "reactive airway disease," (one pulmonologist said it was that) but now I know definitively what it is. My last ‘flare up’ was February 2020. I mean not a cough or sniffle for 3 years. Now, in February 2023 I have this cough and these diagnosis due to finally getting CT scans and lots of testing. Here’s the thing.
In the past, I was never able to use Albuterol inhalers because they instantly irritated and aggravated my constant coughing. This time around with the nebulizing, I cannot stop coughing to save my life. Sometime I am able to cough up sputum, sometimes it just seems like my airways are irritated and raw and the cough is just on an automatic cough loop. My chest is beginning to hurt. Is this kind of coughing normal? I'm getting very depressed with the idea that I may be coughing every minute of every day for the rest of my life.

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@sadair20

@californiazebra Thanks for your reply. I am so happy to hear your octreotide injections are doing the trick for you! That's amazing. I can't wait to see my new ID Dr. to get some answers and some kind of treatment. Also, learning about airway clearance techniques online shouldn't be what a person has to do . I'm going to let my pulmonologist know how disappointed I am with his ability to educate me about anything! (another giant frustration!)

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sadair20. I had a similar experience. I was diagnosed in 2019 and saw the pulmonary doc for 8 months. He never offer any literature on how to maintain MAC disease or even about nebbing, aerobika, chest/vest machine... He only threw the big 3 antibiotics at it which I had to come off after 6 weeks. Thanks God for the internet and also Mayo connect.

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Hi sadair20!
CONSTANT COUGHING
My current situation appears to be somewhat similar to yours. Coughing day and night, mostly productive but sometimes not. I have had Bronchiectasis for more than 10 years and the only symptoms were post nasal drip and shortness of breath. I was recently diagnosed with MAC and on the Big 3 since Sep. 2022. In October, 2022 the non-stop coughing started and has not stopped except when we used an intervention of Prednisone and another strategy of OTC Tussin DM which gave relief for only about 3 weeks. Still using the cough syrup with some decrease in the number of coughing spells but overall the coughing still continues day and night. In January of this year, I was told to nebulize with albuterol and saline at .9% (Pulm does not feel I should be at 3% or 7%) which made the coughing worse at first and still looking to see if it will begin to subside to maybe 5 or 7 coughing spells a day. Trying to neb at least once a day with saline only and using Aerobika 2 x per day. Currently I have coughing spells every 45 minutes all day, and at least 3 or 4 during the night. Is this because I'm not on the right routine? Want to hire a Respiratory Therapist to make certain that my airway clearance techniques are sound.
Sometimes the coughing is so strong that I'm afraid I will throw up. I'm not sure we are suppose to tolerate this for too long!!!! Hoping that if I stay focused on airway clearance religiously, I might be able to manage better.
Sue's strategy of bending at the waist than standing and raising her arms above her head and breathing deeply could help.

Truth be told, I'm worn out from all this coughing for the last 6 months and suffering from fatigue which is interfering with my fitness program to become active again. Maybe my age (77) is working against me but I'm determined to stop the tickle in my throat and the crazy cough cycle as soon as possible. Want to hire a Respiratory Therapist Will look into Reactive Airway Disease. Very thankful to Sue, our volunteer MENTOR, the Mayo Clinic Connect and this special community of very smart folks.
Frankie@160

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I understand this constant cough because I coughed like this for almost a year. I stopped working because the coughing was really, really bad. I also avoided people because of the looks and sometimes terrible comments. Finally, actually last week, I started my MAC/bronchiectasis treatment and I still cough but it is less intense and less often. But my rib muscles still hurt a lot after months of coughing. Mornings are the worst though. So before I even start the day I nebulize with albuterol, and then use aerobica- it never really helped much with the cough but it did not hurt either. I asked my pulmonologist about pulmonary therapy but she said i would not qualify. I had a short session with the pulmonary therapist and he said one important thing about aerobica- when you blow the air in the device make sure the air does not go to your cheeks. I was not able to do it so he told me to press my cheeks with a thumb on one side and fingers on the other side of my mouth and hold the device with the other hand. I learned to do it although I do not produce any mucus anyway. He also showed me the 5 huffs/panting like a tired dog and then one big cough technique . I do it but still no mucus. May be somebody went through the same and finally produced mucus- I would be grateful for the advice. Returning to the bad cough, when you cough do not try to support your lungs- which i did because muscles hurt really bad. My pulmonologist said it is a big "no"instead bend to the side. I also see a natural medicine specialist, and he uses massage to relax my tiered from cough muscles (at some point the pain felt as having a constant liver pain) and then having a warm bathtub soak when i get home. Well it works for me and it does not cost anything, so try it too and hopefully you will realize one day that you can breath not cough. My best regards.

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When I first used an inhaler for asthma, that albuterol hit the back of my throat and it started a coughing frenzy. My lung doctor finally ordered me a spacer to use with the inhaler, I do not know why they do not order the spacer when you first start using the inhaler, it keeps the albuterol from hitting your throat and you just breath it in. The only times I used the albuterol inhaler was to open up my air ways and then never more than once a day or sometime once a week and only one puff. Now with the MAC I use it once a day and it helps with the air way clearing more than anything. I have the saline but it does not seem to help me at all. Going for a walk early in the morning when the air is misty works good for me also. Heating a small pot of water over the stove until it starts steaming then hold a hand towel over your head and breath the warm steam.

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I hope that the water is boiled first for 10 minutes depending on altitude...perhaps you should talk to your doctor about the safety of doing this? Moist air with MAC is a huge no-no.

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