Ashe About Your Health: How to deal with a persistent cough

By David Baron

Excuse me, exactly how long have you had that cough? That’s probably the most important question you can ask yourself about a common symptom that can mean anything from allergies, to bronchitis, acid reflux, tuberculosis or cancer. If your cough has been going on for two weeks or more, that’s a pretty good reason to get some medical attention and figure out the cause of the cough so you can resolve it.

Probably the most common cough that prompts most people to ultimately see a health care provider is the one that just lingers and lingers in the wake of what we thought was “just a bad cold.” And often times, it seems to be worst at night, when you most want it to go away.

It does seem to be worst at night, partly due to the simple mechanical effects of lying down on your anatomy, and partly as a result of the normal, daily chemical and hormonal cycles in your body. Some people cough so hard they may cause painful strains in muscles in the chest, back, neck or abdomen, headaches or vomiting.

In these cases you can understand why someone would ask for a prescription for antibiotics, or at least a prescription cough medicine. But in most such cases, a clinician may tell you that your lungs sound clear and antibiotics won’t help.

So what’s going on here? Well, when you get a typical upper respiratory infection, primarily caused by a class of viruses called “rhinoviruses,” you’ll be sick with the acute phase of the illness, the fever, aches, sore throat, nasal congestion, etc. for four to six days. After those first few days, you will gradually improve, with the whole thing lasting on average between a week and 10 days.

Your immune system does a pretty amazing job of mobilizing, attacking and eliminating the viral invaders during that period. But what’s left in the aftermath is a bit like a house with termites. Even after you get rid of the bugs, you realize the wood framing has been damaged and needs repair.

In the course of certain upper respiratory infections, the moist pink tissues that line your nose, throat, sinuses and bronchial tubes get irritated, inflamed, swollen and hypersensitive ““ damage your body must work to repair once the bugs have been eliminated.

It’s during that repair period, which sometimes lasts a month or more, when mucus membranes continue to crank out mucus. During this time your natural cough reflex, that’s there to help you expel unwanted materials from your respiratory tract, is seriously overactive. Sometimes it is triggered even when there’s nothing there to expel!

Cold or dry air, wind, dust, a little droplet of saliva, exercise, laughing or just lying down can trigger a coughing fit which, once it starts, perpetuates itself by further irritating your airways.

As you probably know from some experience of your own, it can be painful, exhausting, frightening and at the very least, annoying ““ not only to you but to the people you are with during the day, such as your roommate or classmates.

It gets better slowly. And what helps most is avoiding irritants ““ like smoking, any kind of smoking ““ good hydration and humidification.

During this stage of your recovery you’re generally not contagious. But “cover your cough” anyway, please. If you have a cough lasting more than two weeks, or one that is associated with persistent fevers, chills, sweats, shortness of breath, chest pain, substantial weight loss or coughing up blood, get yourself checked out by a health care professional. You may or may not need antibiotics.

But if you have any of these “associated symptoms,” it’s important to rule out more serious conditions. And even if you just need some reassurance, that’s definitely what we are here for at the Arthur Ashe Center.

Dr. David Baron is the executive director of the Arthur Ashe Student Health and Wellness Center.