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Dry Cough
Jun 17, 2001

Hello Dr. Feinberg - You've been so much help for both me and my Dr's in the past - but this is a new development. HIV+ Since approx. 1986. Never taken any antiretrovirals (or any other sort of anti-HIV drugs). Had DVT & multiple Pulmonary Embolisms in November 2000. Smoker for 30 years, last cigarette in December 2000. Alcoholic, but nothing to drink for at least two months now. After I stopped smoking in December, I began to develop a dry, cough which feel like it is originating rather high up in the throat. It doesn't feel at all like the "smokers" cough I had. The thing about this cough is that it can be embarrassing, I have no control over it whatsoever, it can go on for 5 or 10 minutes, and it is absolutely "racking", in that I will cough until I start gagging. Not good in meetings. I've been to an gastroenterologist - he did an endoscopy, esophagal as well as stomach to the duodenum. Only finding: red and irritated for which I took Acidflex for 30 days.

Chest x-rays have shown nothing. No chest pain or discomfort, except for being quite short of breath. No Dr. has yet been able to figure this one out and I'm getting tired of it. I have to leave my work area at least three times a day because one of these awful coughing fits hits me and pretty soon I'm gagging and making terrible noises. I am on no medications (except PAXIL and Trazadone), and never have been really. Last CD4's approx. 600. Viral Load: approx 55,000. HIV+ and HEP C plus for (that I know of for sure, could be longer) 15 years. Do you have any suggestions on how to get rid of this thing or at least control it a bit? Thank you.

Response from Dr. Feinberg

I am concerned about what is cauausing the cough, not just about controlling it. Given your long smoking history, it would be important to make sure that there is nothing going on in your chest that makes you cough, such as lung cancer. The first step is to get a regular chest X-ray. You may need other tests, such as a chest CT scan or a bronchoscopy, which would be performed by a lung specialist. If nothing is found, you can take a cough syrup with codeine to try to suppress the cough as much as possible.


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