Child Chronic Cough

Discussion in 'Health and medical' started by Tom Burns, Feb 14, 2004.

  1. Tom Burns

    Tom Burns Guest

    I have a 4 year old daughter, otherwise healthy and normal in all respects. She experiences bouts of
    persistent coughing lasting 7-14 days or so, for the last year, maybe one episode every month or
    two. The cough is dry and she indicates that the irritation is in her throat, but it seems to be
    more persistent at night. I thought if it was postural then maybe post nasal drip was causing it at
    night, but she shows no signs of nasal congestion. There are no other indicators that I can see. No
    accompanying fevers. She has had a few ear infections but we were told that there was a lot of this
    happening to children in our area. Treatment with antibiotics cleared up these incidents and she has
    no ear infections for almost a year, and not now with the coughing spells. I'm reluctant to continue
    cough suppressants (as advised by pediatrician), but the problem is causing her to not sleep well.
    Thank you for any help.
     
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  2. Anon

    Anon Guest

    On 2004-02-13 21:05:24 -0500, Tom Burns <[email protected]> said:

    I would be suspicious for asthma. In many cases, asthma's first presenting symptom is a nocturnal
    cough. I suggest returning to her pediarician and inquiring about this.

    > I have a 4 year old daughter, otherwise healthy and normal in all respects. She experiences bouts
    > of persistent coughing lasting 7-14 days or so, for the last year, maybe one episode every month
    > or two. The cough is dry and she indicates that the irritation is in her throat, but it seems to
    > be more persistent at night. I thought if it was postural then maybe post nasal drip was causing
    > it at night, but she shows no signs of nasal congestion. There are no other indicators that I can
    > see. No accompanying fevers. She has had a few ear infections but we were told that there was a
    > lot of this happening to children in our area. Treatment with antibiotics cleared up these
    > incidents and she has no ear infections for almost a year, and not now with the coughing spells.
     
  3. Tom Burns

    Tom Burns Guest

    anon wrote:

    > On 2004-02-13 21:05:24 -0500, Tom Burns <[email protected]> said:
    >
    > I would be suspicious for asthma. In many cases, asthma's first presenting symptom is a nocturnal
    > cough. I suggest returning to her pediarician and inquiring about this.
    >
    >> I have a 4 year old daughter, otherwise healthy and normal in all respects. She experiences bouts
    >> of persistent coughing lasting 7-14 days or so, for the last year, maybe one episode every month
    >> or two. The cough is dry and she indicates that the irritation is in her throat, but it seems to
    >> be more persistent at night. I thought if it was postural then maybe post nasal drip was causing
    >> it at night, but she shows no signs of nasal congestion. There are no other indicators that I can
    >> see. No accompanying fevers. She has had a few ear infections but we were told that there was a
    >> lot of this happening to children in our area. Treatment with antibiotics cleared up these
    >> incidents and she has no ear infections for almost a year, and not now with the coughing spells.
    >
    >
    Thanks for the suggestion. I'm leaning towards sinusitis. Seems to fall into the pattern. There is
    one type that has all the symptoms which my daughter presents - ie: no nasal discharge, comes and
    goes in 30-60 day cycles, etc.
     
  4. Anon

    Anon Guest

    On 2004-02-14 11:07:35 -0500, Tom Burns <[email protected]> said:
    >>
    >>
    > Thanks for the suggestion. I'm leaning towards sinusitis. Seems to fall into the pattern. There is
    > one type that has all the symptoms which my daughter presents - ie: no nasal discharge, comes and
    > goes in 30-60 day cycles, etc.

    In other words, you think it's more likely that your daughter has something incredibly unusual,
    rather than something incredibly common?

    The thought processes of the lay "diagnostician" continue to amaze me.
     
  5. Talkback

    Talkback Guest

    anon wrote:

    > On 2004-02-14 11:07:35 -0500, Tom Burns <[email protected]> said:
    >
    >>>
    >>>
    >> Thanks for the suggestion. I'm leaning towards sinusitis. Seems to fall into the pattern. There
    >> is one type that has all the symptoms which my daughter presents - ie: no nasal discharge, comes
    >> and goes in 30-60 day cycles, etc.
    >
    >
    > In other words, you think it's more likely that your daughter has something incredibly unusual,
    > rather than something incredibly common?
    >
    > The thought processes of the lay "diagnostician" continue to amaze me.

    No, I think I'll let an MD make the determination. But the information I found indicated that some
    25% of children with these symptoms may in fact have sinusitis. That, coupled with 3 indicators
    which specifically suggest sinusitis seems to make it a POSSIBILITY, even for a thought process
    deficient lay idiot like myself.

    As you are seem to be an experienced diagnostician, I'm curious to know how statistical probability
    affects your determinations. I suppose that if 100 people present with the same symptoms, it would
    be statistically correct to assume that a very low number would have the incredibly uncommon
    underlying cause. But in a sample of 1, would you discount the possibility that that one person may
    in fact be suffering from the statistically small ailment? BTW-both her mother and I suffer from
    sinusitis. Of course, I don't know if would have any bearing at all. Still, I'm a little taken
    disappointed in your comments. I'm not trying to diagnose, only to become more educated and
    involved in my own and my family's health care. I think it's only reasonable that we make an effort
    to work with our health care professionals, not abdicate our responsibility. I have on 2 occasions
    caught an error. Once I was prescribed a medication which was contra indicated with respect to
    other medications I am on, the other time I was dispensed the incorrect medication, a situation I
    only knew because I asked the doctor what the prescription was (God knows I couldn't make it out
    from the scrip).

    Food for thought I hope.
     
  6. Anon

    Anon Guest

    On 2004-02-14 22:13:15 -0500, talkback <[email protected]> said:

    > No, I think I'll let an MD make the determination. But the information I found indicated that some
    > 25% of children with these symptoms may in fact have sinusitis. That, coupled with 3 indicators
    > which specifically suggest sinusitis seems to make it a POSSIBILITY, even for a thought process
    > deficient lay idiot like myself.

    I never called you an idiot. If only 25%, as you say, of persons with your daughters symptoms
    have sinusitis, and you conclude that she must, therefore, have sinusitis, you're *thinking* like
    an idiot. ;)

    Statistical probability *always* plays a role. How do doctors find the off zebra amongst the herds
    of horses that they see every day? Well, my friend...that's what medical school, residency, and
    years of experience are for. Asking a doctor "how do you diagnose" is like asking Pavorotti "how do
    you sing" (not that I'm on the same level as Pavarotti, but you get the point). The point is, it's
    an *art* as well as a science, and it's more complicated than plugging terms into Google or a
    computerized "diagnosis" program and seeing what spits out.

    I'm completely in favor of people taking more responsibility for their health, but while knowledge
    is power, power corrupts. Many people arm themselves with information, thinking that it equates with
    knowledge, but without the background to interpret information properly, they are often led to
    conclude things that simply aren't so. Witness the explosion of "alternative" medicine, with its
    junk science and anti-establishment rhetoric. Yet people are buying it (literally, to the tune of
    billions of dollars annually), hook, line, and sinker. Is there a diamond or two in the rough amidst
    all the snake oil? Almost assuredly. However, there's still a lot of snake oil out there.

    Nobody's perfect, and that includes doctors and pharmacists. You *should* double-check your
    prescriptions. Personally, this is common sense to me, but some people don't think they should have
    to do it. "Contraindicated" has specific meaning, so be aware that many drugs interact but are not
    contraindicated or necessarily dangerous together. The important thing is that someone recognizes
    the interaction, and take appropriate steps to monitor for safety.

    Back to your daughter. The fact that her parents have sinutitis has little bearing on her case.
    Sinusitis, which is simply an inflammation of the sinus passages (usually viral or allergic,
    sometimes bacterial), is not inherited. However, atopy (which includes asthma, eczema, and -
    sometimes - allergic rhinitis, is definitely inheritable). Not knowing details about you or your
    wife, I can't offer any further comments. I would still be suspcious of bronchospasm given your
    earlier description of her symtoms, and not very highly suspicuos of a sinus process given her
    distinct lack of sinus symptoms. However, it's best that her own doctor sort this out.

    Good luck.

    >
    > As you are seem to be an experienced diagnostician, I'm curious to know how statistical
    > probability affects your determinations. I suppose that if 100 people present with the same
    > symptoms, it would be statistically correct to assume that a very low number would have the
    > incredibly uncommon underlying cause. But in a sample of 1, would you discount the possibility
    > that that one person may in fact be suffering from the statistically small ailment? BTW-both her
    > mother and I suffer from sinusitis. Of course, I don't know if would have any bearing at all.
    > Still, I'm a little taken disappointed in your comments. I'm not trying to diagnose, only to
    > become more educated and involved in my own and my family's health care. I think it's only
    > reasonable that we make an effort to work with our health care professionals, not abdicate our
    > responsibility. I have on 2 occasions caught an error. Once I was prescribed a medication which
    > was contra indicated with respect to other medications I am on, the other time I was dispensed the
    > incorrect medication, a situation I only knew because I asked the doctor what the prescription was
    > (God knows I couldn't make it out from the scrip).
    >
    > Food for thought I hope.
     
  7. Anon

    Anon Guest

  8. Talkback

    Talkback Guest

    anon wrote:
    > On 2004-02-14 22:13:15 -0500, talkback <[email protected]> said:
    >
    >> No, I think I'll let an MD make the determination. But the information I found indicated that
    >> some 25% of children with these symptoms may in fact have sinusitis. That, coupled with 3
    >> indicators which specifically suggest sinusitis seems to make it a POSSIBILITY, even for a
    >> thought process deficient lay idiot like myself.
    >
    >
    > I never called you an idiot.

    No, I did. In terms of medical training I have an idiot's equivilancy.

    If only 25%, as you say, of persons with
    > your daughters symptoms have sinusitis, and you conclude that she must, therefore, have sinusitis,
    > you're *thinking* like an idiot. ;)

    I disagree. I would hope that any professional drawing any conclusions would not discount anything
    because of it's relatively low incidence of occurance. If one is guessing, then I suppose that
    probability would be a significant factor, but ideally one would hope that a diagnosis could be made
    based on observable symptoms, tests, etc.

    >
    > Statistical probability *always* plays a role. How do doctors find the off zebra amongst the herds
    > of horses that they see every day? Well, my friend...that's what medical school, residency, and
    > years of experience are for. Asking a doctor "how do you diagnose" is like asking Pavorotti "how
    > do you sing" (not that I'm on the same level as Pavarotti, but you get the point).

    I'm sure you have a lovely voice. (-;

    The point is, it's an *art* as well as a science, and
    > it's more complicated than plugging terms into Google or a computerized "diagnosis" program and
    > seeing what spits out.

    I completely agree. When faced with an unusual situation the "art of diagnosis" is a powerful
    tool. I was, however, referring to less esoteric ailments - ones which could be determined by
    observation and test.
    >
    > I'm completely in favor of people taking more responsibility for their health, but while knowledge
    > is power, power corrupts.

    I think I was corrupt before I knew anything. (-; Many people arm
    > themselves with information, thinking that it equates with knowledge, but without the background
    > to interpret information properly, they are often led to conclude things that simply aren't so.

    That's why I said I leave the conclusions to the professionals.

    Witness the
    > explosion of "alternative" medicine, with its junk science and anti-establishment rhetoric. Yet
    > people are buying it (literally, to the tune of billions of dollars annually), hook, line, and
    > sinker. Is there a diamond or two in the rough amidst all the snake oil? Almost assuredly.
    > However, there's still a lot of snake oil out there.

    Go to a homeopath, become a raw foodist, buy lottery tickets. It's your life. Just spare me from
    having to listen to you.

    > Nobody's perfect, and that includes doctors and pharmacists. You *should* double-check your
    > prescriptions. Personally, this is common sense to me, but some people don't think they should
    > have to do it.

    I read some alarming statistics on the number of people becoming seriously ill from mixed up scrips,
    and this does not include the potentially huge number of people for whom the drugs they were
    mistakenly dispensed had not ill effect, but no benefit either.

    > "Contraindicated" has specific meaning, so be aware that many drugs interact but are not
    > contraindicated or necessarily dangerous together.

    My definition is "DO NOT TAKE "A" IF TAKING "B".

    > The important thing is that someone recognizes the interaction, and take appropriate steps to
    > monitor for safety.
    >
    > Back to your daughter. The fact that her parents have sinutitis has little bearing on her case.
    > Sinusitis, which is simply an inflammation of the sinus passages (usually viral or allergic,
    > sometimes bacterial), is not inherited.

    I didn't think so, and so didn't mention it in the original post.

    However, atopy (which includes asthma, eczema, and -
    > sometimes - allergic rhinitis, is definitely inheritable). Not knowing details about you or your
    > wife, I can't offer any further comments. I would still be suspcious of bronchospasm given your
    > earlier description of her symtoms, and not very highly suspicuos of a sinus process given her
    > distinct lack of sinus symptoms. However, it's best that her own doctor sort this out.

    As she will on Monday. I was just trying to solicit some insights here, which, on the whole, I've
    found to be helpful.

    > Good luck.

    Thank you. I'm sure you want to know how it turns out. Of couse, if it does turn out to be
    sinusitis, I'll be torn between letting you know and trying not to look like a wise-ass. (-;
     
  9. Anon

    Anon Guest

    On 2004-02-15 12:17:33 -0500, talkback <[email protected]> said:
    > I would hope that any professional drawing any conclusions would not
    > discount anything because of it's relatively low incidence of occurance.

    Dismissing something out of hand as "impossible" (which I would never do) is much different than
    discounting something because it's highly improbable. The point is, "When you hear hoofbeats, think
    horses...not zebras" (an old saying that is oft-repeated). Your daughter's symptoms just don't fit a
    sinus problem.

    > If one is guessing, then I suppose that probability would be a significant factor, but ideally one
    > would hope that a diagnosis could be made based on observable symptoms, tests, etc.

    Believe it or not, many diagnoses are nothing more than educated guesses. The accuracy depends on
    the education of the guesser. ;-) Don't forget that most symptoms are generic, and exist in many
    different conditions. Many common conditions are not diagosable by objective tests, thus the "art"
    of medicine.

    > Go to a homeopath, become a raw foodist, buy lottery tickets. It's your life. Just spare me from
    > having to listen to you.

    As a doctor, I'm unfortunately stuck listening to it.

    > Of couse, if it does turn out to be sinusitis, I'll be torn between letting you know and trying
    > not to look like a wise-ass. (-;

    I'm always willing to admit when I'm wrong. Anyone examining your daughter has a distinct advantage
    over someone trying to figure out what could be wrong based on a Usenet posting, so at least cut me
    some slack. ;)
     
  10. Talkback

    Talkback Guest

    anon wrote:

    > I'm always willing to admit when I'm wrong.

    And I'm probably more likely to be wrong than you are.

    Anyone examining your
    > daughter has a distinct advantage over someone trying to figure out what could be wrong based on a
    > Usenet posting, so at least cut me some slack. ;)
    >

    Slack is available by the foot, prepackaged in 100 and 250 foot lengths, and by the 1000' roll.
    You're welcome to as much as you want. Take lots extra! It's also suitable for fashioning nooses for
    homeopaths, raw foodists and obsessive/compulsive lottery players. Just recently I was able to hang
    4 "Spontaneous Human Combustion-ists". Quite satisfying. Of course, cremation followed. (-;
     
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