DEAR DR. GOTT: In the fall of 2011, I had a first-time bout of pneumonia. It was relatively mild and took about six weeks to recover. However, since then I have had trouble in my throat. I have a persistent cough and am always clearing my throat and occasionally gag from mucus buildup. Also when I lie down (as in sleeping) my throat dries out completely, causing me to awaken and drink water. This never happened before the pneumonia.
After nearly seven months, this just isn’t going away. I have raised the concern with my family doctor and cannot seem to get his interest in this problem. His only advice is to use a salt water nasal cleanser which did nothing helpful. I’m a 57-year-old male, overweight, but in generally good health. Any advice for me? Thank you.
DEAR READER: Pneumonia is lung inflammation that can be caused by infection, parasites, bacteria, fungi or a virus. The most common causes are viral or bacterial in nature. Symptoms can range from being very mild to being life-threatening and can include fever, fatigue, headache, chest pain, shortness-of-breath, cough, and more. Because pneumonia commonly mimics the flu, people often delay seeing a physician and while it can occur in anyone, those with a compromised immune system, have other medical problems such as COPD, or are 65 years of age or older, should be particularly cautious.
Those individuals such as yourself who likely had a mild bacterial case and are relatively young typically respond well to antibiotics and will recuperate easily; however, complications in the elderly can be more severe and difficult to treat. For example, fluid can accumulate between the transparent covering of the lungs which can result in shock and multiple organ failure. For viral pneumonia, mild to moderate cases are treated with rest, fluids and over-the-counter symptom relievers (with the physician approval). In severe cases, an anti-viral may be appropriate, but as a general rule are rarely prescribed.
Diagnosis for pneumonia begins by having a physician listen for crackling sounds in the lungs, similar to what is heard when scrunching cellophane. If any question remains, a chest X-ray or laboratory testing might follow. Cough medicine can be recommended but should only be used under a doctor’s orders. Even then, a minimal amount to arrest the cough is all that is recommended. Any prescribed medication, rest and fluids should complete the course of treatment.
All this brings me to your cough. Did your physician prescribe any medication or listen to your lungs? Did he do a follow-up X-ray to determine if something else has affected you? Perhaps the timing is extremely coincidental. You may have GERD (gastroesophageal reflux disease), post nasal drip, bronchitis, or a completely different respiratory ailment. Do you have sleep apnea? Have you changed jobs and are now exposed to pollutants at your workplace? Do you have new allergies from dog dander, plants, bed linens, dust or countless other things? Are you on medication for anything at all that has a side effect of cough? There are countless possibilities that need to be considered. Is your cough constant or does it become more active at specific times? A little detective work might be in order to get to the bottom of the problem.
If your physician remains aloof, don’t hesitate to find another physician. Your health is important and you deserve to have your questions answered and problems solved. His loss in having the pleasure of caring for you will be the next doc’s gain. Go for it!
Readers who would like related information can order my Health Report “Pulmonary Disorders” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.