Never-ending coughs

As the new school year approaches, I face once again the prospect of being shut up in an exam room with someone in thin control of thick secretions. There are days during the cold and flu season where I feel like shouting into the waiting room "Go home, there is nothing I can do for you. Pick up a prescription for codeine cough syrup from the receptionist and call me in two weeks if it hasn't gone away."

Now, courtesy of The American College of Chest Physicians, there's a whole new lexicon in cough diagnoses. No more 'cough due to post nasal drip' as in the gunk slipping down the back of your throat is making you cough. Upper airway cough syndrome sounds more worthy of that pricey visit co-pay anyway, and the new name recognizes that it's not just about the mucous stuck in your throat anymore but also about inflammation of the cough receptors in the upper airway.

What about the never-ending coughs from hell following chest colds? These coughs last more than 2 months here in Denver where the air is dry and filled with dust and automotive schmutz through the winter months. These coughs are now called post-infectious cough secondary to upper airway cough syndrome.

While the chest docs recommend treatment with an antihistamine-decongestant combination drug, I prefer prescription Tessalon Perles (generically available as bezonatate) which specifically quiets those unhappy cough receptors. The new guidelines also tap an inhaler called Atrovent (ipratropium) as useful for post-infectious coughs.