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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6702
Experience:  14 years as clinician in the field of Family Practice
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my husband has had a productive cough for 3 months, been to

Resolved Question:

my husband has had a productive cough for 3 months, been to the doctor 4 times, chest xray, ct scan, now on antibiotics for the third time, a couple of weeks ago he coughed so hard he fainted. he gags and almost pukes from the mucus, he has sore muscles and his throat is raw from all the coughing, any suggestions on why this wont go away? and no hes not a smoker, he quit 16 years ago
Submitted: 1 year ago.
Category: Health
Expert:  Anthony Bray, MD replied 1 year ago.

Anthony Bray MD : Hello!
Anthony Bray MD : Your husband's prolonged and severe cough would be in need for further steps of diagnosis and treatment...
Anthony Bray MD : I would advise that be follow up with a pulmonolgist ( lung specialist)
Customer:

he was getting better, and then my grandson got a sinus infection and boom, he got worse, had a fever for a couple of days, he also has allergies and astma

Customer:

why wouldn't our family doctor suggest seeing a specialist

Anthony Bray MD : He may benefit from brochoscopy to help in diagnosis... Sputum samples may be collected and sent for cultures and other tests...
Anthony Bray MD : he needs to be checked for resurgent bacteria as a possible cause as well as atypical infections( fungal, mycobacterial, tuberculosis, others)
Anthony Bray MD : chronic inflammation may be infection related or non- infectious ... Some cause of inflammation of the bronchi is probable cause of the chronic cough....
Anthony Bray MD : Allergy mediated inflammation as with asthma or chronic bronchitis could be the cause of his symptoms...
Anthony Bray MD : If this were the case then treatment options that could help may include Singulair, inhaled steroid treatment( ex. Pulmocort) or oral steroid such as prednisone....
Anthony Bray MD : Another potential concern is that certain cancers involving the lung can also present with a chronic cough... Hopefully this is not the case and it has been so long since he stopped smoking that this would seem less likely but still would not be impossible...
Anthony Bray MD : the bronchoscopy would be most useful in such a case to assist in the diagnosis....
Anthony Bray MD : Congestive heart failure may present with chronic cough as another potential cause. With this cause he would probably be worse in reclined position and would be probable to experience shortness of breath as well...
Customer:

they found spots on his lungs, they said 2 were scar tissue and 2 they weren't sure of but weren't concerned about, advised to have a second chest xray in 6 months, I smoke but not in the house

Anthony Bray MD : His primary care doctor probably feels that he has good idea of cause and treatment... This would seem understandable to me with your added history of his ups and downs plus history if asthma...
Anthony Bray MD : Asthma does make recovery from an infection of bronchitis more prolonged. A more prolonged cough is often the case with this....
Anthony Bray MD : Still if his treatments are not leading to improvement then I think seeing a pulmonolgist would be advisable....
Customer:

so in your opinion, how much longer should we give it if he doesn't improve before we seek a 2nd opinion, or should we do that now

Customer:

hes been on his 3rd round of antibiotics for 3 days

Anthony Bray MD : Ok well if he has received recent new treatment such as a new antibiotic for example then I think 2 weeks or so trial on this would be reasonable....if not at least IMPROVING...( he may not even then be 100%) then I would advise seeing pulmonary specialist ....
Anthony Bray MD : is he currently taking anti-inflammatory treatment such as prednisone, Singulair, inhaled steroid, Accolate or other??
Customer:

yes he has an inhaler that has steroids

Anthony Bray MD : Ok so based on the most recent treatment I would recommend giving this one more week>> if not improving at least then I think he should see pulmonary specialist....
Customer:

thank you very much

Anthony Bray MD : OK >> even with inhaled steroid the adding of Singulair( = most common leukotriene receptor blocker>> this class helps to reduce airway inflammation) may be helpful....
Anthony Bray MD : You are very welcome!
Anthony Bray MD : Let me know if you have further questions and I will be happy to get back with you!!
Anthony Bray MD : if my answers have been helpful and to your satisfaction then please remember to leave positive feedback. Thank you and best regards,
Customer:

thank you

Anthony Bray MD : Anthony Bray MD
Anthony Bray MD : Again you are most welcome!! Take care!!
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6702
Experience: 14 years as clinician in the field of Family Practice
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