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Is this cough variant asthma?

Forgive me the length of this post.  

Some background.  My 11-year old son has had an ongoing cough for about 3 weeks.  It started with a runny/stuffy nose.  I thought it was a cold, but it seemed to come and go.  I assumed it was general seasonal allergies, which are terrible in this area.  He's never seemed to have a big problem with seasonal allergies in the past other than some occasional sniffles.  However, the pollen has been extreme in our area this season.  It's non-stop.  You can see it all over everything.  He doesn't get itchy or puffy eyes.  Just on and off stuffiness and drippiness.  I've given him Zyrtec and Flonase.  

At one point, the drippiness and stuffiness were somewhat bad (again, I can't swear if it were a cold or allergies, although it did seem more like allergies).  During that time he started coughing, which I attributed to post nasal drip.  However, after a couple of weeks he was still coughing periodically.  It wasn't a hard or painful cough.  No wheezing.  He felt like it was a tickle, but he wasn't totally sure.  Last week I took him to the doctor, who felt that given how long it had been going on he would put him on a Z-pak, although his lungs seemed clear.  I'm not one to rush into antibiotics, but since he hadn't been on any antibiotics for at least the last couple of years, I went with it.

He finished the antibiotics on Monday.  Today, he is still coughing.  It's not constant, but it is periodic throughout the day.  He's not having fits.  It's "cough, cough", or "cough, cough, cough" and then nothing.  It's just, kind of there.  I'd have thought it would be gone right now.  I suppose it could be some remaining irritation.  It could be some more allergy issues (I'm personally occasionally having mild issues and once in a while coughs that seem pollen related).  But I'm not sure.

I'm wondering if this could be cough-variant asthma.  Does anyone know what cough-variant asthma sounds like?  Is it more constant, or does it come in larger fits?  

I should say that he's sleeping through the night. A little over a week ago, it kept him up a bit one night, but that was the only the one time.  

He seems to think it's better than it was.

If you're still reading this… thank you!

 

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  • K8sMom2002

    Hi, and welcome, Ameli79! Coughs are tricky things, and they can linger even in folks who don't have asthma. 

    My asthma is definitely more of the cough-variant type — in fact, sometimes, for me, coughing can trigger a bigger more "classic" asthma flare. My doc has pointed out that a cough or throat tickle for me can be the first signs of something bigger going on, and it's part of my overall asthma action plan to manage it. 

    Chronic coughs (those that last more than 8 weeks) can be caused by a variety of things: post nasal drip, GERD, other medications, and, yes, cough-variant asthma. 

    Could you circle back to your doctor and ask these questions:

    • When should I expect this cough to get better?
    • When should I begin worrying about this cough?
    • Are there tests that you can suggest that would rule out asthma? (By the way, here's a great resource to help you talk with your doc: )
    • If it isn't asthma, what other things do we need to rule out and what do we need to do that?
  • Ameli79

    Thank you so much.  That makes a lot of sense, and those are very helpful questions to share with his doctor.  I can't tell you how much I appreciate it!  

    May I ask, what are your coughs like?  I'm guessing there's not one type that defines cough variant asthma, but I'm still curious.  

    I will definitely follow up on this using your questions.  The catch now is that my son is leaving in just one week for a month of sleepaway camp.  This doesn't leave much time to figure this out.  Eek!

  • K8sMom2002

    Oh, yikes, you're right — not much time at all! Could you schedule an appointment before then with either your doc or the NP or PA that works with your doc? You could ask to check for post nasal drip and if there is something that might help beyond antihistamines … I know my doc has me take decongestants to open things up and get everything drained out. Part of my plan as well is to up my fluids to thin everything out.

    You asked about my coughs. Sometimes (many times) they are the typical dry cough that go with cough-variant asthma. If I have a lot of mucus, then they sound "wet" or more productive. If it's triggered by irritants, and I have no mucus, it's going to sound more dry. 

    A tickle to the throat — dry bread crumbs from toast, dust — can set me off. My doc has suggested that if it's "just a tickle" that I try drinking some water to settle things down. If it continues, then I move on with my plan as she has it written. 

    Also, my doc has suggested a tablespoon of honey — ask your doc if this is okay for your kiddo. Apparently (and again, this is just according to my doc) one of the reasons that cough syrups "worked" was that it soothed the throat and eased that cough reflex. Mayo Clinic has this to say about .

  • LK

    Welcome Ameli79!  

    I have adult-onset, cough variant asthma.  I agree with all the great ideas given above about what to talk over with your doctor.

    There are many causes of coughs and as you say a cough can linger for weeks even after the major illness is gone.

    My cough is usually a dry cough.  For several years before I was diagnosed with asthma I thought it was just allergies or dust since I work with horses and there is a lot of dust around barns and riding arenas.  

    I would cough off and on during the day and night.  Some of my coughing was due to acid reflux but some also was due to my asthma.  My cough would increase if I laughed heartily, exercised and when I would be exposed to dust or strong scents.

    I used to try a sip of water or a cough drop but they didn't really help me since asthma is down deep in the lungs.

    Hope you are able to contact your doctor and set up an appointment before your son goes on his camping trip.  Let us know how he is doing!

  • Ameli79

    Thanks to both of you!  He came home today and swore he wasn't coughing at all.  I haven't heard anything yet.  If he's not better Monday, I'll call the doctor and see what we can do.  It sounds like there's no exact "type" of cough per se.  My son's definitely sounds more dry.  It's not hacking or harsh.  It's not like each bout goes on a long time, maybe 2-3 coughs then nothing for a while.  Hopefully it's just some lingering irritation.  He's a bit drippy again, and so is my other son.  This allergy season is hitting even people who haven't suffered much in the past. 

  • K8sMom2002

    That sounds like a great plan! Hoping that the weekend showed some easing off of that cough, but if it isn't, then I'm hoping your doc will have some ideas!

    You're right about this year's allergy season! Yikes!

  • Ameli79

    Thank you all again!  He seemed to get much better over the course of the weekend. We'll keep an eye on this, and after he gets back from camp if it begins happening again we'll follow up on it.

  • K8sMom2002

    Could you give the camp a heads-up as well, so that they will be able to keep an eye on it? Also, that way they'll know that you have had him checked out by a doc.

  • Ameli79

    I will definitely give the camp a heads up to look out for this.  

    He is doing better, thank you so much!  

    I'm still going to have him checked with an allergist when he gets home after camp.

  • K8sMom2002

    I hope camp goes well for him, and I think it's an excellent idea to have an allergist check him!

  • Ameli79

    I don't have an allergist yet. I'm going to get a name to set up an appointment when my son comes home.  Cough aside, he had a rough time with general allergies this spring.  He's never been that bad before.

  • Melissa G

    This spring was really bad this year for spring allergies! I struggled more this past spring than I have in years. I hope you can get an appt quickly!

  • Melissa G

    @Ameli79 How has everything been going? Were you able to get an allergist for your son?

  • Ameli79

    Thanks for checking in.  He's actually been fine.  I still haven't gotten him to an allergist, because we've have some crazy other issues going on here.  Always something.  But I do plan to get him in sometime over the winter.  It always seems to start in spring.

  • Melissa G

    That is great that he has been doing well asthma wise! Sorry things have been crazy! Thanks for checking in!

  • Ameli79

    I have an update.  We took him to an allergist.  He tested positive for grass pollen allergies.  Also, oddly, he had a welt and itching for clams.  That surprised us, because he has eaten clams many, many times, including quite recently, with no reaction whatsoever.  The doctor said not to worry about it and that he can eat clams.  I'm a little confused by it. 

    Anyway, the doctor said that his lung capacity test (I think that's what he called it) before they gave him an inhaler was 70%.  He prescribed BREO to be given once per day, and then we are supposed to return in a month.  He said this was mild and not dangerous.  But when I look online, 70% seems to be just above the concerning range.  

  • Melissa G

    Food allergy testing can be very confusing! Here is a some information on  from our sister site .

    Can you call and chat with the dr to express your concerns? Has your son started the Breo? How is he doing now?

  • Ameli79

    He only just started yesterday.  It's a little hard to tell right now.  I guess the next few days will start telling us a lot.  He didn't give us an action plan.  Hmm.  Maybe he said it was "cough variant asthma" so maybe that isn't quite the same?

     

    I see you posted a response on my updated post "Son newly diagnosed" so you saw my latest info.  I really appreciate all your help!!!