Please stop my cough!
October 30, 2011 7:03 PM   Subscribe

Please help me kill this cough....

On Friday, I went to the doctor after a few days of cough and fever and was diagnosed with bronchitis. I was given a prescription for a 5-day course of zithromax (I've taken 3 of the 5 doses) and 12 100 mg capsules of benzonate for the cough.

The benzonate does nothing for the cough. Zero. I called back the office today hoping they would call in a 'script for a codeine cough syrup, but they refused. (I had a 'script for some back in August - perhaps they think I'm drug seeking?)

The cough is a nightmare. Coughing until I throw up. A deep hacking (productive) cough that racks my whole body. I can't sleep. I can't lie down. I haven't had more than 3 hours sleep at any one time in days and days and I just can't take it any more. I feel quite a bit better since I started the antibiotic, but the cough refuses to get any better at all.

Things I've tried:

- 100 & 200 mg doses of the benzonate. (Does absolutely nothing.)
- Mucinex, both on its own and combined with the benzonate.
- Robitussin DMmax, both on its own and combined with the mucinex and the benzonate.
- Hot tea with and without lemon and honey
- Hot showers (works for about 15-20 minutes)
- Vicks vap-o-rub, combined with any/all of the above.
- Hot rum in the tea (works the best of anything so far, but not perfect, and doesn't allow me to get anything done)
- NyQuil (worked the first night and hasn't worked since)
- Hot vapor steamer in my bedroom combined with lots of the above.

I'm getting to the point where I'm kind of afraid I'm going to poison myself by combining so many things (say, Robitussin, benzonate, and rum).

Suggestions? Is there anything OTC that I can try??
posted by anastasiav to Health & Fitness (39 answers total) 15 users marked this as a favorite
I have benefited from "Olba's Pastilles" for temporary relief. This is usually available in Whole Food.

I had a horrendously bad cough for close to a month last April (couldnt sleep for most of the night for several weeks). My doctor eventually gave up and gave me a shot of steroids. That fixed things. But this is obviously the doctor's prerogative and probably not the first or the best option.

My good wishes ...
posted by justlooking at 7:09 PM on October 30, 2011 [1 favorite]

Oh man, I have been here. (You're planning on finishing your Z-Pak, right? OK, good. Now that that's out of the way...)

Here are a few at-home-remedy things that I find soothing when I'm coughing uncontrollably:

-Hot milk and honey. Microwave a mug of milk (watch it, though, since dairy will boil over) until it's very warm but not too hot, then stir in a tablespoon of honey. Sip. For me, this is the most effective.

-Honey, straight up, by the teaspoonful. Swallow and let it coat your throat. Works for a little while.

-Do you have a gas stove? Take a slice of lemon and roast it over the flame for a bit until it browns. Put a tiny bit of honey on it. Make sure it's not so hot that it'll burn you, then pop it in your mouth and suck on it.

-Apple cider vinegar. With ice. Sip it slowly. (It's gross, but it's soothing and breaks up the mucusy throat crap.

-As for an OTC product, those Sucrets numbing lozenges are pretty great, but only work for as long as they're actually in your mouth. And it makes your tongue feel weird.

-You can also, instead of taking showers, just pour yourself a mug of boiling water. Hang your face over it, drape a towel over your head, and breathe.

Hope you feel better soon!
posted by phunniemee at 7:15 PM on October 30, 2011 [6 favorites]

I had a very similar condition two years ago, and cycled through the many of the same products. Here's what gave me relief (and peace of mind that I wasn't poisoning myself): Slippery Elm tea. I used Traditional Medicinals Herba Tussin, and it helped a lot.

I also got some relief from TheraFlu, in the hot drink formulation, though this is like NyQuil in that it is a multi-symptom medication and may be more likely to conflict with other things you are taking.
posted by apparently at 7:21 PM on October 30, 2011

Can you call your doc again and/or make an appointment to go in again tomorrow morning? Or go to a different doc? Because "coughing till I throw up" certainly seems worthy of the strong stuff.
posted by BlahLaLa at 7:24 PM on October 30, 2011 [3 favorites]

I have just stopped taking zithromax for almost the same thing. My doctor also gave me Claritin-D to take twice a day, and hydrocodone-homatropine syrup to take once or twice a day.

You say you already tried for the codeine cough syrup, so not sure what else you could do there. Or keep badgering your doctor (and if the antibiotics don't work, steroids are the next step). Good luck!
posted by paulesque at 7:27 PM on October 30, 2011 [1 favorite]

Can you call your doc again and/or make an appointment to go in again tomorrow morning? Or go to a different doc? Because "coughing till I throw up" certainly seems worthy of the strong stuff.

They were aware that I was coughing until I threw up at the appointment - indeed I actually did the whole cough and gag routine right in the office. I could go in for another appointment, but it would be an additional $88 charge and no guarantee of a different answer. I spoke today with the same doctor who saw me on Friday; the answer was a flat no.
posted by anastasiav at 7:28 PM on October 30, 2011

I don't see Advil Cold & Sinus on your list of tried medicines. Seriously, you should get some. I know that it doesn't seem like it would work for a cough, but it has truly been a miracle worker for me when I've had nasty colds in the past.
posted by erstwhile at 7:29 PM on October 30, 2011 [1 favorite]

Buckley's cough syrup literally tastes like you're swallowing something in the final stages of decomposition, but it works like magic.
posted by decathecting at 7:36 PM on October 30, 2011 [2 favorites]

Oh, man, I TOO have so been there.
When daughter Smoobles first started preschool she brought home every bug, and I got sick for the first time in like twenty years.
REALLY SICK. Chronic bronchitis for two months and now I have a permanent tendency to get a cough and lung mucus with every little illness.
My doctor could do nothing and the prescriptions did nothing, many many times over.
I have no advice on how to make the coughing diminish and in my experience there is really nothing to be done. My strategy is to ride it out by knocking myself out at bedtime using an herbal like Wish Garden Serious Relaxer, some homeopathic sleep remedy such as Coffea Cruda, and treating the illness with Chinese herbal Chuan Zin Luan and homeopathic Arum Triphillium.
I know I sound like some new age hippie alternative medicine type but that's not the case.
It's just that I've been through this so many times, one illness after the other and I do not wish to be on pharmaceuticals constantly during cold and flu season.
Do NOT take any expectorants, medicinal or homeopathic at bedtime as it just facilitates coughing by moving your lung mucus up. Also occasionally I have ground up an aspirin and dissolved it in a glass of water to gargle with when the accompanying sore throat becomes unbearable.
posted by No Shmoobles at 7:43 PM on October 30, 2011

Is your Nyquil the cruddy kind with phenylephrine, or the good "D" kind with pseudoephedrine? In my experience, only the pseudoephedrine formulation does anything. You don't need a prescription for it but you do have to show ID and sign a book at the pharmacist because I guess people use it to make methamphetamine.
posted by bcwinters at 7:43 PM on October 30, 2011 [2 favorites]

From a previous post: a quick summary of ACCP guidelines. Here is the full report.

So try some Benadryl and Motrin. Benadryl to help suppress the cough, Motrin as an anti-inflammatory drug.

Note: this is presuming there's nothing insidious or serious going on (not to trivialize what you're going through, of course).
posted by herrdoktor at 7:49 PM on October 30, 2011 [1 favorite]

And please, for the love of god, don't stop taking your Zithromax. It doesn't work overnight. It's a nice 5-day course because it lingers around and keeps on working. It was prescribed for a reason (whether or not it's indicated cannot be assessed from this end of the internet).

There's a lot of work and research that went into the ACCP guidelines.
posted by herrdoktor at 7:55 PM on October 30, 2011 [3 favorites]

I second Benadryl.
posted by francesca too at 8:03 PM on October 30, 2011

Easy on the rum and other alcohol (Nyqil!) with the antibiotics. I'm pretty sure it interferes with the effectiveness.

I've also been here. back in 2004. I will never ever forget it.

Advil Cold and Sinus (in the US, it is behind the pharmacist's counter) IS magic.

I also like the Benadryl and Motrin suggestion.

I'm also really really keen on homeopathics. I've been amazed in the last 2 years using them. I have no idea what you might take for a horrid cough like that, but I would consult the Dr. Google and then run down to the nearest Whole Foods or healthfood store. Usually between $5 and $8, take a dose once every 15 minutes for the first hour for a severe symptom (coughs) and then as needed or by directions on the bottle.

This resource seems excellent!

Match your exact symptoms to the questions or chart and buy that remedy.

Get well!
posted by jbenben at 8:12 PM on October 30, 2011

You can do the homeopathic remedy with the other meds, just easy on the alcohol.
posted by jbenben at 8:13 PM on October 30, 2011

I'm very surprised so many people are singing the praises of Zithromax. What you are doing is creating resistant bacteria. I feel I must post to try to get the word out that most bronchitis does not need antibiotic treatment so that expectation is not out there, because it makes my job that much harder when I have to try to explain to a person suffering a miserable cough who thinks they need antibiotics why I'm not giving the script to them. Most bronchitis is viral, and antibiotics have often been found unhelpful in the treatment of bronchitis.

Sorry I don't have any other good solutions to add for the cough! I sparingly use hydrocodone-homatropine syrups for folks in your situation and am pretty liberal about syrup with codeine... I haven't encountered many people I suspect are trying to abuse it.
posted by treehorn+bunny at 8:23 PM on October 30, 2011

I don't disagree with you, treehorn+bunny, but I just can't speak about what the reasons could be for the poster's doctor's prescription for it. Your points are, of course, right on the mark, and are in the guidelines I referred to.
posted by herrdoktor at 8:46 PM on October 30, 2011

Seconding what Herrdoktor said with the added encouragement that you continue with the humidified air if it's working for you (hot showers, vapor steamer, &c). There are commercial humidifying aerosols available, but there's no good data that they're any better than good old water vapor.

As for the Z-pack, 90% of acute bronchitis is viral and won't respond to antibiotics, but 10% isn't and might. It's tough to tell the difference between the two, and most of the literature cautions against using antibiotics for acute bronchitis. That said, there are good reasons for prescribing antibiotics in certain situations, such as if you're over 65, prone to pneumonia, or if your doc thinks you have pertussis (possibly based on the cough/vomit pattern).

If it *is* pertussis, then going off your antibiotics could interfere with your treatment. Going off the zithromax early is a decision that should be negotiated between you and your own doctor.
posted by The White Hat at 8:52 PM on October 30, 2011

I had this kind of cough for a YEAR after I had pneumonia. Coughing so hard I threw up every other day, throwing up five times in a row, usually if I tried to lie down. I never found a remedy that really worked for this (Sudafed helped for a few days), to be honest. They gave me inhalers, they said to take Claritin and other antihistamines --boy, did that do nothing. They decided by default that I had asthma at some point because they couldn't come up with anything else (I didn't). Really, doctors didn't know shit.

What actually worked was...exercise. I know you feel like absolute dogshit right now and are not up to that, but nothing got rid of the damn cough except when I started going to the gym a few times a week. Maybe wait until the antibiotics are done to try this--because other than my daily cough-and-puke stints, I felt fine-- but honestly, that's all I've got.
posted by jenfullmoon at 8:55 PM on October 30, 2011

Man, I call WTF on your doctor. That sounds codeine-needing to me! (I don't know if there's some sort of registry that keeps track or anything, but is there any chance you can go to urgent care and see a DIFFERENT doctor for just the cough?)

Peppermint tea with honey and lemon might help (I see you've used tea, but the peppermint helps).

When I was pregnant and had a similar cough, they gave me a lidocaine-benadryl-and-mylanta solution to swallow to numb and soothe my throat (also known as "magic mouthwash" when you don't swallow it). It worked okay, enough so that I could sleep in short bursts, but eventually they gave me codeine anyway.

One doctor told me cold vapor (humidifier?), but I didn't get around to trying it.

Sudafed makes these pucks called "shower soothers" that you put on the ground in the shower and the hot water dissolves it and it's basically vaporub in the air. Effect lasts somewhat longer than shower on its own.

I was also once given an asthma inhaler (don't know what it was specifically, sorry) for a bad bout of bronchitis, and that helped some with the coughing. Although it wired me up so I didn't sleep so well.

There's that awkward OTC stuff you spray in the back of your throat -- cepacol? -- that's supposed to numb it up a little. I can't do it (can't spray it back there) but my husband gets some effect from it.

If you're not already doing it, get a really firm pillow -- like a solid couch pillow or even a couch cushion if the pillows are too soft -- and crush it against your abdomen every time you feel a cough coming on. It keeps you from convulsing so violently, so your abs and ribs don't ache so much. It's a small thing, but it helps a lot. (Especially if you start with it early in the cough -- at this point you'll have to do it for 24 hours while taking some advil or something to help the muscle pain to get much relief.) You do it a lot with little kids who can't have much medicine while coughing themselves to pieces.

This is a serious quality of life issue; there are no alternatives at all that the doctor can offer?
posted by Eyebrows McGee at 9:09 PM on October 30, 2011 [1 favorite]

I'm on day... um... 14 or something, of my current cold/cough cycle. The coughing didn't quite get to the point of actually throwing up, but it was bad enough my doctor gave me the hydrocodone plus whatever stuff. Of course I am basically immune to the effects of both codeine and hydrocodone, so I hardly used any of it, but hey. Just finished my pack of azithromycin yesterday; the benzonatate is only marginally more effective than the Robitussin DM for me (good for mild coughs, useless for this thing.)

The things that have helped me the most have been Advil, the albuterol inhaler (I walked away from the doctor with four prescriptions,) tons of lying very still (kind of upright but on my side, suffering through the first few fits until they died down) and drinking juice. I'm now up to a good hour or two between debilitating coughing fits.

If you know that codeine works for you, I would say go to a different doctor. The only reason I'm not taking that stuff is because it doesn't work for me. Nothing else I've tried has been particularly effective. Once I endured a good year and a half of coughing and the thing that broke through was moving across country. They decided, after the fact, that it must have been my allergies keeping it going.
posted by SMPA at 9:11 PM on October 30, 2011

Not familiar with the contents of all you have tried already. However, I suggest something with codeine in it, and then wash it down with a hot drink (alcohol, hot water, lemon, honey, ginger). Usually I use brandy for medicinal purposes, but a while ago there was some bourbon in the house and it seemed very effective. Wait... you can't get anything with codeine over the counter where you are? Sorry.. you can in Australia.

You say that the rum has worked the best but has stopped you from getting things done. I don't think you should actually be trying to do much. Lying on the couch, at best. Some cold and flu medication with the hot drink and take it easy.

Also, something like Unisom or other OTC sleep aid (maybe Advil PM), just to try and get you some sleep.
posted by AnnaRat at 9:16 PM on October 30, 2011

I'm a pharmacist. In some states (including Maine, apparently) you can buy a small amount of codeine OTC, but it is a hassle. Search for "exempted codeine products" plus your state name to find info.

It's at the pharmacist's discretion, the codeine is kept behind the counter, and you have to be an adult, sign a log book and show ID.

Just because state laws say it's legal doesn't mean every pharmacy does it. Some big chains may have corporate policies prohibiting it.

As a pharmacist I'd be most comfortable selling this to somebody who was a regular customer that I knew. But even if you don't have a regular pharmacist, you could ask. I would call or go in person and ask to talk to the pharmacist -- not the pharmacy technician, who may be the person who answers the phone.

Explain to the pharmacist that you have this wicked cough, are being treated with antibiotics, but can't get to your doctor for a codeine Rx for a couple days. Ask if you can get a small amount of codeine from them. The limit is something like 4 oz of codeine syrup per month. If they aren't allowed to do it by corporate policy or whatever, ask what pharmacies they think may be able to help you. Most pharmacies have a list of other pharmacies' phone #s and know who has what.

Personally I would go to a different doctor, because coughing till you throw up is pretty serious and you deserve to get that treated effectively.
posted by selfmedicating at 9:23 PM on October 30, 2011 [3 favorites]

Oh,and if it helps to have brand names: Robitussin ACĀ® and Phenergan with CodeineĀ® are examples from this page from the DEA of codeine containing products that may be sold OTC in small quantities.
posted by selfmedicating at 9:30 PM on October 30, 2011

I'm just coming off a 3 month coughing jag just like yours, they think it's either whooping cough or a virus but I would cough for an hour straight. I had added complications in that because I'm pregnant (due in 2 days) there's a lot I couldn't take. I've actually fractured ribs from coughing on both sides and because I'm pregnant, I can only sleep on my side so I've been sleeping on broken ribs (or not sleeping, I've spent most of it exhausted and crying in pain as every time I cough, I get stabbing rib pains, and I was coughing constantly).

Anyway the only thing that provided me with the slightest relief was hot showers where the steam broke up the mucus so I could cough it up and also using gravity. When it came time to cough, I would bend over - fold in two, as much as I could with a big belly - and your body doesn't have to force the mucus up, so you don't work as hard. So basically cough with your head and chest facing the floor like you're touching your toes. I would also wrap my hands around my ribs to give them some support.

Be very careful, if you're like me after 3 months of explosive coughing, it's quite likely you'll crack ribs. If you do, get them strapped. I think it's the only thing that's going to give me a chance of managing labor in a couple of days. Best of luck. Worst 3 months of my life.
posted by Jubey at 9:56 PM on October 30, 2011

I heard this crazy story on npr a while back about home remedies. The guest said that there was one for curing a cough that involved sleeping with vicks vapor rub on your feet (under thick socks)...he had no idea how it worked, but he swore that it did. Couldn't hurt. report back if you do...I'm curious.
posted by shrimpsmalls at 10:10 PM on October 30, 2011

The last time I had bronchitis, the doctor prescribed me an inhaler that asthmatics use. It helped open my airways up so my coughs were more productive. It was a godsend and if I ever come down with bronchitis again, I will ask for it. Also, do you smoke? If so, it will impede your recovery.
posted by MaryDellamorte at 10:14 PM on October 30, 2011 [1 favorite]

Did you get the Mucinex pills? They're like an entire bottle of guaifenesin in one, one or two of those should dry you up for at least a little bit. It's no codeine, but there you go.
posted by rhizome at 10:42 PM on October 30, 2011

decathecting is absolutely, dead-bang on right.

Well, except, that is, for his description. I find it tastes more like trees -- evil, foul-tasting, haunted-forest trees -- but definitely something woodsy.

If you think you'll need something even stronger than the original version, there's a DM version that is even worse tasting that might be of benefit to you.

One word of caution: try to take it when your stomach isn't already queasy from a coughing fit. The first time you try it, you may have the inclination to reject your choice.
posted by sardonyx at 11:16 PM on October 30, 2011

I can't believe the thread is this long and no one is saying the obvious. You need LOTS and LOTS of water. If you make it a point to start in the morning with a 32oz glass, and drink it down as fast as practical. A good rule of thumb: you should need to get up to go to the bathroom by the time you are finishing the glass. If you haven't had THREE of these 32oz glasses AT A MINUMUM before lunch, it's not enough. 3 or 4 by lunchtime and you probably don't have to keep up this pattern all day. After you do this for about 3 days you should notice the cough suddenly get a lot looser and you're on your way to kicking it.

I don't mean to say guifenisin (sic) and the rest aren't a good idea, by contrast they are a great idea. But if you don't flood your tissues with water you're not going to get anywhere.
posted by skybolt at 11:24 PM on October 30, 2011 [1 favorite]

Thirding Buckley's Mixture. I found it via a mom-and-pop drug store in my neighborhood, when I staggered in after 4 days of constant coughing and said to the guy behind the counter, "I JUST WANT TO STOP COUGHING'. He gave me that. I took my first dose -- and literally TEN MINUTES LATER stopped coughing. Not for good -- I started up again a few hours later, when it wore off -- but it was working.

and my own assessment of the "Unique" taste is: imagine if someone took a mentholated Vick's lozenge, melted it, used that to brew a tea made with pine needles, and then seasoned that tea with ground-up mothball.
posted by EmpressCallipygos at 12:38 AM on October 31, 2011

I'm convinced that Buckley's works because you get better so you don't have to take another dose. It is truly hideous, but effective.
posted by crankylex at 6:42 AM on October 31, 2011 [2 favorites]

Completely unscientific and anecdotal, but I had relief from a persistent cough from eating dark chocolate alongside my standard steaming techniques.

Actually, this is apparently supported by some science. See here.
posted by knapah at 7:27 AM on October 31, 2011

Seconding lots of water, though I don't think I agree that you should drink as much as skybolt recommends -- you don't want to die of water intoxication.
posted by rabbitrabbit at 9:46 AM on October 31, 2011

i was in a similar situation last christmas in NYC. Coughing untill you puke.. except you didnt eat anything. Went to emergency and got diagnosed with Bronchitis/Pnuemonia symptoms and was prescribed 5 day Zithromax. The cough for the first days will be there and Robitussin especially in bacterial infection will not do anything. Its a cough suppressant but not helpful in these situations. Relax, Drink soups and lots of fluids, take Ibuprofen/ advil for the fever if you have any and wait it out... . Also helpful.. keep a plastic bag near your bed so you dont constantly have to go to the bathroom for the dry hacking cough.

After a couple days, your cough will be more.. "productive" and eventually should clear out at the end of the 5 day prescription. If you still have problems afterwards, get another prescription for another Zithro( 7 day one) and end of that ... relief.
posted by radsqd at 10:15 AM on October 31, 2011

Last winter I coughed for like three months. I tried every over the counter thing available and nothing worked as far as STOPPING it (just masking it for a few hours). Finally my coworker brought in some fresh ginger, chopped it up, brewed it, and made me drink it. It tasted like miserable spicy death, but it worked! A couple days of drinking that stuff and my cough was gone.

Get the gnarliest, funkiest looking chunk of ginger you can find. Wash it, slice it into thin slices, put a LOT in a cup, fill with hot water, and let it sit there for a few minutes. Then drink, sadly. Repeat a couple times a day. It works, honest!
posted by silverstatue at 12:02 PM on October 31, 2011

you don't want to die of water intoxication.

Gah, this comes up almost as often as water itself. It's extremely difficult to suffer from hyponatremia. If you are a candidate, you will have already gotten a warning (either from a coach or your body) to supplement your electrolytes somewhere along the line, and water intoxication is way down the line from there. It's on par with accidentally starving to death.
posted by rhizome at 2:02 PM on October 31, 2011

When I had a nasty, gagging, might-have-been-pertussis cough, I was prescribed cough syrup with codeine on my first visit to the doctor, and a steroid(?) inhaler on the second one. The inhaler actually worked much better than the cough syrup did. That kind of cough inflames your lungs. For me, I think that the antibiotic actually dealt with the root cause, but my lungs were such a mess that my body kept coughing until I had something to reduce the inflammation. An NSAID helped with the inflammation, too, but be careful with your acetaminophen intake.

That said: if your cough is productive, doctors aren't going to want to suppress it, because you will literally drown in whatever mucus your body is producing.
posted by catalytics at 2:30 PM on October 31, 2011

I hate to say it but your symptoms sound like me when I had pertussis/whooping cough. You definitely want to take the full course of antibiotics, whatever the case. However the only things that helped (a bit) besides time, to relieve the cough were breathing steam like this "pour yourself a mug of boiling water. Hang your face over it, drape a towel over your head, and breathe", and using a vaporizer.

When I had a bad case of bronchitis, I was given an inhaler that helped a bit. Codeine cough syrup did little but make me groggy.
posted by gudrun at 6:46 PM on October 31, 2011

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