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Interviewer: Dr. Tom Miller, we have a question here from Lisa in Sandy, Utah. She apparently had a cold and feels like she's over her cold, but yet this cough kind of is persisting. Is that something to be worried about? What is that? What's going on?
Dr. Miller: Usually, not. There's two points. One, could it be serious? Is this something that you need to worry about? And again, you go back to worrisome signs and symptoms. So if you have fever, if you either have a measurable fever and you're continuing to cough or you feel like you have a fever or you have night sweats, then that's something you need to get checked out. If you're coughing up a lot of sputum, you know, thick, gunky, smelly sputum, that's something you need to get checked out. If you have rib pain, if you're short of breath, that's something you need to get checked out.
Most of the time with a viral infection, an upper respiratory tract infection, you're sick for anywhere from three to seven days, and you get over it. I mean, you cough a little bit and you're hoarse, and then it goes away.
Interviewer: Are we talking about a cold when you say . . .
Dr. Miller: We're talking about a cold, an upper respiratory viral infection. I mean, everybody gets those in the winter and sometimes in the summer and spring, but mostly in the winter.
So what do you do? You have this cough. It's called a post-viral cough. It's not productive. It's annoying. It's probably due to the fact that the virus, which is gone after seven days, has irritated the bronchial lining and the cough receptors in your airways, and they continue to produce this cough reflex and you continue to cough. And it can go on for eight weeks, sometimes ten weeks.
Dr. Miller: A long time. I know patients who have had chronic cough that's not productive after a viral illness, after a cold that goes on a couple of three months, and there really is no good treatment for it. A lot of those antitussives, those cough medicines you can buy at the store, they really don't work. And so it's nagging.
And sometimes though, patients who do have chronic cough might have asthma or might have asthma triggered by the cough, and so it doesn't hurt if you're really struggling with that cough to go see a physician to see if there could be something else causing it. You know that you haven't had any worrisome signs, you're not worried that you've got pneumonia or some other bad thing going on, but the cough is just driving you nuts, go see a physician about it. You might have an asthma variant of the cough, which could respond to treatment, inhaler or something like that. But a lot of times, you're just kind of stuck with it until it goes away, which is really bothersome, but we don't have great treatment for that.
Interviewer: And most of the time, that's what the case is after a cold and I continue to have a cough for two or three weeks afterwards.
Dr. Miller: Correct. Now again, the vast majority of patients that get colds, they get better, and only it's a small percentage with this chronic cough.
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