Thursday, December 22, 2011

Does your cough last a long time? It might have something to do with your MS.


As much as I welcome cooler weather, I always get a little anxious when the thermometer starts dropping, as that signals the onset of cold, flu, bronchitis and pneumonia season. Many years ago, I discovered that when I got a respiratory illness, my cough would be the very last symptom to resolve and it would last much, much longer than seemed "normal."

My bouts of coughing also tend to be a lot more prolonged and dramatic than those of others, as it is hard for me to catch my breath, so I turn red and have to lean on something to keep my balance. More than once, during public coughing fits, I have been asked by restaurant managers or salespeople if they should call someone to help me.

It turns out that this tendency to cough is at least partially related to my multiple sclerosis. It is estimated that about 30% of people with MS have decreased respiratory function. However, this number may be even higher, as studies of the muscles involved in respiration (breathing in and out) have shown that people with MS can have reduced breathing strength, even early in the disease. The tests that are used to measure breathing assess the functioning and strength of respiratory muscles by testing maximum inspiratory (breathing in) pressures and maximum expiratory (exhaling) pressures.

Lower respiratory strength can result in coughs that are weaker, and therefore, less productive (bring up less mucus). In some people, this may translate into a cough that lasts longer, since the coughs aren't getting the job done. One study found that lower "voluntary cough efficacy" is related to level of disability in people with MS, so that people with a higher EDSS tend to have "weaker" coughs.

I dread coughing so much that I have become very aggressive in my efforts to prevent or shorten such cough-producing illnesses. I have found that it is very important to see the doctor early.

In my younger days, I would let a cough go for a long time before seeking treatment. I remember a time during graduate school where my cough lasted from Christmas to Spring Break (you can imagine that I was a favorite in the lecture hall). Finally, it petered out on its own.

Now, I head to the doc within a day or two of developing a cough. Even if the doctor thinks it is a virus (that will not respond to antibiotics), she can give me instructions such as, "call me back if it is not better in 4 days," which may indicate that a bacterial infection has developed. A doc can also prescribe something to keep your cough under control – the over-the-counter cough remedies do nothing for me, I need the stuff that requires a prescription.

So, my bottom line here is to take all of the precautions to stay healthy during the "cough season" (avoid sick people, wash your hands, get your flu shot, get enough rest), as well as respond quickly to first symptoms of illness by seeing a doctor. What about you? What has your experience been and what do you do to prevent coughing or make it better once it starts? Let us know in the comments section.


  1. Thanks so much for this. Currently, my cough has lasted for 11 weeks. I've been for a chest x ray and had a course of antibiotics. I have an inhaler but I still have the cough. It's very tiring....

  2. The timing of this is amazing. I've been battling what is either allergies (I have several indoor allergies that are worse this time of year) or a bad cold for a week. Most symptoms have gone a way, but the cough is centered right in my chest. I'm also an asthmatic, and have been doing both inhalers, as well as a nebulizer treatment a day - but not working. I've been thinking about a clinic visit tonight, after reading this, maybe I should!!

  3. Yes, I've had this problem. I've also had an acute sinus infection since March. Two surgeries, tons of lab work, specialists, and oral, inhaled and IV antibiotics. I've also been taken off my MS meds (Rebif) due to speculation that it might be interfering with the antibiotics. Has anyone had experience with this? I'm afraid to be off MS meds too long but I really want to get rid of this miserable infection!

  4. Wow , I have always hated even getting a ear infection because the natural progresion of head to throat to chest it always takes. And of course once in the chest it seems to never go away even with the strongest medication. I always thought that my lungs must be a weak section due to this and thi pretty much confirms that for me. I guess it is a trip to the doctor at the earliest sign of anything!

  5. I have had this problem for several years, and this year I went to an allergist who told me I have 'seasonal asthma'. After a round of inhalers and nasonex, the problem still isn't resolved. I went back today and now I'm on a new regime that includes a reflux med, a throat numbing pill and advair. My allergist did confirm this may be related to my MS, which I was shocked to hear! I'm hoping this will work as the cough lasts for months. I cough so bad at times it feels like my ribs are cracking! I feel better knowing I'm not alone here, tho I wouldn't wish this misery on anyone!

  6. As a relatively recent inductee into the MS world at age 48, I have also discovered that my respiratory system is especially challenged by otherwise routine ailments. Got so bad in the most recent go-round, because I was experimenting / learning my new physiology so did not go to doc for awhile, that when I finally did go to doc that they gave me antibiotics plus steroids. I will not let the cough thing go like that again, as the steroids were quite an unpleasant experience.

  7. I have to say that reading this really confirms things for me. Both myself and sister have MS. We have been told from several doctors that sinus infections and MS go hand in hand. We have to stay pro active and see our doctors at the earliest symptoms to start treatment. Coughing has always been a huge problem for me. During these times I need to sleep on the couch to allow my husband to sleep since the coughing fits can last so long and are disturbing to listen to. The best remedy I personally have found works the best for me is to take Sudafed every 4 hours to dry the sinus drainage a bit and I also take over the counter Mucinex tablet that helps with the congestion and constant cough. I take them around the clock and start getting rest or relief within 1 day. A noticeable improvement....

  8. If I'm not mistaken, people with Multiple Sclerosis has a descending kind of numbness. This is the reason why respiratory system gets affected. It is essential for a patient with MS to treat simple infections like cough and colds. In line with this, he must also need to take vitamins to boost his immune system. 4rx

  9. Minor cough could lead to a major cough problem if you can't do about it. This is also dangerous especially for kids. It should be treated by asking physician.

    nasonex cost