Would you go to A&E for a cough?

[LeopardPrint21]

Had a cough for 7 months. Have had some tests done for gastro as the GP initially thought acid reflux, have literally today been referred for chest x-ray and lung tests.

It has gotten to the point where I cannot stop coughing. Literally having fits of coughing every few minutes and this lasts from the minute I wake up until the minute I go to sleep and sometimes throughout the night too. I also feel unwell with it and I’ve felt unwell since the cough started at the beginning of the year. I feel like I can’t cough up whatever is there but I also can’t swallow it back down so it just feels stuck in my throat and all the constant coughing is leaving me feeling like I can’t breathe properly.

I have been in tears all day because I genuinely can’t go on like this, I dread every second of the day because of how bad it is. I am at my breaking point with it.

Would you go to the hospital for a cough that is constantly there and you’re never getting a let up from it along with everything else I’ve written?

Normally I would say this isn’t something to go to A&E for but I actually think you should. They may be able to give you some steroids or something to calm things down. If you’re constantly coughing they’ll see and hear it whilst you’re waiting too.

It could absolutely be an emergency if time is of the essence and the GP has fobbed her off multiple times for 7 months. The fact is no one knows and I wouldn't be waiting around any longer to find out.

Jess' rule exists for this reason. Fobbed off by the GP for 5 months and ultimately died from stage 4 cancer.

Understandably, but if she is having any chest pain, then stating that isn't lying. And I'm saying what happened to me recently after that.

I was having pain in my chest area and didn't know what it was, but assumed it was just heartburn. I wouldn't have gone to A&E except when I mentioned shortness of breath, the GP said I should consider going. So I did.

People are clearly gatekept from A&E to MSDEC (Medical Same Day Emergency Care) and having never been before, I was unaware of this two stage process. I'm sure there must be others that I'm unaware of.

It was operating well within capacity early on a Tuesday morning not during a heatwave and having been advised by a GP, I didn't feel there was anything wrong in attending.

As it turns out, the tests they did that day seem to have shown up signs of an underlying heart condition and I need to go back for further tests soon. What's not clear yet is whether that was playing any part in the symptoms I was having or it just so happens the tests have shown it up now just because.

Either way, I'm now in the system as an outpatient to be seen at their convenience, which is presumably the best condition for all concerned.

I presented to A&E last year with an issue which had been ongoing for 5 months but was deteriorating rapidly. I had been referred to the correct department by the GP but the waiting list to be seen was 51 weeks. The A&E staff did make appropriate contact with the relevant departments to ask that my referral was expedited. Oh and they did bloods as well.

Did you go op? What did you decide to do

The cough has progressed rapidly, is constant and causing difficulty breathing. she needs rapid assessment.

A cough like this is not trivial. A chronic condition like this can become acute, as with OP.

Did you go to A&E or any other medical facility?

How are you today?

My money is on asthma/ hayfever / allergy.

People with these are finding the hot weather with dry air and pollen making things worse.

It’s still not an emergency, finding it hard to breath , also able to sleep 8-9hrs a night…..wasting time on Mumsnet……you are absolutely right….must go to A&E and demand a resus bed for this life threatening emergency. Do you not think going back to the gp is the most sensible option? What do you think A&E are going to do beside some obs and a dr to listen to their chest. They don’t Xray every little thing because you know….radiation! It’s a chronic problem, yes it needs looking into but it is not an emergency.

this is why healthcare will end up private and when it does and people can’t afford it…..use A&E appropriately.

But clearly was not an emergency if all they did was ‘expedite an outpatient clinic appt’. We need to use A&E resources appropriately, if we did then the waiting times wouldn’t be the worst it’s ever been. I arrived on shift the other day with a 9.5hr wait for a dr…..yet when the football was on, A&E was the best it had been for years. Says it all really.

A&E are specialists in emergency care and will refer to an appropriate speciality for further emergency care. It is the GP who is responsible for referrals under the 2 week wait and for routine clinics.

again OP has a chronic issue, states they cannot breathe but is on Mumsnet and can sleep 8-9hrs! If they truly could not breathe they’d be going straight to A&E or calling 999 not wasting time. Yes it should be looked into but the GP needs to be referring. There’s so much literature about what is suitable for A&E, people use it like a GP waiting room because people want to be seen the same day. A consequence of the 24/7 society where anything you need is easily accessible.

If OP had to pay hundreds to attend A&E I wonder if they would. That says a lot about whether it is a true emergency.

The GP should have referred months ago, not fobbed her off for 7 months. That is part of the problem and a reason why people can struggle to trust GP's. Conditions can and do deteriorate when things are left for so long and that would be my concern as well as potentially something more sinister such as cancer which GP's are hardly strangers to missing.

OP has waited for 7 months, not 7 days. It isn't expecting too much to have wanted something more by now.

Again, you don't know for a fact that it is a chronic issue.

Personally I think medical professionals should be one triaging OP rather than posters on here - if she feels she is deteriorating 111 or if she hasn't tried A&E yet back to GP with emergency appointment and ask to see someone else - number of locums diagnosing long standing problems in kith and kin is alarming but it that new eyes situation- perhaps take a family member along.

Also it's the aging population who need increased amount of medicial care combined with new expensive treatements that is most likely to bankrupt NHS.

I do increasingly see with older relatives people told off from people with no medical knowledge about using services entirely appropriately in HCP eyes - most shocking FIL fell down stairs broke back and had collapse lung MIL was told off by well meaning friend for calling an ambulance - he needed back and neck brace and medical care and went straight into surgery but people thought they could load him into a car and trun up at a&e rather than bother professionals. Even on here there was a poster saying asthma attacks shouldn't go to A&E when if blue inhailors don't work the medical advice is to go immediately.

Sounds like you don't have respiratory issues yourself or you'd have a better understanding of why OP is concerned.

Also sounds like working in healthcare has made you worryingly cynical, if I'm being completely honest.

It’s chronic as in it’s been 7months. I didn’t say it’s not important, it’s just obviously not an emergency life or death situation. There’s a difference.

You know very little about me, I’m actually an experienced A&E sister of over 20yrs, I’m the least cynical person ever, my dept of over 200 colleagues would vouch for that. It does not change what the purpose of A&E is there for.

What I’m saying is if someone can ask for opinions on Mumsnet then it’s hardly going to be a life or death emergency that needs immediate investigation and treatment. If you have to second guess whether you need A&E, it’s highly unlikely you need it! A&E needs to be used appropriately, it’s exactly why waiting times are so high. Exactly the same argument as people calling for the big yellow taxi to transport them there. I’ve seen it all and I can spot a sick patient a mile off.

The OP needs to get the gp to refer appropriately, I agree this should have been done months ago. it’s needs investigating but they won’t do the relavent investigations in A&E. They will ask the gp to refer on. There are other gps available to have a second opinion. No GP practice is run single handedly by one GP. OP needs to be on their case.

There's no obviously about it. It could absolutely be life threatening, especially since it seems to be getting worse as it's been left for so long or if a GP has missed cancer yet again.

Using a and e is a subjective thing and many of us disagree with you. Vehemently.

We've explained our reasons.

Still waiting for op to return, some of us worried about her.

You sound a worry tbh.

You may have been in the job too long.

I think you might have tagged me mistakenly, I'm strongly advocating for the OP to go to A&E if she feels she needs it

And if OP turned out to have TB?

I think @sparklyblueberry2 would be correct if we had “proper” A&E and/or decent primary care in the UK. The problem for people like the OP is there is seemingly no healthcare available between “this person’s head is hanging off” and “this can be pissed about with ineffectually for months” which seems to be all that a GP does.

We need some kind of clinic set-up where internal physicians can order immediate blood tests, scans and X rays. No second class letters, lost referrals or waiting for someone to answer the bloody phone.

OP, I had very similar symptoms.
A cough that wouldn't go away, but for me it felt like something blocking me so I couldn't breath properly.

At night, it felt like I was drowning and so I ended up sleeping on my sofa. My rib were sore from all the coughing and I thought I was losing my mind.

I ended up having silent reflux and a hiatus hernia.
I was given lansoprazole, told to buy a triangle pillow for the bed, not to eat spicy food (I was like "erm doc... my heritage is Jamaican, that's never gonna happen" 😂), and not eat late. I saw this consultant about a year after my symptoms started.

It took about 2 weeks on the pills for the coughing to ease off. If I didn't take it, it would come back almost immediately.

I also started doing intense Dr Fung style fasting and time restricted eating for a separate issue and noticed that the coughing eased and I'm now off medication.

I noticed now if I eat out of my eating window the cough starts, so I keep it strict now because I prefer to be medication free.

I really hope you get some answers soon. It's horrid.
❤️
To answer your question though. I didn't go to A&E because I didn't think there was anything they'd be able to do. I was given an inhaler on one of my many visits to the doctor.

I totally agree with you x

OP- any update?

It was an emergency, expediting treatment wasn't all they did. If I'd stayed at home, I would have died. I was taken straight through from the desk without even being triaged, given emergency treatment in resus and then admitted. You need to be very careful about making sweeping generalisations when you don't have all the information.