Years of hideous coughing in 4 year old

[Greentomatoes21]

Sorry this is long.

I would love to hear from anyone with similar experiences. (We are seeking medical advice too and have been for a couple of years).

My son is 4. Since around 18 mths old, he has been dealing with an incredibly difficult type of cough that is set off by any virus, however mild, and results in him coughing so much and so incessantly (day and night) that he is vomiting, unable to stop coughing to eat despite being hungry, unable to get full sentences out etc and eventually he crashes due to exhaustion, sleeps, and it starts again until, for some unknown reason, it stops completely. Then the next virus hits and we start again. At 4, he gets sniffles all the time so this has a big impact on his life. He can't go to school due to how debilitating the cough is, for example, and he is obviously very miserable being in a near constant state of coughing spasm am wrenching/vomiting.

The cough is also accompanied by the most watery, drippy nose you could imagine. Not a typical thick runny nose. It's clear and constant, consistency of water like a tap. Cough and nasal discharge happen simultaneously. When one clears up, the other follows.

Due to the above issues he is being treated for asthma, although he has NEVER had breathing difficulties (thankfully), no worrying stats or wheeze that would normally be associated with asthma.

The meds from GP came on a sliding scale over the years but he is now at max therapy for his age:

• 2x dark brown inhaler morning/night
• Blue inhaler
• Montelukast granules
• 2.5ml antihistamine twice daily
• Flixonase nasal spray (only just put on this due to GP looking up his nose two weeks ago and noticing a lot of inflammation).

He gets all these without fail and we are confident we are administering inhalers correctly.

Unfortunately we have never seen any of these medicines offer him relief. We are really very unsure that any of them are doing anything to help him. The only thing that ever seems to relieve the coughing, albeit briefly, is some time in the bath with the hot shower running to create steam. However as soon as out of the bathroom he starts again.

He has a very occasional chest infection but usually all issues seem to be upper respiratory, therefore steroids are unnecessary. He has had steroids before from GP which did nothing for his cough (unless the cough is very obviously croup, in which case the steroids work really well).

Chest xray clear.

No known allergies (but never been tested). Only ever brought on by a virus - never season related or when around animals or hay-fever or after eating something. All seems to be viral induced.

The whole thing is very stressful for all of us, but obviously especially for him.

We are due a second visit to a paediatrician this week. We are desperate for a way to sort this for him beyond the "he'll probably grow out of it".

Anyone similar experiences or something to share?! Thank you.

Answering to get more attention for you as my experience in the area isn’t quite as extreme.

I always had a cough as a child. I did eventually develop asthma as a teenager but as a toddler I was always being looked at by doctors for my cough that was pretty much continuous for most of the year. The doctors pretty much said there was nothing they could do (and my mum thought it was psycho-somatic anyway). The best thought anyone came up with was that it was probably caused by having had whooping cough as a baby, there was talk of me having damaged lungs because of it.

However mine was never so bad as to make me sick! I don’t recall being kept off school much either, mum just reassured school that I wasn’t infectious.

I don’t remember when it stopped, I just grew out of it. No drugs ever made any difference! Nowadays, I do still get a bad cough from time to time, but nothing like it used to be.

As an adult, I’ve taken all sorts of things for my asthma, the worst of which is montelukast. When I first took it, it seemed like a miracle drug as I’d had an infection and my lung had felt like I wasn’t infectious drowning afterwards, just really full of fluid. The montelukast fixed it on the first dose, but I was recommended to continue taking it and after a few months I started to get some really odd side effects - anxiety being the worst, which took a few weeks to resolve after I stopped. So I definitely suggest careful monitoring of that drug and only staying on it if it’s really helping.

My final piece of experience to share is actually that of a friend. He had a post-Covid cough, after getting it during the first year of the pandemic. He hadn’t required treatment during the infection, but clearly had lung problems afterwards. His X-Ray was completely clear, but because he works in a research hospital in London, he was able to convince a colleague to get him a CT scan of his lungs. Even though nothing was visible on his X-Ray at all, they could immediately see damage on the CT and targeted treatment to the damage, which, was they could see it, they could then check whether drugs were actually helping. He’d been having problems for two years before the scan and it took a couple of months to completely resolve once they could see the problem. That hospital had now changed its standard procedure (so he tells me anyway!) to routinely offer lung CT scans to people with long covid, not just x-rays.

Thank you so much for replying. Sorry to hear you had a difficult time yourself - reassuring to hear you eventually grew out of it. We are struggling to see how he can continue responding to viruses at this level - just hope the paediatrician can offer more insight on Thursday. Will mention your comments about scan if nothing else suggested. Thanks so much.

Hi, I was just wondering if you ever got any useful advice from the paediatricians, as I have a similar problem with my son, although he is not coughing to quite the same extent? Thank.you.