About this Cough

I was so sure it was the new blood pressure med, but I stopped it 3 weeks ago and it is still there.  It starts as a tickle and just keeps going.  It isn't all the time but multiple spurts throughout the day and it wakes me up a few times at night.  Usually a drink or two of water will clear it for a time before it starts up again.  Is it time to be concerned?  It has been over 6 weeks now.  No unusual shortness of breath mostly just the cough and for the most part it is a dry cough though I do have some sputum.  It is more like a hack and it is becoming annoying not just to me but to my coworkers aswell.  I also noticed I am losing weight now.  I have been sick a lot since starting methotrexate so some of it can be attributed to this, but look when I try to lose weight I can't lose an ounce and though I am eating somewhat healthier my heart isn't quite into it yet the weight is coming off and though I should be happy there is that inch of concern there aswell.  Actually, in the last three weeks my weight has dropped 15lbs.  So, I know something just isn't right.  Overall?  I don't feel too bad.  I can't say I am doing great but not horrible either.  I actually have had days where I was able to go ice skating and roller skating and stuff.  Okay, one day but I sure felt like a kid.  I did have a strange episode after mild-moderate exercise last week where the right side of my body didn't want to work right after I stopped exercising.  I literally couldn't get my right leg up to go up the steps right and tripped and my right arm felt heavy.  Then they hurt/ached for the rest of the night.  It almost seemed neurological.  It scared me enough that I decided to hold off on exercise till I talk to the rheumy again.  But, what about this cough?  Could it just be a dry cough?  It seems to worsen the more I come down off of the pred? and the more I go up on the MTX.  Could it just be nothing or have I got a serious issue here?

Thank you

Theresa

Hi Theresa,

Ducky's right--you should contact your rheumy immediately.  You're on a fairly high dose of mtx, and it sounds like you've been taking it a while.  I developed a cough within 3 weeks of starting mtx--rheumy took it seriously and I had to have a full evaluation by a pulmonologist.  As it turns out, it was not the mtx, but some sort of weird viral infection (perhaps viral pneumonia) that has scarred my lungs, although it has not altered my lung functioning.  The ramifications of letting the cough go are too risky--whether the cough is due to mtx  or to an infection.  Any kind of infection (viral or bacterial) can get out of control when you're taking immunosuppressant drugs.  I'm not trying to be alarmist, but what can it hurt to simply call your doctor?

El

Hey Theresa,

I used to smoke as well--I quit 5 years ago.  I was also scared of what I might have heard when I went to the pulmonologist.  But, ultimately, I had to go anyway.  You would not necessarily be sick (or feel sick) if mtx were affecting your lungs.  The lung infection I had didn't make me feel sick at all--I had no fever, no fatigue, nothing--just a dry cough that got worse at night.  And yet, it still scarred my lungs. 

I would still recommend that you get it checked out anyway.  Good information to know.  Plus, when I got my evaluation done, my rheumy said it was excellent that now I had a very extensive work up on my lungs--more than most people get in a lifetime.  So now, if anything were to happen to my lungs, I have a great baseline for comparison purposes.

Make the call anyway--worry about quitting smoking some other time.  What you have going on could be absolutely nothing.

Elcamino

I called the Rheumatologist office yesterday but really don't feel any better. They didn't call back yesterday. Did call this morning though. Said it probably isn't the mtx so continue taking it and try to stop smoking. That's it. So, why am I still very concerned?

I also called my GP about that medication that helps people stop smoking called Chantix. And I think they are just giving me the run around as they want me to come in yet again for a 3rd BP check even though the last one was down significantly. So, she isn't going to rx it either.

Do I just have a bunch of doc who just want money? I don't want to leave either of them because they both are the ones who finally figured out what was going on, but I am not made out of money either. For some reason I feel like I am being taken for a ride here and that in the end she won't rx the med anyway.

Still don't know what to do about this cough though.

Theresa

Well, I did call back and they finally said they would mail me an order for a chest xray even though they know it isn't mtx related without seeing me. Go figure. I got the order in the mail today and it says. Persistent Cough from tobacco use. Great. My insurance company is going to love this one. Not sure I am getting this xray done. Cough has improved anyhow and I am thinking it is from reflux after all of this.

Theresa

how unprofessional to be so sterotypical in looking at symptoms. i agree with ducky this guy is gonna label everything on ur smoking- not good. i wouldnt want my hmo to get that script either....of course the xray maybe would document smokers type lung view anyway? idk, i would want to confront the office and ask the doc why he would jump to that relationship verses the standard persistant cough. period! - but i would be too chicken to really do it. well not to fuel ur fire here but UGH. good luck, hopefully u will keep getting better.
((((hugs))))) yalinda

ah, it was the rhuemmy- not the pcp. got it. perhaps they wrote that smoking thing because like my rhuemmy he felt mtx cough was extremely rare and therefore never considered any other factors as he is a specialist. hence the narrow thought. definetely get the rx from the pcp later this week. good luck yalin

I was on mtx for a year - I had a horrible tickle/pain in my chest and throat. I had a persistant cough. I couldn't walk by someone smoking w/o hacking for the next hour and then felt rotten for the rest of the day. I felt like my lung capacity shrunk by 1/2 - I suddenly couldnt walk the stairs w/o huffing and puffing. I always felt like I was coming down with something constantly (you know that "I don't feel right today" feeling, only it was every day.) They checked me with xrays, breathing test, etc. and claimed I was "not allergic to methotrexate" nor were my problems "methotrexate releated" and said I had plurisy (sp?)

It was a bunch of crap. I had never had those problems before I started it and once I stopped the med,the problems. went away. Get it checked out.

****

bablybloo,

 

I'm not sure what is causing your caugh, I don't smoke but I do have asthma and a little over a year ago I got a bad chest cold and one of those coughs you are describing, it just wouldnt go away and kept me awake all night, finally I had to go in and get a prescription cough medication.  But from there, my joints began to hurt, I just hurt everywhere and I began to have the swelling and from there it settled in the hands, knees, fingers and hips and here I am

 

If I were you, just go in to see your pcp, it sounds like it could be a chest cold, it is that time of year and people get sick! Especially if your chest feels like it is on fire when you cough, you need to go soon!  I am sure the smoking is not helping the situation but assuming it is the cause is not okay.

 

I hope you feel better!

Hang in there Theresa!