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.
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Julie

Julie Stachowiak, PhD

Julie is the author of the Multiple Sclerosis Manifesto, the winner of the 2009 ForeWord Book of the Year Award in the Health Category. She is an epidemiologist who is also a person living with MS, Julie has an in-depth understanding about current research and scientific developments around MS. She also has first-hand knowledge of the frustrations and anxiety surrounding the disease, as she had MS for at least 15 years before receiving a diagnosis in 2003 and has had several relapses since her diagnosis.