Feeling incredibly frustrated, so doing a sanity check to figure out if I need to chill or if I should pursue a 3rd opinion.

Daughter is 10. She has been diagnosed with reactive airway, but not asthma. Allergic to pretty much every tree and grass in Texas. Allergies are always at their worst in October/November.

Her daily year-round regimen as recommended by her allergist is:

Zyrtec
Fluticasone (inhaler)
Nasacort

She started coughing in early November and hasn't really stopped since. When it had been going on a couple of weeks without improvement, I took her to her pediatrician. They recommended that she use her albuterol inhaler daily, which she has been for about a week now.

Last week the cough became more frequent, causing her to have difficulty sleeping. OTC cough suppressants have not mitigated it at all. She's coughing up quite a bit of yellow mucus. Also suffering from an incessant runny nose. She's noticeably fatigued. And maybe related or not, but her eczema has flared worse than it ever has since she was a baby. We're treating that topically with a prescription cream and bleach baths.

Yesterday she was coughing so much at school that her teachers told me she could barely focus long enough to get anything done. I kept her home today, and of course her pediatrician had zero openings, so we went to urgent care.

Urgent care examined her and found that her blood pressure was high, but no other symptoms besides the cough/congestion. Covid/strep/flu tests were all negative. They stated that she has viral bronchitis and uncontrolled allergies and refused to do anything for her, just recommended that I continue with what we're doing (allergy meds + albuterol) and wait it out. The doctor said 6 weeks is normal for this type of cough to linger. We're at the end of week 6.

So, should I go back to the pediatrician when I can get in (middle of next week) and see if they have a different solution? Another urgent care? Anything else I can or should be doing OTC or home remedy? Seriously open to anything at this point.

Not certain if this matters, but I've had the same symptoms since November 1st. My cough was unbearable the week of thanksgiving, my doctor prescribed antibiotics, which seemed to help and I'd almost stopped coughing completely up until a week ago. Went back in day before yesterday and they gave me steroids, which seems to be helping so far.

Keep Vicks vaporub on her chest at night and get the inhaler stick that looks like a lip balm container for the daytime. I got through pneumonia with those.
And, the yellow mucus sounds like she needs antibiotics.

I would run the Vicks in a steam vaporizer at night. This always helps my son when he sick and struggling to get over it.

Guaifenesin, much like phenylephrin, has recently been found to be ineffective. Of course, those of us who've actually used it have known this for 30 years.

1) Coordinate your care through your allergist/ENT for your child. Your pediatrician doesn't have the knowledge necessary.

2) Doctors are too often concerned about the clinical efficacy of treatments (expect, apparently, for drugs that are proven not to work) and neglect to consider the importance of treating secondary symptoms. In your case, it is likely that the cough isn't the problem; rather it is the sleep deprivation and the body's inability to heal because of the fatigue. If I had the cough, I wouldn't mess around here. I would find a doctor to write me a promethazine/codeine prescription. A child may need something different. Doctors in the past have whined at me and told me that promethazine isn't for coughs, like I'm too stupid to understand them...so I get out my crayons and explain to them the connection between sleep and health.

3) For a child, your situation may be totally different. But I'd find somebody who isn't afraid to knock the child out at night.

Thank you all for taking the time to reply. I appreciate all the advice and insight.

Her cough has improved a bit at night over the past couple of nights, but it's still very frequent during the day.

The thing is I love her pediatrician, he's widely considered one of the best in Fort Worth. But he is very rarely available, so we usually see an NP and maybe one of the other doctors in the practice for sick visits. She is nearing puberty and I always had in the back of my mind she might want to change to a female doctor at that time, so perhaps it is time to make that move.

Her allergist did all the asthma testing, most recently about a year ago, and he was the one who ruled out asthma based on the test results at that time. I will say that her symptoms and the frequency of respiratory illnesses has increased over the past 4 months or so. We spent the whole summer in New England and she had zero allergy or breathing issues, but part of me wonders if the time away might have increased her sensitivity to everything in the air here.

aglaohfour said:

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Thank you all for taking the time to reply. I appreciate all the advice and insight.

Her cough has improved a bit at night over the past couple of nights, but it's still very frequent during the day.

The thing is I love her pediatrician, he's widely considered one of the best in Fort Worth. But he is very rarely available, so we usually see an NP and maybe one of the other doctors in the practice for sick visits. She is nearing puberty and I always had in the back of my mind she might want to change to a female doctor at that time, so perhaps it is time to make that move.

Her allergist did all the asthma testing, most recently about a year ago, and he was the one who ruled out asthma based on the test results at that time. I will say that her symptoms and the frequency of respiratory illnesses has increased over the past 4 months or so. We spent the whole summer in New England and she had zero allergy or breathing issues, but part of me wonders if the time away might have increased her sensitivity to everything in the air here.

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Assuming the allergist did pulmonary function tests and they are negative why is she using albuterol at all? It just doesn't make medical sense.

Was she allergic to cedar? That is about the only pollen out in the winter.

Except for roaches, pets, food, mold...but yeah, for seasonal stuff, I'm way worse in spring/fall.

And even though it's not an allergy, my nose really runs when I'm in the cold. I carry a rag with me on those cold morning runs. If your nose doesn't normally drip in cold weather, it's hard to understand.

94chem said:

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Except for roaches, pets, food, mold...but yeah, for seasonal stuff, I'm way worse in spring/fall.

And even though it's not an allergy, my nose really runs when I'm in the cold. I carry a rag with me on those cold morning runs. If your nose doesn't normally drip in cold weather, it's hard to understand.

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Yeah that is why colds are called colds. People equated viral infections to how your nose feels in the colds before germ theory was invented. It is also why we see more infections in the winter because the dry cold air irritates the mucosal lining allow viral penetration.

Have you tried a nebulizer and/or a Neti Pot?

I have horrible allergies and they help with the phlegm and congestion.

My morning regimen is

Saline spray - can under pressure.
Blow nose
Saline spray
Blow nose
Flonase spray
Allergy meds

I have a cold right now and I use the nebulizer I bought during Covid morning and night. Really clears a little bit of mucus when you are bad. 5 to 10 minutes is enough.

In the past I used a Neti Pot. I got tired of heating the water so I bought a powered one for a while. I used it so much I also bought a water distiller. I found using the saline nasal spray is just about as good so that is what i use now.

I have a deviated septum. Any diagnosis of that? Might go to an ENT. I went to a good one. He looked at me for 5 seconds and said you have a deviated septum. 30 years and no one told me that. Confirmed by X-rays.

Anywho, good luck.

Kid Doc is right. Daily Albuterol is NOT a great idea. If she has to use it daily, something else is failing. Unless you have exercise induced asthma or something, Albuterol should only be a "rescue".
If things have been going on that long, and the pediatrician is not addressing it beyond what you've said, I would go back to the allergist, since you already have a relationship there. Pulmonary function tests can be re-done if they were done a long time ago. And if that's normal, there isn't anything wrong with getting a chest x-ray and 4-view sinus films. If those are normal, you could certainly feel better about trying to wait it out. This year there have been a few really nasty viruses which have caused people to cough for a really long time - yours truly included.

Thanks, y'all. You've convinced me to take her back to the allergist as soon as we can get in. I had no idea albuterol daily was so problematic - it was initially prescribed for rescue, though she's never had to use it for that. I can't exactly blame her pediatrician for that; every sick visit we've had since this started has been with the NP and that's who told us to use it daily. It's not helping anyway, so I'll have her stop it in the meantime.

I've had zero experience with asthma in my life, and never had allergies or respiratory illnesses myself until recently, so I've been doing as I was told. I should've questioned them more, I guess. Not having the knowledge needed to help your child has to be one of the worst things about being a parent.

Closest I've ever come to punching a human in the face was listening to our daughter cough through the night for months on end. Pediatrician was conservative in his treatment, which I can understand, but it definitely got to a boiling point for me. Hope you get it dialed in. Nothing worse than watching or listening to your kids suffer.

wcb said:

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Closest I've ever come to punching a human in the face was listening to our daughter cough through the night for months on end. Pediatrician was conservative in his treatment, which I can understand, but it definitely got to a boiling point for me. Hope you get it dialed in. Nothing worse than watching or listening to your kids suffer.

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Equally bad is the intersection of tree-hugger and home-schooler who won't treat a fever because "the body is fighting the infection."

94chem said:

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wcb said:

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Closest I've ever come to punching a human in the face was listening to our daughter cough through the night for months on end. Pediatrician was conservative in his treatment, which I can understand, but it definitely got to a boiling point for me. Hope you get it dialed in. Nothing worse than watching or listening to your kids suffer.

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Equally bad is the intersection of tree-hugger and home-schooler who won't treat a fever because "the body is fighting the infection."

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That actually is true. I generally don't treat my own fevers until 102+ as it has been shown to decrease duration of viral infections. Over 102 you start to burn so much water it is hard to keep up.

Of course it's true. But it's frustrating as a parent in the real world who views his family as customers and not science projects.

And fevers can spike rapidly and go undetected for hours. It's a purely hypothetical, la-la land idea that a parent should not treat a 101 fever before bedtime, and have the child run 105 for several hours before it gets detected and treated.

During my recent stay at TCH, I watched neurologists, neurosurgeons, GP's, NP's, PA's stack meds like there was no tomorrow, and I had to rein them in like a sheepdog. Meanwhile, being told to ignore fevers and coughs until the skin starts to boil or a lung gets hacked up makes no sense.

If you haven't already, minimize excess paper (crafts, journals, workbooks, etc.) and fluffy things like stuffed animals/blankets in the room where she sleeps, and get a really good air purifier for that room. If there's carpet, vacuum a least a few times per week. I don't know if she eats dairy, but one of my kids had worse skin rash and congestion with higher dairy consumption. That's purely anecdotal but I know what it's like to feel desperate to help/willing to try anything for your kid!!

I'm a doctor but a mental health one. This probably doesn't apply but I have a fascinating story.
5 years ago in late January I began to have a very consistent productive cough.
It was disgusting and Flem would fly out. Maybe 3 coughs and hours during the days. No sore throat. Over the counter meds did nothing. Did a biopsy via scope and it punctured my lung. X-rays done once a month in the spring and summer showed nothing. They staffed it and decided to stop antibiotics and wait 3 months and do another CAT scan. 4 lungs specialist on TexAgs weighed in. One said he'd give me prednisone if I were his patient. I went to the ER for hemoptysis and had Rhabdomyolysis. I was put on prednisone and on day 8 of 10 the cough stopped and I've been cough free for 5 years. I needed my immune system quelled and my body stopped attacking the unknown cause of my ball of white blood cells and I've been symptom free for 5 years.
This is not medical advice but it was an amazing miracle cure (it seemed).