The Cough

Yesterday afternoon I met with the pain management doctor to discuss options to deal with The Cough (seems appropriate to capitalize it). I spent quite some time first with the resident and then Dr. Gulati, and we came up with a menu of options. The first is to try Lyrica, which is a medication used to treat fibromyalgia, thought to be caused by overactive nerves (I'm sure you've seen the ads). The doctor thinks it may help desensitize the phrenic nerve and thereby reduce The Cough. He wants me to take it for three nights, just in case I have a reaction (confusion being the main one he mentioned), and if I have no problems, I'll take it twice a day. I should know in a few days if it helps.

The second option is numbing the nerve. That would be done by injecting a block into the nerve on the side of my neck. There are actually two nerves he is thinking of blocking, but in his opinion, I will likely only get a few days' relief from this option. If that's true, the only bonus I can see is that we'll know that the phrenic nerve is or isn't the main cough irritant.

The third option is a neurostimulator. This Medtronics device is recommended mainly for people who have chronic leg or arm pain and is implanted under the skin, delivering electrical impluses to nerves in the spine. It works by tricking the brain into feeling a tingling sensation rather than the pain. Dr. Gulati thinks that it may work in my case by disrupting the sensation in the phrenic nerve that tells me to cough. The device can be turned on and off, and it's recharged and controlled using a remote control. The downside is that the device is implanted under the skin (and it's twice the size of my mediport) and in my case, that would probably mean in my chest. A test is done first where temporary leads are implanted and hooked to an external device that I would wear at my waist. If it works to control my cough after a week's trial, the actual device would then be implanted, so it's a temporary way to find out whether or not to go through with it.

He is also thinking of other options, which we can discuss if we exhaust these three. I told him I needed someone who would think outside the box, which I suppose he has to do anyway. He told me that of the four patients he's treated in the past two years with phrenic nerve issues, they all involved hiccups -- no coughing. So I continue to be unique. Yay me.

Tomorrow we were planning to visit Longwood Gardens in Pennsylvania since I didn't want my birthday celebration to hinge on food (usually we go out for a good dinner). However, with all the pollen in the air, my cough is worse than normal and Ed questions the sanity of visiting a garden. I guess I'll have to give that some serious thought this afternoon. Otherwise, I have nothing planned and I won't be having my usual four layer vanilla cake with chocolate icing, since I can't tolerate the taste of chocolate right now. Maybe a vanilla cake with lemon frosting?? Or a pound cake?? Both of those actually sound yummy.

It's been difficult the past few days trying to eat five meals a day. I've tried getting in some extra snacks and I've been also trying to drink fruit juice, but the 260 extra calories from the juice seems to fill me up. Oh well, I'm giving it my best shot. I guess we'll see in a week or so if it's working.

Before I sign off, I want to send a greeting to Lydia A., who shares my birthday if not my age (she's a spring chicken). Happy birthday, my dear friend. I hope you have a fabulous day!

Have a wonderful weekend everyone!