Discussions By Condition: I cannot get a diagnosis.

Frequent attacks

Posted In: I cannot get a diagnosis. 2 Replies
  • Posted By: smo425
  • October 12, 2007
  • 07:12 PM

I have periodic "attacks" of very violent coughing spells, which lead to vomitting, loss of bladder control, high blood pressure, rapid pulse, profuse sweating, severe headache, and my face turning red. Sometimes these attacks are accompanied by swelling of various parts of my face. When I have an attack I feel like I am burning up. Sometimes my throat swells shut and I have to seek immediate assistance at the ER.

This all started a year and a half ago. For the most part the attacks have been fairly infrequent, but for the last few weeks I've been having them every couple of days. I cough so hard that all the muscles in my torso are very sore. Following an attack I'm exhausted, congested and basically knocked flat for a number of days. When the attacks come on I am fine one minute and then I start coughing, sweating and retching the next. Attacks can last from 1 to 4 hours.

My doctor has given me Tussionex which does seem to short circuit the episodes but it knocks me out for the rest of the day when I take it.

Anyone have any ideas? This is really interfering in my life. I would do anything to get to the bottom of what is causing this, but I don't know what to do.

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  • AngioedemaSigns and symptomsThe skin of the face, normally around the mouth, and the mucosa of the mouth and/or throat, as well as the tongue, swell up over the period of minutes to several hours. The swelling can also occur elsewhere, typically in the hands. The swelling can be itchy. There may also be slightly decreased sensation in the affected areas due to compression of the nerves. Urticaria (hives) may develop simultaneously.In severe cases, stridor of the airway occurs, with gasping or wheezy inspiratory breath sounds and decreasing oxygen levels. Intubation is required in these situations to prevent respiratory arrest and risk of death.Sometimes, there has been recent exposure to an allergen (e.g. peanuts), but more often the cause is either idiopathic (unknown) or only weakly correlated to allergen exposure.In hereditary angioedema, there is often no direct identifiable cause, although mild trauma and other stimuli can cause attacks. There is usually no associated itch or urticaria, as it's not an allergic response. Patients with HAE can also have recurrent episodes (often called "attacks") of abdominal pain, usually accompanied by intense vomiting, weakness, and in some cases, watery diarrhea, and an unraised, non-itchy splotchy/swirly rash. These stomach attacks can last anywhere from 1-5 days on average, and can require hospitalization for aggressive pain management and hydration. Abdominal attacks have also been known to cause a significant increase in the patient's white blood cell count, usually in the vicinity of 13-30,000. As the symptoms begin to diminish, the white count slowly begins to decrease, returning to normal when the attack subsides. As the symptoms and diagnostic tests are almost indistinguishable from an acute abdomen (e.g. perforated appendicitis) it is possible for undiagnosed HAE patients to undergo laparotomy (operations on the abdomen) or laparoscopy (keyhole surgery) that turns out to have been unnecessary.HAE may also cause swelling in a variety of other locations, most commonly the limbs, genitals, neck, throat, and face. The pain associated with these swellings varies from mildly uncomfortable to agonizing pain, depending on its location and severity.Predicting where and when the next episode of edema will occur is impossible. Most patients have an average of one episode per month, but there are also patients who have weekly episodes or only one or two episodes per year. The triggers can vary and include infections, minor injuries, mechanical irritation, operations or stress. In most cases, oedema develops over a period of 12-36 hours and then subsides within 2-5 days. Someone on the board has suffered from angioedema and will probably fill you in some more.
    rad-skw 1605 Replies
    • October 13, 2007
    • 07:16 AM
    • 0
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  • Thanks for the reply. We have been focused on the angioedema ever since my face began swelling, but the cough seems to be the predominant issue. (A chronic cough actually began a year before the angioedema began.) I'm on a cocktail of antihistamines, but the attacks keep coming.Also, these attacks are sometimes accompanied by the angioedema, but sometimes not. The attacks come on very quickly and are very violent. It seems like it is a systemic attack:the cough begins, I get very hot, turn red, begin retching, lose control of my bladder, my sinuses swell, and I have profuse drainage all within a matter of minutes.We have ruled out the hereditary angioedema, so this would be acquired chonic idiopathic agioedema. Also, sometimes my throat swells shut, but more recently that hasn't been an issue.It's happening a couple of times a week now, and is definitley brought on by stress or exhaustion. It's interefering with my work, and my life. I need to find a way to stop this.
    smo425 2 Replies
    • October 13, 2007
    • 03:26 PM
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