Meds can help find cause of cough

Dear Dr. Roach: Iam an 103-year-old woman with a medical problem that I hope you can help me with. I cough up a lot of mucus every day, which is clear with no discoloration. The cough can start at anytime, but it is more prevalent at night. The mucus starts with the cough and can last anywhere from 15-30 minutes or more.

I don’t know where the mucus is coming from and was wondering if you had any suggestions. My chest X-ray was normal.

R.S.

Answer:

The mucus has to be coming from above (such as the nose and sinuses) or below (usually the lungs and rarely the digestive tract). If you had other symptoms pointing one way or the other, that could help.

An antihistamine for a week is pretty safe, and if it helps greatly, the postnasal drip becomes the likely culprit. Similarly, an inhaler or a medicine to stop acid secretion might lead to improvement right away.

I’d recommend another visit with your doctor, since the X-ray didn’t lead to the diagnosis. It’s time to try something new.

Dear Dr. Roach:

Iam a 68-year-old man in good health. Last year, the chronic numbness in my left thigh turned into a debilitating pain almost overnight. I could not walk 10 feet. An MRI showed a disc protrusion, likely an extruded disc fragment at the L3-L4 level, and a diskectomy was scheduled.

Since the pain went away, I sought a second opinion instead of surgery. A second MRI six months later showed that the fragment was gone, apparently absorbed by the body. The pain is largely gone. However, the numbness in my thigh remains. Is there any way to cure this numbness without surgery?

Answer: I’m not sure if the original chronic numbness was part of the herniated disk or not. You might have had a different reason for chronic numbness that had nothing to do with the disks. Chronic thigh numbness gives me suspiciouns about a condition called meralgia paresthetica, which is caused by pressure on a peripheral nerve. A neurologist or pain medicine specialist can help sort this out.