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persistent coughing/enlarged tonsil
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maureenklutch posted:
My daughter, who will be six in two weeks, has been coughing since September. I have been told by two pediatricians that it is allergies. We have tried allergy medicine to no avail. Monday I took her to an ENT. He believes she does have allergies, but the main reason for her coughing is the size of her tonsils. They are extremely large (as I have been toold by every doctor she has ever seen) and he believes they are obstructing her breathing and if she does have allergies or even a virus, they may be even more enlarged as a result. So she is on antibiotics with the hope that any infection she has may clear up and subsequently reduce the size of her tonsils and provide her with some relief from the coughing. I don't know what to do. It seems nothing is working. She has been taking claritin and a nose spray with no improvement; now antibiotics. Yesterday she had a nose bleed and lst night was up most of the night coughing. HELP!!!!!!!!!!!!!!
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Rod_Moser_PA_PhD responded:
Maybe....tonsils can be large enough to compromise breathing, eating, and yes...they can cause a reactive cough. Of course, so can about a hundred other things. Other things that need to be investigated would chronic sinusitis (a CT of her sinuses may be needed), asthma (perhaps the most common cause of chronic cough), allergies, and even...less common, but it does occur --an aspirated foreign body. I once had a patient who coughed for months, until a chest xray revealed a foreign body -- a piece of crayon lodged in her lung.

When children start school (September), they are absolutely bombarded by respiratory viruses. Each cold can last a week or two, and there are over 200 viruses known to cause the common cold. When they occur back to back, it can seem like one L O N G cold. Girls are especially social, so they tend to get lots of colds from the growing cadre of friends.

I can't tell you if a tonsillectomy is going to solve her chronic cough or not, but if all other avenues have been explored, you will need to make a decision. Have you had a "second opinion" by another ENT?
 
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AER1972 responded:
My son (6 years old) had enlarged tonsils and adenoids, asthma, allergies, chronic cough (asthma related), snoring and waking up off and on throughout the night. We had his tonsils and adenoids removed on the same surgery at the end of July and ever since he has been great. A little cough when allergies act up but not near what we have experienced in the past. Even his behavior improved. ... which was a big plus in my book. I would suggest getting a second opinion.
 
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sneal1979 responded:
Hi there. I was curious to find out if you have a found a treatment that has worked for you daughter? My daughter is 9 and has had a dry raspy, almost bark like cough for years. I don't mean every so often for years, but daily. Out of 12 hours, she probably spends 1.5 hours coughing. I am trying to research to find out if her coughing could be from enlarged tonsils when I ran across your post. I would like to hear what treatments you have found, if any, to treat your daughters persistent cough, or if she had her tonsils removed.

Thank You, Stephanie
 
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mercedessol responded:
Hi there. My daughter (4 years old) also has similar problems. She started grunting about 3 months ago, and after quite a while we found that her grunting was another method for her to cough. After 2 months of constant grunting, she couldn't take it any more and the grunting turned into a full cough. We have tried antibiotics, allergy medicines, cough suppressants, humidifiers, saltwater gargling, but nothing seems to have any effect on her. She continues to have a loud dry barking cough. She doesn't have any other symptoms. We have seen a pediatric ENT who says her tonsils are very large.

Is there anyone out there who knows of anything else we can try?
 
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Rod_Moser_PA_PhD responded:
Has your daughter seen a pulmonolist (lung specialist) or allergist for her cough? Many of these are reactive airways due to asthma, but there are many, many reasons. Enlarged tonsils may or may not be contributory to her cough.
 
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mercedessol responded:
Hi Stephanie, I am wondering if you already find a treatment for your daughter, because my daughter has 4 years old and has the same symptoms. Thanks, Mercedes
 
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chiefswife13 responded:
have a 3 yo who has had strep throat 5 times now and 4 days before she saw ENT, last week, she started with a slight clearing of the throat sound, which tends to get worse by the end of the day. ENT said that she has severely enlarged tonsils and recommended during surgery, mainly because she is having a hard time sleeping at night and is constantly tired and cranky.
 
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bnnyc responded:
Hi Maureen or anyone out there who can help. My 6 year old son has had a dry persistent cough for 6 months. It is non-stop when he's eating but at also happens at other times. He says he can feel something in his throat. He is clearly suffering, loosing weight and unhappy. He does not, however, cough when sleeping. We have been to an allergist (he has no allergies and Dr doesn't think it's asthma). We went to an ENT who found enlarged tonsils and adenoids and said the tonsils could be irritating him but has not given us any ideas how to help him other than surgery which may or may not help. He is currently using Pulmicort which Drs thought might help but it's helping at all. Does anyone have any other ideas of what this could be or what could help? GERD? LES, COPD? Should we try antibiotics? I just feel that there must be other kids and parents out there who've figured this out. Please send me any ideas if you them - I don't know what to do next.
 
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Rod_Moser_PA_PhD responded:
Not an exaggeration, but there can be HUNDREDS of causes of a cough in children. Yes, a reactive airway (like asthma) is probably the most common cause, along with frequent, recurrent colds. I once had a little patient who was coughing for months and she was found to have a piece of crayon lodged in her lungs....so, there are MANY possibilities. Unfortunately, it would not be possible to sort them out in the context of this Board.

Tonsils could be contributory, but it would not be high on my list.

Seeing a pulmonologist - a lung specialist -- would be the best way to go at this point, even if you have to drive to the next town to find one of these pulmonary experts. Clearly, something happened or changed in yoru son's life about six months ago....so, some persistent medical detective work should (hopefully) find it.


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