Update: The Chronic Cough in Children online course is now available. Learn more here.
I feel rather embarrassed and incredibly frustrated to be a Pediatric ENT Specialist whose child, spouse, and dog are all currently having ENT issues! Claire can’t seem to stop coughing the past 2 weeks, Dave has been complaining of a sore throat, and Shiro the dog has a swimmer's ear with awful bad odor coming from his ears! I am sure Shiro got swimmer's ear from having his ears so wet from playing in the wading pool at doggie day care ( a luxury in Orlando)! Claire has been healthy for over 8 months, but about 10 days ago caught some type of viral illness, as she had high fevers for 2 days, followed by runny nose for 3 and a wet cough. Things were better about a week after it started, when for the past 48 hours she has been coughing excessively whenever she lays down to sleep or first thing when she wakes. The last 2 nights she has woken up from the cough, and proceeds to come into our room, climb into our bed, and then after 3 minutes of hearing her ever-so-annoying cough which was going to keep all of us up I reluctantly climbed out of bed, walked her back into her room, and prayed that she would be able to fall back asleep.
I thought about what could be wrong, since her runny nose stopped and cold symptoms seems to have gone away. This sounds crazy, but I discussed with Dave this morning that I think her real nemesis and reason for the cough was an excessive consumption of sugary drinks lately. I started reflecting on our recent blessed but busy social calendar, which involved many get togethers with our new fantastic neighbors/new friends, as well as her frequent camps and playdates with her new friends, during all of which she has had access to sugary drinks like Capri Sun, which I stopped purchasing or keeping at the house over 1 year ago. Perhaps because we do not have that at home, she naturally gets excited and in fact drank 2 pouches yesterday at the 4th of July party we attended.
I must also admit that since we all consume very little dairy, another recent change was that I have been buying these Horizon Organic low fat strawberry, chocolate, and vanilla milk in disposable pouches. She loves them, especially the chocolate milk. Perhaps it was guilt for moving all of us from our beloved friends and neighbors, along with guilt for being so focused at my new job, and guilt from always being hard on her and criticizing her for choosing sugar and chocolate even though she has a sensitive stomach and always complains of “chest pain” after consuming excessive sugar, basically I have likely been the cause of her prolonged nagging cough, even after a cold. No lie, this morning before going to work, feeling grumpy as I was woken up at 4am and could not go back to sleep, I declared to both Dave and Claire that she was not to have sugar today, or must have very little. She wanted a pouch of the milk for breakfast and was instantly denied. She accepted my decision without protest when I asked her how many grams of sugar was in each pouch, “twenty-two grams of sugar, mommy”. I walked in at 5pm today, and asked how her cough was. She proudly told me that the ONLY sugar she consumed all day was one single piece of “Turtle” candy, chocolate and caramel covered pecan and nothing else. Dave told me she did not cough today. Really? I must be joking right?
Maybe it was a coincidence, maybe not. You can decide if your child has frequent/chronic cough which is annoying and you can’t seem to make it stop. Simply try it, stop the dairy and sugar and see what happens. I assure you that even the cough does not stop after the first day or two, you will likely notice a significant reduction in cough after just a few days. I know as a mom that if you hear that “throat-clearing” or cough, after a while, you either go crazy or you block it out. I am amazed at times when I can hear it in friend’s children but they have clearly gotten used to it. The larynx should not be hyper-reactive, irritated, nor cough unless it feels it needs to in order to prevent “aspiration” of food or liquid into the windpipe. The problem is that if it senses “stuff” near the vocal cords, it will trigger the cough and then after many excessive triggering events, it can become a habit. I have long believed that when a child has been ill with a virus, and likely has excessive mucus and phlegm draining from the nose as well as the inflammation of the nasal, sinus, and respiratory tract mucous membrane which triggers the cough reflex, for weeks after the voice box stays hyper-reactive until it can truly rest again.
Imagine if the voice box can never rest, what a terrible way to live! Anyways, I apologized to Claire tonight for not being more aware, especially given what I have observed in not only my patients but her as well, and knowing that she has a sensitive stomach like me, yet making one excuse after another and being lax, all in the name of trying to appease her. I told her that I was not completely banning those delicious and so conveniently packaged milk pouches nor sugar, we just need to make a conscious effort to take a serious break. Once her cough goes away completely, we will carefully allow her to enjoy a little bit more, but no more Capri Suns and excessive juices. The night before last we ate out and I let her order apple juice, because we do not keep it at home and she never drinks that at home. Perhaps that’s why whenever we’re out instead of water she wants apple juice. No question that as she enjoyed a big cup of that along with her Mac n’Cheese, that very night the stomach content was likely highly acidic and there was the reflux which got the cough going. Even now, we as a family still need to discuss A Healthier Wei and how our daily diet may impact all of us.
I have already forgiven myself, my work has just about consumed all my energy these days and I can’t really afford to lose more self-esteem. Tomorrow will be a better day, tomorrow she will have minimal sugar again. Since her cough was so much less today, tomorrow maybe it will be just about gone. But we are hosting a dinner party tomorrow night…I will have to make sure we watch what goes in her mouth! Oh, and Dave, well, he had a cold too, but we both remembered last night at 9:45, after the fireworks, several of the men gathered around the kitchen before we all left and they bonded over leftover pull pork sliders. Rare for him to agree with me, but he did think that the rare late night eating likely led to some reflux, causing some of his throat discomfort this morning and today. Claire always reminds me of the term "The Kitchen is Closed," which I affectionately titled my documentary trailer. I have to remind her that good choices need to occur throughout the day, not just in the evenings after dinner.