Ask the doctor - respiratory system

Read expert medical advice with doctors' questions and answers from Prima, SHE and Good Housekeeping

 

How can I cure my dry cough?

I have a dry cough which keeps me awake at night. I have never smoked, and I've had a chest X-ray and blood tests, which were normal. My GP has given me an inhaler, but it doesn't work. I also take tablets for high blood pressure. What can I do?

There are a few possibilities here. Firstly, if you have high blood pressure, you may well be taking a medicine called an ACE inhibitor, which can cause a troublesome dry cough in at least one in fi ve people. Changing to a related medicine called an ARB could solve the problem. Otherwise, it is worth asking your GP about a spirometry test. This gives an indication of how well your lungs are working and whether the problem you have is one of obstruction (as in asthma or chronic lung disease, called COPD) or restriction (which can be an issue if you are overweight). This will help decide which treatment will work best for you. It may be that you will need to be referred to a chest clinic - either at the hospital or at one of the many NHS community clinics which have been set up in recent years.  

Dr Sarah Jarvis, Good Housekeeping (July 09)

 

A natural cure for colds?

I've tried echinacea to reduce colds, but it doesn't work that well for me. Are there any other natural options?

A recent review of eight trials involving a Zulu herbal remedy, Pelargonium sidoides, confirms that it successfully treats symptoms of acute rhinosinusitis and common cold, such as sore throat, cough, runny and blocked nose. It can also relieve acute bronchitis. It's the number-one selling cough and cold remedy in Germany, and is now available in Boots as Kaloba (£7.99 for 20ml). Start taking it at the first sign of a cold - 30 drops, three times a day, in a glass of juice for example. For children aged six years and over, reduce dose to 20 drops, three times a day. For more information, visit www.kaloba.co.uk.

Dr Sarah Brewer, Prima (Feb 09)

Allaboutyou adds: Easy ways to fight colds and flu

 

 

Can the Alexander Technique help asthma? I have asthma and I’m told the Alexander Technique may help my breathing. How?

 

The Alexander Technique is based on the belief that poor posture and faulty body movements contribute to illness. Practitioners teach you to recognise ‘patterns of misuse’ in your movements – paying attention to how you stand and the alignment of your head, neck and spine – to help you move in a more balanced, relaxed and fluid way. During a lesson you’re asked to stand, sit and walk while the teacher assesses how you move.

 
Adjustments are then made to help you become aware of how you feel when your posture is corrected to optimal. Gentle exercises teach you to move correctly, without stress, using your muscles with minimum effort and maximum efficiency, and expanding the chest fully for better breathing. Early studies done 20 years ago showed the technique can improve breathing, and many actors recommend it for this, but no recent research has been carried out. For information and qualified teachers, visit www.stat.org.uk.
Dr Sarah Brewer, Prima

Pulmonary rehabilitation

I used to smoke heavily and now I have chronic airways disease (COPD). My doctor says pulmonary rehabilitation could help, but hasn’t really explained what this is. 

Pulmonary rehabilitation is a programme of increasing exercise, education and psychological training to help you stop smoking. Treatment, usually as an outpatient, takes place every day for at least four weeks - a big commitment, but one of the most effective non-drug ways of improving the quality of life for people with COPD.
Dr Sarah Jarvis, Good Housekeeping
 

High temperature with a cold

Whenever I have a cold, I just sit it out, but my husband says that when he’s ill, he finds keeping his temperature normal helps him get well faster. In future, would I be better off taking drugs to bring a fever down?

It's likely that having a higher temperature than normal can help your body to fight off viral infections, although a very high temperature can be harmful. So if you have a slight temperature with a cold - not above 38°C for an adult or child - don't feel obliged to take paracetamol to lower it. Having said that, it's unlikely that you'll do yourself any major harm if you do take something - particularly if you're aching or have a sore throat, too.
Dr Sarah Jarvis, Good Housekeeping
 

Injections against pneumonia

I’ve just received a letter inviting me to have an injection against pneumonia. I’ve never been offered one before and wonder if it’s necessary.

Yes, absolutely. This injection is to protect you against pneumococcal disease, which can cause pneumonia, meningitis and infection of the whole bloodstream. It's reckoned that it kills and hospitalises almost 20,000 people a year in the UK, with older people and those suffering chronic diseases such as diabetes or heart, lung, liver and kidney disease particularly at risk. The Department of Health recommends that all people in these groups should be vaccinated. The pneumovax injection offers very good protection against pneumococcal disease - and, best of all, once you've had one injection, you'll be protected for life!
Dr Sarah Jarvis, Good Housekeeping
 

My husband's snoring wakes him up

My husband snores and frequently stops breathing for short periods before waking up and going back to sleep. He wakes up moody and tired. Is there anything we can do?

It sounds like your husband suffers from obstructive sleep apnoea (OSA). OSA is a condition where the sufferer stops breathing for short spells while asleep. During sleep the throat muscles relax – for most this isn't a problem but for some the muscles become so floppy that they narrow the airway or even block it. Snoring is the result.

If the airway is completely blocked then the sufferer will stop breathing and is eventually forced to wake up. They then go straight back to sleep. This cycle can occur hundreds of times a night and although sufferers may not remember anything, their sleep is greatly disturbed. As a result, the next day they feel tired and irritable.

There are some lifestyle changes that will make a difference. If your husband is overweight, he should try to slim down (a collar size of over 16 is associated with snoring). Advise him not to drink alcohol for a few hours before going to bed. There are mandibular (jaw) devices available that fit inside the mouth when you sleep to keep the throat open. Contact a dentist to get one properly fitted. If snoring is a problem speak to your GP and contact the Sleep Apnoea Trust; 0845 606 0685. Dr Louise Selby, SHE
 

Does my daughter really need an inhaler?

My daughter is almost two years old, and has suffered from  a night-time cough for the past two months. Now our GP has suggested she uses an inhaler, even though he’s never heard any wheezing. Is this a safe option, given that we don’t even have a diagnosis?

One of the biggest problems we have with coughs in children is they are often caused by a tendency to inflammation of the airways that does not show itself, as it does in older children, as ‘wheeze’. Indeed, often the only symptom is a persistent cough, especially at night. The only way to differentiate between this cause of cough and others is to give a trial of therapy – in this case an inhaler. The medication in this inhaler is extremely safe and, because it is given straight to the lungs, where it is needed, the dose is extremely small. It is therefore a standard treatment for a persistent cough at this age, and is often effective.
Dr Sarah Jarvis, Good Housekeeping

 Are eco-inhalers effective?

My son has asthma and the pharmacist says his inhaler will soon change to a more environmentally friendly one. Will this be as effective?

Some types of reliever inhalers still contain chlorofluorocarbons (CFCs) as the propellant gas to deliver the inhaled asthma drug. These are being phased out and an ozone-friendly propellant gas, called hydrofluoroalkane, is being used instead. The drug in your son’s inhaler will stay exactly the same but he may notice it no longer feels cold at the back of his throat, or that it feels and tastes slightly different. It will still control his asthma in exactly the same way. For more information about asthma, and to find out which inhalers still contain CFCs, visit www.ourasthma.com.
Dr Sarah Brewer, Prima
 

I’d like an alternative to air freshener

My dog has a definite doggy odour. But my son has asthma and I’m worried about spraying chemical air fresheners into the air. What can I use instead?

Over-use of air fresheners is not a good idea – especially in homes with young children or people with asthma or other respiratory problems. Ask your vet for advice on products you can use to bathe your dog regularly. You can remove pet and other odours safely with the Fresh Air Globe (£39.99 from www.jmldirect.com) which pumps air through water to clean it, while at the same time providing mood lighting.
Dr Sarah Brewer, Prima

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The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP. For more information, visit www.netdoctor.co.uk