Doc: Adult whooping cough can drag on and on
Dear Dr. Roach: Thirty years ago, when I was in my 40s, I was diagnosed with bronchiolitis, which was considered a disease of young children. When lying down in bed at night, I coughed to clear my rattly chest and suddenly could not breathe at all. It was terrifying, and just before passing out, my breath returned with the bray of a donkey. This happened several times over several nights, although never in the daytime. Thereafter, for weeks and weeks, I coughed until I vomited, I couldn’t catch my breath, my ribcage hurt and my face and eyes were puffed up from the strain of the coughing. For that, I was given steroids, I believe. It was about six weeks from the first little tickle in my throat until the horrible experience ended.
My question is,could this have been whooping cough?
Dear E.O.: It’s impossible to be sure now, but I think it’s very likely it was whooping cough. I have had letters from people whose symptoms lasted up to six months. It’s quite horrible. The steroids sometimes can help with the airway inflammation, but only early and appropriate antibiotics can really stop the six weeks to three months of intense coughing.
Dear Dr. Roach: Recently, I had an ultrasound on my gallbladder and liver, mainly to check on a polyp found on my gallbladder six months ago. There was no change in size, so my doctor isn’t concerned.
However, the ultrasound showed that I have an abdominal aortic dilation/aneurysm (2.9 cm). My doctor doesn’t seem too concerned, suggesting that I follow a healthy diet and lose some weight (I’m overweight by about 30 pounds). She said I’ll have another ultrasound in a year. After looking up the condition online, it sounds rather serious.
Dear K.M.: The aorta is the largest blood vessel in the body, coming directly off the left ventricle of the heart, arching in the top of the chest to provide blood to the head and arms, then progressing down the body, providing blood to the abdominal organs before it divides into the femoral arteries (to the legs) at about the level of the bellybutton.
The aorta can become enlarged (dilated), and when large enough, it is referred to as an “abdominal aortic aneurism.” Rupture of an AAA is disastrous: It usually is fatal, so when it is recognized, it is watched and intervention is undertaken before it becomes a high risk for rupture. AAAs are more likely in men, and the major risk factors are smoking, atherosclerosis (fatty deposits and calcium in the blood vessels) and connective tissue diseases, such as Marfan’s syndrome.
Men ages 65 to 75 with any history of smoking should be screened for an AAA. An ultrasound is a quick, safe, reliable way of screening. The diagnosis of an AAA depends on size: For most women, a level of 3 cm is a reasonable cutoff. You are just below that, so I understand why your doctor may want to check up on it again. Assuming you don’t smoke (quit now if you do), then it’s most important to control your blood pressure. A diet with plenty of fruits and vegetables was found to be protective against AAA. Being overweight or obese may increase risk, so work with your doctor on losing the extra weight.
Email questions to ToYourGoodHealth @med.cornell.edu.