Dueling Coughs


“You sound worse than I do,” my patient said to me this morning.

“How about we draw straws to see who gets seen at the ED first,” I said.

My cough is actually improved from a week ago. My preceptee was treating a lady with chest pain who had a deep rattling cough. I was sitting in the captain’s chair and every time the lady coughed, I responded in an eerie EMS version of “Dueling Banjos.” I’d replicate her cough and then do a variation on it that she would try to match, but then I’d out cough her again.

I’m actually hoping I have turned the corner. A few days ago, after five weeks with the cough, I finally went to the doctor and was put on antibiotics and given some Tessalon Perles.

My room air SAT is back to 99% after a recent dip to 94-95% and not just 94-95% one time, but 94-95 % on our three pulse oximeters and on every oximeter at every hospital triage station I could test.

This cough is an annual winter passage for me, but it seems to be getting worse each year. It starts in my head, then descends to my chest and like a nasty tenant, is a bitch to evict. The weather this season hasn’t helped. I thought I was over it a week back when we had a rare balmy day, then the next day it was back to cold and wet and my cough was back with a vengeance.

After awhile the coughing wears you out, particularly when it wakes you up at night. I was hoping to keep my physical fitness up through the winter, but have given up now. I just need to rest this out – rest this out while still working, although I did take two sick days in the last two week period from my 70% desk job. I actually find I get the most rest at my paramedic job, because here at least if I am not doing a call, I can rest. The desk job has me on the go and home – with three girls 2 years, 9, and 14 with all their activities – there is no easy rest there.

Last night when the town was quiet, sitting alone in the back of the ambulance, watching my ETCO2 wave form roll across the screen, and trying to blow vapor rings with the nebulizer, I knew quite assuredly that I was not alone. I knew that in other ambulance stations and in ambulances on street corners in other towns and cities across this country and perhaps even the globe, other medics and EMTs were doing the same as I was, sucking in some Albuterol, getting the medicine down into our lungs so we could breathe a little easier, so we could, as Bob Dylan sang, “keep on keeping on.”

Ah, to see Spring.


Unfortunately, this had been an annual topic.

2008: Medicine For Paramedics

2007: Sick

2006: Hacking


  • Kelsey says:

    This is hilarious. Just last week, my manager “told on me” to employee health, who threatened to take me out of work for a week. I bargained my way into staying at work by downplaying my symptoms. I neglected to tell them that I was working on almost continuous nebs (between calls, I’m an asthmatic), and with a temp of 100.6, having been given many bags of fluids and zofran by my coworkers…

  • Renee says:

    I’ve definitely been there… this year has been surprisingly good for me, although I remain ever-vigilant about my asthma. I’ve sat there sucking on albuterol more than once via neb between patients. Treated a patient more than once with my wheezing worse than theirs. I always wonder if they realized it.

  • michael says:

    This is the first time in nearly twenty years I haven’t had a cough of cold. Coincidentally (ha) it is also the first time in nearly twenty years I haven’t spent most of my time in the back of an ambulance!

  • KLemtRN says:

    What’s worse is when you get sent on a call, and have to put a O2 tank in the cab to continue your neb, so you can haul the bags etc to the 3rd floor walk up apartment to treat the drunk, constipated, or CPR prank caller…. Yup been there… and doing peak flow measurements to see how bad off I am.

    Gotta love a job where we can self treat (with the non-regulated meds of course), and where most of us are smokers, or asthmatic with a chain smoking partner.

  • Harwetopa says:

    I know this all too well, too: just last week I was coughing up a lung; went home after half a shift when I got tired of hospital staff asking, “Who’s sicker, the patient or the paramedic?” It took a few days of Albuterol and Mucinex DM, but I think I’m sounding better than my patients!

    On a more ominous note: it was just eighteen months ago I was nearly hospitalized with a similar cough: but what I thought was bronchitis turned out to be “Health-Care Pneumonia…” a form of pneumonia transmitted by my patients. This year my doctor rather insisted I take the pneumovax to prevent a repeat performance.

    I think it’s working.

    I hope you are feeling better.

  • medicscribe says:

    Thanks for the comments. I have finished my antibiotics and am feeling better, although I still have remanents of the cough. I SATTed in at 99% this AM. Hope to check out the same.

  • Renee says:

    Pneumovax won’t prevent pneumonia. It just makes it a lot less likely you will die from it.

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