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February 1999 Issue
Why Do You Give Yourself Bronchitis?
by Michael Fick
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What's the worst part of a long, cold winter, for both snow skiers and water skiers? Shoveling? Naaah ... that's just good exercise if done right. Slipping on the ice and breaking a leg? Naaah ... that's just a great opportunity to catch up on your reading. Think about it ... what common hassle makes even a short, mild winter one of the worst seasonal experiences of the year - even for TV fanatics?

Bronchitis is way up on my list. What other often-avoidable diseases besides type II diabetes or a bad marriage makes us that sick so often? Heck, some of us even give bronchitis to ourselves twice each winter to ensure a really miserable season.

That was no misprint; just like the diabetes type II and the bad marriage, we often cause bronchitis by promoting and ignoring its early, often reversible symptoms.

It often starts with a dry throat that wakes us up at night, then adds a slight daytime sniffle. With the dry throat balancing the juicy sniffles, on the average we're still 'fine".

Sure ... Just like we're comfortable "on the average" when somebody jams our bare feet in a snow bank and sets our hair on fire.

We feel OK until the sniffle gets thicker and consistent and the dry nose and throat keep us awake. Then the plot thickens, and soon clearing our head in the morning sounds like five minutes in the pits at a Monster Truck Rally. At least we still sleep OK, because it's all in our head. We assume it's a cold, know we can't stop it, and just resign ourselves to a lousy week.

But soon the throat tickle appears, then a dry cough. Next, yellow slime, then green goo, then maybe brown tar start coming up, as each cough buckles our knees and triggers 28 more coughs in the next 28 breaths.

#%*@! Bronchitis again!

We stop coughing only when we're too exhausted to inhale again. We can't sleep until total exhaustion knocks us out five minutes before the alarm goes off in the morning. We know this round-the-clock exhaustion will last for days and a nuisance cough maybe weeks more. We put Dr. Kevorkian at *1 on our speed dial.

To thin the mucus so we can cough it up, we drink quarts of water, herbal tea, and hot chicken soup. If the coughing is genuinely debilitating, we take drugs for it. An expectorant further thins the mucus, and a cough suppressant at bedtime helps us sleep. (We need to cough in the daytime to clear our chest. Unlike mosquitoes and Pauly Shore, coughing serves a purpose.)

We have few over-the-counter drug options. The only safe and effective OTC expectorant is guaifenesin, and the primary cough suppressant is dextromethorphan. Codeine is a stronger suppressant, but it has many common side effects and requires a prescription in many states. If the bronchitis is bacterial, antibiotics may reduce its duration and severity. But we still feel absolutely AWFUL until we stop that wretched, uncontrollable, bone-wracking, gut-wrenching, frightening, suffocating, totally debilitating, falling-down, eye-popping coughing.

If it's so bad, and often so simple to prevent, why do doctors just treat the bronchitis without telling us how to prevent it? When I finally asked mine how to prevent it during one of my annual bouts a decade ago, he quickly answered, "Oh, you just ...". I did, and I've not had bronchitis since.

Here's what often lies beneath the symptoms we see. Our airways dry out from breathing heated, dry air all night without talking or swallowing or breathing through our mouth and nose alternatively. The dry airway linings crack. Bacteria or a virus settle in the cracks and multiply. We probably get a dry cough soon from the irritation. Our bodies fight back with fluids, producing watery sniffles and postnasal drip. Infection blooms and mucus thickens and darkens, and somewhere in that phase the postnasal drip transports the infection down into our bronchial tubes towards our lungs. The deeper and more productive coughing starts in order to clear our  chest, and doesn't quit until our bodies and/or medications reverse the process.

Any of three triggers contribute to many such cases of bronchitis.

  1. Growing up in a household with smoking parents made many of us highly susceptible to bronchitis. For you and me, that's history. Smokers, however, must realize that bronchitis may be the least of smoking's impacts on their kids' lives.

  2. Smoking kills the cilia that line our airways to sweep out irritants and mucus. Kill the cilia, and here comes smoker's hack and a (probably shortened) lifetime of lung problems. If you stop smoking soon enough (its lung damage was recently found to be much less reversible than thought), maybe you can avoid bronchitis next winter.

  3. The bronchitis trigger most susceptible to simple intervention (stopping smoking is not simple) is the dried-out airways. Buy a humidifier. By humidifying the air we breathe, we can often prevent bronchitis. For under a hundred dollars our recurring bronchitis may become history.
I tried several humidifiers during my learning curve before picking the type I prefer.  The floor or console humidifiers designed to humidify a whole room evaporate a lot of water. The ones I tried left water running down cold windows, became clogged by minerals, required frequent cleaning and developed mechanical hassles.

The ultrasonic mist type humidified a much smaller volume, and thus worked best beside my bed where it surrounding my head with my very own soothing humid air. Because it used much less water, the window sills and bedding and clothes stayed dry, it generated less mineral buildup, and it worked more simply. Big improvement, but the highly rated one I tried spritzed my face with tiny droplets which occasionally awakened me. 

The simplest type blows air through a wet, stationary filter that wicks up water from its immersed base. It has all the advantages of the ultrasonic mist type, and it stops the rain. Reaching out and turning on this device near my head gives my dry throat and nasal passages instant, obvious, blessed relief.

Alas, hard water still left mineral deposits, and some slime still formed, even with anti-slime and anti-deposit chemicals poured into the humidifier. It still required frequent messy cleaning and occasional new $15 filters when used with household water.

But a simple solution leaves it my first choice ... so far. Because it humidifies only a small volume of air and is necessary only in the driest and coldest winter months, I just use distilled water in it. For a few extra bucks each winter, I now sleep much better, avoid bronchitis, and just rinse the humidifier clean every spring.

Whatever type of humidifier you buy, use a bacteriostatic solution in it, available for a few dollars per season where humidifiers are sold. Otherwise its tank of water becomes a bacterial breeding ground.

Sleep more soundly, sleep more comfortably, and avert many cases of bronchitis for $50 up front and $30-40 a season for water and supplies. That's beats just one day of that wretched, uncontrollable, bone-wracking, gut-wrenching, frightening, suffocating, totally debilitating, falling-down, eye-popping coughing.

Bronchitis can do lasting damage or indicate underlying problems. You should see a doctor if your cough lasts for more than a week, if you have serious trouble breathing, if you cough up blood, if your sputum turns yellow or green, if you have known lung disease, or if your temperature exceeds 101. These are times to be a wuss.



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