On the Mayo Clinic Radio program, Dr. Kaiser Lim, a Mayo Clinic pulmonary and critical care physician, explains chronic cough and how it can be treated.
If you have had a cough for more than 8 weeks, the good news is that you don’t have Covid 19. The bad news is that you need a Medical evaluation, tests and imaging to find out what is going on.
COUGH is not a disease, but is a manifestation, a SYMPTOM of a disease.
Your Primary Care Doctor will do a Medical History, an examination and a chest X-Ray which may allow her to DIAGNOSE what disease or problem Is causing the cough, and allow her to treat it.
If you continue to cough, you will be referred to a specialist, such as an Allergist or a Pulmonologist. ENT (sinusitis) and Gastroenterology (GERD) are 2 other medical fields often involved.
Usually blessed relief comes when Chronic Cough is properly diagnosed and treated, but a few Patients continue to suffer, challenging the best of medical care. 2 of my friends continue to cough after Medical School Level evaluations.
Nature continues to hide some of her secrets from Medical Science.
From a Permanente.org online article (May 11, 2020):
“Our patients are glad we offer telehealth options because they don’t want to come to the medical centers. This allows them to stay home andstay safe,” Dr. Lee says. “Before, telehealth was a choice and convenience, but now it’s one of the ways patients remain healthy with social distancing.”
The majority of telehealth visits are phone appointments, but Dr. Lee says video usage is increasing as more patients become comfortable with the platform.
Telehealth can also include services such as remote patient monitoring, which allows patients to take blood pressure measurements and blood sugar readings at home so that their care teams can monitor ongoing health conditions. In the case of the Kaiser Permanente Mid-Atlantic States region, doctors also use telehealth to do rounds virtually for patients who have suspected or confirmed COVID-19.
Patients at higher risk for complications are given pulse oximeters so their doctor can monitor for signs of severe respiratory infection before other symptoms might indicate a need for additional care, including hospitalization.
COMMENTARY
TELEHEALTH is HERE TO STAY. It came in with the telephone, and has been gaining in recent decades. The distancing and Patient convenience so characteristic of Telehealth made it a natural fit for Covid 19, which has accelerated its’ adoption.
Your CLINICAL HISTORY, led by the Story of your Present Illness, has since time immemorial been the MOST IMPORTANT ELEMENT leading to accurate DIAGNOSIS. During a TELEMEDICINE VISIT, your doctor must make the MOST out of your clinical history. She can’t do a proper Physical Exam, although she can usually see you, and maybe direct a SELF exam. Teledata, such as EKG,B.P., and blood sugar will become increasingly available.
Your Doctor can usually get enough information to order Lab work and Imaging; and prolix ordering can be tempered, since a good HISTORY of the PRESENT ILLNESS, systems review, past and family history can narrow the diagnostic possibilities considerably. The pressure of time and demanding computer Records may lead the overworked Doctor to use Lab Tests to make up for insufficient Medical History.
Integrated medical systems, such as Kaiser, can also easily access your past medical information, one of the advantages of having everything under one roof.
Informed Patients, SELF-EDUCATING themselves from the vast trove of medical information on the internet (and maybe DWWR) can author their own MEDICAL NARRATIVE, or at least make the Doctors job easier.
Understanding how the body clears the new coronavirus is becoming more important as the U.S. begins to reopen. WSJ’s Daniela Hernandez explains how the body fights infection and why feeling better doesn’t equal being virus-free. Photo illustration: Laura Kammermann
COMMENTARY
This excellent video is well worth watching and listening to. It revisits how the immune system, both innate and adaptive responds to SARS CoV and other viruses.
It shows graphically how long the body takes to clear the the Covid 19 virus.
And it makes me, a susceptible 88 year old, even more alert to infection. We should keep our guards up.
Even if an effective vaccine is found, it will probably take its place, incorporated into influenza vaccine as an annual immunization.
Connectivity in combination with mobile devices is making home-based services like telepharmacy and telemedicine a reality. These are great options if patients feel too sick to leave their home or they want a second opinion. It’s also possible to connect people in rural areas with academic medical centers. During the pandemic, the use of telemedicine has risen dramatically.
“Technology is enabling access to healthcare in many ways,” Holcomb said. “You no longer need to live in certain places to get access to great care, and you no longer have to go to your physician in person, for many aspects of a visit – this is helping people get care, even as they stay at home.”
Against the backdrop of the aging population and ongoing pandemic, technology is likely to continue to influence healthcare consumer expectations. Almost every aspect of life has been transformed by the emergence of digital conveniences. Digital technology is transforming industries, including shopping, communications and entertainment. Healthcare is no exception.
Doctors Without Waiting Rooms 