Woman with the Chronic Cough 

Images and Text © 2008 Jeffrey C. May

This is a light photomicrograph (about 400x) of dust from Sally's living-room easy chair. The long pink rectangular shapes are dog dander, and the brown spherical shapes are dust mite fecal pellets.

When I first met them, Sally and Burt had been married for 50 years. Though they taunted and teased each other mercilessly while I was in their home, it was clear to me that they cared for each other deeply and were almost the same person - they even finished each other's sentences.

Sally and Burt had lived in the same house since their wedding day. When their oldest daughter got married, they changed the home into a two-family and moved to the first floor, converting a porch built over a crawl space at the back of the house into their new bedroom. Their daughter and her husband lived in the larger apartment above, and over the years, two grandchildren joined the extended family.

Their grandson has asthma. His parents had just stopped smoking because they felt that this would help their child, but the wall to wall carpet in the upstairs apartment still reeked of smoke. Because she had a chronic cough condition, Sally hadn't slept through the night in three years. She would awaken and have to sit up, because she coughed so violently. Then she would pace for hours to calm down enough to go back to sleep. Sally and Burt had a small dog that I suspected might be a problem, and when I visited the house, they put the pooch in a cage for the duration of my stay.

When I arrived, we sat in the kitchen while Burt described his wife's health problems. Sally was sitting in the background, adding comments and muffled coughs. As per my instructions, they had shut all the doors to the various rooms before my visit, to keep air flows to a minimum. The master bedroom was located off the kitchen, and when I opened the door and peeked in, I immediately started to cough (I'm allergic to mold and dust mites).

I explained to the couple that I would have to wear a fine particle mask in order to enter their bedroom to take dust and air samples. As I was putting on my mask, it occurred to me to offer one to Sally. I went out to my car to get a new mask for her, and showed her how to wear it properly (taking care to be certain the fit around her nose was airtight). She looked uncomfortable sitting there with a mask on her face, but I noticed immediately that she was a lot quieter; she had stopped coughing. For the entire three hours of my visit, I don't think that Sally twitched, for fear that she would start to cough again. When I was packing up my equipment to leave, I suggested that she and I both remove our masks together. We both started coughing at the same time.

Subsequent analysis of the air and dust samples revealed significant contamination of the bedroom carpet with dust mites and mold. The presence of carpeting in their bedroom was particularly problematic, for the room wasn't adequately heated; the floor, three of the walls, and the ceiling (directly under a low roof) were always cold. This led to high relative humidity in the cooler seasons of the year. Mildew grows on surfaces when the relative humidity is high; in fact, during my visit, I had seen mildew on the wood panel at the back of their bedroom dresser.

I suggested that Sally spend that night in the guest room, where there was a hardwood floor and a pullout couch that was rarely used. She slept through the night for the first time in years. I recommended that they remove the carpeting in their bedroom and install hardwood floors, disinfect the bedroom walls with a mild bleach solution, and keep the room warmer. I also strongly encouraged them to pick another room for their bedroom.

They later followed my recommendations, and most of Sally's coughing problems disappeared.

Sally is a remarkable person - a real fighter. She had had at least two different surgeries for medical problems, and a third procedure to correct a hernia that resulted from a severe coughing fit. Her spunk was admirable, but some of her suffering, at least from the coughing and hernia, could have been avoided.

   
Case Studies

•   The Little Girl and Her Couch
A concerned father called me because his four-year old daughter was suffering from chronic asthma.

•   The Woman with the Chronic Cough
Because she had a chronic cough condition, Sally hadn't slept through the night in three years.

•   The House Built Over a Crawl Space
Sam and Laura were worried that their house was contaminated with mold.