Let’s suppose I know a couple. Mr A has a wife of several years, Mrs A, nee Miss B. They’ve been together for 7 years, married for 3. Mrs A has a worsening, persistent cough and gunked up throat. Mrs A’s parents and sibling have similar, but much less severe coughs, as does Mrs A’s nephew.

Originally, Miss B had a coughy spell every few days and all was ‘dealable’ with. Over the years, the cough/clearing of throat has increased incrementally, until it is not only every day, but a good portion of the day, every day, but really bad each morning; coughing, retching, occasionally vomiting. She spends a lot of the day struggling for breath, and all this makes living with Mrs A difficult;
[*]-Mr A doesn’t want to be near Mrs A when she is coughing/retching/vomiting/gasping.[/*]
[*]-It is no longer possible to go out to a restaurant or go to the cinema because Mrs A’s coughing etc. disturbs everyone around.[/*]
[*]-Mr and Mrs A can’t do anything that involves an early morning, or anything that precludes taking ~90 minutes for breakfast. [/*]
[*]-Mrs A is exhausted by a day at work and sits on the sofa all evening (clearing her throat).[/*]
Mrs A/Miss B has been to see ‘lots of Doctors’ and none has been able to clear it up, trying things like Asthma, acid reflux and allergies. However, this actually means that she visits a doctor every few years for a one-off appointment, and takes a selection of pills. Encouragement to go to back to the Doctor is met with anger and tears – “There’s nothing I can do!”. Claims of “I’ll make an appointment” drag on for months, as Mrs A is “too busy”

Mr A finds the constant coughing and clearing of throat extremely distressing and stressful, a fact which Mrs A knows. Mrs A, however, treats the issue as Mr A’s problem, insisting that there is nothing that can be done and Mr A should get counselling to cope with it…

Mr and Mrs A want to start a family in the foreseeable future. However, Mr A fears the added stress and tiredness of 1) pregnancy and 2) children would make Mrs A’s problems worse. Mr and Mrs A agreed that they would hold off having children until the cough was under control. Mr A doesn’t want to have a child who inherits this mystery cough, especially given the risk of inheriting Mr A’s well controlled, asthma. Mrs A is now getting broody. Mr A talking about the subject with Mrs A leads to anger and tears, again… and no action. And every day the cough gets worse…

Mr A is fed up with the situation. What should Mr A do?

If I was Mr A, I’d leave. Being with someone shouldn’t make you deeply unhappy.

What Mr A knows he should do but for some reason has already put off too long.

Ultimatum.. Go to docs and get it sorted or I leave.

Is she a smoker? is there any reason for this?

Mr A has a wife.

I, Mr A, take you, Miss B, for my lawful wife, to have and to hold, from this day forward,for better, for worse,for richer, for poorer,in sickness and in health, until death do us part.

Heart & lung transplant, quit smoking or stop injecting heroin. One of them.

Mr A doesn’t want to leave Mrs A. Mr A loves Mrs A, but is frustrated that he can’t lead a ‘normal’ life with her. Mr A is frustrated that Mrs A refuses to face the problem.

Mrs A has never smoked or done drugs. She walks a few miles every day to work and back, although she admits she should be fitter, and will get fitter ‘once I get better’

is there any reason for this?

Oh for an answer to that question!

P.s Is everyone else’s formatting screwed up? Seems the LI tags don’t play nicely with the rest of the formatting.

Get her on Embarassing Bodies – they seem to sort out this random sort of problem when others haven’t!

You’ve eliminated the easy two. Is it Cystic Fibrosis?

Cut our dairy, cut out fruit juices, lots of water.

Exercise is most likely part of the cure, not something to be done after the cure.

But she’d have done all of this already if she could be arsed.

You have to solve it or an unhappy future is waiting there for you.

I suspect there may be a psychological / habit part to the cough. If she will not do anything to find a cure then Mr A is left with a starck choice – put up or go away

Mr A has a wife.

I, Mr A, take you, Miss B, for my lawful wife, to have and to hold, from this day forward,for better, for worse,for richer, for poorer,in sickness and in health, until death do us part..

Nope. Not if people are not willing to seek help. And better to leave before kids rather than after them. Or is it better to end up hating someone for 50 years rather than admit there is a problem…?

Mr M-B A quack speaking- the family bit is interesting. There are a whole range of conditions which can cause difficult coughs which may have a family link from Asthma through to Alpha-1-antitrypsin related emphysema. There are things a family could have been exposed to (like Aspergillus) but there are also annoying “habit” coughs which can be “learnt” in a family. Any history of eating disorders by the way?

The causes of coughs are almost limitless – starting with earwax (yes – it can cause a cough…) through sinusitis/rhinitis/nasal polyps (can be a family history) Ciliary dysmotility syndromes, Acid reflux leading to laryngeal/airway irritation, and that is before we get near to lungs and airways… Then you get connective tissue disorders, wegeners, etc etc and TB… – then further down emphysema, asthma and bronchiectasis.

A young patient with a chronic cough I would expect to have had a couple of weeks of peak flow measurements and spirometry done, trials of salbutamol and low-dose inhaled steroids, a trial of an antihistamine, a trial of a PPI drug like omeprazole, and a trial of a nasal steroid spray for at least 2 months. Further investigation (such as high-res CT scanning of lung bases and/or referral to a respiratory specialist/bronchoscopy or flexible naso-laryngoscopy) would depend on signs found on examination… And psychogenic coughs are far from uncommon.

But that isn’t the issue. The issue is she will attaches little value to Mr A’s concerns and how much it upsets him, and she is unwilling to deal with what sounds like a genuine medical issue. I think Mr A needs to make it clear to her that this is not just you (ooops… MrA 😉 being embarrassed, but his genuine concerns.

If she does nothing I think you/he may need some counselling from an outside party or a divorce lawyer…

This all sounds a bit odd to me. e mail in profile if you wanted to discuss anything privately.

The A family should not enter into parenthood until booth people are happy to do so. It’s very very hard to be pregnant and dealing with other health problems too… however one cannot be completely fit in most cases before being pregnant.

Another discussion without blaming -maybe with counsellor- about all issues involved is needed.

Some ideas:
Mr and Mrs should each try writing out a plan of action which lead to ultimate goals in life. Compare them and work on finding compromises to the places where the goals differ.
Talk about worries and fears with health issues (without blame) I.e. I’m very worried about what it will do to your health… I really worry if WE don’t find a solution to the problem I may end up losing you which scares me and having to raise our future children without you which scares me even more. PLUS I worry that this problem you have combined with my own ill-health will curse our children…

Make health appointments and go together. Find out a course of action which can be taken (from GP or whomever) and follow this. Do research together about what sort of specialists to see and make the calls for her if necessary. It could be that the ‘unknowing’ is scary but Mrs A fears what she will ultimately find out too and is hiding from the fear. Also, she just might not really know what to do and need some hand holding.
(It sounds to me an awful lot like when I try to avoid issues that I know I oughtn’t, but I still do because of my anxieties…)
Help MrsA look at her anxieties and recognise what they are and talk about them (without feeling blame from anyone) and work on a plan of action, a process which she can use to help avoid the anxiety and be pro-active and feel confident and get what she ultimately wants (good health and babies)

emsz – Member
Mr A has a wife.

I, Mr A, take you, Miss B, for my lawful wife, to have and to hold, from this day forward,for better, for worse,for richer, for poorer,in sickness and in health, until death do us part.
Even when she drives me mad and her behaviour guarantees I would be acquitted of murder. When you choose a wife you choose your life. She isn’t a bike (bikes are for pleasure).