Many weeks later, and now almost two years down the road, I changed my diet---for reasons other than my cough.  (Let's just say I needed to get more protein).  After three days, I noticed that I was not coughing as much.  I couldn't be sure, but could the fact that I was not eating pretzel rods, a favorite snack, be contributing to the improvement?  There was only one way to find out.  Four pretzel rods later, I was back to that familiar coughing.  I was on to something!  I began a food journal documenting what I ate and my resulting symptoms, if any. I weaned down on the Zantac and Prilosec and eventually stopped both. (FYI..neither of these meds should be quickly stopped.)

 

Two weeks later, I sat in the exam room with my primary physician as she reviewed my medication list.  "Still on the Flonase? "Nope" The Advair? "Nope" How 'bout the Prilosec? "Not that or the Zantac. I'm off everything and I have good news. I am very happy to report that my cough is gone!! I think I'm allergic to gluten.  Can we run some tests, get some bloodwork?"

 

The bloodwork came back as normal, no allergies or sensitivities were identified, but my doctor said "I wouldn't focus so much on the tests as your experience.  You're the best judge of what works and what doesn't. If you cough after eating gluten, I'd suggest sticking with what you're doing." Wiser advice I have not heard.

 

I have continued to be mindful of my eating and have begun a trial and error period.  When my breakfast is nuts, yogurt and a banana, I am fine.  When I eat an omelette but try to sneak down a piece of rye toast, I cough the familiar bronchial cough, but it stops after a while. I'm grateful that my response is not life-threatening, just inconvenient and frustrating. 

 

The lesson for me is clear.  Although I was attentive and responsive to seeing multiple specialists (a pulmonologist first, then a gastroenterologist and finally an ENT), and compliant with all diagnostic testing, and even took the prescribed medications, I failed to listen to even what I was saying---"it's worse after I eat."  I had never considered that it was WHAT I was eating!!

 

Pay attention to your symptoms, write them down, keep a journal, note what makes things worse and what makes things better.  We, patients, need to be engaged in our care and not simply passive recipients.

 

While I sure will miss hoagies ("mayo, no hots, sweets on the side"), and my pretzel rods, at least dark chocolate is still on my "OK" list.