A chest infection, three weeks of coughing, and I am back where I started

Eighteen months out and I thought this was behind me. Then I picked up a chest infection in May, coughed solidly for the best part of three weeks, and by the end of it I was back in pads for the first time since the autumn.

What has knocked me sideways is how fast it went. Not a gradual slide, not months of getting lazy with the exercises. Three weeks of coughing and it was as if the whole of last year had not happened.

The cough has settled now and things are slowly improving, but not back to where they were, and I have spent a fortnight being fairly grim about it. Is this the sort of thing that comes back on its own or have I actually lost ground? And is there anything sensible to do while you are coughing, other than stop coughing, which was not on offer.

Hay fever does the same thing to me every June and it took me two years to notice the pattern, because I kept filing it under "getting worse" rather than "it is June".

Mine was a winter of my youngest bringing home everything going. I remember thinking that a cough is not exercise, so it cannot possibly count as doing something to me, which in hindsight was a strange thing to believe given that coughing is the exact thing I leak on.

I want to separate what I can say from what I cannot, because there are two questions here and only one of them is answerable from a forum.

The answerable one is whether three weeks of coughing is a plausible amount of load. It is. Coughing raises pressure inside the abdomen sharply and repeatedly, and it is one of the events people leak on in the first place, so a fortnight or three weeks of it is not a neutral background condition that happened while the real story was elsewhere. It is the story. Lindsey has just named the seasonal version of the same thing and I would guess more people on this board have that pattern than have noticed it.

What I would not do is read it as eighteen months undone. The threads on this board where somebody lost ground for a reason and then reassessed almost never end with the ground being gone, and the ones where somebody assumed it was gone and quietly stopped are the ones that end badly. Symptoms getting worse under a load is information, not a verdict.

The thing I would actually change is the record. This is the sentence I repeat more than any other on this site: write down the point at which the symptom appears, not just whether it appeared. Yours currently reads "back in pads", which is a yes or no answer and cannot show you a recovery in progress. The version that can is which cough, at what point in the day, after how many. If that threshold is climbing week by week you have evidence you are coming back, and if it is flat for a month you have evidence worth taking to somebody. I nearly filed my own week nine as no change because I was watching for a yes or no.

On what to do while it is happening, I am not going to give you a technique in my own voice, because I am not a clinician and I have never examined anybody. What I will say is that the timing skill people are taught in clinic exists precisely for events that raise pressure, and whether it is appropriate for you and for a three week cough is a question for the person who treated you rather than for me. Bracing before a cough or sneeze sets out what it is and, importantly, who it is the wrong instruction for.

The unanswerable question is what your fortnight of not quite recovering means. Nobody here can tell you whether that is a slow return or something that has changed, and the honest position is that a symptom that came back and has not fully settled is a reason to be seen rather than a reason to wait it out. Find out whether you can refer yourself back into the same service and whether there is a time limit on it. Keeping it up after discharge covers that, and when physiotherapy is not enough covers the conversation that follows if a fair trial has been had and the symptom is still there.

One last thing, and it is the part I feel most strongly about. A cough that goes on for weeks is a thing to have looked at in its own right, by a doctor, separately from any of this. That is not pelvic floor advice, it is just true.

Later than I meant to report back.

I started writing down which cough rather than whether, as suggested, and it has been quietly convincing. Early June it was most of them. By the end of July it was the hard ones first thing in the morning and almost nothing after that. I would have sworn in June that nothing was improving, and my own notes say otherwise, which is a bit humbling.

Chest was looked at, nothing sinister, and I have an appointment with the pelvic health service in September because the self referral window turned out to be two years rather than one. Still not back to where I was in April. Closer than I thought I was.

Two years rather than one is worth somebody else reading. I assumed twelve months and never checked, and mine has probably expired while I was assuming.