Sharon,
I am continually amazed to hear that people alert their doctors to symptoms for which there are solutions and the doctor ignores them. And the patient (or in the case the mom) even has a hunch as to what is causing the problem. I keep wondering when the medical profession will catch up and treat allergies, irritants, and chemical sensitivities, especially in pulmonary cases. These kind of things are even responsible for all kinds of "unexplained" ailments that people complain of.
Okay. So what do you do? I think the other posters had some great ideas and I would just like to add to them. I can't diagnose your child. But I will tell you my doctor's explanation to me when I had a similar problem. I had what is commonly refered to a "post nasal drip" which just about everybody seems to complain about. Exept for CF patients this could be real problem.
I alway slept propped up due to coughing attacks that would start when I would lie down. I would eat scratchy crackers, take a sip of wine, I didn't know what to do. You found a temporary solution and as you say you already know that Benadryl and prednisolone is quick fix and not a very good one. I'm amazed that a doctor would prescribe prednisolone for that use.
You noticed that these drugs stopped your daughter from coughing. Here's why: Benadryl is an antihistimine. It blocks the action of histamine which is the cause of many allergic symptoms (after exposure to irritants). Prednisolone is a synthetic adrenal cortisteroid which has anti-inflamatory properties by blocking certain hormones. It is usually used for real flareups, not casually. It can cause real harm by taking it for single episodes. That's why doctors are careful about prescribing it and wean people slowly off of it. Because your daughter responded so well to these anti-inflamatories, you wondered whether inflamation seems to be causing her cough. Did you discuss this aspect with your doctor?
For me, the night-time coughing was due to allergens/irritants (dust, dust mites, molds, pollution, fragrances, chemicals, cleaning supplies, carpets etc.) which caused inflamation. My sinuses would drip slowly down and irritate my lungs, bringing on an asthmatic response (coughing), sometimes SOB, and at times, irritated my esophagus ( lung/reflux issues sometimes go hand and hand).
The only way to stop this is to remove the source. I had to remove the allergens/irritants in my house, use an air filter, remove carpets, put allergy protectors on pillows and matresses, keep pets out of the bedroom (I don't have any), stop using fragrances, buy a hepa/charcoal filter vacuum...you get the idea.
At the same time, my doctor treated me for the asthma component of CF and as some people mentioned in addition to the usual CF drugs (including Spiriva,and Asmanax) added Singulair, Claritin; Nasal sprays like Nasonex, Nasalcrom, Astilin. Plus Nasal Rinses.
If you can't convince your doctor to check her sinuses, identify allergies (sometimes tests are negative but they can't test for everything in the world) test for asthma, you must seek out another doctor or at least get a second opinion. And keep looking until you are satisfied.
There have been some other recent threads about inflamation and the asthma component part of CF that you might look for.
