Trucker MD
Hacking, hurting and stroke recovery

By John McElligott, MD

I have a persistent, dry cough that I can’t get rid of. What could that be?

I can tell you that the most common cause of a persistent dry hacky cough is a medication called an ACE inhibitor, which means angiotensin-converting-enzyme inhibitor. That may be Greek to you, but it’s used to treat hypertension and protect kidneys in diabetics who may or may not be hypertensive. Cough is a side effect. If you take blood pressure meds, you should discuss this with your doctor.

The No. 2 cause is smoking. If you are not a smoker, do you have a co-driver or partner on the truck with you who is a smoker? Second-hand smoke is also a dangerous irritant.

The No. 3 cause is allergies with postnasal drip for the ethmoid sinuses. A slow and constant nasal drip caused by draining sinuses can cause coughing and maybe a sore throat.

Postnasal drip can lead to a sinus infection and infection of the upper respiratory tract. Don’t assume sinusitis (or sinus infection) will get better on its own. It needs to be treated.

Again, it’s hard to diagnose a cough. But if it persists, you need to continue your quest to find out what it is.

I have just been diagnosed with rheumatoid arthritis. I think truckers need to know a bit about the different kinds of arthritis. I have always had crooked fingers and toes, but I thought it was something I was born with. 

Osteoarthritis (OA), which is the most common form, is caused from everyday wear and tear. However, it can be seen in families so there may be a genetic disposition. The most common sites for degenerative joint disease or OA are the knees, hips, lower back and smaller joints as one overuses them or ages. The cause is primarily gravity. If you were to live on the moon, chances are you would not have OA.

From there, the list is overwhelming and consists of 20 plus different diagnoses ranging from psoriatic arthritis to systemic lupus erythematosus.

Treatment varies from simple over-the-counter medication to high-powered immunosuppressants. 

I am a longtime professional driver, not yet 60 years old. I am recovering from a stroke. I’ve heard you talk about this on the radio. Can you share some tips on how I can recover and get back behind the wheel?

Recovery from a stroke is a lifelong challenge. Taking into account your condition, behavior and heredity, you and your doctors must be vigilant in order to obtain maximum recovery and – in extreme cases – prevent a vegetative state. So where do you start?

Make sure the condition that caused the stroke has been identified and treated – e.g., high blood pressure, diabetes, heart disease, high cholesterol, sickle cell disease, obesity and, most important, a previous TIA or mini stroke.

Medication to override heredity is used when appropriate.

Modifying behavior is a must. Smoking, diet and amount of exercise must change.

Begin a lifelong rehabilitation program to maintain your daily activities. Several initial steps following a stroke are paramount in one’s rehabilitation:

Be patient and make sure you don’t fall into a deep depression. Stroke patients often make near full recovery. This is assuming that the condition is treated, the behaviors are eliminated, and heredity is controlled. Depression can be the first nail in the coffin if not recognized and treated.

Give your brain time to heal. The body has an amazing way of rewiring the circuits to get the arm, leg or whatever moving again.

Find a physical therapist who knows that the importance of time in maintaining muscle tone is the cornerstone to recovery. If speech or vision is lost, you will need to add others to the team. Don’t forget a good doctor.

Take the rehabilitation time to get on a good diet that maintains your health along with a supplement that contains vitamin D and omega fish oil.

Remember that DOT mandates that with a TIA or stroke you are done driving for at least one year. So be sure to spend the time wisely. LL

John McElligott is an MD, Fellow of the American College of Physicians, and medical director of the St. Christopher Trucker Development and Relief Fund. Jeff Heinrich, who serves as the column's medical editor, has a Doctor of Education degree and is Physician Assistant Certified.

This column is the opinion of the writer and does not necessarily reflect the opinions of Land Line Magazine or its publisher. Please remember everyone's health situation is different. If you have questions regarding medical issues, consult your personal physician.