FROM NORTH AMERICA SYNDICATE, 300 W 57th STREET, 15th FLOOR, DEAR DR. ROACH: A year ago, I had cardiac bypass surgery. Everything went great: I had no pain. In a sense, it didn’t even feel like any surgery took place, except for the incision and drainage tubes, which were a good physical reminder.

About a day or two after getting home, I started coughing. I would cough and cough and cough. It started when I would lie down, and sitting up initially helped. Later, I was coughing all the time. Cough drops or syrup didn’t help. The doctors could not find any fluid around my heart, or anything out of the ordinary.

To make a long story short, my doctor prescribed a short course of steroids and then benzonatate, which was the only thing that would stop my cough. I still cough occasionally, but nothing like it was. What would have caused a post-surgical cough? — K.C.

ANSWER: There are many possible causes for cough after surgery. During surgery, a plastic tube is inserted into your airway so the machine can breathe for you: This can cause irritation, and is a frequent cause for cough. (That usually lasts only a few days.) Fluid overload can also do it. Infection in the lung is probably the biggest concern. Often, medications that are started after surgery, especially ACE inhibitors (their generic name ends in ”-pril,” like ”lisinopril”), cause cough after being on them a short while. The nerve to the diaphragm, the phrenic nerve, can be damaged or irritated during surgery, causing a cough that might last for months.

Benzonatate is a non-specific cough remedy: It is modestly effective at suppressing cough of any type. The short course of steroids makes me wonder if there was a suspicion for reactive airway disease (on the asthma spectrum). Some people without any history of asthma still may have some asthma symptoms, especially cough, after surgery.

DEAR DR. ROACH: I’m a 67-year-old male. I occasionally get lower-back pain. I’ve been reading about inversion therapy (hanging upside down), and would like to know if there are any benefits from this activity, or if it is just another fad. I was wondering if this would be a safe method of relieving the pain and as a form of exercise for overall general health. Are there any risks? — L.C.

ANSWER: There are many causes for back pain, but in some people, the cause is pressure on the nerve roots by the vertebrae. There have been many attempts to relieve that pressure: Older readers will remember when people used to be put into traction. Inversion therapy, which puts someone upside down via a wide variety of devices, is another way of taking pressure off the nerve roots. It can provide short-term relief; however, it has been found to be ineffective in long-term use.

There are several possible risks. The biggest probably is that the pressure in the eye increases dramatically, so it is not recommended for people with glaucoma. After a few minutes, blood pressure tends to increase and the heart rate slows, which can be a problem in people with poorly controlled high blood pressure or some types of heart disease.

The position itself is not a general exercise. There certainly are good exercises involving your body in upside-down positions, but these are separate from inversion therapy for back pain.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.

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