24/7 Respiratory Triage & Post-Viral Airway Evaluation · Texas & Louisiana
3-Week Lingering Cough, Post-Viral Bronchitis & Airway Triage
A cough that hangs on for two to six weeks after a cold or flu is the number-one respiratory reason adults book a Virtual ERs visit in Texas and Louisiana. During a 24/7 video exam, our emergency physicians and nurse practitioners check your breathing effort and fever curve. We separate post-viral bronchial sensitivity and sinus drainage from bacterial pneumonia that needs a chest X-ray.
Shared TX & LA 24/7 Solv Queue: One booking link serves all 254 Texas counties and all 64 Louisiana parishes.
Symptoms & Presentations Evaluated on Video
- Dry or wet cough lasting 2 to 6 weeks after a head cold or flu has cleared
- Nighttime coughing fits triggered by lying flat, cold air, or talking in long sentences
- Throat tickle and frequent throat clearing from post-nasal drip
- Mild chest tightness during recovery from viral bronchitis
- Two-phase illness ("double-sickening") where a cold seemed better and then came back with a new fever and deep cough
- Questions about whether a lingering cough is still contagious at work or home
How Our Clinicians Evaluate & Manage Your Care
Your clinician reviews your timeline, listens to your breathing on video, and explains why your cough reflex is still firing. Instead of guessing at random store syrups, you get a targeted recovery plan matched to the real cause of your cough, plus clear rules on when a chest X-ray is needed.
How We Evaluate a Lingering Cough on Live Video (Clinical Pulmonology Protocol)
Grounded in clinical pulmonary guidelines (Assessment and Management of Chronic Cough), cough duration and breathing observation tell a clinician what is driving the reflex:
Clinical Duration Mapping (Under 3 Weeks vs. 3 to 8 Weeks)
We map your exact timeline. An acute cough (<3 weeks) is usually a fresh viral cold or bronchitis. A subacute cough (3 to 8 weeks) is most often post-viral bronchial nerve sensitivity or sinus drip. Any cough past 8 weeks needs chest imaging.
Full-Sentence Speech & Resting Breath Count
On camera, your clinician listens to you speak a full sentence without pausing for air, counts your resting breaths (<20/min in adults), and listens to the sound of your cough.
The "Double-Sickening" & Pneumonia Screen
Uncomplicated bronchitis rarely causes a new high fever in week two. We check your temperature log, heart rate, and screen for sharp chest pain when taking a deep breath.
Upper Airway & Nighttime Reflux Check
Many 4-week coughs come from post-nasal drip or silent nighttime acid reflux irritating raw throat nerves rather than a lung infection.
Why Am I Still Coughing? Clinical Differential Matrix
Here is how our Texas and Louisiana clinicians separate the five main causes of a lingering cough on video:
| Clinical Presentation | What We Check on Live Video | Care Plan vs. In-Person Escalation |
|---|---|---|
| Post-Viral Bronchial Sensitivity (Subacute Bronchitis) | Normal temperature and calm resting breathing; cough triggered by cold air or talking 2 to 6 weeks after a cold | Caused by raw bronchial lining nerves after a virus; managed with targeted cough-reflex calming steps |
| Upper Airway Cough Syndrome (Post-Nasal Drip) | Mucus dripping down the back of the throat, frequent throat clearing, worse as soon as your head hits the pillow | Targeted upper-airway and sinus drainage plan to stop throat nerve irritation at its source |
| Cough-Variant Asthma or Reactive Airway Flare | Dry cough waking you between 2:00 AM and 4:00 AM or chest tightness with brisk walking | Airway reactivity review and personalized breathing plan; immediate ER care if short of breath at rest |
| Paroxysmal Cough ("100-Day Cough" Pattern) | Back-to-back coughing fits followed by a deep gasp for air or nausea after coughing | Evaluated for exposure timeline, household protection steps, and local diagnostic swabbing |
| Community-Acquired Pneumonia | New fever >101°F, shortness of breath at rest, pulse oximeter <94%, or sharp chest pain when breathing in | Requires an in-person lung exam and two-view chest X-ray at Bellaire ER or your nearest local ER |
When to Seek Immediate In-Person Emergency Care
Go to an emergency room or call 911 if you are short of breath while sitting still, coughing up blood, feeling sharp chest pain when breathing in, reading below 94% on a home pulse oximeter, or running a new high fever after your cold seemed to improve.
Real Texas & Louisiana Telemedicine Scenarios
Four-Week Post-Cold Cough Stopping Sleep at Night
Situation: A 42-year-old in Harris County had a cold three weeks ago. The fever is gone, but every night at 11:30 PM a dry tickling cough starts as soon as he lies down.
Video Evaluation: Dr. Michelle Chan checks his breathing effort on video, rules out pneumonia warning signs, and identifies post-viral airway sensitivity mixed with sinus drainage.
Outcome: He starts a targeted nighttime airway and sinus care plan and sleeps through the night.
Spotting Walking Pneumonia That Needed a Chest X-Ray
Situation: A 55-year-old in Lafayette Parish has coughed for 12 days and yesterday developed a new 102°F fever with right-sided chest soreness.
Video Evaluation: Our Louisiana clinician spots the classic "double-sickening" pneumonia pattern on video and checks his home pulse oximeter reading (93%).
Outcome: The clinician routes him straight to an in-person chest X-ray and emergency exam without delay.
Verified Clinical Team · Statewide 24/7 Texas & Louisiana Telemedicine
Meet the Physicians & Nurse Practitioners Behind Your Care
Every video visit is conducted by our licensed emergency physicians, family medicine physicians, physician assistants, and emergency nurse practitioners. Our clinicians provide hospital-grade 24/7 telemedicine anywhere in Texas and Louisiana.
Emergency-Trained Clinical Depth, Delivered Statewide From Home
Unlike generic telehealth call centers, Virtual ERs is staffed by practicing emergency medicine clinicians who evaluate acute symptoms over live HD video, coordinate same-day care plans in your neighborhood, and guide in-person diagnostic or emergency escalation whenever needed.
Meet all 15 physicians & nurse practitioners on our team →
Common Questions
Why does a cough last 3 or 4 weeks after a cold is already over?
Respiratory viruses shed the top protective layer of your bronchial lining and leave the cough nerves underneath raw. Even after the virus is gone, cold air or talking sets off those nerves until the lining finishes healing.
Does green or yellow mucus prove I have a bacterial lung infection?
No. Green or yellow phlegm comes from normal white blood cells clearing out old cells at the end of a viral cold. Clinicians look at your fever curve, breathing effort, and whether you got worse after initially improving.
When does a lingering cough require an in-person chest X-ray?
You need an in-person lung exam and chest X-ray if your cough comes with a returning fever, shortness of breath at rest, pulse oximetry below 94%, coughing up blood, chest pain, or a duration past 8 weeks.
Am I still contagious if I have a post-viral cough 3 weeks after a cold?
Usually not, if you have been fever-free for several days and your other cold symptoms are gone. Your clinician can review your exact timeline during a video visit and provide a return-to-work note if needed.
Ready to Start Your 24/7 Video Evaluation?
Connect from anywhere in Texas or Louisiana with no app download and no waiting room.