Hello...I am sorry for her symptoms.
By what you say I feel that she has severe persistent asthma or severe COPD as per GINA guidelines and international recommendations and classification.
It is classical to present intermittently like this.
My suggestions for her -
1. Oral Prednisolone at 20mg thrice a day dose for 2 - 3 days.
2. Inhalers are the newest management strategies for this. I suggest the use of Formoterol+Budesonide metered dose inhaler (100mcg) 4 puffs twice a day through a spacer and this is for regular use for 2 weeks and then you can taper down to 3 puffs twice a day for another 2 weeks and then stabilize at 2 puffs twice a day to continue. Another metered dose inhaler is Levosalbutamol and this can used as rescue therapy whenever you are having severe cough in spite of regular usage of Budesonide- Formoterol. The technique is very important and very crucial for the drug to be delivered correctly to the lungs. Regularity of medicine usage also matters a lot. So do not discontinue abruptly after you notice some improvement. The technique of administering an inhaler using a spacer has to be taught to you by your doctor and these are prescription medicines. So I suggest you consult your physician for this.
3. Tablet Monteleukast 10mg once a day in the evening at 6pm daily for 3 months.
4. Triggers can be environmental changes/ dust/ talcum powder/ seasonal changes/ un-cleaned a/c vents/ cold weather etc....we cannot specifically say this is the cause - unless we observe closely - best person is yourself.
5. She will require a spirometry.
6. If these doesn't work then we need to think about a restrictive lung disease as an occupational exposure related issue. The other possibility is an evolving interstitial lung disease (but extremely unlikely as breathlessness would be the predominant symptom than cough).
I sincerely ***** ***** I have helped you today!
Is there anything else where I can be of assistance to you in this regard please. We can continue here until you are satisfied, simply use the reply box and let me know.
Kind regards ***** ***** Sumanth Amperayani