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The cough you can’t get rid of…

You can’t stop coughing and you’re embarrassed to be out in public.  Not only are you embarrassed, you’re afraid to go out.  It comes on suddenly, sometimes it’s triggered by someone’s perfume, other times it might be reacting to some chemicals in the air, or smoke.  But, the problem is when you start, you cannot stop.  

You might experience incontinence, or muscle pain because you cough so much and so hard.  Your throat hurts, your voice sounds weak and raspy, and sometimes you just can’t even breathe.  

Yep.  I hear you.  And, I feel you.  It’s called a chronic cough or vocal cord dysfunction (VCD) and it’s horrible.  It’s very debilitating; it causes you to be unable to speak, do your job, socialize, so you isolate yourself socially. Very few people want to go out in public and cough, especially during the era of COVID-19.  You can’t be around any scents without feeling like your throat is closing up on you.

Most people do not realize that a speech language pathologist (SLP) can help with that!  

This chronic cough is not something you have to live with for the rest of your life.  There are cough suppression strategies and a plethora of other strategies and exercises that can help you.  It’s all about stopping the negative cough cycle, which is:  you sense an irritant, so you cough, and your larynx becomes irritated, which makes you have to cough, which increases the irritation, which increases your feeling of the need to cough.  

The more you cough, the more sensitive your larynx becomes, and it becomes more irritated with less stimulus.  Pretty soon, you become tense, anticipating these coughing episodes, which causes muscle tension, and it’s the perfect storm for vocal hoarseness and/or strain and -MORE LARYNGEAL IRRITATION, which increases the feeling of the need to cough.  

This cough is sometimes first diagnosed as asthma by the doctors.  They may prescribe inhalers and other medications to help decrease the urge to cough, but if it’s VCD, those medications won’t help very much.  It can also be misdiagnosed as reflux…

And THAT is when you call me!  (704-264-0528)  Tell your physician that you want a referral for speech therapy at Resurgence Neuro Rehab.  I can help you!

Here’s another tidbit for you, too.  Sometimes a different type of chronic cough/VCD can come after a viral infection and that is called a neurogenic cough. It’s an actual infection of your tenth nerve, that goes from your brain to your vocal folds, all the way down to your stomach.  The tenth nerve, Vagus, is responsible for several essential bodily functions. Sometimes after viral infections (a cold, an upper respiratory infection, OR AFTER COVID) the infection stays in the nerve, and creates irritation, aka neuropathy (yes, like the feeling of tingling that diabetics can get in their feet when it’s not managed) It can be helped with medication, but it requires a differential diagnosis from an SLP to determine if the cough is neurogenic in nature OR from reflux.  

So, what does therapy for chronic cough look like?

  1.  The Evaluation:  I will scope you and look at your throat and your vocal folds while you complete a variety of speaking tasks.  I will test your lung capacity and future out how coordinated your breathing and your phonation (making voice sounds) is.  I will have you fill out a few questionnaires that will help me determine the origin of your cough.  I might also do an acoustic assessment or a behavioral voice assessment depending on what you might need at that time.
  2. I will analyze all that information, make a therapy plan that is specific to you and your complaints, and send it to your doctor. If the signs point to a neurogenic cough, I will ask your doctor to consider prescribing medication.  *I am not a doctor, so I cannot prescribe medications nor can I tell your doctor to prescribe medication.  
  3. I will work with you to help you cough less, breathe better, and reduce any strain or tension in your voice so that you can get back to your life!  This type of therapy involves an intensive home program, which means that you won’t have to come to therapy as often, but you will have to work on strategies and exercises in your home environment, so that you can actually use them in your own environment.  

 

Easy peasy, lemon squeezy?  No, not really, but it will be worth it!

It is a lot of work and it’s not easy to remember to sniff when you’re in the middle of a coughing fit.  BUT, if you can practice it when you’re not having coughing fits, the use of strategies can be more easily used when in distress.  Also, changing your vocal habits takes a lot of awareness and behavioral adjustments to improve vocal quality. Therapy for VCD takes practice and guidance; I’m here to tell you that you can do anything you set your mind to and I am here to help you get rid of that cough!

 

Do you have a cough that you can’t get rid of?  Download my referral form from my website and take it to your doctor; tell them you want Michelle from Resurgence Neuro Rehab to help you.