Monday, September 30, 2013

Chronic Cough

My boss is a 63 year old male who has suffered w/chronic cough for nearly 15 yrs. He's seen over a dozen doctors, been through every test imaginable, tried countless medications and nothing has helped. I began researching Vocal Cord Dysfunction about 6 months ago and this last series of tests confirmed that this is most likely the problem. He was advised that raising his pitch will elevate the need to cough. He was also informed that his vocal cords operate backwards? Forgive me because I don't really understand, but apparently upon inhale they're closing and on exhale they're opening? Whatever is going on, it's horrible. He's absolutely exhausted. He's a mental health professional who facilitates workshops to the public. His coughing has become debilitating. Please help!! It's not acid reflux, he's not a smoker, it's not sleep apnea, he doesn't have allergies, not too much mucus. Could a vocal cord problem be causing all of this coughing? How can we fix it? Thanks so much for any help you can offer.

Melissa Kim M.S., CCC-SLP replies... 

To start, I would suggest that he seek out consultation with a laryngologist (an Ear, Nose, and Throat physician who specializes in laryngeal disorders). An accurate diagnosis is necessary to establish an appropriate treatment plan, and this is just not something that is possible via email.

 Speaking more generally, the differential for chronic cough is very broad, including pulmonary disease, medication side effect, acid reflux, sensory neuopathy, and behavioral cough. If cough is related to "irritable larynx syndrome," which can include cough as well as paradoxical vocal fold motion, then relief with is obtained with acid reflux management, expert speech pathology intervention, and use (as necessary) of medications to change the nervous system's threshold for triggering the cough and paradoxical motion. A voice center where a speech language pathologist partners with a otolaryngologist to treat patients in a combined fashion would most likely have a team that is familiar with this disorder.

Best of luck to you!

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