Voice Science provides evidence based speech therapy for chronic cough in Melbourne, Canberra and online.
We help provide strategies and deliver therapy to people who are struggling with chronic cough. Applying latest clinical knowledge, we strive to give you the information and strategies recommended to reduce the incidence of coughing if chronic cough has been diagnosed.
What are some common causes of cough?
The most common medical causes of coughing are: asthma, gastroesophageal reflux, post nasal drip, eosinophilic bronchitis, smoking, lung conditions and vocal fold dysfunction.
Chronic cough is diagnosed when these conditions are ruled out by your general practitioner. Research shows that 80% of patients with cough will see repression of the cough with medical intervention for these conditions. Some 20% of individuals with cough do not respond to such treatments. Speech pathologists work with this 20%.
What is chronic cough?
Chronic cough (or chronic refractory cough) is a very frustrating condition that results in often constant, long term coughing without a known cause. This condition is diagnosed when your medical team can not identify a clear causing agent behind the persistent cough. Individuals with chronic cough often feel like they have exhausted all treatment options for eliminating the cough and may have had numerous medical examinations to rule out respiratory diseases like asthma, bronchospasm, gastroesophageal reflux, allergies, neurological conditions…
The term chronic refractory cough or chronic cough is used to describe a cough that has lasted for more than eight weeks.
Coughing can be so violent that it can lead to incontinence, vomiting or rib fracture. It also frequently leads to limitations on social participation and interaction and can result in social isolation and even depression when symptoms do not ease up.
Why am I coughing in the first place?
Coughing provides protection to your body by clearing your lungs and breathing tubes from things that cause irritation. This includes secretions, mucous, foreign particles.
Coughing is necessary if you are suffering from a chest infection or if some food or drink has gone down the wrong way when swallowing.
Individuals who experience chronic cough are most often coughing even if their is no substance that needs to be cleared from the airway. We call this an unproductive cough.
The cough arises from unidentifiable irritation and can be sudden, violent, explosive and often impossible to repress.
Why can’t I stop coughing?
The big challenge with stopping a chronic cough is reducing irritation. Chronic cough is like a vicious cycle- the more you cough- the more the voice becomes irritated which leads to further coughing. It is important that speech pathology strategies are implemented with an action plan so that when you have the urge to cough, you have a strategy to prevent it occurring as best as possible so that irritation reduces which generally results in coughing reduction.
What are some typical symptoms of chronic cough?
The following symptoms are often characteristic of chronic cough
- An irrepressible urge to cough that has lasted more than 8 weeks
- A cough that can not be solved with medical treatment
- voice quality impacts- your voice may become husky, rough, breathy or damaged from frequent coughing episodes
- voice breaks
- a dry unproductive cough
- Chest muscle pain
- Urinary incontinence from coughing
- loss of sleep due to rousing coughing bouts in the night
- rib fractures
- quality of life impacts
At Voice Science we will take a thorough assessment into cough behaviours and identify potential triggers or irritants that may be contributing to the cough. The assessment session will involve a few clinical tests including:
- Comprehensive speech pathology case history
- The Newcastle Laryngeal Hypersensitivity Questionnaire
- The Voice Handicap Index
- The Reflux Index
- The Leicester Cough Questionnaire
- The Urge to cough test
- Paradoxical vocal fold movement assessment
We will also undertake a comprehensive acoustic voice assessment. The analysis provides vital insight into the vibratory behaviour of your voice muscle. The assessment will also include investigation of pitch features, voice quality, respiration, resonance, projection, vocal range and amplitude. This part of the assessment ensures that vocal irritation is not contributing to the incidence of cough.
How is chronic cough treated by speech pathologists?
Current best practice recommends that speech pathologists apply a behavioural therapy approach to the management of chronic cough. Generally a trial period of voice therapy is recommended to rehabilitate the larynx and provide you with strategies and exercises to assist in suppressing the cough.
We stay up to date with latest research papers investigating speech pathology methods for chronic cough elimination. Our goal is to trial measures that restore your tissue to its original structure and reduce the irritation that is accounting for coughing.
Voice Science provides chronic cough therapy in Melbourne to local clients. We also treat from Melbourne to Bangkok, New York, Sydney, Perth … wherever you are via our global service. Face to face voice therapy and voice treatment is offered in Melbourne at our Collins St clinic.
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