How long do I need to follow my protocol instructions? Although many patients notice an improvement in their cough after the first 2-3 weeks, it is important that the larynx has recovered entirely before discontinuing the guidelines provided to you. Although you may be doing much better in regard to your coughing behavior, the larynx can take quite a while to recover (>8 weeks) and be prone to injury very easily during this recovery time. Your doctor or SLP will instruct you on when you can begin to wean from the protocol instructions.
I don’t have reflux so why do I need to take reflux medicine and/or follow a special diet? Even if reflux is not believed to be significantly contributing to your cough, you will still be placed on a reflux management protocol. It is important to follow these guidelines to minimize the potential for even occasional reflux further damaging the already sensitive larynx during this recovery process.
How long will it take for my cough to get better? Many patients notice a significant improvement after the first 2-3 weeks. How dramatic a change you notice is usually dependent on how well you are able to follow the protocol instructions and how effectively you are able to reduce your amount of volitional coughing and throat clearing.
Of course, a more severely irritated/sensitive larynx will typically take longer to recover than a more mild case. Your SLP can provide general guidelines for your recovery time on this basis, although recovery is always dependent of how well you are able to comply with the protocol guidelines, especially regarding cough avoidance.
Why do I have to restrict my voice use? It has been determined that your coughing is the result of a very irritated larynx (voice box). Although the reasons for how it became irritated can vary, there is usually a degree of inflammation/trauma involved in the irritation. By limiting your voice use and preventing voice use that may be further traumatizing to the larynx (such as yelling), the larynx is allowed to recover without risk of further trauma. Consider it similarly to being careful with a sprained ankle while you are trying to allow it to recover. You wouldn’t likely jump or run on it during the recovery period. Same thing!
Why are cough drops bad to use? There is very little, if any, cough suppressant medication in most cough drops. Also, it is important to remember that patients with a irritable larynx do not receive any benefit from typical cough medications. Besides not benefiting from any medicinal effect, these drops typically contain menthol and/or eucalyptus which are EXTREMELY IRRITATING to the larynx. In other words, they serve to make the larynx more irritated, which is the primary issue we are trying to correct with your chronic cough!
The primary reason patients feel relief from using cough drops has to do with the lubricating effect they have on the throat. Well lubricated surfaces of the throat are typically less sensitive, although the menthol/eucalyptus will quickly cause a notable irritation once the cough drop is gone. This is why some people are constantly sucking on cough drops. They experience relief when using them, then once the drop is gone, a notable throat irritation is left, prompting them to “need” another drop.
The soothing effects of the cough drop’s lubrication property can be experience by sucking on a hard candy instead. In fact, this is far more helpful as candy drops/disks have the same lubrication/soothing effects, without the harsh irritation of the menthol/eucalyptus.
NOTE: Avoid mint and sour hard candies as these can also be irritating; butterscotch disks and similar are generally recommended if you find this helpful.
Why do I need to sleep with a humidifier? The throat is designed to be moist. A lack of moisture/lubrication can result in more sensitive tissues. This is why drinking water and sucking on hard candies can help sooth an irritated throat.
During the day, we typically breathe through our nose, which serves to moisten the air we inhale. At night, however, most adults tend to breathe through open mouths when sleeping, which does not have the same ability to humidify the air. In fact, breathing through the mouth dries the lining of the mouth and throat, allowing for increased irritation. This is why many patients report waking up coughing. Sleeping with a humidifier may help improve the moisture in the throat, reducing the potential for further irritation/sensitivity.
How does swallowing help keep me from coughing? Coughing is a traumatic event where the vocal cords clap together forcefully. Think about clapping you hands together, frequently, all day long. Your palms would be sore and irritated. Now imagine how your vocal cords must “feel” after a day of coughing!
When we swallow, the vocal cords come together, as they do during a cough, but in a much more gentle manner. In this sense, swallowing can act similar to “rubbing an itch” instead of harshly scratching an itch, as when you cough. In many cases then, swallowing can help to lessen the itch or tickle, perhaps not the same as a cough, but enough to where you feel you can manage without coughing or throat clearing. This saves your vocal cords the trauma of the cough! The more often you are able to do this, and avoid a cough, the more your vocal cords are able to recover, becoming less and less irritated.
Just as coughing can make you more irritated and need to cough more; not coughing can reduce your need to cough.
Copyright 2011-2013 Katrina M. Jensen, M.A., CCC-SLP, PLLC