Lung Disease and Your Throat

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1 Lung Disease and Your Throat Presented by Beth Causa Speech Pathologist Wollongong Speech Pathology With sincere thanks to Kate Baumwol Speech Pathologist, Western Health (Perth) For sharing the contents of this presentation

2 Aims 1. Normal Larynx 2. Facts about coughing 3. Speech Pathology and chronic coughing 4. Increasing control over coughing 5. Breathing difficulties and vocal cord dysfunction 6. Voice issues and vocal hygiene

3 Larynx : Voice Box

4 Larynx: Voice Box Breathing in Talking Breathing out

5 Chronic Coughing

6 What happens when we cough or clear our throat Vocal cords slam together Can be damaging to the vocal cords

7 Coughing fact 1 Reflex: triggered by an irritation OR Deliberate: e.g. to clear something from the throat

8 Coughing fact 2 Heal the body Clear secretions or phlegm Clear infected material Protect the body Clear food from the airway, if swallowed the wrong way

9 Coughing fact 3 Not always necessary Chronic coughing: occurs only due to the irritation; there is nothing to be cleared from the lungs Irritation Coughing Coughing Irritation

10 Coughing fact 4 Controlled by the brain Both automatic AND under conscious control In speech pathology treatment we aim to increase your voluntary control of cough

11 Coughing fact 5 Most common causes of cough: Asthma Reflux Post nasal drip Bronchitis Smoking Lung pathology Vocal cord dysfunction

12 Coughing fact 6 Speech pathology is for patients who have: 1. No known cause for their cough 2. Cough despite treatment for asthma, post nasal drip and gastroesophageal reflux 3. Vocal cord dysfunction

13 Coughing fact 7 80% of patients with chronic cough are helped by medical treatment 20% of people with chronic cough are not helped and may benefit from speech pathology treatment 20% 80% Medical Treatment Speech Pathology Medical treatment is effective for most people with chronic cough

14 What to do about a chronic cough

15 Reduce irritation Avoid exposure to smoke Breath through your nose Increase hydration Reduce dehydrating substances e.g. alcohol & caffeine Managing reflux Suck on non-menthol lozenges Inhaling steam

16 Conscious control over the cough Although irritation may build up in the throat it is still possible to control the cough What feelings happen before you actually cough? Prevent the cough by replacing it with a Cough Suppression Swallow

17 Cough Suppression Swallow At the very FIRST sign of a cough 1. Push hands together 2. Head down towards your chest 3. Effortful swallow

18 Vocal Cord Dysfunction

19 Vocal cord dysfunction Cough attack causes vocal cords to close when they should be open Excessive tightening in the throat during breathing Breathing in Breathing out

20 Signs of vocal cord dysfunction Difficulty breathing / shortness of breath Coughing / throat-clearing Noisy breathing Difficulty swallowing Hoarse voice Feeling of choking

21 Causes of vocal cord dysfunction Common cold Strong odours Smoking Post nasal drip Acid reflux Strong emotions and stress Physical exercise Talking / laughing Can occur with Asthma

22 Treating vocal cord dysfunction Treat existing medical condition Speech Pathology Teach you to avoid triggers Breathing exercises Relaxation techniques Reducing throat irritation Voice and swallowing therapy

23 Relaxed throat breathing 1. Sitting upright 2. Shoulders down 3. Hands on side of abdomen 4. Gentle sniff of air IN Notice your tummy moving out Relaxed lips no force About 1 second for the inhale 5. Gentle blow of air OUT Through slightly tight lips About 2-3 seconds for the blow Notice your tummy moving back in Silent breathing

24 Your voice

25 Voice issues A hoarse or strained voice can be a sign of increased swelling or tightening in the larynx To prevent issues: Look after your voice!

26 Vocal hygiene 1. Avoid: excessive talking talking over background noise shouting whispering These behaviours can make your voice tired, leading you to strain, which causes swelling and irritation

27 Vocal hygiene 2. Reduce coughing and throat clearing Stop vocal cords from slamming together Stop the cycle of cough irritation cough

28 Vocal hygiene 3. Drink good amounts of water every day and reduce caffeine Dehydration can cause sticky mucous and increases irritation in the throat

29 Vocal hygiene 4. Rinse the mouth well following inhalers and use a spacer if possible Inhalers can cause irritation to the vocal cords Some inhalers can cause thrush in the mouth and throat

30 Vocal hygiene 5. Avoid smoking Smoke is toxic to the larynx and can cause swelling of the vocal cords

31 Vocal hygiene 6. Avoid talking with a sore throat or cold Rest your voice when unwell Avoid menthol lozenges

32 Take Home Messages Throat issues may cause or worsen a person s respiratory symptoms and prevent a person s response to medical therapy A speech pathologist trained in the area of laryngeal disorders may be able to help Discuss any concerns with your respiratory physician

33 References Speech Pathology Treatment for Chronic Cough: Self Management Education Material Vertigan, Gibson, Theodoros 2008 Clinical management of chronic cough and paradoxical vocal fold movement: a multidisciplinary approach Webinar Dr Anne Vertigan Again thanks to Kate Baumwol (CPSP) for this presentation

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