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
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
Larynx : Voice Box
Larynx: Voice Box Breathing in Talking Breathing out
Chronic Coughing
What happens when we cough or clear our throat Vocal cords slam together Can be damaging to the vocal cords
Coughing fact 1 Reflex: triggered by an irritation OR Deliberate: e.g. to clear something from the throat
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
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
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
Coughing fact 5 Most common causes of cough: Asthma Reflux Post nasal drip Bronchitis Smoking Lung pathology Vocal cord dysfunction
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
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
What to do about a chronic cough
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
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
Cough Suppression Swallow At the very FIRST sign of a cough 1. Push hands together 2. Head down towards your chest 3. Effortful swallow
Vocal Cord Dysfunction
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
Signs of vocal cord dysfunction Difficulty breathing / shortness of breath Coughing / throat-clearing Noisy breathing Difficulty swallowing Hoarse voice Feeling of choking
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
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
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
Your voice
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!
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
Vocal hygiene 2. Reduce coughing and throat clearing Stop vocal cords from slamming together Stop the cycle of cough irritation cough
Vocal hygiene 3. Drink good amounts of water every day and reduce caffeine Dehydration can cause sticky mucous and increases irritation in the throat
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
Vocal hygiene 5. Avoid smoking Smoke is toxic to the larynx and can cause swelling of the vocal cords
Vocal hygiene 6. Avoid talking with a sore throat or cold Rest your voice when unwell Avoid menthol lozenges
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
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