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Attendees Learn How to Prepare to Battle the Cough

Albert L. Merati, MD

Albert L. Merati, MD

Attendees learned Tuesday how to better fight a common enemy: the cough.

During the instruction course “Cough: Prepare for Battle,” presenters considered both the patient and the physician’s role in the fight, and shared the benefits of helping patients with chronic cough.

“We gave this course a title like that because so often patients are battling for some solution to a cough,” said Thomas Murry, PhD, professor of speech-language pathology in the Department of Otolaryngology at Weill Medical College of Cornell University, New York. “They’ve tried this, they’ve tried that, and everything works a little bit and nothing works for any length of time.

“The other battle is for those of us who see patients with cough or do research in the area, certainly difficult to find a good homogeneous group that you can study because this is really not a homogeneous group that we’re looking at. The only thing they have in common is that they’ve coughed a great deal.”

During the course, Dr. Murry discussed treatments that have proven to help patients with chronic cough, and Albert L. Merati, MD, professor and chief, Laryngology Department of OTO-HNS, University of Washington School of Medicine, Seattle, addressed issues physicians face in dealing with cough.

Dr. Merati said he enjoys helping patients overcome coughing attacks.

“A cough can be hugely rewarding,” he said. “It can also be aggravating. I have an interest and a passion for it, but I recognize it’s not that fun for everyone.”

However, Dr. Merati said there are many advantages to being known as a “cough expert.”

“For those early career folks in the room, it is a remarkable way to practice-build because you can have instant connection with some of  your main referral doctors: pulmonary, GI, and neurology, to a lesser extent. With a successful partnership on a cough patient—that doctor is going to send you a casual hoarseness patient that may need surgery. Don’t underestimate the power of being the go-to cough expert as an otolaryngologist.”

Chronic cough is frequently caused by a combination of factors, including reflux disease, nasal drainage (allergy/sinusitis/rhinitis) asthma, and neurologic irritation or damage, among other causes, Dr. Murry said.

“This is not a single treatment or a single condition that patients come with,” he added. “About 50 percent to 60 percent of patients don’t respond to one single medical treatment, which means just because you’ve tried something and it’s not working well doesn’t mean you should stop the treatment. Maybe it means it should be combined with something else.”

Dr. Murry started studying cough several years ago when a pulmonologist referred a female patient to him.

“When she described some of the problems, it seemed like she had a number of things going on I treated her for a condition called paradoxical vocal fold motion,” he said. “I saw her once or twice and she went back up into the hills of central California.”

“Three months later, I saw the pulmonologist in the parking lot and he said, ‘Tom, I want to thank you for taking care of Mrs. So-and-so. She called our office and she said she’s not coughing anymore. She’s a very nice lady. She offered me two weeks of her condo in Hawaii.’ What happened to me?”

Since then, however, Dr. Murry has seen countless benefits of treating patients with cough.