Hot-Wired to Cough: Your Throat’s Nerve Endings are on Fire!


If you think of your body like a map of a city, you may visualize cough living in the following neighborhoods:  lungs, chest, and upper respiratory system.  But some coughs have a different address: some coughs live in the nerve endings in the back of the throat. Neighborhoods are all different. They dress different. Have different slang. Perhaps they have different shops and restaurants. And all these differences create a unique environment.  Let’s take Jane Smith, for example. Read more


Major Breakthrough in Cough Treatment on the Horizon


There’s a major breakthrough in cough treatment on the horizon and it shows promising preliminary results!

Dr. Mandel Sher and Center for Cough are currently enrolling volunteer patients in the clinical trials of AF-219, a new drug that shows promise as a breakthrough in cough treatment. For a limited time, patients have an opportunity to try this promising new drug before it’s available to the general public.  Please call Amy today, Center for Cough’s Clinical Research Nurse Coordinator, to learn more about this promising new cough treatment: (727) 393- 8067.

Do you know someone who has been coughing for months, years, or even decades? Has that person seen his or her doctor and tried different cough treatments or cough remedies only to fail and still be coughing? Does that person describe their cough as trying to cough-up something tickling the back of his or her throat? As a concerned family member or friend, are you thinking that this person will never decrease the intensity of his or her cough or get rid of it completely? Read more


Not All Coughs Are Created Equal

not-all-coughs-are-created-equalThere are different kinds of cough and not all coughs are created equal.

Think about it like you would an online dating profile. There’s always a form you have to fill out introducing yourself to the online dating world. Right? You have to list your hobbies, your favorite foods, what kind of books you read, and so forth. If coughs had a profile, the questions they would have to answer to help identify themselves would look a little more like this…(and should probably be answered a bit more honestly than that dating profile you were filling out!!!). Read more


10 Questions to Test Your Medical IQ


How much about chronic cough do you know? Do you suffer from persistent coughing or a nagging itch at the back of your throat? How about a friend? A loved one? A colleague?

Knowledge is power. Knowing what your symptoms mean can help to restore health and happiness!

So…do you consider yourself a medical wizard? Test your knowledge today!


Take the Chronic Cough Quiz! Read more


Dr. Sher Leads National Conversation on Chronic Cough


“Cough is the most frequent illness-related reason people visit their doctor,” according to the Centers for Disease Control and Prevention’s National Center for Health Statistics.

But not all coughs are created equal.   Some people are dealing with an active upper respiratory infection or the aftermath, and others have a cough that just won’t go away.  A cough that lasts eight weeks or longer is considered a “chronic cough.” 10% of the population have a chronic cough and a large number from this group cannot find effective treatment because their physicians are diagnosing and treating the symptoms rather than the underlying cause. Read more


Did you know chronic cough could be asthma?

Did You Know?



Persistent cough is an often overlooked sign of asthma according to a study by National Jewish Health in Denver, Colorado.  Persistent, or better known as chronic cough, affects approximately 10% of the population and can be a symptom of many underlying causes, some of which are unexplained. Patients who are treated for their symptoms rather than their root cause often become frustrated and feel hopeless because they just can’t seem to get better. In reality, these root causes are not always obvious. Read more


Dr. Mandel Sher Had A Fit!

Dr. Mandel Sher had a fit! – A coughing fit similar to the experience of people with Chronic Cough and patients at Center for Cough.  He had an upper respiratory infection five weeks ago and is experiencing residual cough.  Since his is related to a post-viral acute cough, Dr. Sher quieted his cough by slowly dissolving a menthol lozenge in his mouth. A chronic cough, on the other hand, is soothed by lozenges with pectin as the main ingredient because they are lubricating.  Different cough causes and triggers have different treatments.  It is important to know your specific cough profile.


ACE Inhibitors May Produce Chronic Cough

A 15-month medical mystery of “coughing fits” was solved as reported in KOMO News.  A persistent, dry, tickling cough is a relatively common result of ACE inhibitors, such as lisinopril, which are used to treat hypertension, heart and kidney diseases. Cough may occur within hours of the first dose of medication, or its onset can be delayed for weeks to months after the initiation of therapy. Cough usually resolves within 4 weeks of stopping ACE Inhibitor therapy.  An alternative therapy  with a different drug class can be used successfully even in those patients with a history of ACE inhibitor-induced cough.


Hard-Wired to Cough and Chronic Cough

Are you hard-wired to cough?  And if you are hard-wired to cough, then normal cough that everyone experiences and needs becomes exaggerated.  That means your cough mechanism is easily irritated and sets-off coughing spells. People who are hard-wired to cough suffer from Chronic Cough.  Dr. Mandel Sher is a Cough Specialist and one of the very few doctors in the Tampa Bay area who is specially trained to use an advanced diagnostic tool during an office visit to determine if you are hard-wired to cough.  Accurate diagnosis of cause is the key to developing an effective cough treatment plan.

A current school of scientific research and thought around Chronic Cough points to an overly sensitive cough mechanism, also known as Hypersensitive Cough Reflex, as the underlying cause of Chronic Cough.  A relevant discussion was presented by Eva Millgvist, M.D., Ph.D. in “The Problems of Treating Unexplained Chronic Cough” in the March 2016 issue of the journal Chest.  The article reports that chronic cough, similar to chronic pain and itch, is neurogenic mediated. In the case of Chronic Cough, this means that the nerve endings at the back of the throat become irritated and set-off a coughing episode. 

Dr. Mandel Sher is one of the nation’s leading doctors investigating neurogenic mediated cough.  Dr. Sher’s diagnostic approach concludes by identifying the underlying cause of your unique cough.  People who are hard-wired to cough may follow a cough treatment plan that includes speech therapy and a combination of prescription drugs such as chlorpheniramine extendtabs and gabapentin to cool down the cough.

If you have a cough that won’t go away, contact Dr. Mandel Sher today at Center for Cough:  727-393-8067.

Hillary’s Hypersensitive Cough Reflex

Why is Hillary Coughing (Again)?

Why is Hillary Coughing (Again)?

Hypersensitive cough reflex is a mouthful, but it sounds more complicated than it is.  Hypersensitive simply means overly sensitive, and cough reflex refers to the series of steps that get stimulated to produce cough.  Secretary Hillary Clinton has a history of coughing spells.  While Dr. Mandel Sher has not evaluated Secretary Clinton, he suggests that she likely has a hypersensitive cough reflex.  Secretary Clinton fits the profile of the typical Chronic Cough patient.  Women, particularly as they age, are affected by Chronic Cough more often than men. 

Each of our bodies are equipped with a cough mechanism.  Cough has a very important function.  But when cough cannot be managed, it becomes disruptive to daily life.  At best, cough that cannot be managed because of its frequency and/or intensity can have negative physical, mental, social and professional consequences.  At worst, cough that cannot be managed can be an indication of a serious medical condition.

If you or someone you love has a cough that won’t go away, contact Dr. Mandel Sher at Center for Cough for evaluation and cough treatment:  727-393-8067.

Chronic Cough is in the news as a result of Secretary Hillary Clinton’s disruptive and persistent cough.  Hillary’s hypersensitive cough reflex is likely the culprit.  Allergies may be a trigger of Mrs. Clinton’s cough, but a hyper or super-sensitive cough mechanism is probably the cause.  When an overly sensitive cough mechanism becomes irritated, coughing spells can result.  Talking is a powerful irritant.   A relentless campaign season offers no refuge.