asthma-cough

Did you know chronic cough could be asthma?

Did You Know?

asthma-cough

 

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-lozenge

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

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.

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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.

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Clinical Trials Conducted at Center for Cough

Dr. Mandel Sher and Center for Cough are grateful to their many patients who volunteer for clinical trials. The Wall Street Journal reported on April 12, 2016  that fewer than 10% of Americans participate in clinical trials to test new drugs and treatments because they are unaware of that option or their doctors may not suggest them. Trusting their doctor and having a desire to advance medicine and therapies are the motivating factors for patients’ participation. Please learn more about Amy by visiting Center for Cough’s website Contact Center for Cough today to learn about opportunities to participate in clinical research:  727-393-8067.

Chronic Cough is a Gender Issue

Did you know that the debilitating medical condition of Chronic Cough is a gender issue?  Chronic Cough is not gender neutral.  In fact, Chronic Cough favors women.  While Chronic Cough does affect both men and women, just being a woman sets you up for Chronic Cough.  Chronic Cough affects women more often than men.  And it particularly affects women as they age.   Dr. Mandel Sher’s vast experience diagnosing people who suffer with Chronic Cough and recommending cough treatment confirms the higher incidence of Chronic Cough among women.

“Chronic Cough as a Female Gender Issue,” a review article by Kavalcikova-Bogdanova, Buday, Plevkova, and Song published in the January 9, 2016 issue of Advances in Experimental Medicine and Biology, addresses this phenomenon.  The authors suggest the role of hormones in excessive cough.

According to Dr. Sher, women are hard-wired to cough.  That means that women organically have a more sensitive cough mechanism.  The higher sensitivity of the cough mechanism means that it takes a lower level of irritants or stimuli to trigger coughing spells.  And since cough begets cough, Chronic Cough can become the result.

Dr. Sher emphasizes that cough is an important mechanism in all children and adults.  But in 12 to 15% of the population, a persistent cough that won’t go away becomes disruptive.  Chronic Cough has negative physical, mental, professional and social consequences.  Dr. Sher goes on to say that the goal of cough treatment is to normalize cough – not to suppress cough. 

Sometimes, cough is an indication of a more serious underlying medical condition.  In people suffering with Chronic Cough, cough is often THE problem.  A lingering cough is not normal and should not be ignored.  If you or someone you love has a Chronic Cough, contact Dr. Mandel Sher at Center for Cough:  727-393-8067.


Depression and Chronic Cough

Chronic Cough is not gender neutral.  While Chronic Cough affects men and women, it affects women more often; particularly middle-aged and older women.  Chronic Cough is a debilitating medical condition with physical, mental, social, and professional consequences.  Social isolation and depression are often associated with Chronic Cough.

If you or someone you know has persistent cough and symptoms of depression, contact Dr. Mandel Sher at Center for Cough:  727-393-8067.

“Prevalence of Depressive Symptoms Among Patients With Chronic Cough”  by Dicpinigatis, Tso, and Banauch, published in the December 2006 issue of Chest, reported that over fifty percent of patients with chronic cough were clinically depressed. The authors pointed-out that physicians and others should be aware of the association between chronic cough and depression and recognize depression symptoms. Patients who were treated and experienced decreased cough also experienced a decrease in depression according to the authors.

Persistent cough is not normal.  A cough lasting more than eight weeks should be evaluated by a Cough Doctor to identify the cause and develop a comprehensive cough treatment plan.  Sometimes, cough is a symptom of a serious underlying medical problem.  Sometimes, cough is THE problem.  Chronic Cough can be successfully treated even in patients who have seen other doctors and failed other cough treatments.

Dr. Mandel Sher Presents Advanced Diagnostic Tool to National Physician Audience

Dr. Mandel Sher recently presented a seminar on Rhinolaryngoscopy  at the American Academy of Allergy, Asthma & Immunology in Los Angeles, California. Rhinolaryngoscopy is an advanced diagnostic tool used to identify the underlying cause of Chronic Cough.  Dr. Mandel Sher is specially trained in Rhinolaryngoscopy and one of the few doctors in the Tampa Bay area who uses rhinolaryngoscopy in the office to make a firm diagnosis of Chronic Cough or Upper Airway Disease. 

Rhinolaryngoscopy is in invaluable diagnostic tool for identifying the triggers and causes of chronic cough and upper airway disease” stated Dr. Sher.  Dr. Sher has performed thousands of rhinoscopies in Center for Cough and regularly teaches other physicians how to perform rhinolaryngoscopy.  Endoscopy or rhinolaryngoscopy of the nasal and sinus structures, back of throat and the voicebox (larynx and vocal cords) is an advanced diagnostic tool that enables Dr. Sher to clearly see sinusitis, allergic rhinitis, nasal polyps, deviated septum, infected or enlarged adenoids, layrngopharyngeal reflux (stomach acid attacking the voice box), vocal cord nodules and polyps, and “dancing” vocal cords – a sign of neurogenic cause of chronic cough. 

This simple and relatively non-invasive procedure is a cornerstone of the diagnostic approach used by the Center for Cough.  Diagnostic precision of underlying cause of Chronic Cough is the first step to Dr. Sher developing an effective cough treatment plan for each patient. 

Dr. Sher and his colleague, Dr. Gary Stadtmauer of CityAllergy in New York, New York collaborated on this program. 

Bob Dylan Sings About Cough: “The Cough Song”

Have you ever heard this Bob Dylan classic released in 1963, “The Cough Song”? Dr. Mandel Sher and  Center for Cough team sure do like it!  Dr. Sher doesn’t play harmonica and can’t sing as well as iconic songwriter and performer, Mr. Bob Dylan, but he will offer you an effective and lasting  cough solution.  Mr. Dylan and Dr. Sher are both native Minnesotans, so, “The Cough Song” was meant to be.

Contact Dr. Mandel Sher at Center for Cough for a cough evaluation and cough treatment plan:  727-393-8067.

“Cough” surprisingly shows-up in contemporary music as well.  There’s Grandpa’s Cough Medicine Band, bluegrass music established in Jacksonville Florida.  And “Cough Syrup,” by Young The Giant and other musical performers.