Later, during that same initial evaluation, when a videoendoscope had been inserted and was recording a view inside her throat and voicebox, she suddenly began to exclaim, “There! It’s dripping! It’s dripping! It is going to make me cough!” Every conceivable treatment for this “dripping mucus,” applied across the years, had made no difference. Sometimes she also experienced leaking of urine.ĭuring her visit with me, she explained that the typical initiator of the coughing attacks was a sensation of mucus dripping down the back of her throat. The several particularly bad episodes of coughing each day were brutal: she would vomit or nearly vomit due to the violence of her attacks. Co-workers were annoyed family members were distressed. There were so many episodes of coughing each day, and some so violent and protracted, that it was seriously diminishing her quality of life. Consider, for example, the following composite anecdote.Ī middle-aged woman had been coughing for more than 10 years. This patient may interpret a completely convincing sensation of mucus (dripping or suddenly filling the throat) as being actual mucus, when in fact it isn’t. Circumstance #1 In More Detail: When Mucus Is Clearly “Felt” but the Mucus Is Not Actually There If a patient does not recognize this, he or she can get sidetracked, continuing to focus on and manage the mucus without ever improving the cough or throat clearing.
1 2 For patients like these, it is crucial to recognize when the cause of their cough or throat clearing seems to be, but is not mucus rather, the cause is a sensory neuropathic disorder. These patients were all diagnosed not with a “mucus” problem, but instead with sensory neuropathic cough or throat clearing. When mucus is indeed present, but it is the result of coughing rather than its causeĪt Bastian Voice Institute we have seen hundreds of cough and throat-clearing patients who at first cannot identify with either circumstance #1 or circumstance #2, but for whom one of the two above circumstances in fact applies. When a sensation of mucus is felt, but, while hard to believe, there is not any actual mucus presentĢ. When it comes to coughing and throat-clearing, however, there are two kinds of circumstances in which mucus might seem to be the cause, but actually is not:ġ. And, if mucus becomes purulent, we treat it with antibiotics.
Other times, mucus may become thick and crusted, in which case we thin it out by drinking more fluids, using a humidifier and Neti pot, or taking over-the-counter mucolytics. Sometimes, such as during an upper respiratory infection, our bodies over-produce mucus, in which case we cough it up, blow it out, or “dry it up” with decongestants. We all have experience trying to manage mucus that is causing us a problem.
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