I absolutely love being a speech-language pathologist. I believe in my role as a tool for the Creator to provide healing and relief to others, and witnessing such is what drives me to continue in this field, even if workdays are often long 🙂
And our field is vast!! While our focus is direct treatment for speech, language, cognitive, voice, and swallowing impairments, we must also understand so much more related information in order to provide the best care to our patients. Actually, this part of our work keeps me stimulated.
For example, a couple of years ago (this pandemic has conflated my concept of time, but around there) an adult patient came in for a voice evaluation because he had ongoing hoarseness and would lose his voice during conversation. He had a history of coughing but had been through all kinds of testing to determine the cause, to no avail. Due to his ongoing hoarseness, his primary doctor recommended voice therapy, so here he was.
As part of the evaluation process, I asked about the origins of his cough and he revealed that it began about one year prior during an illness, and it never left! Since his lungs were clear, he didn’t have reflux or gastro concerns, his heart health was reportedly normal for his age, I wondered about this chronic cough which was likely the reason for his hoarseness.
Then it occurred to me – I asked if he used cough drops to minimize the cough… and he pulled several from his pocket to confirm that he did, all day long, day after day for just about a year! The continued use of cough drops was the likely culprit for all his troubles!
Having taken further education courses in upper airway conditions prepared me for that gentleman and we immediately set up a program for techniques to suppress the cough. Remember, his lungs were clear, after months of examinations there was no known cause for this cough, and there was no indication that he actually needed to cough. No more cough drops with strategies to suppress the cough and within a week he no longer needed to see me – his coughing subsided and his related hoarseness naturally improved.
What happened is that the menthol cough drops dried up the mucous in his airway so that he felt better and his cough would subside for a while. But this effect then sent the body into panic mode because mucous in the airway tract is important to trap debris and irritants, etc., and his body likely went into overdrive to supply more mucous so that his airway wouldn’t remain too dry. Add his new habit of coughing to the increased mucous production and he just couldn’t stop coughing through each day. The gentleman would then take another cough drop to suppress the annoying symptom of coughing, and the cycle continued from there. So this was a mix of physiology and behavior that needed to be addressed. We could have done voice exercises, but without eliminating this ongoing cough those exercises would have been in vain for the most part.
That’s also an example of why teamwork is important in the medical field 🙂
There are plenty of experiences to share but I do like this example in particular since it highlights the need to be a well-rounded therapist. A Master’s degree is what gets us started in the therapy room – but ongoing education is truly a must.
Oh, and if you know someone who takes menthol cough drops like candy, please tell them to stop 🙂