Advice after your nerve block for surgery
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This page aims to give information about:
• What happens when you cough
• Why cough control is important
• Practical suggestions to break the cycle of a persistent cough
What is a cough?
A cough is an important reflex to clear the throat. It is your body's way of automatically stopping choking; and clearing dust and other irritants out of your windpipe and lungs.
Why do we cough?
It has been found that the cough reflex sensitivity can become over-responsive to small stimuli. This may have developed after a cough linked to an infection or other pathology. This can become a vicious cycle where too much coughing causes irritation and inflammation, which makes the cough worse. This type of cough is sometimes called a persistent cough. Sometimes this type of cough can be voluntary where you cough on purpose because of the tickle in your throat. It can be difficult to control.
What can cause a cough?
- Post nasal drip: Excess mucus from the nose / sinuses that drips down the back of the throat and causes an irritation and the feeling of needing to cough and clear this.
- Reflux: Acid rises from the stomach up the oesophagus and this can then tip over onto the vocal cords, causing an irritation and coughing. Lifestyle or dietary alterations, postural care and medications are the best treatments for this; you may wish to speak to your GP for further advice.
- Sensitive airways (often due to a lung condition like asthma): Coughing may not happen all the time but it can be triggered by breathing in cold air or certain smells / chemicals.
- Chest infection or exacerbation: A cough can remain following an illness such as a cold.
- Phlegm: Some people produce more phlegm than others, this can irritate the airways and cause a ‘productive cough’.
- Medications: Coughing can, in some cases, be a side effect of some medications such as angiotensin-converting enzyme (ACE) inhibitors commonly prescribed for high blood pressure and heart failure. It may be beneficial to discuss with your GP about any possible medication changes.
- Stress: This can cause tension in the muscles around the neck which can contribute to a cough.
- The cough itself: Repeatedly coughing can cause the voice box to become inflamed and irritated which can then make the urge to cough even greater.
Common triggers
• Change in air temperature
• Aerosols, sprays, perfumes and cleaning substances
• Inhaling cigarette smoke
• Pollen and dust
• Dryness
• Viral infections
• Bacterial infections
• Physical exercise
How is chronic cough treated?
The treatment will depend on what has caused it. You may be advised to take one or some of the medicines below:
- Antihistamines (to prevent the effects of allergies)
- Decongestants (to relieve a blocked nose)
- Inhaled medication
- Antiacids
- ACE inhibitor medication may be changed to another medication which does not have cough as a side effect
How to control your cough
There are certain things you can do to control your coughing. Try some of the techniques below.
If you feel your cough is due to phlegm, then try a couple of huffs to clear it (see the Chest Clearance Leaflet) before returning to normal, nasal breathing.
If the cough is irritable and not due to phlegm, then try the following:
• Tell yourself you do not need to cough
• Hard / dry swallow
• Hold breath for a few seconds / count in head
• Breathe in and out through your nose
• Sip water
• Suck hard sweets
The Stop Cough Exercise (for dry and tickly coughs)
- As soon as you cough, or feel as though you are about to cough, put your hand over your mouth (this stops you taking a big breath through your mouth).
- Swallow once.
- Take a small breath in and out through your nose. Hold your breath for a few seconds.
- Breathe slowly and gently for at least 30 seconds. Keep your hand over your mouth.
- Tell yourself you are not going to cough.
- Finally take a smooth, normal-sized breath through your nose and take your hand away from your mouth.
- If you still feel a tickle in your throat, repeat the exercise from the beginning.
Hold, Blow, Sip, Swallow technique
The moment you experience the sensation…
Hold your breath for a count to five – 1, 2, 3, 4, 5 (or as long as you can manage)
Blow the air out of your mouth as if blowing candles
Sip some water
Swallow while tucking your chin down towards your chest
Take another sip of water immediately. This will soothe the voice box and help thin out the mucus that builds up in your throat. Make a habit of sipping some water every 15 minutes or so to keep your throat moist.
Other strategies to try:
- Nasal breathing with sniffs: breathe in through your nose, 3-4 short, sharp quick sniffs, then blow out gently through pursed lips. This channels air and ‘cushions’ the vocal cords to help reduce irritation
- A strong sniff followed immediately by blowing out through pursed lips
- Avoid triggers e.g., By wearing a light scarf over your mouth in cold weather
It is important to recognise that there is no ‘quick fix’. Using a combination of these techniques is better at reducing coughing than using just 1 or 2.
Practice the techniques that work best for you regularly, little and often, even when you are not coughing.
Cough control can at first seem hard to do, but keep practising and it will become easier.
Contact us
If you have any queries relating to this information, please contact the Respiratory medicine service.
About this information
Service:
Respiratory medicine
Reference:
W/038
Approval date:
25 November 2024
Review date:
1 November 2027
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.