Coughing in Dementialand

When we bought a new vehicle a while back, it came with a free subscription to Sirius XM radio. Although we were too cheap to pay for a subscription when the free subscription expired, we enjoyed the variety of talk radio it allowed us to access.

My favorite was Doctor Radio. After quite a few work road trips, I started to think I was quite the expert in plastic surgery, oncology, and truck driver urinary health. Believe it or not, there was a whole program on the latter. It was fascinating.

But it was a show featuring a general practitioner that really got me thinking….

Someone called in and asked what he’d recommend as a cough suppressant.

His response was, “Why would you want to suppress a cough?”

Coughing, like vomiting, means there is something in you that needs to get out immediately. Why would you want to stop it from exiting?

The doctor went on to say that there are times when you can justify the use of a cough suppressant–if you are going to give a presentation or be in a play, for example–but we should really think about the logic behind taking it whenever we start hacking. (I will also add, although the doctor didn’t say it, that it’s no fun to be exhausted after a night of being kept up by a cough.)

Individuals with later stage dementia often have a decreased cough reflex. That seems like no big deal, but it really matters.

You know when something goes “down the wrong tube,” as people often say? The other day I was chugging water from my water bottle while driving home from work. I hadn’t done a great job keeping up on my hydration during the day, so perhaps my chugging to catch up was a bit too enthusiastic. I ended up coughing up water all over the windshield.

And I continued to cough..and cough…I was contemplating whether or not I should pull over when I finally got myself together. (I mean, coughing explosively while driving has to be at least as dangerous as texting while driving.)

While I was annoyed at the explosiveness of my cough, it’s a good thing. My body knew the water was where it shouldn’t be–so it expelled it.

A cough begins when the nerves of the respiratory system are stimulated either chemically or mechanically. A message is then sent to the respiratory muscles instructing them to contract in a way that forces the body to expel the irritant with a force of air. Our bodies work hard to keep our lungs and lower respiratory systems free from microorganisms. When the mechanism that triggers the cough is no longer active, we run into problems like aspiration, respiratory infection, and pneumonia. And those are big, sometimes life-threatening, problems.

In short, coughing protects our airways and lungs. When our bodies lack the ability to cough as needed, there are often dire consequences.

As dementia progress to the later stages, individuals lose the ability to cough when they need to clear their throats, when food or liquid ends up in the trachea, or when they have a build up of mucus. That message that is sent to the respiratory muscles to tell them to contract? Their brain loses the ability to convey it. And, yes, this can contribute to the death of someone with dementia–rather suddenly or over time.

We still think dementia is all about forgetfulness. We think it’s about memory. Sure, loss of memory can be one piece of dementia. For many individuals with certain types of dementia like Alzheimer’s, memory deficits may be the first symptom noticed by family and friends. But it’s not all about memory.

I wish we saw dementia as brain failure in the same way that we view heart failure. In many cases, it’s a slow and drawn out process… I know people who have been living with dementia for 15 years and continue to live with a positive quality of life, but dementia is progressive and fatal.

The brain is the control center for the body. I could give you a list of body functions that are controlled by the brain…but I’d have to list ALL body functions. Coughing. Swallowing. Bowel and bladder control. Walking (or any purposeful muscle control). The brain cannot be severely damaged without an impact on the body as a whole. Our brains and the remainder of the body are not separable. There is a point at which dementia compromises the brain so significantly that the body cannot sustain life.

For some, this point comes a couple years after diagnosis. For others, it may not be for a decade or more. Many people live and live well after learning they have Alzheimer’s, Lewy-Body, Frontotemporal, or another type of dementia.

However, I have realized that fundraising is dependent on making the general public aware that dementia isn’t just about old people becoming annoying forgetful. It’s not about Grandma mixing up her grandkids or Grandpa telling the same story five times in an hour.

This is about brain failure.

Considering that your brain is the control center for everything you do, brain failure is a big deal.

And the next time you have a cough, be thankful for that cough.

One thought on “Coughing in Dementialand

  1. As always, I want to share this with the world—you do such a great job of educating people!! Thank you so much for sharing your knowledge and wisdom with us all. I just want to sit down and have coffee and pick your brain to unearth all the information in there! Maybe we can enjoy some 80s on 8 while we chat. That was my favorite station during our free trial! 😁

    Like

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