Laryngeal Sensory Neuropathy (LSN). My whole story.
February 7, 2013 1:56am CST
Twelve years is a long time to have a cough. That's how long this ailment has been with me. My career was my voice. I was a moderately accomplished singer. Not a Caruso by any means, but I had reached the top of my trade according to the talents given to me. A Bachelor and Masters degree in music used to adorn my wall. My peers even invited me to perform for them. But something happened. I am about to give you a self-diagnosis based upon what I have researched over the years. I know that self-diagnoses is the worst kind but you will understand why I am doing this by the time I am finished. For years before this I had been plagued by attacks of acid reflux at night as I'm sleeping. I dare say many of you have experienced the same thing. It's when you sit bolt-upright in bed out of a deep sleep as stomach acid pools in your mouth as it gushes up, probably through a small hernia in the upper part of the esophagus. A doctor discovered this condition through an endoscopy about 5 years ago. This was probably the start of my condition. As the years went by I noticed it was getting more difficult to sing. The tones which used to float freely no longer were very easy to produce. The first few minutes were no problem, but as time went on, the tones became labored and instead of enjoying the experience I began to sweat due to the effort it took to produce a pleasant sound. About twelve years ago I developed a nagging cough. I thought I had a cold but there was something very strange about it. I had no congestion as you might expect with a cold; No mucous build-up to expel with the cough. It is as if the body is searching for something to expel, but to no avail. This causes very violent gagging convulsions causing me to actually crack ribs. The cough is dry. No sputum. Just AIR. There is nothing worse than a non-productive cough. It seems to be triggered by a nerve centered near the larynx. Once it starts, there is no stopping it. I often find myself wishing I could catch a cold so that I could at least have something on which the cough could hold to and be productive. Not long after it first manifested itself, It would last at least a year. It since has shortened its life-span due to reasons I can't understand. Now, it usually starts in the winter around late Nov. or December. This year it stared on the first of December as a cold. The cold ran its course in about two weeks but the cough continued and continues today and there is no telling how long it will last. BUT I DIGRESS. The worse part of my story is yet to come. Naturally, when the cough started I went to a doctor as anyone would do. The doctor naturally ordered x-rays to see if they would reveal anything. That's when the real adventure started. The next day he called me into his office to reveal what he had found out. He told me that my x-rays had revealed something he had never seen before. It seems they showed small spots much like a rash in both quadrants of my lungs. Of course he wanted to explore this further and ordered an MRI be taken; and sure enough, there they were; small rash-like spots scattered throughout both lungs. He then referred me to a pulmonologist which I promptly visited. Even after seeing my MRI he still wanted to take more x-rays on his machine. Fine. Anything to find out what is causing the cough. After examining his x-rays He comes to me with the conclusion that the spots were probably something I was born with and seemed to be functional. However, it would bear keeping an eye on. He also concluded that they had absolutely nothing to do with the cough. So, for another year and a half he kept an eye on something that never changed. However, my first visit showed I had a 110% lung capacity. But after my last visit (about 2 years later) he discovered a significant decreased in lung capacity. You see, over the years I had developed chronic bronchitis which runs in my family and which I fully expected to have one day. On my last visit to him he concluded that I shouldn't worry about the spots; that they would probably be of no consequence. Before leaving his office, I asked him the question that has been plaguing me for years. What about the cough though? He said, "O, that's probably bronchitis." I'll never forget that answer. I didn't have bronchitis when I went in for treatment for the cough, but I sure had it now about 2 years later. Still, no answer. Later, as my career was drawing to an end I decided to make an appointment with an auto-laryngologist to see if he could find anything wrong with my vocal chords. After putting me through some of the strangest tests, he could find nothing wrong. After that I was advised to have an endoscopy/colonoscopy done because it would be a good idea at my age. It was then I discovered the upper hernia near the top of my esophagus which was causing the acid in my stomach to reflux into my mouth. After prescribing one Prevacid a day I no longer have that condition. THIS IS WHAT I THINK CAUSED IT. This research is based on an online article by a Dr. Chang who is probably the only person in this country that treats this condition. However, you won't get a diagnosis or treatment until you have eliminated everything that it is not, which means a battery of tests you will have to go through. Acid reflux was the main culprit. Years of this condition burned my larynx with stomach acid. According to Dr. Chang, if you've ever had a minor burn which healed, you probably noticed that it was hard to tell where the burn was once the new skin covered it. However, you probably also noticed that the area remained sensitive to the touch. This is what happened to my larynx and explains why it became increasingly difficult for me to sing. Even now, if I try to sing, it will trigger the cough. Now, any irritant can trigger the cough reflex. I can usually get to sleep at night if I get my neck and body warm. Sometimes the auto cough reflex will wake me at night but not too often. Sipping water seems to help in an emergency. Spraying Chlorasceptic in my throat seems to deaden the nerve temporarily. What now? To tell you the truth, I don't know. I don't know if anybody will ever read this article and I don't really care. Just putting my story in this article is very therapeutic for me. Yes, I've written about this condition 3 years ago on Mylot but now I wanted to get the whole story out. Maybe someone will get some help from it.
• Montreal, Quebec
23 Oct 13
Hi Singout, I have had the same condition the last 8 years (I am now 26). I am going to see a throat and ear specialist today, will let you if I find out anything new. Also, I found this link intriguing about neuropathic sensory cough.
Laryngeal sensory neuropathy (LSN) is a recently described condition felt to cause a chronic cough in patients when treatment for everything else has been managed.
7 Jul 13
Hey Singout, sounds familiar. I'm searching the web for a way out of this horrible condition. Have you had any luck getting rid of it? It's the choking that's terrifying me, I wake up at night not being able to breathe, I have to grab a glass of water (which is always by my bed now) which seems to clear my throat. Even if I clear a little tickle in my throat I can feel it blocking my windpipe, all I can do is take a slow breath through my nose and hope the cough clears my throat. Im seriously worried in the future if I catch a cold and get a blocked nose, that scares me. Anyway I hope your on the mend, your post has probably been read by many people all searching for a solution to this hell. Here's hoping for all of us in the future with this problem. Take care. Matt