Jamie A. Koufman - The Chronic Cough Enigma: How to Recognize, Diagnose, and Treat Neurogenic and Reflux Related Cough

Copyright 2014, 2021 Katalitix Media

ISBN 978-1-940561-00-4

ebook ISBN 978-1-940561-01-1

Published by Katalitix Media

Printed in the United States of America

Distributed by Simon & Schuster

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any other storage and retrieval system, without the written permission of Dr. Jamie Koufman and Katalitix Media.

notice and disclaimer

This book is intended as a reference volume, not as a medical manual. The information is designed to help you make informed decisions about your health. It is not intended as a substitute for any diagnostics or treatments prescribed by your doctor. If you suspect that you have a medical problem, we urge you to seek medical help. Any use of this book is at the readers discretion, as the advice and strategies contained within may not be suitable for every individual.

Mention of specific companies, products, organizations, or authorities in this book does not imply endorsement by the author or the publisher, nor does mention of specific companies, organizations, or authorities imply that they endorse this book.

Third Printing March 2021

For additional information, see: www.JamieKoufman.com and www.KoufmanConsulting.com

Dedicated to all the patients who have taught me about chronic cough

The foreword of a book comes first and tells the reader what lies ahead. For me to be able to write this particular foreword seems perfect, and I will tell you why. I am sixty-two years old, but until two years ago I was afraid to look forward. I was afraid to try anything that might bring on an asthma attack.

For as long as I can remember, I had suffered from what many doctors told me was asthma. I never left the house without my inhaler and pills, my rescue kit in case an attack came on. If I laughed too hard I would start wheezing. If I went snorkeling I would start wheezing. As I got older it seemed anything and everything I did would bring on an asthma attack.

Now as you know, my professional life is spent in front of live audiences. As time went on I could barely get through a talk or TV show without gasping for breath. If you watch my PBS special The Money Class closely, you will hear and see me gasping for breath between every sentence.

My life started to come to a close. For over one year I stopped taking speaking engagements. My shows took forever to complete. To say I was in trouble was putting it mildly.

And then my first glimmer of hope appeareda doctor recommended to me by Dr. Oz told me that I might have reflux.

Are you kidding?

Just imagine my reaction to this after countless doctors had told me the opposite for years. Well, thank God I listened to him and my journey to find a great reflux doctor began. Unfortunately, one GI doctor after another examined me and recommended the same little purple pill, which didnt help at all.

Feeling totally lost, I found a book by Dr. Jamie Koufman called Dropping Acid: The Reflux Diet Cookbook & Cure. I read the book and with every page I turned, I thought, Wow, this doctor makes total sense. I need to go see her.

So now lets jump ahead two years.

Dr. Jamie saved my life. This may sound dramatic but it is exactly how I feel. When you are gasping for breath, unable to speak, sleep, or do much, your life takes on a whole different meaning. And all of that changed for me, thanks to Dr. Jamie.

Treating reflux is complicated because there is far more to it than just popping a pill. What you eat, how you eat, and which (if any) medication is right for you is a science and Dr. Jamie is the rare expert.

So for those of you who have suffered from asthma for years, or those of you who already know you have reflux, there are real solutions that will allow you to live a life that you can look forward to each and every day.

Dr. Jamie, I thank you again and again for this book and for your insight into this devastating but curable disease.

Suze Orman

If you have chronic cough and you have not already seen your doctor and had a chest x-ray, this book is not for you. And if you are a smoker with chronic cough, this book is probably not for you either.

I am not a lung doctor and this book is not about lung disease or asthma, but if in addition to cough, you have unexplained breathing problems or your asthma has not responded to treatment, then read on. This book is for people who have breathing problems and who have been coughing for months or years and cannot get useful answers.

When I first wrote The Chronic Cough Enigma, I had no idea it would be the only information of its kind available anywhere years later. It is an important book for several reasons. First, it gives chronic cough sufferers hope and a roadmap towards health. Second, it can be used to educate physicians. And third, it suggests that the future of healthcare needs to be re-consolidated, with the primary care physician (PCP) being put in charge of most common aerodigestive diseases. However, PCPs must be trained in integrated aerodigestive medicine (which I practice) so that expensive and ineffective specialists can be left out.

Chronic cough remains enigmatic because the medical community remains unaware that LPR (laryngopharyngeal refluxtoday called respiratory refluxis a major cause of chronic cough. In addition, neurogenic cough also appears to remain invisible. Its rather like a medical black hole. And while there are only minor revisions in the text of this edition, my experience treating thousands of chronic cough patients has borne out all the observations and conclusions in this book.

Chronic coughcough for more than four weeksis an extremely common condition, but virtually the entire medical establishment remains clueless how to diagnose and manage non-pulmonary cough. Non-pulmonary? Most people with chronic cough are non-smokers with no lung disease, and that is the definition of non-pulmonary. And by the way, non-pulmonary cough is more common than the pulmonary type.

Over the last few years, I have received hundreds of letters from strangers thanking me for the book that helped them get well. In addition, many chronic coughers buy copies of The Chronic Cough Enigma for their physicians. They educate their doctors to be able to help them. And yes, I have had thank you notes from physicians, too.

So, one might ask who is the audience for this book? And the answer now appears to be doctors and patients. This book, and specifically clinical use of the diagnostic indices (pages 1214), especially the Koufman Chronic Cough Index could be used by all physicians involved in treating cough, including pulmonologists (lung doctors), otolaryngologists (ear, nose, and throat doctors), allergists, pediatricians, critical care specialists, and generalists. i.e. PCPs and family physicians.

Just saying the word cough, youd think that the go-to physician would still be the pulmonologist, but lung doctors seem to know nothing about reflux-related and neurogenic cough. Its just not in their curriculum.

How could it be that medical specialists who deal with the airway know so little about it? The problem, at least in the United States, is over-specialization. Indeed, when it comes to respiratory reflux and chronic cough, the specialist model of American medicine has failed. Thats because the idea of dividing the body up into small, non-overlapping, anatomic areas makes no sense. The respiratory and digestive systems are intimately connected, and specialists dont seem to know that.