Melissa Canclini has been making gnocchi since she was eight-years-old. She became a chef and opened her own Italian restaurant in Sydney’s south west, where she specialised in making gnocchi. “It was my bread and butter – everyone knew me for that,” she says. When asthma isn’t asthma
However, throughout her life, Melissa had been prone to coughing. As the years went by, it worsened. “I went to my GP and she told me she thought I had ‘baker’s asthma’ as every time I was making the gnocchi, I was coughing non-stop after,” she says. “I didn’t know what to do and slowly, slowly, I started not being able to work.” Melissa also kept heading to the Royal North Shore Hospital (RNSH) Emergency Department (ED) because she couldn’t breathe – she estimates she visited around six times. She eventually saw the upper airway team in the Department of Respiratory Medicine at RNSH: Speech pathologist Dr Danielle Stone, Respiratory Physician Professor Greg King and Physician and Respiratory scientist Dr David Chapman. The team observed that Melissa had many symptoms affecting the throat which may not in fact be asthma but rather, a condition called Vocal Cord Dysfunction or Inducible Laryngeal Obstruction.
They recommended rescue breathing and cough control exercises as part of speech pathology treatment. “Even though it was a bit weird, I did it. Every time I went to cough, I would do that noise,” says Melissa. “I think I had my next appointment two weeks later. By the time I went back, I didn’t have a cough anymore.” Melissa’s experience highlights the challenges in diagnosing breathing and upper airway disorders, and the role that speech pathologists and an upper airway team can play in treatment. People with these conditions can suffer from breathlessness, habitual coughs or throat irritation. Their symptoms often mimic asthma, and studies suggest that about one-third of people who are told they have asthma likely do not have it. “In these cases, the problem is not the lower airway; it’s in fact the throat,” says Danielle. Unfortunately, while many of these conditions are treatable with the help of a speech pathologist, patients often endure lengthy waits of up to nine years to get an accurate diagnosis.
(L-R) Professor Greg King, Ryan Wallis, Dr Danielle Stone and Dr David Chapman
24 Tomorrow’s medicine today
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