A cough that lasts more than eight weeks stops being a symptom. It becomes the problem. It wakes you at night, interrupts conversations, makes restaurants impossible. You've done the rounds: GP, respiratory specialist, maybe an ENT. Everything comes back normal. But the cough is still there. Sacha has worked with chronic cough patients at Te Whatu Ora Wellington, where she saw how often persistent cough falls between the gaps of medical specialties. Respiratory says the lungs are fine. Gastro says the reflux is managed. ENT can't see anything wrong. Nobody owns the problem. Research published in The Lancet suggests up to 42% of chronic cough cases have no identifiable medical cause. These are the patients who respond best to speech therapy. Not because the cough isn't real, but because the mechanism maintaining it lives in the larynx and upper airway, the exact structures speech therapists know best. If your cough has outlasted every explanation, this is worth exploring.

The larynx, the throat muscles, the breathing coordination that controls coughing: these are the same structures we use for speech and swallowing. Speech therapists work with this anatomy every day. When chronic cough persists despite normal medical results, the problem usually sits in laryngeal hypersensitivity or habitual patterns. Both respond to the techniques we use in clinic.

The post-infection cough that won't clear
You had a cold three months ago. Or COVID six months ago. The illness passed, but the cough stayed. Dry, persistent, triggered by the smallest thing. Your GP says the infection is gone. But the cough disagrees.

Normal tests, still coughing
You've seen the respiratory specialist. The CT is clear. The bronchoscopy showed nothing. The blood work is fine. Everyone says you're healthy, but you're still coughing fifty times a day. You're starting to wonder if anyone can actually help.

The social cost nobody sees
You skip the cinema because the quiet scenes are impossible. Meetings at work are embarrassing. Restaurants are out. Phone calls are interrupted. The cough has shrunk your world, and people around you have stopped asking how you are.

Reflux that shows up as cough
The gastroenterologist managed the reflux. The medication helped the heartburn. But the cough and throat clearing are still constant, especially after meals. Nobody connects the two, but the upper airway is still irritated.

Exhausted the medical pathway
GP, respiratory physician, ENT, gastroenterologist. Maybe an allergist too. You've been passed from specialist to specialist. Each one rules out their area and refers you on. Speech therapy is often the last door, but it should have been earlier.