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Ask a Pulmonologist: What to Know About Chronic Cough

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Dr. Bushra Mina with his team

With spring upon us–and summer fast approaching–the last thing you want is a lingering cough keeping you down. As a pulmonologist, I’ve seen firsthand how a chronic cough can disrupt quality of life, making even the simplest conversations or a good night’s sleep feel impossible.

What is chronic cough?

Many people think of a cough as a temporary annoyance, perhaps from a cold or the flu. But there’s a distinct difference when a cough becomes chronic, particularly when it lasts two weeks to a month, or longer.

It’s crucial to understand that a chronic cough isn’t the problem itself. It’s a symptom; a signal from your body that something deeper needs attention.

Why does chronic cough happen?

It’s not one-size-fits-all when it comes to understanding a chronic cough–some investigation is needed. The first thing your doctor will ask you is whether it’s a dry or wet cough. A dry cough doesn’t produce mucus or phlegm–it’s typically due to irritation or inflammation. A wet cough does produce mucus or phlegm and is typically caused by an infection. Once that is determined, a physical examination, imaging scans and further studies might be needed to find more answers.

Dr. Bushra Mina

It’s equally important for your doctor to understand the occurrence of the cough and if there’s an underlying condition in play, which may include:

  • Post-nasal drip: Mucus dripping down the back of your throat can irritate airways.
  • Asthma or emphysema: These conditions can present primarily as a cough and are especially common in smokers.
  • Allergies: Seasonal changes or exposure to certain environmental triggers, including smoke, dust or chemicals should be considered.
  • Gastroesophageal reflux disease (GERD): Acid from the stomach can irritate your throat and airways, causing chronic cough.

Less commonly, chronic cough may be a sign of a more serious lung condition, vocal cord disorder or neurological condition that affects motor function (such as Parkinson’s disease), which is why a thorough evaluation is so important.

When to seek medical care–and where to start

If you’ve been experiencing a persistent cough for weeks, months or even years, our multidisciplinary team at the Chronic Cough Clinic in Westchester provides comprehensive care to help you get the relief you deserve.

After a comprehensive evaluation, we’ll connect you with a specialist who best meets your needs in areas such as pulmonology, gastroenterology, immunology, ear, nose and throat (ENT), neurology and speech therapy.

Let’s get to the bottom of your cough together. Call (914) 821-6389 to schedule an appointment today.

Colorectal Cancer: A Growing Concern for Younger Adults

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Dr. Eric Silberman

A quiet but significant change is underway in colorectal cancer trends, one that is increasingly affecting adults well before traditional screening age.

Colorectal cancer includes cancers of the colon and rectum, the last segments of the gastrointestinal tract. Colorectal cancers begin as polyps – small growths inside the intestine – that slowly develop into cancer over time. When detected early, colorectal cancer is highly treatable, which is why timely screening and early recognition are so critical.

Since the mid-1990s, rates of colorectal cancer have declined among older adults. In contrast, the rate of colorectal cancer diagnosis among adults under the age of 50 have steadily increased, with an annual rise of approximately 2% among adults ages 20-39. In fact, colorectal cancer is now one of the fastest-increasing cancers in young adults.

And it’s not just a numerical increase; there are increasing cancer burdens as well. Studies have shown that younger patients are more likely to present with later-stage disease and, in some cases, more aggressive cancers. Younger patients may also face unique challenges compared to older adults, including concerns related to fertility, family planning, career development, and financial stability.

In response to these rising rates, screening guidelines have evolved. In recent years, both the American Cancer Society and the U.S. Preventive Services Task Force have lowered the recommended starting age for colorectal cancer screening in average-risk adults from 50 to 45 years.

Encouragingly, these updated screening recommendations are already making an impact, with more adults between 45 and 49 undergoing these life-saving tests.

While expanded screening has improved early detection, researchers continue to investigate why colorectal cancer rates are increasing in younger populations. Several theories are being explored, including:

  • changes in diet and lifestyle
  • alterations in the gastrointestinal microbiome
  • rising obesity rates
  • environmental exposures

A major ongoing challenge is in patients younger than the screening age of 45 years old, in whom gastrointestinal symptoms may still be dismissed or attributed to stress, diet, or benign conditions like hemorrhoids or irritable bowel syndrome. Increased awareness of the symptoms of early-onset colorectal will be essential in guiding patients to the proper care going forward.

The symptom most strongly associated with early-onset colorectal cancer is rectal bleeding; other concerning symptoms include persistent changes in bowel habits, unintentional weight loss, and unexplained abdominal pain, cramping, or bloating. When these symptoms persist, they warrant medical evaluation.

Individuals with a family history of colorectal cancer or inflammatory bowel disease are at higher risk and may need earlier screening. However, many young adults diagnosed with colorectal cancer have no known risk factors, highlighting the need for vigilance among both patients and healthcare providers.

Colorectal cancer screening is typically performed with a colonoscopy, which allows a gastroenterologist to sample or remove concerning polyps during the same procedure. Blood-based and stool-based tests are also available for average-risk patients, though any abnormal result will need to be followed with a colonoscopy. Importantly, anyone experiencing concerning symptoms should be evaluated by a gastroenterologist regardless of age or screening history.

Early detection saves lives. Understanding symptoms, recognizing risk, and knowing when screening is appropriate can make a profound difference as the demographics of colorectal cancer continue to change.

A Day in the Life of an Oral Surgeon

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My day usually starts around 7:00 a.m. I get ready, answer a few emails, and head out the door. I’m not much of a breakfast person–I tend to do a light morning fast and save eating for later in the day.

On the drive into the office, I listen to music. It helps me shift gears, clear my head, and get into the right mindset for the day. Most mornings it’s the Grateful Dead, though I’ll mix in some country now and then. It’s a simple routine, but it helps me stay relaxed and focused before the work begins.

When I arrive at NYOMIS, the team is already preparing for the day’s patients. Before we begin seeing anyone, we come together to review the schedule and map out the day ahead. We look closely at each case–especially larger procedures or implant cases–and make sure we’re fully prepared. We double and triple check materials, equipment, and timing so there are no surprises.

Preparation sets the tone for everything that follows. When we’re calm and organized, it creates a better environment for both the team and our patients. Being prepared minimizes stress and allows us to deliver the best care possible.

On a typical day, I perform a range of procedures, most commonly wisdom teeth extractions and dental implant cases. These can range from straightforward single implants to more complex full-mouth procedures.

Patient anxiety is something we take very seriously. Oral surgery can be intimidating, and I think much of that fear comes from the word “surgery” itself. I often prefer to use the term “procedure,” which helps reframe expectations and ease anxiety. We take time to listen, answer questions, and reassure patients that they are in good hands. From compassion and clear communication to sedation options like nitrous oxide or IV sedation, everything we do is centered around patient comfort and trust.

The most rewarding part of my work is seeing the impact it has on people’s lives. Helping someone feel better, improve their quality of life, or regain confidence in their smile is incredibly meaningful. I recently treated a patient who had struggled for years with her smile and underwent a full-arch dental implant procedure. Seeing her reaction afterward was a powerful reminder of why I love what I do.

In surgery, the moment I feel most in my element is when everything comes together–the planning, the precision, and the final result. That’s when you know the work has paid off.

At the end of the day, our team comes together again to review cases, look ahead to the next day, and make sure we’re fully prepared. When I get home, I unwind by spending time with my son, having dinner, and catching any Michigan or Detroit sporting event on TV, if one’s on.

A good day, to me, is simple: knowing I helped make a positive impact on someone’s life and being grateful for the opportunity to do so.

When Experience Meets Innovation: A Precision-Based Approach to Pain and Movement

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Real Time Ultrasound Imaging

In my clinical practice, I often meet patients who have done “everything right,” committed to recovery yet still frustrated by lingering pain or limited movement. What is missing is rarely effort; it is precision. That is why I built my practice around one guiding principle: every patient deserves care that is precise, individualized, and evidence-based.

I founded Mohini Rawat PT PC to move beyond generalized, protocol-driven care and provide physical therapy that is targeted, efficient, and grounded in objective clinical data. My approach integrates advanced diagnostic tools with hands-on rehabilitation to identify the true source of a patient’s symptoms and address it directly.

Over the past two decades, I have worked in clinical practice, education, and professional leadership within physical therapy and diagnostic imaging. One principle has remained consistent: better clinical information leads to better outcomes.

Neuro Re-education

When appropriate, I incorporate real-time musculoskeletal ultrasound and electrodiagnostic testing (EMG/NCS) into the evaluation process. These tools allow me to assess muscles, tendons, joints, and peripheral nerves dynamically, often while a patient is moving or reproducing their symptoms. This level of assessment provides clarity that cannot be achieved through symptoms alone.
Rather than guessing which structure is contributing to pain, I can determine whether a tendon is degenerative, a muscle is under-recruiting, a joint is not functioning optimally, or a nerve is involved. Treatment is then designed around these findings, not around a generic diagnosis.

This precision allows care to be more focused and efficient. Patients are not asked to perform unnecessary exercises or attend prolonged treatment plans without clear goals. Rehabilitation is targeted, measurable, and continuously reassessed based on how the body responds.

My practice operates as a one-on-one, boutique model, allowing the time and attention required for this level of care. Each session is both therapeutic and educational. Patients see their findings, understand the reasoning behind treatment decisions, and are actively involved in the recovery process.

EMG Nerve testing

Many of the individuals I see are active adults, athletes, and adults who want to maintain their independence and mobility. Some have complex or persistent conditions; others want answers early to prevent prolonged issues. In every case, the goal is the same: restore movement and function with accuracy and intention.

Innovation in healthcare is often discussed in terms of technology alone. In my experience, innovation is most meaningful when paired with clinical expertise, thoughtful reasoning, and individualized care. When experience meets innovation, physical therapy becomes not just treatment but a clear, efficient path forward.

Ultimately, my goal is to combine the rigor of science with the nuances of individual care. By integrating safe and advanced imaging, electrodiagnostic testing, and hands-on assessment, I can identify the cause of dysfunction and design treatment that is both targeted and measurable. For patients, this means care that is not only effective but efficient, helping them return to the activities they value with confidence and clarity. In my practice, precision is not just a technique, it is the foundation of meaningful recovery.

At Mohini Rawat PT PC, we specialize in combining advanced ultrasound imaging with individualized, one-on-one physical therapy. Our goal is to help you move better, prevent injury, and regain confidence in your body.

Ready to learn more or schedule an evaluation?

Visit www.mohinirawatptpc.com and take the first step toward understanding what your body is really telling you.

How Spirituality Fits into Psychotherapy

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After nearly two decades working as a psychotherapist, I’ve learned that healing is rarely just about insight or symptom reduction. It is alive. It is felt. It unfolds through the body and touches something deeper than thought or language.

So how does spirituality actually fit into psychotherapy? My experience is that it already does. Deep psychological pain has a way of interrupting our lives and opening questions that go beyond coping strategies. Questions about meaning, connection, and what sustains us when what we relied on falls away.

For some, this is understood through religion or faith. For others, it is experienced through nature, creativity, relationships, or a felt sense of being part of something larger than the individual self. Spirituality is not something to be defined for clients through theory, but respected in the ways it is understood and lived.

My philosophy as a psychotherapist, and one that guides the work at Repose, is not to prescribe a spiritual framework, but to make room for one to emerge. The therapist’s role is to support enough safety and attunement for clients to discover what an embodied connection to their own consciousness looks like for them.

Trauma and grief have a way of stripping life down to its essentials. They disrupt familiar narratives and challenge our sense of control. Many people find, sometimes unexpectedly, that suffering can also become an opening. Not because pain is redemptive, but because it brings us into contact with parts of ourselves that had been inaccessible.

This is not about spiritual bypassing or finding silver linings too quickly. It is about recognizing something I have witnessed repeatedly in clinical work. Our capacity to experience deep pain is inseparable from the depth of our capacity for love, joy, and connection. When we shut down one, we inevitably limit the other. Healing is not about eliminating pain. It is about expanding our capacity to be with experience so the stream of life can move through us more fully.

As a Somatic Experiencing Practitioner®, my work is grounded in the understanding that trauma lives in the nervous system, not just in memory or thought. The body is not merely a container for emotion. It is the primary pathway through which experience is processed. This is also why talk therapy alone is often not enough.

In somatic therapy, we slow the process down. We help clients track sensations, breath, impulses, and subtle shifts in the body. Rather than reliving what happened, we focus on restoring the nervous system’s natural capacity for regulation and resilience. Over time, what once felt overwhelming becomes tolerable, then workable, and eventually integrated.

Something subtle yet profound often happens in this process. As people reconnect with their bodies, they begin to experience themselves not just as doers, thinkers, or problem solvers, but as conscious beings able to observe, feel, choose, and respond. This is often where psychotherapy begins to touch what many would call the spiritual self.

I think of consciousness as the spacious awareness that can hold experience without being consumed by it. The body is the container. Sensation is the language. Emotion is the current. And consciousness is the observing, compassionate presence within that allows us to navigate life with greater ease and perspective.

Peter Levine, the founder of Somatic Experiencing®, writes, “Trauma is hell on earth. Trauma resolved is a gift from the gods.” When people move through the other side of pain, they don’t simply feel less broken. They feel more alive. In that aliveness, spiritual meaning or purpose often comes into focus – however one chooses to frame it.

From this place, clients often describe a shift. Not that life becomes easy, but that it becomes more livable. There is a settling. Even amid ongoing challenges, there is a felt sense of “I can handle this.” Here, psychotherapy translates into spiritual growth.

Spirituality in psychotherapy is not about answers. It is about access to the wisdom of the body, to experiencing emotion without overwhelm or narration, and to deepening relationships with self and others.