Asthma or Vocal Cord Dysfunction? What's the Difference?

Wheezing and gasping for air, a senior on the water polo team for an Oregon high school, collapses at a meet. Since he is a good self-advocate for his health, the young man always carries his rescue inhaler, which adults helped administer while waiting for quick-response Emergency Medical Technicians (EMT) to arrive. One prescription inhaler for exercise-induced asthma like his often used in such a situation is Proventil HFA. But the rescue inhaler is not effective. Thankfully the EMTs arrive in time to assess his vital signs, give him oxygen, and monitor as he recovers from this mysterious event.

Fortunately for the young man, he survives the attack. A few similar episodes occur and he makes a visit to a doctor specializing in respiratory disorders. Because his rescue inhaler prescription did not help him recover from what seemed to be asthma attacks, the doctor orders a special test that looks at the larynx, or vocal cords, while the area is in motion during breathing or speaking. In doing this test, it is discovered that his larynx is not always closing and opening properly. The problem is called vocal-cord disorder (vcd). It is also known as paradoxical vocal cord dysfunction (pvcd).

Confusing and complicating the issue can be the fact that symptoms be not only similar to asthma, but also to gastroesophogeal reflux disease (gerd), and even post-nasal drip. A patient may indeed have one or more of these disorders as well as vcd, and can result in a doctor not even thinking to test for it.

What's the Difference between VCD and Asthma Attacks?

A vcd attack sounds sort of harsh like sawing, while an asthma attack wheeze sounds more like whistling, according to the July-Sept 2002 National Health Institute's Journal of Athletic Health by Katherine R. Newsham, et.al., titled: "Paradoxical Vocal Cord Dysfunction - Managing Athletes." The report also says that when a patient indicates the problem area, the chest shows it is asthma and the throat shows it is pvd.

Can VCD be Cured?

Medicine does not cure vcd, but the athlete, or anyone dealing with this disorder, can take control of this disorder. It doesn't happen overnight, however. Vcd is a condition that does not develop in a short period of time, so it takes time to bring it under control. With the help of regular guidance and practice with a speech therapist, the patient works on relaxing the larynx, breathing from the diaphragm, and in using the abdominal muscles in breathing.

It takes a tremendous amount of mental and physical energy for anyone to focus on adjusting breathing to new pattern after a lifetime of another practice. Controlling these spasms can allow the patient to participate in the lifestyle he chooses and manage daily life. The Oregon high school water polo player is working diligently to achieve this healthy goal today.

Sources

Paradoxical VCD - Management Athletes National Center for Biological Information (NCBI)
VCD - Beyond Severe Asthma (NCBI)
VCD - Familial , Rare Diseases, National Institute of Health (NIH)
Irritant Associated VCD (NIH)
Paradoxical VCD ... Past, Present, and Future (NCBI)