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My Various Maladies

March 13, 2009

Celiac disease is not my only ailment. In fact, I’ve got a host of medical issues; although, not all of them are permanent. In the past 6 months, I’ve had two gum graft surgeries to treat a receding gumline. I’ve been seeing a neurologist for migraines. And I’ve been doing physical therapy to treat chronic muscle spasms in my neck (which are still a problem).

This past Tuesday I went to see an allergist for two other problems (these are permanent): exercise-induced asthma and exercise-induced anaphylaxis. Exercise-induced asthma you’ve probably heard about – when I exercise, I get asthma attacks. It’s as simple as that. But exercise-induced anaphylaxis is probably not something you’re familiar with. I used to run cross country and track back in high school, and if I was pushing myself hard enough, I would get these attacks where my throat closed and I couldn’t breathe. They were much scarier than asthma attacks because I couldn’t get any air in at all – not even a little. The allergist I saw back then said that I was experiencing an anaphylactic response to exercise (similar to what people experience when they’re allergic to bee stings) – basically, I was allergic to exercise. Since then, I’ve had to carry around both an inhaler and an EpiPen every time I run.

Well during college, I didn’t really work out that much, so I never had to deal with the anaphylaxis. But about three weeks ago, I joined this “bootcamp” exercise program at my work, and I’ve been working out heavily 4-5 days a week. Naturally, I’ve started having breathing problems again. I haven’t experienced any throat closing episodes, but I’ve had lots of asthma attacks, and that’s why I went to see the allergist – I was hoping he could give me a better inhaler. I talked to him about my issues, and he asked lots of questions.

Q. How long does it take you to get an attack after beginning exercise?
A. A couple minutes.
Q. Do you have more trouble breathing on the inhale or the exhale?
A. Definitely the inhale.
Q. Do you pre-treat with your inhaler before exercising?
A. Always.
Q. Does it help?
A. It doesn’t seem to.
Q. When you used to have a throat-closing episode, did you also get hives or swelling of your limbs?
A. No.
Q. What about a hoarse voice?
A. No.
Q. I think what you may have is actually exercise-induced vocal cord dysfunction (VCD) rather than exercise-induced anaphylaxis. Did your previous allergist ever talk to you about that?
A. No.

Are you kidding me? Exercise-induced vocal cord dysfunction??? I sang in choir! I talk all the time! My vocal cords are fine! So after the appointment, I went straight to my trusty friend, the Internet, and started doing some research. It turns out, there’s a very good chance that I do have VCD. VCD is a condition where your vocal cords get agitated by something (in my case, exercise) and as a result shut down. In normal breathing, your vocal cords open when you breathe in and close slightly when you breathe out. During a VCD attack, however, they close when you try to breathe in. If it’s only a partial closure, you’ll end up wheezing on the in breath, causing a sharp high pitched noise as you do so. If it’s complete closure, your throat will constrict, blocking all airflow. Both of these happen to me. In fact, I think that what I’ve been taking to be asthma attacks for the past three weeks are truly VCD attacks – whereas I have trouble breathing in (complete with the high pitched noise), asthma causes you to have trouble breathing out. And that also explains why my inhaler hasn’t worked so well. (Although, I still need it – the allergist believes that I also have asthma, as previously diagnosed.)

So how is VCD treated? Not with an EpiPen. If I were to give myself a shot of epinephrine when having a VCD attack, it would do me absolutely no good. Instead, if it turns out that I really do have VCD, I will need to see a speech pathologist to learn breathing techniques that will help me relax my vocal cords. Only in that manner will I be able to stop the attacks. But how do I confirm the diagnosis? I have to see an Ear Nose Throat (ENT) doctor, induce an attack, and allow him to stick a camera down my throat to observe my vocal cords. Sounds fun, doesn’t it? Ugh. My appointment is scheduled for a week and a half from now. I’ll let you know how it goes!

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4 Comments leave one →
  1. March 5, 2010 5:55 pm

    Great Blog!……There’s always something here to make me laugh…Keep doing what ya do 🙂

  2. Glen Bards permalink
    April 24, 2010 6:34 am

    An Atrovent (ipratroprium bromide) inhaler can be effective for treating vocal cord dysfunction. If you go to pubmed.com and type in “vocal cord dysfunction atrovent” you will find 2 medical journal articles on the subject. It can be a very effective treatment without many side effects. Hope it helps!

    • Anonymous permalink
      April 24, 2014 10:24 pm

      My pharmacy charges $250.00 for an Atrovent inhaler. They said there are no generics available.

  3. Sabrina permalink
    April 24, 2010 6:59 am

    Thanks! =)

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