Tag: asthma

Is VCD An Allergic Response

VCD and Asthma Symptoms

With Vocal Cord Dysfunction, sufferers may have a cough and wheezing and difficulty in breathing; and they may feel they have a tightness in their throat or they may find their voice goes hoarse. These symptoms are very similar to those of asthma and both can be triggered by such things as colds or viruses, breathing in lung irritants, such as smoke or even exercising. Reflux from the stomach (GERD) can also be a trigger.

An Allergy Or Not?

Unlike asthma, however, VCD is NOT an allergy nor an allergic response and the treatments for both are very different. They are also different in that asthma sufferers have more difficulty breathing out than in, whereas VCD suffers have more difficulty on the in breath. Also, the allergic response of asthma means the bronchial tubes constrict (tighten), whereas it is the muscles in the vocal cords that tighten with VCD. VCD can also result from paralysis of one (unilateral paralysis) or both (bilateral paralysis) of the vocal cords.

https://www.vocalcorddysfunctions.com/

It is possible to suffer from both simultaneously and in this case, it’s important to see a specialist who has experience with these types of complex situations.

Treatment for the allergic type reactions in Asthma may include the use of an inhaler to expand (dilate) the bronchial tubes, whereas treatment for VCD may include relaxation techniques and muscle control exercises for the throat muscles.

Asthma Or Vocal Cord Dysfunction: Which is it?

Vocal cord dysfunction (VCD) is also known as paradoxical vocal cord dysfunction. So what are the symptoms and how do you tell the difference?

Vocal Cord Dysfunction Symptoms (VCD Symptoms)

It can be difficult to diagnose whether or not a person has asthma or vocal cord dysfunction because they have similar symptoms and triggers. Breathing is made more difficult in both, as well as having a hoarse voice, tightness in the throat, wheezing, and coughing. They are however two totally separate disorders.

When you have VCD, vocal cord dysfunction, this means your vocal cords do not close properly when you are breathing in. If you are exposed to any lung irritant or contract an upper respiratory infection, this can trigger the symptoms, as also can exercise . The same is true with asthma. Asthma is the immune system having a reaction and involves  lower airway infection, whereas, VCD does not, therefore treatment will be different for each condition.

This is important because if improperly diagnosed, a person who suffers from vocal cord dysfunction and who is treated with prescribed asthma medication such as cortisteroids and bronchodilators will receive absolutely no benefit and may indeed suffer from unwanted side effects.

VCD Symptoms

One way to suspect vocal cord dysfunction instead of asthma is if

  • Result of pulmonary function test comes back normal
  • Asthma medication does not work
  • Tightness in your throat
  • When your symptoms flare up you have more difficulty breathing in rather than out
  • You have no respiratory infection
  • Nothing is present obstructing your airway

Asthma Symptoms

With asthma you will have

  • Tightness in your lower or middle chest
  • More difficulty breathing out, with high pitched or wheezing sound
  • Respiratory infections are more prevalent
  • Bronchodilator or other asthma medications work
  • As many as 25% of those who suffer from vocal cord dysfunction also have asthma so they may not realize that they have both of the disorders until the vocal cord dysfunction starts to worsen.

It Is NOT A Panic Attack

Vocal cord dysfunction has also been misdiagnosed as panic attacks because it can be triggered by psychological distress. It is important to note that it is not caused by stress but when a person is under extremely stressful situations, this can trigger the symptoms. Other factors that seem to bring on symptoms are having a post nasal drip and suffering from gas reflux. At times environmental causes, such as shouting or singing, tobacco smoke exposure, chemical fumes or even physical exercise can trigger the symptoms.

How To Improve VCD

There is no specific medication for those with vocal cord dysfunction other than to treat any sinus infections or acid reflux symptoms that may occur. There are, however, techniques to control the vibration of the vocal cords and to relax when you breath, that have proven to be helpful; and consultation with a speech therapist can help you to learn these.

Asthma is when the bronchial tubes are inflamed. This causes sticky secretion to be produced inside of the tubes. This mucus clogs the airway and restricts oxygen flow to the lungs. Those at risk the most for asthma are those who suffer from allergies and those who have family histories of asthma. If a parent suffers from asthma, their children are from 3 to 6 times more likely to have it also. In childhood it is more common for boys to be diagnosed while girls are diagnosed more as adults. If you have frequent coughing, sleeping difficulties, fatigue that cannot be explained and feeling as if you’re out of breath, you may consider being checked for asthma.

Asthma sufferers use long term medications to control the bronchial inflammation. Even so there are sometimes flare ups (called asthma attacks) in which an inhaler filled with medications much be used immediately. These medications will work very quickly to relax the muscles that tighten around the airways and allow the flow of air to the lungs to be restored. These inhalers must be carried by the asthmatic at all times since they could be exposed to a trigger and have to use it.

In cases that are severe, asthma can be life threatening because it closes off the airway. Vocal cord dysfunction, however uncomfortable and whatever terrible feelings it produces, does not close off the airway. It is not life threatening. It can of course, still be the source of much anxiety so it is important that you get checked out by a doctor right away if you have any of the symptoms mentioned, to get the proper diagnosis.

Asthma Advice For Anyone Dealing With This Problem

Asthma can be a difficult condition to have to deal with. And for some people, such tasks as even going for a stroll, may be too difficult. Asthma is incurable and can be difficult to control but there are many ways in which you can stop your symptoms from getting too severe.

Peer Support for people with asthma

Speaking to your peers, who also suffer from asthma, could be an eye-opening and life-changing experience. Support groups can give you some suggestions on how deal with certain situations, and help you to fight your asthma and understand how best to deal with it. Support from people who understand your situation is key.

Medical Professionals to help with asthma symptoms and management

You should have a team of medical professionals to help you craft your asthma treatment. Of course your regular doctor will be the one you go to for help with your asthma, but you should also see a specialist. Asthma centers, pulmonologists, nutritionists and allergists can all work with you, making sure you are getting all the treatment you need. Your own doctor or medical practice may also have special clinics run locally, to help you avoid travelling long distances and can also help you learn to manage your asthma.

Asthma medication may need to be adjusted if you are suffering from a cold, flu or hay fever. The effects of some illnesses can exacerbate the effects of asthma, causing the need for more treatments. The doctor may choose to pursue additional treatment options during your illness as well.

If you need to take your asthma supplies on an airplane, it is a good idea to bring your doctor’s prescription with you. If you have written proof about the item you have, and that it is medically necessary, there will be fewer hassle with security.

Keeping your home suitable for someone with asthma

Clean your home with a wet mop instead of a broom. Sweeping the floor kicks up dust and other debris that can set off an attack of your asthma. You can greatly reduce this by using a wet sponge, damp rag, or moist cloth instead of your a broom or duster.

If you suffer from asthma, you might want to use a pillow that doesn’t contain feathers. Pillow feathers are known to worsen asthma and affect the lungs. The same reasoning applies to all bedding – only purchase bed sheets and comforters that are manufactured from hypoallergenic materials.

Asthma can be a dangerous disease – never ignore the symptoms. Take the appropriate steps to prevent and reduce symptoms, and consult professional help if you think that the symptoms are starting to get out of control. If you use the above advice, you can make asthma something you only have to attend to occasionally rather than something that rules your life.

Paradoxical Vocal Fold Movement or Paradoxical Movement of Vocal Cords

PVFM or PMVC

Paradoxical Movement of Vocal Cords (PMVC) or Paradoxical Vocal Fold Movement (PVFM) are older terms previously used for what is now known as Vocal Cord Dysfunction (VCD). All three of these terms will be used interchangeably in this article. VCD happens when the vocal cords close inappropriately on the in-breath, which results in obstruction of the airway. During normal breathing, the vocal cords move apart from each other when we breathe in, allowing air into the airway. The vocal cords move towards each when we breathe out, when we speak and when we cough. The key feature of VCD is that, during breathing, the vocal cords can try to close over rather than stay open and it is this squeezing that reduces the size of the air passages, making it harder to get air into the lungs. In order to diagnose VCD, the doctor will watch the vocal cords moving. Between attacks the vocal cords may appear to move normally, resulting in a false negative test, so it can be necessary to trigger an attack.

The tem “paradoxical” is used in medicine to denote something happening in the opposite direction to what is expected. When a person is breathing, it would be expected that the vocal cords would be open to allow the greatest possible air flow. But in some people, the vocal cords close over when they are breathing, squeezing the air passage. This lessens or restricts the air flow and so this movement of the vocal cords is termed “paradoxical” because they close over when they should be open. http://en.wikipedia.org/wiki/Paradoxical_reaction

Intermittent paradoxical closure of the vocal cords can bring on a major attack of breathlessness, or air hunger (dyspnea). The paradoxical movement of the vocal cords or decreased movement during attacks can be recorded on video by a doctor or can also be seen by using a mirror placed at the back of the tongue. Paradoxical movement of the vocal cords can also cause noisy breathing, raspiness or wheezing (stridor). PMVC / PVFM / VCD is not the only cause of noisy breathing: it can also be caused by laryngitis, inflammation of the vocal cords and vocal polyps or nodules (little swellings). (more…)

Vocal Cord Dysfunctions (VCD)

What is Vocal Cord Dysfunction?

With vocal cord dysfunction your vocal cords don’t work properly and this can affect your breathing system because the vocal cords close over, or narrow at the wrong time when breathing, making it harder to get air into your lungs. It is often misdiagnosed as exercise-induced asthma and it is easy to confuse it with that because both conditions have similar symptoms. Vocal cord dysfunction can occur at any age but happens more commonly in teenagers and young adults. It is a serious disorder because your vocal cords are not functioning properly on the in-breath (inspiration). People with asthma may also have vocal cord dysfunction when breathing in. When you breathe in, your vocal cords ought to be wide open to allow air to flow to your lungs, but instead they are closed or partially closed. It is thought that maybe 1 in 20 of severe asthma sufferers may also have VCD and as much as 40 % of those thought to suffer from asthma may actually have VCD, although this may be in combination with asthma.

Diagram of the airways to show position of the vocal cords in vocal cord dysfunction

Diagram of Human airways showing the throat and vocal cords


What are the vocal cords?

The vocal cords are what help us to speak. They are tough bands of sinew that vibrate to make noise and this vibration is what allows us to talk and sing. These folds of tissue stretch across your voice box and relax during normal breathing, letting air pass through the trachea (air tube). Vocal cords can be damaged just from dryness, which is why singers always ensure they are well hydrated. While breathing, (exhaling or inhaling) the vocal cords remain apart but they close and vibrate over the airway to make sound when you are talking. In people with VCD, the vocal cords close over the airway just with breathing, making it extremely difficult to get a breath. In other words, the vocal cords are closed when they should be open.

Watch the Vocal Cords working

Is it the same as Asthma?

Because the symptoms of VCD are similar to those for asthma, that is, wheezing, coughing and shortness of breath, vocal cord dysfunction can be misdiagnosed as asthma. Just as with asthma, symptoms of vocal cord dysfunction can be triggered by exercise, by breathing in irritants, such as smoke or fumes or by having a cold. Asthma is an inflammatory disease of the airways and is commonly associated with symptoms of chest tightness, shortness of breath, coughing and/or wheezing and the symptoms can change over time. It affects about 17 to 20 million Americans and is a leading chronic illness among children and adolescents in the United States. It is the most common cause of childhood ER visits and is related to a number of factors, including family history, smoking, stress and allergies.

Asthma is a reversible airway disease and can be chronic or intermittent. It is characterized by variable and reversible airway obstruction and inflammation of the airways. It is a problem that occurs on expiration (breathing out) caused by a narrowing of the airways and an increase of airway resistance. It is a diagnosis that often is given to those with VCD and can co-exist in some patients.

How can you tell the difference?

Vocal cord dysfunction does not respond to asthma treatment, even though the symptoms may be similar to those of asthma. It may coexist with asthma and can make asthma look worse than it is. Vocal cord dysfunction does not respond to inhaler treatment.

What are the symptoms of VCD?

In children, vocal cord dysfunction is often seen in competitive athletes and can lead to a need for oxygen after finishing exercise. It can mimic exercised-induced asthma because both conditions have similar symptoms. A sudden attack may need emergency room treatment. At its worst, it may lead to a spasm in the larynx (voice box) – laryngospasm . The common signs are:

* Shortness of breath or feeling that it’s hard to get air in and out
* Frequent coughing or throat clearing, or feeling that you are choking
* Noisy breathing, with a raspy or wheezing sound and hoarse voice

Unlike snoring, it does not usually happen when you are sleeping.

What causes VCD?

There are a lot of possible causes but often, no cause in particular is found. An attack can be caused by exercise, or by having a cold, or by tobacco smoke, strong smells or fumes. It can also be caused by acid reflux (GERD) or by stress. The muscles of the vocal cords can weaken over time as we age, so it may also appear in older people.

How do I know if I have VCD?

Vocal cord dysfunction can be hard to detect, often because people are just assumed to have asthma when they wheeze. The triggers for asthma and VCD are very similar and there is no specific test for either asthma or VCD. But it should be suspected when you have breathing problems, or are short of breath, and asthma medication does not work.

When people have had an exercise induced cough and wheezing after exercise, it has often been assumed in the past that they had asthma. There is no good diagnostic test for asthma, with the presence of a cough and wheeze generally having been considered to be sufficient diagnosis. The vocal cords may show decreased movement. They can usually be seen using a mirror placed at the back of the tongue. The Royal Brompton Hospital in London is investigating VCD with the use of a small camera that watches the vocal cords while you do exercise. The tiny camera is threaded up your nose after the area has been numbed with local anaesthetic. It sits at the top of your nose and looks down on the vocal cords and provides a picture of them while you are speaking and exercising. As VCD often occurs during or after exercise, the patient is sat on a stationary bike and asked to pedal. The vocal cords are observed while the person works quite hard and also when they speak. The cough and wheeze do not respond to asthma medications.

Very often, someone with VCD will wheeze when they breathe IN, whereas those with asthma may wheeze when they breathe OUT. It is possible to suffer from both asthma and VCD.

What is the treatment?

Treating underlying conditions that might be triggering your vocal cord dysfunction can help reduce symptoms but voice therapy is recommended to help ensure easier breathing and better breath control. Techniques to control breathing and calm down spasms of the vocal cords are the mainstay of treatment. In addition, visual imaging techniques are taught as a method of keeping the vocal cords open during rapid breathing. Asthma treatment mainly consists of inhalers, whereas VCD treatment is a form of physiotherapy which teaches breathing control. Often 3 or 4 sessions are booked but the sufferer may well find they can control their breathing well even after just the first session. If you have VCD, it is important to know this, as the use of the blue inhaler often provided to asthma sufferers can actually make the airways respond less well over time in those who do not have asthma.