Tag: VCD

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.

Vocal Cord Exercises

Vocal cords, or vocal folds as they are more properly known, are what allow us to control the sounds that come out of our mouths. For professional singers, vocal cords need to be maintained in top condition so that they can perfectly control the pitch of their voice while performing. Like any muscle group, practice can help strengthen the control of your vocal cords. There are a wide variety of vocal cord exercises that can be done to improve your voice or help you recover from vocal cord dysfunction or injury.

The first exercise starts with a yawn. You need to open your mouth as wide as possible. By stretching your arms out, the movement will become more natural in some people. When you have finished exhaling, bring the tip of your tongue to the bottom of your mouth and take in a deep breath. On exhaling the second time you want to make the “ahhhh” sound as if you are letting go a sigh for about four seconds. The sound should come from deep within the throat, and you need to be careful to continue to make the sound throughout the exhale.

This process should be repeated at least ten times. The sounds should be done as softly as possible. It is much more important that you pay attention to the sound itself, rather than trying to strive for a loud volume. When the exercise is finished, the throat should feel very open.

The next exercise exercise starts with a deep breath taken in from your belly. This time on the exhale you will make the “oo…” sound like in stool. You should also form an “O” with your lips when exhaling the sound out. Again, the emphasis here is on form and not volume. The sound should be as low as possible. Make the sound for approximately 10 seconds.

Next, relax the cheeks and breath in through your mouth and nose. The breath should be intense enough to slightly press out the cheeks. If done correctly, you will notice the vibration in your lips. Once the breath is taken in, make the “oo” sounds again as in the first step. Repeat this exercise ten times.

The next exercise is slightly different from the last one. Again, you will begin with a deep abdominal breath. This time when blowing out you want to keep your lips together, protruding slightly from your mouth. The cheeks and lips should be relaxed as much as possible. From this position, you will make the “brrrr” sound as if you are freezing cold. You should feel the rapid vibration of the sound against your lips. Take in a deep breath as before and then repeat. Do this exercise ten separate times.

The next exercise will work within a larger range of sound. You want to start with the lowest pitched sound that you can make with your voice, and gradually work your way to the highest pitched sound that you can make. The sound you will be making this time while changing pitch is “whoop-puh” with most of the emphasis on the “whoop” while scaling up the pitch. Again, the sound should be soft with an emphasis on precise form. Ideally there should be no pause in the voice as one climbs up towards a higher pitch.

Repeat the previous exercise ten different times. When finished, reverse the process. This time you want to start with a high pitch and work down to the lowest pitch. Say the word “boom” this time. This should also be completed ten times with an emphasis in keeping the sound continuous, as before.

The above exercises help you to gain better control of your voice, and are especially good for singers. However, if your vocal cords ever become physically injured you might need some additional exercises to help to restore the function.

One of the best ways of strengthening weakened vocal cords is to repeat words starting with vowels (such as “Easter”, “old”, and “air”) over and over. Repeating “Ah, Ah, Ah” ten times in a row, putting a hard emphasis on the first word can help to strengthen your vocal cords. In addition, saying “Ah” once with a sharp voice as well as a very prolonged “Ah….” for about 10 seconds will also help. Ideally each of these exercises should be done ten times in a row for three times per day if suffering from weakened vocal cords.

Learning to relax the throat is also important to recover from some vocal cord injuries. This is particularly important for people who have conditions such as vocal cord dysfunction where the cords tighten up on an inward breath, mimicking the symptoms of asthma.

To practice relaxing the vocal cords, start on your back with your feet touching the floor. Concentrate on relaxing your upper body, particularly your head, shoulders, and throat. Inhale slowly in through the nostrils and exhale through slightly pursed lips making a “shhhh” sound. Make sure to be cognizant of your abdomen to gauge the breath as you perform this exercise. After doing it on the floor, try it in different postures while seated.

Your vocal cords can exercised like other voluntary muscles in your body. Whether you are a singer looking for a more melodious voice or a person who has suffered severe trauma to the throat, you can use the techniques outlined in this article to improve the function of your voice box.

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How To Improve Vocal Cord Dysfunction

How To Heal Vocal Cords

Vocal cord dysfunction, also known as VCD, has often been mistaken as Asthma, and at times can co-exist with Asthma. Due to the similarities between the two, it is likely the unnecessary prescribed medication will be given and changed often for the patient, until the right diagnosis of VCD is truly found by a doctor.

Unfortunately, 59 percent of patients are often misdiagnosed with Asthma, prior to knowing they have VCD. Vocal cord dysfunction is often found more in women than in men, and the common age of detection is in persons 20 to 40 years of age, although it has been detected in children as young as eight years of age.

VCD is a syndrome in which airway obstruction leads to respiratory distress, due to improper vocal cord motion. VCD is a condition where your vocal cords don’t function as normally as they should, and instead of the vocal cords opening when you breathe, they close, making it harder for you to get air into your lungs. Patients often describe excessive wheezing, choking sensations, cough and throat tightness associated with vocal cord dysfunction, as well they can experience shortness of breath, chest and throat tightness, chronic cough, frequent throat clearing, voice hoarseness and wheezing.

A detailed patient history is needed to differentiate between the diagnosis of asthma and VCD. VCD is noted with more difficulty in inhalation rather than exhalation, and with the increased sensation of throat tightness or choking. Pulmonary function testing and laryngoscopy usually helps in determining the correct diagnosis.

VCD is a treatable syndrome. A patient is usually referred to a speech-language pathologist to help and provide treatment for VCD. The pathologist will provide education and treatment based on each patients need, and will schedule follow-up appointments to reinforce the treatment given, as well as to support and encourage patients. Speech therapy is the usual form of improvement and treatment for vocal cord dysfunction.

To improve your VCD syndrome there are individualized exercises and techniques given as the patient’s treatment regimen. Some of the exercises taught in therapy treatment involve; increased awareness of breathing patterns, awareness of body posture and throat relaxation, VCD released breathing techniques, control VCD during exercise, suppression techniques for chronic cough, throat clearing techniques, and vocal hygiene. This exercise and therapy regimen is used to improve, prevent and eliminate vocal cord dysfunction. Patients also need to become aware of possible triggers of VCD which could be set off by; upper respiratory infections, exposure to airborne irritants, strong odors or fumes, cigarette or fire smoke, exercise, singing, laughing, environmental changes, stress, anxiety and tension.

As with any other diagnosis related to stress, anxiety and tension, counseling may be needed to help with lifestyle changes needed to improve your VCD. Counseling may also be needed for the extensive treatments, doctor visits and medications

prescribed prior to the proper diagnosis. Some patients fear the worst when symptoms do not go away after numerous prescribed medications and doctor visits. When patients are desperate to find out the problem associated with their symptoms and be correctly diagnosed, they can experience anxiety and stress, which is a known trigger of vocal cord dysfunction. Counseling might be an important part of treatment for VCD, to help with the anxiety and stress some patient’s experience.

The improvement for this condition is not difficult; it just takes time, care and patience. Following the guidelines, exercises, and advice of your physician will help with the prevention and possible elimination of vocal cord dysfunction. With lifestyle changes patients can lead a normal life, and enjoy the activities and exercises they desire. Patients must understand the triggers associated with vocal cord dysfunction and learn how to manage situations that might trigger symptoms. Learning to control stress, anxiety and tension is important in aspects of life, as these symptoms can lead to bigger health concerns. Understand the diagnosis given, listen to your physician and ask questions, be aware of your environment and triggers associated with vocal cord dysfunction. Acknowledge and commit to the treatment, therapy exercises and changes needed to improve vocal cord dysfunction and start living life normally again. In the end not only will you improve your VCD condition but you may even eventually eliminate it.

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.

Exercises to Improve Vocal Cord Dysfunction

Vocal cord dysfunction (VCD) is a condition that that can often be mistaken for asthma. The vocal cords are in your throat and are also known as the voicebox. Normally the vocal cords will relax and open when you breath, allowing air to get into your lungs. In people with VCD, the vocal cords do not function properly and actually will, on occasion, close down the air passageway while breathing. The result is a wheezing or choking sensation that can mimic an asthma attack. However, the treatment of VCD is quite different from that for asthma, as speech therapy and a variety of vocal exercises form the basis of an effective treatment regimen.

VCD is a problem that doctors still do not know a lot about. A wide variety of things are known to trigger an attack. Reflux of gastric acids into the throat, exercise, coughing, laughing, or exposure to certain chemicals can all lead to an attack. Understanding the cause or causes of an attack in an individual is the first step towards treating the disease. In some severe cases, surgery might be necessary to treat an underlying anatomical problem with the vocal cords. However, since the vocal cords are technically voluntary muscles that we can control, speech therapy and exercises can be enough to treat the disease in many cases.

There are a number of exercises that can be useful in treating the disease. These serve two purposes. The first is that exercises can help one better take control of the vocal cords in order to prevent an attack. The other goal is that exercises will help to show a person what to do in the midst of an attack to keep the vocal cords from closing completely. By practicing these exercises constantly when one is not having an attack, the hope is that when an attack arises, instead of panicking, a person will calmly perform the exercise as trained.

Ideally all patients should seek out diagnosis and treatment by a team of specialists if they believe they might suffer with VCD. Each speech therapist will custom tailor a set of exercises based on the specific underlying causes of the VCD. Some sample exercises are listed in this article, although one should always check with a physician before beginning any treatment regimen.


The first exercise that can help improve vocal cord dysfunction begins with lying on your back on the floor. Place your feet on the floor with your knees pointed upward into the air. Let your entire upper body relax, especially in the throat, head, and neck area. Have a book handy to place on your belly which will help you to monitor and be conscious of your breathing as you inhale and exhale (breathe in and breathe out).

Start the exercise by breathing in through your nose using your abdomen. Leave the muscles of the upper chest completely relaxed. You only want to use your belly to take in the breath. Once you have finished inhaling, you will exhale through your mouth. Your lips should be puckered as if you are blowing out a candle. As you exhale (breathe out) use your vocal cords to make the soft “shhhhh” sound. Allow your belly to contract naturally without pushing it, observing the book as this happens.

This exercise should be continued for several minutes at a time. As your perform it, you want to vary the length of your breaths from short to longer. This exercise should be performed from three to five times daily.

The next exercise takes place in the upright position while sitting in a chair. Make sure to sit up straight with your spine straight. Do not slouch. You can improve your posture by making sure your shoulders stack back and relaxed while the chin is tucked in roughly parallel to the floor. It can be difficult for some people to maintain this position because we are so used to reclining chairs that don’t provide our backs with the proper exercise to keep our muscles in trim.

Now place your hands at the sides on your lower rib cage and allow your elbows to flare out. You want to use them to be conscious of your breathing as you were with the book earlier. You will proceed just as before. Keep your upper body, throat, and neck relaxed while slowly drawing in a breath with your belly. Be sure to keep your awareness on the breath using your hands.

Your exhale will also be as before. Let the rib cage relax and contract naturally, keeping a relaxed upper body. As you exhale, whisper “shhhh” with your vocal cords through pursed lips. Continue this process for several minutes, varying the length of your breaths periodically.

Once you have finished breathing in this position, the next step is to vary your posture. Lean forward while performing the same exercise for a few minutes. The entire circuit in the seated position should be completed three to five times per day, preferably after you finish the parallel exercise on your back.

If you encounter a VCD attack in the future, then you should immediately stop what you are doing and focus on your breathing. Start to do one of the above exercises in the posture that is most convenient for your situation. These should be initiated at the first signs of trouble whether it be shortness of breath or just any sort of tightening in the throat.

Vocal cord dysfunction is not a problem that many physicians know about, and thus often goes misdiagnosed and not properly treated. By seeing a qualified specialist and learning specific breathing exercises such as the ones outlined above, you can begin to reclaim your life from the clutches of VCD.

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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.