Are you suddenly having difficulty breathing? Let's learn about Vocal Cord Dysfunction (VCD)!

Have you ever suddenly found it hard to breathe, feeling like your throat is closing? When you try to take a breath, it feels like it's closing, and it's scary. Many people think that this is asthma at a time like this. But it's not always the same asthma. Today we're going to talk about a condition that has similar symptoms, but is different from asthma. That's Vocal Cord Dysfunction, or VCD for short.

Simply put, what is Vocal Cord Dysfunction (VCD)?

To understand this, let's first learn a little about our vocal cords. These vocal cords are located in your throat, specifically in the larynx. They are like two bands of muscle.

Think of it like a gate. When you breathe in, this gate (the vocal cords) should open completely , so that air can enter your lungs without any obstruction. When you speak, cough, or clear your throat, this gate closes. The vibration of these two bands together creates your voice.

Now, a person with a condition called Vocal Cord Dysfunction (VCD) experiences the opposite of this process. That is, the vocal cords, which are supposed to open when you breathe in, accidentally close or narrow . Imagine what happens when the airway suddenly narrows? That's what happens with VCD. This makes it very difficult to breathe. For some, this condition can occur frequently and severely.

What are the most common symptoms of VCD?

A person with VCD may develop these symptoms suddenly. This can be a scary experience. But it is very important to be aware of these symptoms.

Why does this happen? Causes of VCD

Doctors still don't know the exact cause of VCD. But they have identified several factors that can contribute to, or "trigger," the condition. These can be divided into several main categories.

1. Exercise

Some people, especially young athletes, can develop VCD during or after exercise . This is called ``Exercise-induced laryngeal obstruction (EILO)''. It is more likely to occur during strenuous exercise, such as running or swimming.

2. Other medical conditions

VCD can also be aggravated by other illnesses you have.

• Asthma: Although asthma and VCD are two different things, a person with asthma is more likely to develop VCD.
• Gastritis or gastroesophageal reflux disease (GERD): Stomach acid can cause the vocal cords to swell and become sensitive, causing VCD.
• Upper respiratory tract infections: This condition can be caused by swelling of the vocal cords due to things like colds and throat infections.

3. Mental Health Conditions

Stress and anxiety can be a major cause of VCD.

• Generalized Anxiety Disorder: Constant worry and fear can cause the muscles in the body to tighten. Similarly, the muscles in the throat can tighten, causing VCD.
• Clinical Depression
• Post-traumatic stress disorder (PTSD)

4. Inhaled Irritants

Inhaling certain things in our environment can sensitize the vocal cords and cause them to suddenly close.

• Cold, dry air
• Dust, smoke (mosquito coil smoke, cigarette smoke)
• Strong scents such as perfumes and air fresheners
• Harsh chemicals like bleach and ammonia
• The spice that comes from cooking some people's food (three or five spices)

How do you know for sure that this is not asthma, but VCD?

This is the biggest challenge. Because the symptoms of VCD are so similar to asthma, even doctors can sometimes confuse the two conditions. Therefore, it is very important to get an accurate diagnosis. Otherwise, you will not get any relief from your asthma treatment.

Your doctor may perform several tests to diagnose this condition.

• Laryngoscopy: This is the best way to diagnose VCD. In this test, a very thin, flexible tube with a camera attached is inserted through your nose and down your throat to look directly at your vocal cords. The doctor will ask you to breathe and speak normally while observing how your vocal cords function. Sometimes, you may be given a trigger (such as a strong smell) to see if your vocal cords close. This is called a provocation test .

• Pulmonary Function Tests (Spirometry): This test measures how well your lungs are working. You are asked to blow air into a device called a spirometer. If you have asthma, the results of this test may be different. Since there is usually nothing wrong with the lungs of a person with VCD, this test can often be normal. However, sometimes the shape of the graph (`flow-volume loop`) on this test can raise suspicion of VCD.

What are the treatments for VCD?

When treating VCD, it's important to consider what's causing your condition, how often it occurs, and how severe your symptoms are.

There are two main treatment methods:

1. Respiratory Retraining Therapy: A specially trained speech-language pathologist will help you with this. When you have VCD, you will be taught some special breathing exercises that will help you control your breathing. For example:

• Pursed Lip Breathing: Breathing in slowly through the nose and exhaling slowly through the mouth as if blowing a whistle.
• Diaphragmatic Breathing: Practicing breathing from the belly. This technique relaxes the muscles in the throat and allows the vocal cords to open again. You will feel a big difference after just a few sessions of this treatment.

2. Treating Trigger Conditions: Treating the underlying cause of VCD is also very important.

• If you have GERD (gastritis) , you should use the medication exactly as prescribed by your doctor.
• If you have anxiety or stress , it is essential to see a psychiatrist for advice and treatment.

Some of the most important questions about this

Can this condition be completely cured?

No, there is no one-size-fits-all "cure" for this. However, by identifying and treating the causes of VCD, and practicing proper breathing exercises, you can go a long way toward preventing this condition from occurring, and if it does occur, you can better control it.

Is Vocal Cord Dysfunction Life-Threatening?

No. This is the most important thing you need to know. Although VCD can be scary and can be life-threatening, it is not a life-threatening condition . Even though you may feel like you are having trouble breathing, your body is getting the oxygen it needs.

However, never ignore shortness of breath. If you continue to have trouble breathing, go to the nearest hospital's Emergency Department (ETU) immediately. The tests there can confirm whether you are truly lacking oxygen or not.

How can I protect myself from this situation?

The best way to prevent VCD is to identify the factors that make you susceptible to it and stay away from them.

• If this is caused by strong fragrances, avoid using such things.
• Wear a mask when going to dusty places.
• If this is happening due to stress, try to calm your mind through things like meditation and yoga.
• Talk to your doctor and come up with a plan to manage this condition that works for you.

Vocal Cord Dysfunction, Inducible Laryngeal Obstruction, VCD, Dyspnea, Asthma, Stridor