Do you sometimes feel like you're suddenly choking and can't breathe? You've probably experienced this while talking, exercising, or just being still. Although it can be a bit scary, today we're going to talk about a condition that can cause this. This is called Vocal Cord Dysfunction (VCD) , sometimes called Inducible Laryngeal Obstruction (ILO) .
What is vocal cord dysfunction (VCD/ILO)?
Simply put, this is when your vocal cords , or the part of your throat that controls your voice, called the larynx (voice box), don't work properly. Think about it, when we normally inhale, our vocal cords should open to let air into our lungs. But in this condition called VCD, when you inhale, your vocal cords try to close, or rather, they close at the wrong time. That makes it hard to breathe, right?
This is easier to understand if you learn a little more about our vocal cords. These are two muscular tissues inside our larynx. They act like two little doors in our throat.
- When we breathe: these two doors open, allowing air to pass into the lungs without any obstruction.
- When we speak: These two doors come together, meet in the middle, and vibrate. That vibration is what produces our voice. Similarly, when we swallow something, clear our throat, or cough, these vocal cords come together and close to prevent those things from going into the windpipe.
So, what happens to someone with VCD is that when they try to breathe in, the vocal cords close incorrectly at the time they should be open. That's why things like difficulty breathing and choking occur. For some people, this can happen frequently and severely. At that time, it feels like it's very difficult to breathe.
What are the symptoms of this condition?
If you have vocal cord dysfunction (VCD), you may feel a lump in your throat (a sensation of a lump in the pharynx ) or a tightness in your throat. There are a few other symptoms, see if these sound familiar to you:
- Difficulty breathing: This is the main and often most frightening symptom. It feels like you're suffocating, like you can't breathe down your throat.
- Constantly feeling like clearing your throat , as if something is stuck in your throat.
- Feeling dizzy or lightheaded (lightheadedness).
- A sensation that you're choking or suffocating.
- A sound comes from the throat when you breathe in (stridor or noisy breathing on the inhalation). It may sound like a whooshing sound.
- Tingling sensation in your hands and feet.
Why is this happening? What are the reasons?
Experts are not yet sure what exactly causes this. But they believe that there may be more than one cause. Things that can trigger, or start, or worsen this condition can be divided into several categories:
- Exercise-induced laryngeal obstruction (EILO): This is, as the name suggests, a condition that occurs during exercise. It is especially common among young athletes . Imagine, for example, when you are playing school sports, running, or jumping, you suddenly find it difficult to breathe.
- Other medical conditions: Some medical conditions can also increase the risk of VCD. For example:
- Asthma
- Gastroesophageal Reflux Disease (GERD) (We call it heartburn, heartburn, that's what it is)
- Upper respiratory infections (e.g., colds, throat infections)
- Mental health conditions: Some mental health conditions can also worsen VCD. Things like stress and anxiety caused by these can affect the functioning of the vocal cords. For example:
- Generalized Anxiety Disorder
- Clinical Depression
- Obsessive-Compulsive Personality Disorder (OCPD)
- Post-Traumatic Stress Disorder (PTSD)
- Irritants that you inhale: Sometimes this can be caused by things we inhale. These can be a 'trigger', or stimulus, for our vocal cords. Here are a few examples:
- Very cold, dry wind.
- Toxic gases, like ammonia or bleach.
- Cleaning chemicals for cleaning houses and bathrooms.
- Strong smells or perfumes, incense smoke.
- Smoke, that is, not only cigarette smoke, but also smoke from wood stoves, vehicle exhaust, and other types of burning.
How do doctors diagnose this condition?
In fact, this condition can be a bit difficult for doctors to diagnose right away, because the symptoms can be similar to other respiratory diseases, such as asthma. Some studies have shown that doctors sometimes mistake vocal cord dysfunction (VCD) for asthma or croup (a respiratory disease that affects young children).
So, to know this exactly, a doctor will usually do these things:
1. A physical examination is performed.
2. Ask about your complete medical history (previous illnesses, medications you take, whether anyone in your family has had similar conditions, etc.).
3. Ask about activities or exposures you were exposed to before this shortness of breath occurred (e.g., did you exercise? Were you exposed to a certain smell?).
In addition, these tests may also be performed:
- Laryngoscopy: This is often the most important test. This involves the doctor inserting a small camera on a thin, flexible tube into your nose or throat to look at your vocal cords. Don't worry, they will make sure you are comfortable while they do this (they may give you a little medicine to numb your throat). This will allow them to see how your vocal cords open and close when you breathe and speak. Sometimes, while the doctor is looking at your throat, they may also do something that can trigger VCD (for example, they may ask you to smell a certain scent or take a few quick breaths). This is called a provocation test . This will allow them to see exactly what happens to your vocal cords when you have difficulty breathing.
- Pulmonary function tests and spirometry: In these tests, you are asked to breathe in and out into a device called a spirometer . This measures how much air you can inhale and exhale, and how fast you can exhale it. Your doctor will do this test to rule out other conditions, such as asthma. Sometimes, changes in the flow-volume loop (flow-volume loop) from this test can suggest that you have VCD. But the important thing to remember is that these lung function tests alone cannot tell for sure whether you have VCD. They are only a guide.
What are the treatments for this?
Treatment options may vary depending on your condition, including the triggers that cause your shortness of breath, how often it occurs, and how severe your symptoms are (mild, moderate, or severe). Common treatments for vocal cord dysfunction (VCD) include:
- Respiratory retraining therapy: This is the most important and effective treatment . Specially trained speech-language pathologists teach you breathing exercises. These exercises help you control your breathing when you have VCD. They teach you how to relax your vocal cords and change your breathing pattern. For example:
- Pursed lip breathing: Exhaling with pursed lips, as if you were whistling. This helps keep the airways open.
- Diaphragmatic breathing: We call it belly breathing, which means breathing deeply and calmly.
Sometimes, just a few sessions of this breathing therapy can significantly reduce symptoms. If you learn it properly, you can take control of this condition yourself.
- Treating trigger conditions: For example, if you have a chronic condition like GERD (gastroesophageal reflux disease) , it is important to treat it properly. Stomach acid can make your vocal cords more swollen and sensitive when it comes back up into your throat. Doctors also recommend controlling and treating colds and other infections that can trigger VCD symptoms. If stress or anxiety are contributing factors, it is also important to seek counseling or treatment for those.
Can this condition be completely cured?
No, there is no cure for this yet . But don't worry. It is a manageable condition. Doctors can help you find the triggers that cause your vocal cord dysfunction (VCD). They can also recommend treatments, especially breathing exercises, to help you manage your shortness of breath. Then you can live a normal life without feeling short of breath.
How can this be prevented from happening?
The only way to reduce the occurrence of this breathing difficulty is to avoid and control the causes and conditions that contribute to your difficulty breathing.
- Imagine, if you know that you will develop these symptoms when exposed to a certain chemical in your workplace, you can reduce that risk by using protective breathing gear.
- If you know that things like strong perfumes and smoke are bad for you, try to stay away from them.
- If you have a condition like GERD, take the appropriate diet and medication.
- If this happens while exercising, things like warming up before starting and cooling down after exercise can help. Also, talk to your doctor about what exercises are right for you.
Is this vocal cord dysfunction life-threatening?
In fact, when this VCD condition occurs , it can feel life-threatening. It is a very scary and disturbing experience. But it is not actually a life-threatening condition. Because the vocal cords are completely closed and you cannot breathe, you will not go anywhere. However, if you are having a lot of difficulty breathing, you should go to the emergency department without hesitation. The tests done there will often show that your body is getting the amount of oxygen it needs, even if you do not know it.
Important: If you experience severe shortness of breath, it can be difficult to tell for yourself whether it is VCD or something else. It could also be a more serious condition, such as asthma. Therefore, it is wise to seek medical advice immediately.
How do I take care of myself?
It is very important for you to discuss this vocal cord dysfunction (ILO/VCD) with a team of doctors who have expertise (an ENT specialist, a speech therapist). Then you can better understand what is happening to you and what to do when you have this kind of breathing difficulty (such as breathing exercises). They will create a management plan that is tailored to you personally.
When should I see my doctor?
If you've done the breathing exercises correctly, managed any underlying conditions (like GERD), and avoided the things that trigger this condition, but you still have symptoms, be sure to see your doctor. Your treatment may need to be changed or more tests may be needed.
If you have shortness of breath that does not subside for any reason, if it is accompanied by chest pain, if your lips turn blue, or if you feel like you are losing consciousness, immediately call the 1990 Suwaseriya Ambulance Service or go to the nearest hospital emergency department.
What to remember from what we have discussed (Take-Home Message)
We all have times when we find it hard to breathe. Think about it, when you're exercising hard, running for a bus, or when something stressful happens. But if you have vocal cord dysfunction (VCD), or inducible laryngeal obstruction (ILO), you may have trouble breathing for no apparent reason.
Although VCD is not life-threatening, it can be a very distressing and frightening experience. Therefore, it is not advisable to ignore it. Although doctors cannot completely cure this condition, they can help you find out what the triggers are. They can also teach you treatment methods, especially breathing exercises, that can help you control your shortness of breath when it occurs. Therefore, if you have these symptoms, it is best not to be afraid or embarrassed and seek medical advice. There are people who can help you and guide you to live successfully with this condition.
` Vocal Cord Dysfunction, Inducible Laryngeal Obstruction, Difficulty breathing, Throat congestion, Larynx, Laryngoscopy
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