When Your Child Can’t Breathe

It may be vocal cord dysfunction, not asthma

Breathing technique makes a difference—Josh Inman, 14, of Allentown has vocal cord dysfunction, but with help from speech pathologist Denise Wolst, he’s able to enjoy sports and other activities.

Symptoms of VCD

• Difficulty breathing, especially during exercise
• No relief with asthma inhalers
• Loud sound in the throat when inhaling
• Sensation of a lump in the throat
• Sudden onset, sometimes for no reason
• Worsening during times of stress

Watching a child struggle to breathe is enough to make any parent anxious; when he doesn’t respond to medication, both of you may panic. But this situation doesn’t always signal asthma. It may point to vocal cord dysfunction, or VCD (see symptoms, right). “VCD can be even scarier than asthma because it feels like your throat is closing up,” says Robert Miller, M.D., pediatric pulmonologist (lung specialist) at Lehigh Valley Hospital and Health Network. “Stress and anxiety make it worse.”

VCD shows up mainly in adolescents, often when they get involved in competitive sports. It strikes boys and girls equally, though boys may be more reluctant to admit they have a problem.

Many different things can trigger a VCD attack, including upper respiratory infections, environmental allergens like smoke or mold, postnasal drip, acid reflux disease and even coughing or laughing. To diagnose the problem, Miller uses exercise testing or a lung function test. An exam by an otolaryngologist (ear/nose/ throat specialist) can determine if a physical abnormality is the cause of the problem.

Breathing technique makes a difference—Josh Inman, 14, of Allentown has vocal cord dysfunction, but with help from speech pathologist Denise Wolst, he’s able to enjoy sports and other activities.
VCD often is mistaken for exercise-induced asthma. They’re different, but it’s possible to have both asthma and VCD. With time you learn to differentiate the two and treat each in the appropriate way.

“The first thing I tell patients is that they don’t have to quit their sport,” Miller says. “Once we diagnose the problem and get them into treatment, VCD can be completely controlled, and they can lead normal, full lives.” Sometimes, he says, just knowing what’s wrong can break the cycle.

Since VCD can have many components, it may need a combination of treatments, says otolaryngologist Niketu Patel, M.D., of Lehigh Valley Hospital and Health Network. “For example, someone with acid reflux may have VCD resulting from an irritated airway. We can treat the acid reflux with medication, but he or she will also need to learn relaxation and breathing techniques.”

Speech pathologist Denise Wolst teaches those techniques to help young patients learn how to prevent and manage attacks and feel more confident.

“These are often very dynamic students who really want to succeed,” she says. “Our goal is to help them be true champions. There’s nothing like seeing a teen-ager with a huge smile on his face, saying ‘I did it! Thank you!’”

Want to Know More? For relaxation and breathing tips or referral to a physician specializing in VCD, call 610-402-CARE, or click here.

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