Expert Answers: Vocal Cord Dysfunction and the Use of Inhalers

Every so often, a question comes up that piques the interest of several community members who can relate. When that happens, we like to ask our experts to weigh in on the topic. This happened recently in regards to vocal chord dysfunction. See how they answered the following question, and add any ideas you may have in the comments!

“I have vocal cord dysfunction caused by the use of inhalers. Do you have any ideas/strategies on how I can cope with it?”

Response from Leon
Vocal Cord Dysfunction (VCD) means that your vocal cords do not act normally. This disorder can also be referred to as paradoxical vocal fold movement. With VCD, instead of your vocal cords opening when you breathe in and out, your vocal cords close. When your vocal cords close, it makes it harder to get air into or out of your lungs. VCD is sometimes confused with, or misdiagnosed as asthma because some of the symptoms are similar. Although the two have similar triggers and symptoms, the treatment approach for VCD is very different from that used to manage asthma. This is why proper diagnosis is extremely important. There are several triggers that may be associated with VCD. Sometimes, however, no trigger can be determined. The triggers can include: acid reflux (commonly referred to as GERD – gastroesophageal reflux disease), post nasal drip, upper respiratory infection (commonly referred to as a cold), strong odors or fumes, tobacco smoke, and strong emotions or stress. It should be noted that Inhalers have not typically been identified as a cause of VCD. Once an accurate diagnosis of VCD has been determined, treatment should implemented.1-2

VCD can be very hard to detect. Your healthcare provider can find out if you have VCD by testing your breathing and looking at your vocal cords. The breathing test is called spirometry and it can show how well air moves in and out of your lungs. If you are having VCD symptoms during the test, the test will usually, but not always, show blockage mainly of the air flowing into the lungs. Breathing test results can be normal if your VCD is not active at the time of testing. This is one reason why determining if you have VCD can be so hard. The best way to tell if you have VCD is for a healthcare provider to look at your vocal cords when you are having difficulty breathing.1-2

Because VCD is so vastly different from other diseases characterized by breathing issues, medicines are not the main treatment to control or prevent VCD. The main treatment for VCD is learning techniques that help you control your vocal cords. These techniques are usually taught by a speech therapist or psychologist who is trained and experienced in treating VCD. The techniques you will learn will help to improve your ability to relax your throat muscles which allows your vocal cords to behave more normally.1-2

Strong emotions and stress can trigger VCD too, so it is important to learn to manage your stress. Relaxation techniques, biofeedback, and psychotherapy have been shown to be helpful in controlling VCD. If you have asthma and VCD, it is important that your asthma is under good control. If your VCD is triggered by post-nasal drip or acid reflux (GERD), it is important to talk to your healthcare provider about what you can to do control these as well.1-2

Response from Lyn
Sadly, Vocal Cord Dysfunction (VCD) is still poorly understood by many. However, there has been progress in the recognition and treatment of it. Treatment for VCD usually involves relaxation techniques using deep breathing and forms of speech therapy. Interestingly, many times the symptoms of VCD are very similar to asthma. They often include:

  • Coughing (the most common symptom)
  • Wheezing
  • Hoarseness
  • Difficulty breathing
  • Throat constriction
  • Sensation of choking

These symptoms range from mildly annoying to a scary, inability to get enough air. Often, the worse symptom for anyone experiencing it is panic. Just like asthma, triggers may include chemicals, perfumes, fumes, cigarette smoke, or any number of other strong odors.

The best treatments for VCD come from seeing a Speech Therapist. After identifying the triggers, which may be different for each person, they will teach methods and techniques to help prevent episodes of VCD. The trick is to learn breathing techniques that become so “hard-wired” that a person automatically does them during an attack.

How about you? Have you found any strategies or techniques to help combat vocal cord disfunction? Share in the comments!

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