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CAN'T BREATHE? SUSPECT VOCAL CORD DYSFUNCTION!


List of some SIGNS (physical, objective--can be observed by others) and SYMPTOMS (subjective--experienced by the patient) that occur during (& between*) VCD attacks. These vary with each patient:

The References mentioned below (in parentheses) are all listed on web-page 9 of this website. Here is a link to web-page 9: http://cantbreathesuspectvcd.com/page9.html 
Some SIGNS of VCD:

chronic cough* (Ref.1,3,7,17,21)

"barking" (Croupy) cough (Ref.21)

wheezing (whistling or sighing sound) (Ref.1,3,5,17,21)

stridor (harsh, high pitched, windy, gasping sound) (Ref.3,7,17,21)

hoarseness/laryngitis (Ref.1,7,10)

voice changes during attack: dysphonia (hoarseness) to a-phonia (no voice sounds at all/can't speak/talk) (Ref. 4,17,21)

speech may be breathy & forced (Ref.4,5,17)

rapid shallow breathing (tachypnea) (Ref.4,17,21)

neck and chest retractions (Ref.21)

passing out (unconsciousness) in some untreated, severe cases (Ref.17)

hypoxia (not enough oxygen gets into blood-stream) requiring intubation (into trachea) &/or tracheostomy (emergency opening placed into windpipe) in some severe cases (Ref.3). Almost 25% of a sample of VCD patients had abnormal (low) oxygenation, as measured by Pulse Ox or Arterial Blood Gas tests.(2003 VCD Conference). 

hypoxia accompanied by cyanosis (skin color turns blue, gray, or purplish, due to hypoxia) in some severe cases (Ref.5)

severe agitation (Ref.5,17,21). 

Some VCD patients' vocal cords very slowly close, during a VCD attack, and later, very slowly open up. Other VCD patients' vocal cords very quickly close, during a VCD attack, and then, very quickly open up again. 

Some SYMPTOMS of VCD:

difficulty breathing/dyspnea (Ref.1,3)

difficulty getting air in (inspiration/inhaling)
(Ref.1,5,17)

feeling that not enough air is coming in, when inhaling (Ref.21)

difficulty breathing out (exhaling)--found more with Irritant-induced VCD (IVCD) than with other types of VCD. But, rule out asthma attack, &/or severe allergic reaction (anaphylaxis), which can happen alone, or along with a VCD attack. (Ref.21)

throat tightness (Ref.1,5,10,17,21)

choking sensation (Ref.3,11,17,21)

feels like trying to breathe through a straw  [Ref.17: A "Triage"(Emergency Room) Nurse at National Jewish Medical & Research Center]

can feel like throat is swelling up (can be VCD, or severe allergic reaction called anaphylaxis, or both at the same time! Get medical help immediately!) (Ref.17,21)

no air can get in, at all (Ref.17,21)

dry &/or sore &/or irritated throat (Ref.7,17,21)

tightness of the neck muscles (Ref.3,17,21,22)

panic & fear of impending death due to feeling like suffocating (Ref. 17,21). 

chest tightness (Ref.1,5,10,21)

substernal [under the "breastbone"] chest pain/burning, from gastric reflux, &/or irritant- associated VCD (IVCD), (but rule out heart problem, etc.)  (Ref.9,21)

sometimes a warning (like an aura?--that precedes a seizure): feeling a "lump" in throat (globus), or sharp taste in throat (like from acid or alkaline gastric reflux, from medicines, or from chemicals, etc.), then feeling a movement inside throat, followed by a sharp pain on one side of throat, then an uncontrollable cough, followed by a VCD attack. (Ref.7,17,21) 

shortness of breath (Ref.17,21)

dizziness/lightheaded feeling(Ref.21)

symptoms of hyperventilation, like numbness &/or tingling of fingers, toes, feet, or around mouth (peri-oral)  (Ref.21)
 

Also, between attacks*, some VCD patients have noticed difficulty swallowing food and liquids (dysphagia) (Ref.7,10,17,21). Many VCD patients temporarily feel like they are "swallowing the wrong way" very frequently, causing some actual choking, that results in an immediate VCD attack. (Ref.17)

It is generally thought (but not by every medical person) that if a VCD patient faints (syncope)/passes out/becomes unconscious, from a severe VCD attack, that the vocal cords would automatically open up, allowing the patient to breathe again. But, I believe that it is safer to not test this theory out: It is theoretically possible that there could be some exceptions to this theory (Dr. Ray Wood, M.D., at 2003 VCD Conference). And, there may be life-threatening conditions happening, instead of VCD, or along with VCD.

In a few very severe cases of VCD, tracheostomy (an opening placed into the windpipe/trachea) has been necessary and helpful. See webpage 4 for  many other (non surgical) ways that VCD can be treated.

"In some cases the condition [VCD] can be life threatening: VCD has led to several near drownings among competitive swimmers." (Ref.10)

In the case of infants and babies having "pediatric" GERD/Gastro-Esophageal Reflux Disease, the VCD/laryngospams can be life threatening, and have caused death that was labeled as SIDS (Sudden Infant Death Syndrome). See a good PEDIATRIC GI (Gastro-intestinal) doctor right away, if your child may have gastric reflux.

Some people have a complication of nose (nasal) surgery, after the nasal turbinates are removed or "reduced" too much. This surgical complication (bad side effect) of turbinate reduction surgery, is called Empty Nose Syndrome [ENS] (also known as "secondary" atrophic rhinitis).Some symptoms of Empty Nose Syndrome (ENS) can include feeling (sensation) of suffocation, no mucus in the nose, dryness in nose & throat, burning, nasal congestion, pain, crusts in nose, voice changes for the worse, hoarseness, etc. Only a very few doctors know about and treat ENS. Here are links to 2 excellent websites, written by doctors-- Dr. Steven Houser, MD., in Cleveland, Ohio, and Dr. Murray Grossan, MD., in California, about Empty Nose Syndrome (secondary atrophic rhinitis). Both doctors are ENT's/Ear, nose & throat doctors.:
http://www.geocities.com/shouser144/empty.html
http://www.ent-consult.com/emptynose.html
Empty Nose Syndrome can exist alone (as a "VCD mimic"), or along with VCD, gastric reflux, &/or other conditions. Also, see "sinus tips" on webpage 10, in this website.

However, to be safe, get emergency medical help, immediately, for any breathing problems! See webpage 4, about getting immediate emergency medical help, in case of life-threatening breathing problems!

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