Diagnosis of Vocal Cord Dysfunction Helps Solve Young Runner’s Medical Mystery

March 1, 2008

Imagine the terror of being in the middle of a race and suddenly finding yourself unable to breathe. That’s what was happening to young Dylan Truman when he competed in his favorite sport. A student at Silver Creek Middle School, Dylan had been to specialists in pediatrics, pediatric cardiology and immunoallergy to try to determine a cause for his mysterious malady. His cardiac evaluation was normal. The only allergy he had was to dust mites, a very common problem. He was initially diagnosed with asthma, but the medications and inhalers didn’t seem to be helping. That’s when his mother, Marsha Robinson, took Dylan to see Dr. Stan Schooler.

Stan Schooler, MD, is a board certified specialist in pediatrics, emergency medicine and sports medicine. “After studying Dylan’s history and symptoms,” said Dr. Schooler, “I thought the problem sounded more like vocal cord dysfunction, or VCD. So, I contacted Susan Mathews, who has extensive training in the condition.” Susan Mathews, MS, CCCSLP, is a speech and language pathologist at Floyd Memorial. As she explained, “VCD is often misdiagnosed as asthma. Diagnosing it requires asking the right questions when you take the patient’s history to learn about the onset of symptoms and how quickly they resolve. I believe it is more common than we are seeing.”

What is Vocal Cord Dysfunction?

VCD occurs when the vocal cords go into a sort of spasm and close up tightly. That causes sudden and severe episodes of breathing difficulty. Many times, they are so severe that patients may believe they are dying. VCD may be present alone, or co-exist with asthma or other disorders.

How is VCD Diagnosed?

In order to test Dylan for VCD, Dr. Schooler and Mathews worked as a team. “We tested him on a treadmill to see if we could induce symptoms,” explained Dr. Schooler. “We conducted the test at Floyd Memorial to make sure he was in a safe environment. After several minutes of running, he began to show symptoms. We immediately got him off the treadmill and performed the diagnostic test.” Mathews used an advanced technique called videostroboscopy to visualize and record Dylan’s vocal cords during the attack. “With the digital videostroboscopy machine, which is the only one of its kind in Southern Indiana, we could see that instead of opening, his vocal cords were closing when he tried to exhale,” she said.

Once they made the diagnosis, Mathews taught Dylan some simple breathing techniques he could use to prevent the spasms. “You start by practicing the techniques at rest,” she said, “then while talking, then while exercising.”

Dylan and his mother were tremendously relieved by the diagnosis and therapy. “For over a year,” said his mother, “Dylan had been taking several asthma medications in increasing doses. Now, he’s been able to get off his medicines and do a very simple breathing exercise instead. It’s worked well so far, and we’re looking forward to putting it to the test during the upcoming track season.”

For more information on Dr. Schooler or vocal cord dysfunction, contact the Active Athlete practice at 812-949-3482.