I read somewhere that breathing in through your nose as well as mouth triggers the vocal chords to open. Also, when your mouth is partially closed, you’re forced to inhale slower, which irritates less. So, wide open mouth and forcefully inhaling, rapidly, over and over again, is wrong. Calm down and imagine that 350 W is 150 W yoga session.
The techniques created by the doctor in the video are vaguely described here:
http://training-conditioning.com/content/breath-fresh-air
It almost sounds like they all initially restrict airflow to get the vocal cords to open up before then opening up the mouth to let more air in.
Also, taking Atrovent (TEU required) beforehand seems to be a helpful treatment for the exercise-induced type of vocal cord dysfunction.
Hi bud, sorry to hear you are dealing with this. If you strongly suspect you have vocal cord dysfunction and you have been seen by a specialist who says you don’t have asthma after a pulmonary function test (PFT)… then you are probably correct. But before you settle on that diagnosis, you should have an otolaryngologist take a quick look at your vocal cords to make sure there isn’t something else going on. It’s really ideal to have them look when you experience the symptom, but they might think you are weird if you show up to the doctor with your trainer. 
Seriously though, have someone take a look to make sure something else isn’t going on. You might also bring the original data from the PFT because a diagnosis of VCD can be supported by the finding of variable extra thoracic airflow obstruction seen on the flow volume loop.
The problem with vocal cord dysfunction is that before you figure out how to make it better, thinking about it probably makes it happen with more frequency and intensity.
Hopefully the otolaryngologist can put you in contact with a good voice center where there are speech pathologists who specialize in treating patients with VCD. Perhaps seek an otolaryngologist at an academic center.
Hope this helps.
1 Like
Thanks! Me and my girlfriend have been thinking about going to an ENT for a while since we both have nasal issues and I have a throat issue. Just need time to go. Coincidentally, I also had sleep apnea and horrible snoring when I was much fatter (not sure whether I still do), which is probably related to my vocal cords. I can even recreate snoring and apnea intentionally (while awake) just like I can make my vocal cords close off by breathing in too hard while going extra hard.
The thing is, I knew I didn’t have regular asthma when I went to the pulmonologist. I specifically wanted to get checked for EIA/EIB since I have many symptoms similar to them (wheezing and coughing after TTs in cold, dry conditions, tight chest during full gas efforts), but the doctor said they didn’t have the equipment to do the test, which is weird for how large of a hospital it is… Although I did learn that I have nearly six liters of lung capacity, which isn’t too shabby.
Unfortunately, EIA and EILO require that you visit multiple doctors and neither are likely to be able to help if they aren’t used to working with (wannabe) athletes.
Wish I had known I had this issue when I was younger. I might stayed skinner and fitter all these years.
Here is the American Thoracic Society’s position statement on exercise induced bronchospasm, you may have already seen this. ATS Position Statement Exercise Induced Bronchoconstriction
We had an exercise induced bronchospasm testing protocol at our health center for a while but it didn’t get used much. However we do offer cardiopulmonary exercise stress testing which is a very good surrogate because we perform spirometry before and after VO2 max testing on the bike. If that’s what you are after you shouldn’t have too hard of a time finding someone to do that for you (I’m at a large community health system in North Carolina).
That being said, if you can hear a change in your breathing then you are probably dealing with a vocal cord issue…
1 Like
I actually specifically asked two different hospitals if they could do VO2Max testing and neither could. Which is weird since I thought all it took was a pulse oximeter, a spirometer, and some sort of ergometer, and I am pretty sure they have all three of those thing, since I did a stress test at one of them and an EKG at the other…
Given my MAP and my weight, my VO2Max is almost certainly very bad for a serious cyclist.
I am sorry this is not adding anything to the debate. But the word ‘otolaryngologist’ is causing acute vocal cord disfunction for me. Is that a running joke in that profession?
2 Likes
Funny. Just go with ENT. I bet the Brits on here have a different name for the profession. I think I’m a respirologist over there.
Nope ENT is ENT in the UK
1 Like
The proximity of the video recorder to the rider is why I suggested an onboard camera. Also the ones they show on Eurosport don’t have funky music soundtracks.
Honestly though, I’d just record yourself and show it to your doctor. They can arrange the other stuff if they think it is needed. Alternatively, they may just say it’s normal and save you time/effort/money.
1 Like
Do you have any specific examples? Usually all you can hear on onboard videos from the TDF is the sound of the wheels or the announcer…
Zwift races with a miced up streamer are probably about the best example I can think of… WE WON AGAIN!! Zwift Team Italy Gladiators Race - YouTube
So basically, a healthy elite cyclist going full gas shouldn’t sound like much at all.
1 Like
Is this a laser supraglotta…something… surgery? How does it work to solve the problem?
Would any decent ENT surgeon be able to do this?
By the way, EILO seems to mostly effect teenage girls, but it’s not unheard of for a male in their 30s to have it, right? Especially for someone who was sedentary enough in their teens for it to never been an issue at that time.
That seems like very much a last resort option and something that I think I would never recommend.
I’ve seen all demographics have this problem
so… Atrovent?.. with a TUE of course… cough cough.
Not off by heart. I will have a look after the sprint. I’m thinking a stage that took a long while to get away, as the early bits often have the highest short duration intervals & the crowd noise is less, for example when Yates got away in a massive break.
Wheeze tends to be when you breath out. Stridor tends to affect both. Wheeze also affects the ratio of in/out. This is why I think you should show a recording to someone with medical training.
My understanding is that wheeze is noise in the chest, stridor is noise in the throat.
It’s mostly an issue of the inhale, but I do feel somewhat restricted on the exhale because of tightness in the chest that occurs as I work very hard.
Just did a ramp test and realized I might have both a stridor (maybe not full EILO?) and EIB, since forcing air out of my lungs became harder and harder throughout the test. I also sound very wheezy when I try to force air out with maximal force. Unless that’s normal?
I got a prescription for an inhaler just to try it and see if it made a difference, since the doctor didn’t have any of the equipment you’d need to actually test for EIB/EIA or EILO…
I suspect the stridor might just be because I’m fat. Hah.
I doubt it has anything due to your weight unless you truly are over weight and that has predisposed you to gastroesophageal reflux which makes vocal cord problems more likely. Stridor, wheeze… these terms mean a lot to doctors but when patients hear any abnormal sounds with breathing they tend to call it “wheezing”.
Again, if you can hear it then it’s probably from your vocal cords. But I think it’s worth it for you to see an ENT who could scope you when you have symptoms to evaluate further. It helps if they have a good speech therapy team that works with them.
If you live anywhere near to North Carolina I can help you get set up with all of this if you desire it.
I am about 10 kg overweight but was almost 40 kg overweight and had (have?) obstructive sleep apnea. I did have pretty bad acid reflux then, but not now.
I am in Japan. Haha.
I am 99% sure no local ENTs are capable of scoping me while exercising. One semi-local ENT listed online as a sports doctor didn’t even know what EILO was…
VCD and EIB comorbodity is pretty common though, isn’t it?
I think about 15% of patients who have asthma can have vocal cord dysfunction. And about 50% of asthmatics will have EIB. So there is definitely overlap between the two conditions.
Some health centers will actually dedicate the resources to have the equipment to be able to induce the wheeze (typically with a medicine, but exercise could be easily feasible) and then perform pulmonary function testing and laryngoscopy immediately thereafter. It is time consuming, but not unheard of.
I can’t say that I remember reading about this from any Japanese sources, but there is probably someone over there who could accomplish this.