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    Is anyone here diagnosed with asthma and VCD?
    AngelFish31123 posted:
    Hi guys,[br>
    I've been here before but have been MIA for a while. I've lived with pretty bad asthma for years, but it turns out I probably have a few things wrong with me. I'm confused because my pulmonologist says I have "mild" asthma if anything, because my PFTs are normal, but I still get really bad coughing, chest pain, trouble breathing, and cough up mucus and wheeze when it's bad. I have trouble walking actually and have to hide out indoors. Also I thought that there are a variety of things besides breathing tests that are supposed to determine how "bad" asthma is? Like symptoms?[br>
    I am moving again in a few weeks back home, and will being seeing my allergist who does think I have moderate asthma. This week was hard because after two weeks of getting chest pain (and taking a high dose of steroid inhalers), I finally went to my family doc and he was nice enough to agree to give me pred. (which I tend to take 2-4 times a year).[br>
    Anyways, I had switched off of advair about a month ago to flovent, as advair tend to give me palpitations, but I do think it works better. I've taken flovent for years, and then advair for years. They seem hesitant to put me back on the advair, saying that people are more likely to get intubated on it, but I wonder if that is just because people who take combined inhalers just have worse asthma?[br>
    So about the point of this post. Apparently I also have VCD. I'm still trying to understand how this can possibly contribute to chest pain? My doctor keeps insisting that the problem is coming from my throat (vocal cords), but my throat feels just fine, it's my chest that hurts and wheezes.[br>
    So I was wondering if anyone else has dealt with this, and how you take care of both conditions at the same time? I've agreed to try speech therapy to help the VCD, and indeed would be happy if it does help, but am not sure what to expect. I'm trying to keep an open mind![br>
    Sorry if this post is way rambling. I've got pred in my system![br>
    sgbl88 responded:
    I understand your confusion. I have both athma (sever) and VCD.

    It is difficutl to distinguish between the two attacks. What I do is try the VCD exercises first and as I get my medicine out. If that works, I dont' take the medicine.

    The symptoms of VCD are referred to the chest. I am getting to where I can feel my throat tighten up and know a VCD attack is coming, but that has taken a while to recognize.

    The speach therapist will give you several exercises to work with. Mainly exercise to vorce the vocal cords to relax. They should also disus habits you may have that cause irritation of the cords that trigger attacks. One common habit is clearing your throat which is VERY bad for the vocal cords. Also, you need to make sure that acid reflux is very well controlled if you have it.

    Good luck with speach therapy. It helped me and several others in the community.

    Let me know if you have other question.

    AngelFish31123 replied to sgbl88's response:
    Hi Sonya, [br>
    Thanks! That helps a lot. I would be very happy to have better control over part of my symptoms, but I have a feeling there is more than one condition (asthma, VCD, reflux etc.) contributing to them. That makes sense too that the feeling of chest tightness can be coming from somewhere else.[br>
    I will ask if I think of any more questions. Do you still need to take pred. for bad attacks?[br>
    sgbl88 replied to AngelFish31123's response:
    I am glad I was able to help you some.

    Unfortunately, yes, I do have to take pred for flares still on occassion. I just finished my 3 burst this year a week ago, and so now I am waiting to see a pulmo. I have really been in a flare since Oct and just can't shake it. My peak flows will go up for a day or two and then drop again even lower than they were. It is frustrating.

    Just let me know if you have more questions. I am sure there are others out there to share their stories as well.

    Gregory M Metz, MD responded:
    Good morning. For some patients, their vocal cord dysfunction is the primary problem which mimicks asthma. For others, they have both asthma and VCD. I am glad that you will be seeing a speech therapist as the VCD manuvers can be employed to treat the component of VCD. If you have both asthma and VCD, both will need to be treated but hopefully the VCD manuvers will help control some of the symptoms and you may need less asthma medications.
    Manx3696 replied to Gregory M Metz, MD's response:
    I have had mild asthma for over 20 years. Since I started working in a different building 3 years ago, I have started having acute asthma attached. After being exposed in Feburary to paint fumed, where they painted an office beside mine, I have swelling of the throat, which causes extreme fatigue and horaseness. Then the swelling usually goes into my lungs causing asthma attack. No one here in Charleston West Virginina seems to know what to do for me.

    There is a print shop in the building and know when they run the carbonless copy paper I have throat swelling and chest tightness within 3-5 minutes. I use to recover from this after leaving the building for 10 - 15 minutes, but know the symptoms continue for weeks even when using Atrovent in Nebulizer and 20 mg of prednisone twice a day. I have been on the prednisone since August 11.

    I need help but no one seems to know what to do. This is the 3rd incident where I have missed up to 1 - 3 weeks of work.

    I appreciate any help and/or assistance you can provide.

    Thank you, Manx3696
    MSandyd replied to Gregory M Metz, MD's response:
    I have had bad asthma since June 22. The first thing that happened was I lost my voice. I have not heard of VCD. I have an appt to see an ear, nose, and throat doc next week. Can you tell me more about this problem? It is now into Sept. and I still have a very hoarse voice. The speech therapist who comes to my house is going to work with me after the doc diagnosis this.
    MSandyd replied to sgbl88's response:
    I just now saw the discussions on VCD. I have that and acute asthma that has lasted since June 22. I have home health, and a speech therapist is going to work with me as soon as a ENT doc makes a diagnosis next week. I didn't know there was just a thing. I am constantly clearning my throat. How does one stop this? I also have acid reflux but it is controlled with Nexium. Please let me know more.
    Gregory M Metz, MD replied to MSandyd's response:
    Vocal cord dysfunction can lead to cough and episodic shortness of breath. There are numerous other potential causes to hoarseness and throat clearing. The ENT physician will likely examine your throat to see if there is any irriration which may be triggered in part from acid reflux and/or post nasal drip.
    Dancinggrl responded:
    I have also been told that I have VCD and mild to moderate asthma. I understand your confusion because the symptoms feel the same. My allergist told me to use my peakflow as a marker. If it is above a certain number than assume it is VCD and do the breathing exercises he gave me. If it is under that certain number than use your inhaler. However, I can be at or above that certain number and feel tight like I want my inhaler. Does anyone know anymore about VCD and does it affect your peakflow? I have heard that it is not good to use the inhalers as can worsen the VCD. Since I am using my peakflow as a marker was just curious if VCD actually effects that.
    sgbl88 replied to Dancinggrl's response:
    Hi, VCD occurs on inspiration. Since peak flow is done on expiration it will not be affected by a VCD attakc.

    I do the VCD exercises while I am getting my inhaler out. If that seems to be helping, I chalk that attack up to VCD and continue doing the exercises until I have full relief. If it doesn't help, or only partially relieves the symptoms I go ahead and use my inhaler. It is possible to have both a VCD attack and an asthma attack at the same time.

    Take care.


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