EP. 21 - How to Stop Vocal Cord Dysfunction (VCD) Attacks
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Dr. Amber: If you or someone you know struggles with episodes of sudden difficulty breathing from vocal cord dysfunction, this episode is for you. We're talking about breathing exercises to help relax your throat when vocal cords tighten up. And this is a condition that sometimes confused with asthma. So if you experience this, you know that it can be scary and frustrating.

But the good news is it's manageable. Today, we're giving you a guide to powerful, relaxed throat breathing techniques. We'll walk you through some simple exercises you can practice every day to help you prevent and manage vocal cord dysfunction episodes. Welcome back to Allergy Actually.

This episode is intended to be purely instructional. We're going to give you three different types of breathing exercises you can practice. I recommend that patients with vocal cord dysfunction pick a time every day to go through five cycles of a breathing exercise. And you can choose one of these, or maybe your doctor has another one they recommend.


Daily Practice: Forceful Exhale Breathing Technique
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Dr. Amber: But I will demonstrate the first type of breathing exercise. And the intention is that it helps open up your throat so that you can breathe easier. So for this one, you're gonna sit up nice and tall. You can also stand. Breathe in nice and slow through your nose. When you breathe out, breathe out forcefully.

So either purse your lips or make an S sounds. Or if you have a straw you can keep handy. You've got a fast food straw. Breathe out through the straw. But you should be forcing the air out that tightens your cheeks. Your tummy should feel tight, and by activating those muscles, it loosens the muscles around the vocal cords and in your throat and opens it up.

So just to do a full cycle in through the nose, out forcefully. And in and out five cycles. Practice that daily. And then if you're in an episode where you feel like your vocal cords are tightening up or spasming, you feel your throat getting tight, have a hard time breathing in, feel a throat tickle that's causing you to cough, go into that breathing exercise to help stop the problem. Megan, do you wanna show another great option for vocal chord dysfunction?

Dr. Meagan: Yes. And this isn't something that I tell people to sort of practice on a daily basis. This is more of an acute technique for whenever you're symptomatic. And one other thing I just wanna point out too is that vocal cord dysfunction and asthma often coexist. And so, if you're not getting relief with these techniques and you need to consider, is this something with asthma that's going on. But it really helps to recognize each one because they're managed differently in this overall knowing all those things can help your breathing in general to get better. So what I always tell my patients is I think that I probably sit up tall, but I don't generally say that to them, maybe I should now. But what you're gonna do is put your hand up above your face. And I've had kids, teenagers who looked at me like, I'm not doing that, that looks dumb. And I'll tell, just go in the bathroom under the bleachers. Just go behind, you know, the concession stand.


Acute Rescue: The "Cold Blow" Hand Technique
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Dr. Meagan: That's fine. So take a big deep breath in and then you're gonna blow out, and that's through your nose. So breath in through your nose and you're gonna do a hard breath out through your mouth. So similar in technique to what Dr. Patterson just did. So, you take a big, deep breath in and then blow out. And one of the things that I was told by a speech therapist is that when you're doing this, you should, the air that hits your hand should be cold, it shouldn't be warm. And you should think of it more as a hard blow where you're trying to cool something off versus just a soft, sort of puff coming out.

So the other thing is that some people benefit from doing a splitting of the breath out. So you do your breath in first, then out three times.

Dr. Amber: I like that one.

Dr. Meagan: And so that one also can help if you are doing it, but the one solid long breath out isn't helping. So those are the two techniques that I teach. And I also wanna add here too, is that speech therapists are a wealth of information for vocal cord dysfunction, but since it's a relatively newer diagnosis and medicine, I think the first case series was published in 1984? It is something that not everyone's educated about. And so we actually have someone locally here in Huntington, West Virginia that specializes in vocal cord dysfunction, a speech therapist. And so I'm very lucky that I can send to her, but it's a good idea for you to find someone that's very knowledgeable about vocal cord dysfunction if you need more help than what we're showing you here.

Dr. Amber: And the good news is many people with vocal cord dysfunction once you diagnose it and know that it's there, a lot of times the symptoms resolve. It's like somehow just knowing that helps relax your throat. If not, you now have these tools that you can practice and use as rescue breathing when you feel the throat tightening.

But Kara, can you explain another type of breathing that can be useful for more of a wider audience, not just vocal cord dysfunction.

Dr. Kara: Yeah, so one of the things that kind of unites vocal cord dysfunction, asthma, even folks who have lived through anaphylaxis, is it's incredibly scary, right? It activates our nervous system and puts us oftentimes and purposely into fight or flight. And so it can be helpful to have techniques that help ground and calm your body after that initial wave of symptoms has resolved. You're feeling better but not a hundred percent better. So I really love learning and learning personally, but also teaching folks box breathing. 


Calming Down: Guided Box Breathing for Your Nervous System
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Dr. Kara: So I want you to visualize 

a nice little box as we're doing this. But the in breath is going to be an equal length. You're gonna hold it. So usually four seconds in, hold for four seconds. Exhale for four seconds. And then hold again for four seconds like you're making a box.

So we'll go through it together. I like putting my hand on my chest and one on my belly. Again, setting up straight can be really helpful. And you're gonna breathe in through your nose and again, out through your mouth. So we'll inhale for one, two , three, four. And hold, two, three, four. Exhale, two, three, four. Hold, two, three, four. And this can be repeated for, you know, up to two minutes in total. And really just help kind of bring you back down from that fight or flight, kind of get you back into rest and digest mode. While you're doing that breathing, it can be helpful to just feel your sensation of wherever your feet are hitting the ground, your bottom is hitting the chair or the ground, or the bed and focus on that and just let go of that scare, that anxiety, the fear and everything that you just made it through.

Dr. Meagan: Did anyone else get a sense of calm right when we did that? Like right as we finished, I was like, Ooh that was.

Dr. Amber: I'm gonna bookmark this episode and maybe watch this as I'll do my breathing exercises each day. Bookmark, like, subscribe, comment, share with a friend, or if you're an allergist, share with your patient so they know how to do these breathing exercises. We look forward to seeing you again next time on Allergy Actually. 

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