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Breathing problems

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PostPosted: Fri Jun 25, 2004 1:37 pm GMT +0000    Post subject: Breathing problems Reply with quote

Hey Doc,
I have a question for my 13 year old daughter. She's been riding bikes for a while and done some races, and never had any problems. But this spring she started having occasional problems on hard rides where she says her throat feels like it is closing up. We had her checked by her doctor for ashtma before the spring races, and he said it is not asthma, but it may be something else ( I forgot what he called it, it was 3 initials) and it wasn't serious.
She did some of the spring races and had no problems, but lately she has started training again for the fall races and is having the same problem again. Is there anything we should be doing to prevent this from happening?

Second question, for me;
I crashed last fall on a road bike and got some deep road rash on my shoulder (on the bump from a previous seperation). The bones have grown back together fine, but the road rash scar itches like a chigger bite all the time. Will anything stop it?

Last question,
How can anyone as hairy as you be allergic to cats? Rolling Eyes

Thanks Doc!
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The Bike Doc

Joined: 08 May 2003
Posts: 1371
Location: Corpus Christi and Warda, Texas

PostPosted: Fri Jun 25, 2004 3:58 pm GMT +0000    Post subject: Reply with quote


Answer 1:

Your daughter may have Vocal Cord Dysfunction or VCD (the three letters your doctor may have mentioned). VCD is the abnormal adduction (inward movement) of the vocal cords during inspiration (the vocal cords normally should abduct, that is move outward during inspiration) causing obstruction of the airflow and producing high pitched stridor or wheezing like noise primarily during inhalation and occasionally into early exhalation. VCD characteristically occurs more often in females and in highly competitive athletes that have great anxiety about failure. Onset is during the adolescent and young adult years. Additional aggravating factors for VCD include post nasal drainage, chronic sinusitis, pharyngitis, laryngitis, habitual cough, chronic throat clearing, sleep apnea, aspiration and gastroesophageal reflux. Episodes associated with strenuous exercise tend to develop shortly after the onset of the strenuous activity and rapidly resolve within 1-5 minutes of cessation of the activity. Exercise induced asthma (EIA) characteristically develops 5-20 minutes after the strenuous activity is completed and can last for several minutes to an hour or more. VCD does not respond to inhaled asthma medications like albuterol, but EIA does respond to these medications. VCD can occur in individuals who also have EIA.

Treatment for VCD involves breathing exercise training and relaxation therapy techniques. VCD responds well to these therapies in most individuals. Being seen by a physician familiar with the diagnosis treatment and management of EIA and VCD is critical in getting the diagnosis sorted out. A Pulmonologist combined with an Otolaryngologist can be valuable in sorting out the diagnosis and getting appropriate treatment. Often a Speach Therapist and a counselor are involved in the treatment program for VCD to help with teaching breathing and relaxation techniques.

Answer 2:

It is quite possible you have some deeply imbedded road grit in the shoulder that your body is reacting to. An ultrasound of the affected area specifically looking for the burried debree can be helpful. If there is debree there, depending on the location and depth, it may be best treated with ultrasonically guided removal or to leave it alone all together. If the wait and see approach is taken taking a daily doses of an histamine 1 blocker such as clemastine (Tavist), Clarinex or Zyrtec combined with daily doses of histamine 2 blockers such as Zantac can block the histimine 1 and 2 receptors in the skin that are triggering the itching. Topical antihistamine creams such as Benadryl (diphenhydramine) may also help.

Answer 3:

I have no earthly idea! Maybe it is because all that facial hair I have gives me a dog face. Laughing

Paul K. Nolan, MD
AKA: The Bike Doc
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PostPosted: Sat Jun 26, 2004 11:37 am GMT +0000    Post subject: Reply with quote

Thanks Doc, that sounds exactly like what she has. I'm glad to hear it can be controlled with learning some breathing exercises; We'll check with her doctor for a referral this week.

On the road rash; My wife does ultrasouds for UT, maybe she can sneak me in and look for some rocks. Otherwise, I'll just wait until it has to get Xrayed for some other crash!
Thanks again,
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