Tuesday, February 17, 2009

Breathe In, Breathe Out

Brody's asthma has been acting up since October. Several doctors have tried switching his asthma medications, prescribing a short burst of oral steroids (which did wonders for his eczema!), trialing medication for reflux, and even suggesting that what Brody really has is VCD (vocal cord dysfunction). Yesterday Brody had an appointment with his pediatric pulmonologist who wanted to have him do an exercise treadmill stress test to see if this would trigger an asthma attack with pre- and post-exercise PFTs (pulmonary function tests) which evaluates how quickly you can move air in and out of your lungs. Of course Brody loved running on the treadmill and the nurses were quite amazed at how well he did. I tried to explain to them that Brody is an extremely active child and this test wasn't really going to show much or even trigger an asthma attack because he usually pushes himself much harder than they were allowing him to run on the treadmill. He's quite the competitive little boy I must say!

As I expected, the test did not trigger an asthma attack and his PFTs looked great, but luckily Dr. Guilbert agreed that they probably hadn't pushed him hard enough during the test to get to his trigger point. The doctor suggested that Brody start pre-treating with his Albuterol inhaler before any strenuous exercise (gym class, karate class, just running nonstop like the crazy child he is) to see if that helps stop him from developing the chest tightness, shortness of breath, etc. Dr. Guilbert does still think that Brody might have a component of VCD along with the asthma and thinks he should see an ENT specialist to look into that possibility. Unfortunately diagnosing VCD involves spraying a numbing solution into the nose and then threading a tube with a small camera attached at the end up through the nose and down into the throat to actually visualize the vocal cords while making various sounds. Not something Brody has any intention whatsoever of agreeing to! For now we'll see how the pre-treating with Albuterol goes and then decide where to go after that.

1 comment:

lioness321 said...

I found your blog because of the VCD reference, and I just wanted to mention that you shouldn't ignore the possible VCD component.

My son's "asthma" seemed very severe and resistant to treatment until we realized that most of his symptoms were VCD. VCD is much easier to treat than asthma, and is treated by a speech therapist teaching him breathing exercises -- no drugs!

It can be diagnosed (not authoritatively, but well enough to take action) without the camera up the nose thing, based on flattened inspiratory loop on PFTs, and analysis of where the tightness is (throat versus chest) and analysis of when the attacks come on.

Hope that helps!

Click on my link above for the blog discussing my son's experiences with asthma and VCD