EILO respiratory problems in young athletes

Reese Tempest had breathing problems in sixth grade. Reese loves jogging. Severe shortness of breath unfortunately hinders track and field training with teammates. The girl cried all the time fainted once.

Justin Tempest – Reese’s father, middle school cross country coach, and mother think Reese may have seasonal allergies due to the humid heat in Virginia.

The pediatrician diagnosed Reese with exercise-induced asthma after giving her a baseline spirometry test, which checks the amount of air exhaled. But Mrs Cameron – Reese’s mother disagrees with this diagnosis, because she used to suffer from asthma when she was a swimmer at university. She noticed that Reese’s symptoms were different, and that the symptoms did not improve with inhalers (inhalers).

Parents referred Reese to a heart health check-up and VO2 max test at the University of Virginia hospital. Diagnosed with exercise-induced asthma, Reese also has a little-known respiratory condition that affects the amount of air inhaled – exercise-induced laryngeal obstruction (EILO disease). It often occurs in young athletes and is often misdiagnosed as asthma.

EILO, also known as vocal cord dysfunction (VCD), occurs when the small muscles at the top of the larynx fail. When in their normal state, these muscles close when you swallow but otherwise remain open. When exercising, the small muscles will expand more than usual. With EILO, the muscles at the tip of the larynx close when the athlete performs an inhalation, making it difficult to perform an effective intake of air into the lungs. The patient will feel like he is breathing through a straw and choking. Preliminary symptoms may look like asthma, but the problem is limited to the throat, not the chest like asthma. Oxygen levels with EILO also did not change. Symptoms should disappear after 1 to 5 minutes of cessation of physical exertion. For athletes, it can be said that this is a frightening experience that prevents the sick person from participating in sports and other activities.

The disease, first discovered in 1842, is common in adolescent girls and can affect boys and adults. While the prevalence of EILO is unknown, research suggests it is common at around 5-7% among adolescents and around 8% of people with asthma also develop the condition, especially young athletes. year old. People with EILO are often misdiagnosed as having asthma. Pediatrician J. Tod Olin, at National Jewish Health (Denver) – an expert on EILO, said that up to a third of patients think they think they don’t really have asthma. , or they don’t realize they also have EILO.

Patients with EILO do not respond to asthma medications and are often treated with speech pathology therapy. Once diagnosed, Reese was treated with speech pathology exercises. The therapy is designed to be completed while sitting, not running, so Reese still faces many challenges when it comes to training.

“I am sad to see my daughter’s mental breakdown. Reese is a self-made and very gifted athlete,” said Reese’s father. Reese’s A-list is a prime example of a patient with EILO – an athlete who strives to achieve high. Reese’s parents turned to Dr. Olin to continue their daughter’s treatment. Olin has extensive medical experience treating high school athletes and Olympic coaches.

In 2014, Dr. Olin invented a new breathing technique to help athletes overcome EILO called Olin EILOBI breathing technique. This breathing technique helps the upper airways to tend to open to accommodate comfortable oxygen. “Physical exercise is important, so is the mind,” advises Olin to athletes. He attaches a small camera through an athlete’s nose to monitor working vocal cords during exercise tests.

Dr. Olin’s team, including psychologists, said: “The upper respiratory tract is like a window that helps to illuminate our brain. Emotions of frustration, harsh criticism in the body Exercise when controlled has a positive effect on the movement and shape of the throat.”

The doctor also encouraged and motivated the athletes with messages like “Think of this as a video game. You did a great job, no good or bad. You just need to learn from the experience. experiment and don’t give up. As long as you stay focused and change.”

While cycling in place in Dr. Olin’s clinic, Reese said, she was relieved to see her vocal cords open and close on the screen. She realized she was in control of herself. Olin’s goal for patients is to train them to perform the technique physically, to approach situations from a psychological perspective, and to apply both physical and psychological treatment during the practice. practice sports.

Olin and colleagues published a study in the Journal of Voice in 2017, that followed treatment for 61 athletes who learned the technique over 18 months. They found that 79% were able to apply the technique during intense exercise and 66% of them found the techniques to be effective.

Another expert in the field of EILO, pulmonologist James Hull at the Royal Brompton Hospital (UK), uses a similar technique with his patients. “The ability to use a technique to disrupt the speed of the airflow as you inhale during competition is a huge step forward in the treatment of EILO,” he said. 70% of the patients that Hull sees each week are treated incorrectly because they have EILO, not asthma. There are cases of both asthma and EILO. Hull uses a voice therapy technique called “Hoover”, based on the same principles as Olin’s.

About 10% of Dr. Hull’s EILO cases under 20 years of age require surgery due to failure to improve after trying different techniques. Surgically removes the “flaps” above the vocal cords, which block the patient’s airflow. Surgery is usually outpatient and is similar to recovery after tonsillectomy.

Fortunately, the 14-year-old Reese is still training for her freshman year of cross country – having her EILO disease under control. Reese still uses her daily Flovent inhaler and Albuterol to treat her asthma. However, she had good control over her breathing and ran at the desired speed. Reese credits herself with progressing through regular practice of Olin’s techniques. “Although I used to have breathing problems, I overcame the pain by choosing to be optimistic and thinking about the many good things going on around me,” the athlete shared.

Mai Trinh (According to npr.org)