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Have laryngospasm, sore throat, taken Cocodamol and Doxycycline. X-ray shows scarring from pneumonia. Help

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ENT Specialist
Practicing since : 2001
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Hello doctor,

Not sure if you can help as I have already been to several doctors and consultants and getting very frustrated as there doesn't seem to be an answer.

I will try and keep it brief. After returning from a trip to South Africa back in February I developed a sore throat which didn't clear up so eventually went to the doctors and got some anti-biotics which did nothing so back to the docs who advised steam treatment like for whooping cough, next day I awoke at 5am and couldn't breath for maybe a minute, a lot of panic especially for my wife. My breathing returned to normal and another visit to the doc's who said I had a virus which caused this Laryngospasm. Prescribed Co-codamol and doxycycline but the same thing happened the next morning, back to the doctors who couldn't fit me in so went to A + E where when I was being examined had another spasm which was sorted out with oxygen. Sent for examination with camera up nose to examine Larynx and was told all OK and not to worry as nobody dies with Laryngospasm. Went home and developed a severe pain in the back and spasms coming regularly (had 8 in one day) all very frightening, the following morning had one that carried on for several minutes and my wife called the paramedics who put me on a Nebuliser and it cleared. Still with back pain back to the doc's and got diagnosed with Plurisy and Pneumonia and sent into hospital. Had x-ray which showed scarring from the pneumonia, Bronchoscopy which was all clear and a scan which was clear. Told to go home and the virus would eventually clear. Bought a Nebuliser for home and the spasms slowly stopped for several weeks although still have a tickly and very sensitive throat and then yesterday sneezed and coughed and had another Larygospasm. Very difficult not to cough as the slightest irritant i.e. smoke, dust, sprays etc. cause a coughing fit. If I breath in through the mouth my throat feels very raw. Consultant last week thought I had developed asthma and gave me a puffer to try twice a day but this irritated my throat even more.

Sorry to waffle on but have you any idea how I can improve the situation?
Kind regards

Posted Fri, 24 Aug 2012 in Ear, Nose and Throat Problems
Answered by Dr. Naveen Kumar 8 hours later

Thanks for the query and a detailed history.

I will definitely try to help you in finding a solution for this and ensure that you will recover soon.

After going through the history, I am of the opinion that you are suffering from a recurrent laryngospasm secondary to vocal cord dysfunction.

Vocal cord dysfunction (VCD) is a condition wherein the vocal cords come together when breathiing in when normally they should go apart, resulting in any of a number of symptoms such as, wheezing, dyspnea, cough, and shortness of breath.

Many patients with VCD are wrongly diagnosed with asthma and suffer morbidity from unnecessary treatment such as high dose exogenous steroid and bronchodilator use, which would sometimes worsen the symptoms. VCD is also very common among asthmatics, because the symptoms are similar to those found in patients with only asthma, it is often overlooked and all the patients presenting with the above symptoms are presumed to be having asthma.

Triggers for these episodes are numerous such as stress, allergies, anxiety, asthma exacerbation, acid reflux disease, upper effect (ACE Inhibitors), exercise, cold air, etc. The treatment is aimed at identifying such triggerers and treating the same.

The following investigations have to be done to rule out the triggering factors:
1. 24 hour acid pH monitoring.
2. Allergy Workup - CT Sinus scan (Evaluate for subclinical chronic sinusitis), allergy testing.
3. To check for Vitamin B12 deficiency.

Once the appropriate diagnosis has been made, the causative factors should be treated accordingly. Even after all the above investigative procedures and medicines you are not feeling better, consider getting BOTOX injected into the vocal cords which will physically prevent the vocal cords from coming together and as such, prevent the difficulty in breathing should an attack occur.

Also, you can try the following maneuvers when there is an attack:
1. Breathing technique: when you feel you are getting an attack, breathe in slowly through the nose and not through the mouth; quickly exhale out through the mouth with pursed lips. Continue slow nasal inhalation and quick mouth exhalation with pursed lips until the episode passes.
2. Applying pressure behind both your earlobes where there is a notch between the bone of your mastoid process and ear will help in relieving the spasm.

Hope this answers your query; I will be available for the follow-up queries.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
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