Exercise Asthma Testing and
Laryngoscopy for Vocal Cord Dysfunction
All athletes involved in endurance sports should undergo testing to exclude the presence of Exercise Induced Asthma. Clin J Sport Med. May 2004; 134 - 138.
Dr. Silberman specializes in the work-up and treatment of exercise related breathing complaints, such as exercise induced asthma, exercise-induced laryngeal obstruction (E-ILO), vocal cord dysfunction (VCD) or paradoxical vocal fold motion (PVFM).
Dr. Silberman has diagnosed and treated elite, collegiate, high school, and recreational athletes who had previously been seen by pulmonologists and allergists. He has diagnosed Epstein Barr Virus (EBV) or "mono", anemia, and heart disease in athletes with breathing problems diagnosed as "asthma". It is common to hear, "You have done more than the pulmonologist".
Clinical symptoms and questionnaires may guide the diagnosis of asthma but have been found to be only a mediocre guide, often underdiagnosing and overdiagnosing exercise induced asthma (EIA) or exercised induced bronchospasm (EIB). Symptoms of exercise induced asthma or EIB are often 1. Expiratory, 2. Peak after exercise, 3. Peak 3-15 minutes after exercise (Roksund OD).
If your symptoms are 1. Inspiratory, often with coarse or high pitched inspiratory stridor, 2. Peak at peak exercise, and 3. Stop 1 to 5 minutes after exercise then you may suffer from exercise-induced laryngeal obstruction (E-ILO) formerly called vocal cord dysfunction (VCD). The Continuous Laryngoscopy Test (CLE) is a method that allows
for continuous documentation of your laryngeal airway using a laryngoscope, a small video camera placed into the back of your throat that allows visualization of your airway during exercise (Roksund OD 2006, J. Tod Olin 2014).
An exercise challenge test, otherwise known as spirometry or pulmonary function test, can be performed in the NJ Sports Medicine Performance Center. A VO2 max test is usually required to reach effort to bring on asthma. If office testing is negative, Dr. Silberman may test your performance in the field or with pre- and post- bronchodilator
medication inhalation. If symptoms and/or findings are compatible with E-ILO or you fail treatment with asthma medication, then the Continuous Laryngscopy Test will be performed with a flexible laryngoscope visualizing your vocal folds and airway during exercise.
If you are a cyclist, Dr. Silberman may test you out on the roads you ride on.
If you are a swimmer, Dr. Silberman can perform pulmonary function tests at your pool.
If you are a skater, Dr. Silberman can perform pulmonary function tests you at your rink.
You will not achieve peak potential if you have untreated asthma.
Untreated asthma is a serious health risk.
Link to World Anti-Doping Agency Medical Information to Support the Decisions of TUE (Therapeutic Use Exemptions) Committees - also called TUE Physician Guidelines - on Asthma.