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Published: 07/07/2007
Updated: 07/12/2012

Vocal Cord Dysfunction (VCD) Exercises

Vocal cord dysfunction (VCD), is also known as paradoxical vocal fold movement (PVFM).

The best treatment for VCD is speech therapy with specific voice and breathing exercises. It is important to rest the voice, drink fluids, reduce exposure to triggers when possible, and reduce stress. Keep a list of what you are doing when the VCD occurs. Listed below are 3 exercises that help patients relax the vocal cords.

-- Relaxed-Throat Breathing Exercise: 1. double-sniff inhale, 2. exhale through pursed lips

Sniff in through the nose slowly, twice (visualize smelling a flower) and gently exhale through pursed lips (visualize blowing out a candle). Count to 4 on the exhale.

Train deep inhalations and long exhalations. Repeat 10 times and practice 3 times a day so you will know how to do it well when VCD occurs.

Practice releasing the exhaled air saying a soft ‘‘s,’’ ‘‘sh,’’ or ‘‘f’’.

In the video below, a speech pathologist from Nemours Children's Health System shows how to do rescue breaths for vocal cord attacks, teaching the “rescue breath”:

https://www.youtube.com/watch?v=cKHd935oRBg

-- Paused breathing

Sit in a position that allows your neck and shoulders to relax but keep your back straight. Breathe in gently through the nose. Stick your tongue out of your mouth, past the teeth and lower lip, in preparation to exhale. This forward stretch of the tongue helps to open the airway at the vocal cords. This may be difficult to do with a severe spasm but will be easier the more you repeat this exercise. With the tongue out, exhale only through the mouth in slow, paused or spaced breaths. The timing should be like saying "Ha, Ha, Ha, Ha", very slowly. Don’t use your voice, just breathe out. Repeat 10 times and practice 3 times a day so you will know how to do it well when VCD occurs.

-- Belly breathing

Sit in a position that allows your neck and shoulders to relax but keep your back straight. Place your hand on your belly. Breathe in gently through the nose with your belly pushing your hand outward from your body. As you start to exhale, place the tip of your tongue where your upper teeth meet the roof of your mouth. This will allow you to make a hissing or “S” sound as you exhale. This creates a back pressure to help keep the airway open. Slowly exhale allowing the hand & belly to move inward to a resting position and make the hissing or “S” sound as you push the air between your tongue & teeth. Repeat 10 times and practice 3 times a day so you will know how to do it well when VCD occurs.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC164364/ 

https://emedicine.medscape.com/article/137782-treatment 

https://azsneeze.com/vocal-cord-dysfunction-breathing-exercises/

Low Nickel Diet in Allergic Contact Dermatitis to Nickel

Editor: V. Dimov, M.D., Allergist/Immunologist, Cleveland Clinic Florida, Clinical Associate Professor, FAU Charles E. Schmidt College of Medicine



Low Nickel Diet in Allergic Contact Dermatitis to Nickel - Illustrated (click here to enlarge the image).



Low Nickel Diet in Allergic Contact Dermatitis to Nickel (click here to enlarge the image).

References:

Penn State Hershey Medical Group

Published: 07/12/2019
Updated: 09/18/2019

Surgery-Related Contact Dermatitis

Editor: V. Dimov, M.D., Allergist/Immunologist, Cleveland Clinic Florida, Clinical Associate Professor, FAU Charles E. Schmidt College of Medicine

Contact dermatitis can be either irritant or allergic. Surgery can induce both.

Exposure to irritants or allergens can happen before, during or after surgery:

1. Preoperative Contactants: Antiseptics, Skin pen markers, Anesthetics
2. Operative Contactants: Gloves, Metals
3. Postoperative Contactants: Sutures, Tissue adhesives, Staples, Topical antibiotics, Wound dressings (bandages)



Surgery-Related Contact Dermatitis: Contact Irritants and Allergens (click to enlarge the image).

Common causes of contact dermatitis (contactants) are remembered by the mnemonic:
AAAAA BMS

Antiseptics - Not in TRUE/NACDG 65 patch!
Adhesives - Not in TRUE/NACDG 65 patch!
Anesthetics
Antibiotics
Accelerants in rubber gloves
Bandages
Metals
Sutures



Surgery-Related Contact Dermatitis: Contactants Mnemonic (click here to enlarge the image).

References:

Surgery-Related Contact Dermatitis: A Review of Potential Irritants and Allergens
https://www.jaci-inpractice.org/article/S2213-2198(17)30168-X/abstract

Published: 04-25-2019
Updated: 04-25-2019