Sunday, November 30, 2014

Suddenly Unable to Breathe

A young man came to see me the other day complaining of several episodes of frightening shortness of breath. The first episode developed quickly one day when he was leaving work. He had been tired that week, perhaps with early symptoms of a respiratory tract infection or perhaps his allergies were acting up, but his distress seemed to come on “out of the blue.” Quite abruptly, he recalled, he couldn’t breathe. His symptoms improved relatively quickly, such that by the time he arrived home 30 minutes later he felt all better, although frightened by such a severe attack.

He experienced several similar events over the next few weeks, many waking him from his sleep. He had no prior history of asthma, although he had a history of mild seasonal rhinitis. He experienced occasional post-nasal drip and had no symptoms of heartburn to suggest gastroesophageal reflux. He had never been told of asthma as a child, and he was a lifelong non-smoker.

When questioned more about his difficulty breathing, he was quite clear: he simply could not get air in or out of his chest. It was not that it was hard to empty the air from his chest, he said, it was that no air would move at all. He was given an albuterol inhaler to try, but found it difficult to use and in truth had not tried it.

He reported only minimal cough, no sputum production. He had not experienced wheezing, but recalled a respiratory sound that he made as his episodes gradually resolved. His wife thought that she too had heard a breathing noise, particularly when he tried to breathe in. They have two cats at home but noted no increased likelihood of symptoms when around the cats. In the absence of these attacks, he felt well and was able to work out at the gym without limitation due to his breathing. His only medications were vitamin D and glucosamine chondroitin.

His chest examination was normal. Chest X-ray was normal. Breathing tests (spirometry) performed at a time when he felt well was likewise normal. And the question was: is this asthma?

Asthma causes symptoms that come and go. Between attacks one can feel entirely well with a normal chest exam and normal lung function. However, the history that this young man offered was atypical in several ways, including no prior history of asthma; sudden severe attacks that came on without warning and resolved within a few minutes without treatment; and his sense that during these spells it was not hard to breathe, but impossible to breathe at all – no air movement in or out at all. As the episode abated, there came an inspiratory sound; and when asked if he could localize the site of his distress, he offered that he thought his problem was in his throat more than in his chest.

The diagnosis? Not asthma but laryngospasm – an alternative and more plausible explanation for these sudden attacks of difficulty breathing. Imagine that some irritant triggers the vocal cords to suddenly come together and tightly obstruct the upper airway. One cannot breathe (or talk), and it feels as though one were about to suffocate to death. One tries to inhale or exhale, but no air can pass the closed glottis. After what seems like an eternity but is probably well less than one minute, the laryngeal spasm begins to abate. As the vocal cords begin slowly to move apart, one can start to get air passed, with an inspiratory sound that we recognize as stridor. At first air enters the lungs with increased resistance through the narrowed upper airway, but over several seconds, as the laryngeal muscles further relax and the vocal cords abduct fully, normal breathing is restored. The entire event is over in a minute or two, and no medication is needed (or likely to help). An inhaled bronchodilator might be more irritating to the larynx and should probably be avoided.

What causes some people to develop laryngospasm is not known. Our young man had a normal ENT examination with direct laryngoscopy to exclude a structural abnormality of the glottis. His laryngeal sensitivity developed without prior trauma or other explanation. Potential triggers that may set off spasm of the sensitized larynx include mucus draining from the posterior pharynx, acid refluxed from below, cough with secretions expectorated at high velocity, or oro-pharyngeal aspiration.

Preventing provokers of laryngospasm, such as laryngopharyngeal reflux, is an important treatment, especially in persons with frequent night-time episodes. Other management strategies that have been described include “rescue breathing” techniques taught by speech-language therapists; application of forward and upward pressure behind the earlobes and in front of the mastoid processes in what has been described as the “laryngospasm notch”; and, rarely, botox injections into the larynx.

In most instances, coming to understand the mechanism of the event is key to dealing with it: one needs to try to stay calm, attempt small breaths in through the nose, and perhaps visualize relaxation and separation of the vocal cords. Knowing that the spasm of the larynx will pass in a matter of seconds and that there will be no long-term harmful effect are the reassurances that we have to offer. Distinguishing these episodes from asthma attacks is also crucially important. Treatment with bronchodilators and corticosteroids will not bring relief or prevent episodes of laryngospasm. It only confuses the issue, obscures the diagnosis, and likely frustrates the sufferer.

37 comments:

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  2. Not being able to breathe is one of the scariest things you can experience. Granted it hasn't happened to me, even though I do have asthma. There have been a few times where it acts up, but nothing serious yet. That doesn't rule out the possibility of it happening. I would not like that to happen, so I think that getting some treatment would be best for me. http://www.familyasthmaandallergyofwestvirginia.com/Asthma_Treatment_Charleston_WV.html

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  3. Asthma specialist in Gurgaon Delhi is a top class clinic in Gurgaon . Ger cured by world class doctors and specialists for asthma and lung cancer related diseases. For more information visit http://lungcancertreatmentdelhigurgaon.blogspot.in/2015/01/how-to-lead-normal-life-with-asthma.html

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  8. Emphysema Treatment ought to include, obviously, eliminating exposure to emphysema-bringing about poisons. This includes more than the evasion of tobacco smoke. You ought to look at your everyday life and check for different wellsprings of poisons.

    ReplyDelete
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  10. Thanks for sharing this extremely informative article on breathing problems due to cough. I recently read about breathing problems on website called breathefree.com. I found it extremely helpful.

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  11. As a sign of gratitude for how my husband was saved from asthma , i decided to reach out to those still suffering from this.
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  12. Very helpful article for those who are suffering from asthma. Thanks for sharing this extremely informative and insightful article on breathing problems. I saw a similar article at http://allergyweb.com/ and found that extremely helpful.

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  15. Just wanted to say a huge thank you to Dr Williams for everything he have done in my life. I have been in tears for so many years now, having found that my husband is suffering from asthma , lesion after some years of being under extreme stress., . I spent 24 hours freaking out and finally calmed down after reading some testimony on here about Dr Williams herbal medicine to asthma . The moment came and I mumbled out to my husband about Dr Williams product (with a few tears) and he was AMAZE – . He was just worried about his health, been free from this , that was how will order for Dr Williams product on line , after my husband finish taking Dr Williams medicine for just within a period of one month. Will went to the doc together who confirmed that he was asthma free.
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  17. Irrespective of receiving daily oral or future injectable depot therapies, these require health care visits for medication and monitoring of safety and response. If patients are treated early enough, before a lot of immune system damage has occurred, life expectancy is close to normal, as long as they remain on successful treatment. However, when patients stop therapy, virus rebounds to high levels in most patients, sometimes associated with severe illness because i have gone through this and even an increased risk of death. The aim of “cure”is ongoing but i still do believe my government made millions of ARV drugs instead of finding a cure. for ongoing therapy and monitoring. ARV alone cannot cure HIV as among the cells that are infected are very long-living CD4 memory cells and possibly other cells that act as long-term reservoirs. HIV can hide in these cells without being detected by the body’s immune system. Therefore even when ART completely blocks subsequent rounds of infection of cells, reservoirs that have been infected before therapy initiation persist and from these reservoirs HIV rebounds if therapy is stopped. “Cure” could either mean an eradication cure, which means to completely rid the body of reservoir virus or a functional HIV cure, where HIV may remain in reservoir cells but rebound to high levels is prevented after therapy interruption.Dr Itua Herbal Medicine makes me believes there is a hope for people suffering from,Cancer,Hiv_ Aids,Herpes,Copd,Diabetes,Hepatitis,I read about him online how he cure Tasha and Tara so i contacted him on drituaherbalcenter@gmail.com even talked on whatsapps +2348149277967 believe me it was easy i drank his herbal medicine for two weeks and i was cured just like that isn't Dr Itua a wonder man? Yes he is! I thank him so much so i will advise if you are suffering from one of those diseases Pls do contact him he's a nice man.

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  21. 6 months ago I was diagnosed with COPD with 55-60% lung capacity. My doctor just said all the crying , stomping your feet will not change it so just accept it and basically patted me on the back and sent me home to die. I was devastated and was afraid to do anything. I stopped riding my bike, I was afraid to do anything that would cause any exertion. It consumed my thoughts with every breath and the fear of what to expect was almost more than I could deal with. So I couldn't get myself all time I decided to find a herbal cure online and I came acrose Doctor Itua on how he cure several people suffering from Hiv, and Herpes I gave him a call on this Number +2348149277967 also chat on whatsapp he gave me all the details about the cure i paid him for the medicine after 5 working days i receieve my herbal medicine ,I use it for two weeks that is how I get Cured and today I'm living healthy and fine I give him thanks also promise him to testify about his work,He Can also cure the following deseases..Copd,Herpes,Alzheimer's disease,Adrenocortical carcinoma.Asthma,Allergic diseases.Parkinson's Fatal Familial Insomnia Factor V Leiden Mutation ,Epilepsy Dupuytren's disease,disease,Schizophrenia,Cancer,Scoliosis,Fibromyalgia,Hiv,Hepatitis,diabetes,Coeliac disease,Creutzfeldt–Jakob disease,Cerebral Amyloid Angiopathy, Asthma.Contact...drituaherbalcenter@gmail.com..Whatsapp Number...+2348149277976

    ReplyDelete
    Replies
    1. I am here again to say a big thanks to Dr.Abaka for making me a complete
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      Delete
  22. Dr Itua cure my HIV, I have been a ARV Consumption for 10 years. i have been in pains until i came across Dr Itua on blogs site.I emailed him about my details of my HIV and my location i explained every thing to him and he told me that there is nothing to be scared of that he will cured me, he gave me guarantee,He ask me to pay for items fees so when i'm cured I will show gratitude I did and giving testimony of his healing herbs is what I'm going to do for the rest of you out there having HIV and other disease can see the good work of Dr Itua.I received his herbal medicine through EMS Courier service who delivered to my post office within 5 working days.Dr Itua is an honest man and I appreciate him for his good work.My GrandMa called him to appreciate him and rest of my friends did too,Is a joy to me that I'm free of taking Pills and having that fat belle is a nightmare.you will understand what i'm talking about if you have same problem I was having then not now though.I'm free and healthy Big Thanks To Dr Itua Herbal Center.I have his calendar too that he recently sent me,He Cure all kind disease Like,Cancer,Fibromyalgia,Fluoroquinolone Toxicity
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    ReplyDelete
  23. Asthma is relatively easily cured with acupressure. Google for
    gv26 important.
    and see how lip pressure relaxes lung airways. So inhale consciously and mindfully through the nose pulling the lips together and not asthmatically wth mouth breathing. Breathe into the belly and keep clear of sprays, if needed with a doctor’s help. Clenching fists also helps using acupressure.

    ReplyDelete


  24. Am jeremiah, I am testifying about a great hebal man that cured my wife of hepatitis B and liver cirhosis. his name is Dr oniha. My wife was diagnose of hepatities two years ago, i almost spent all i had then, until i saw dr oniha recommendation online, and i call him, then he told me how to get the herb. You can call him on +2347089275769 or email him at dronihaspell@yahoo.com

    ReplyDelete
  25. I am bold enough among many others to state that there is now a potent cure to this sickness but many are unaware of it. I discovered that I was infected with the virus 3 months ago, after a medical check-up. My doctor told me and I was shocked, confused and felt like my world has crumbled. I was dying slowly due to the announcement of my medical practitioner but he assured me that I could leave a normal life if I took my medications (as there was no medically known cure to Herpes). I went from churches to churches but soon found that my case needed urgent attention as I was growing lean due to fear of dying anytime soon. In a bid to look for a lasting solution to my predicament, I sought for solutions from the herbal world. I went online and searched for every powerful trado-medical practitioner that I could severe, cos I heard that the African Herbs had a cure to the Herpes syndrome. It was after a little time searching the web that I came across one Dr Itua(A powerful African Herbal Doctor), who offered to help me at a monetary fee. I had to comply as this was my final bus-stop to receiving a perfect healing. My last resolve was to take my life by myself, should this plan fail. At last it worked out well. He gave me some steps to follow and I meticulously carried out all his instructions. Last month, to be precise, I went back to the hospital to conduct another test and to my amazement, the results showed that negative,Dr Itua Can As Well Cure The Following Desease…Cancer,Hiv,Herpes, Hepatitis B,Liver Inflammatory,Diabetis,Fribroid,,Non Hodgkin Lymphoma,Skin Cancer,Uterine Cancer,Prostate Cancer Dercum,Infertility,fibromyalgia,Get Your Ex Back,Als,SYPHILLIS,Genetic disease,Epilepsy, Parkinson's disease..You can free yourself of this Herpes virus by consulting this great African Herbal Doctor via this e-mail: drituaherbalcenter@gmail.com or call and whatsapp him on +2348149277967 He will help you and his herb medication is sure. he has the cure on all disease .You can talk to me on INSTAGRAM..tashamoore219....

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  26. If you have Herpes in your whole body such as fever blisters, hsv, or roofing shingles you know what it is like to stay with the pain and discomfort that herpes delivers. I don't need to tell you how awesome it would be to find something that works so well that you no longer need to fear about stress or outbreak,Dr Itua herbal medicine cure my herpes in two weeks of taking it.is genuine and natural herbal medicine it has no side effect, The reason I'm writing this is that I promised Dr Itua I will share his herbal work to the world to see Herpes is no more a big deal.also Dr Itua can as well cure the following diseases...HIV,Hsv 1/2,Hepatitis B,Cancer, Diabetes, Men/Woman Infertility, Scoliosis,Fibromyalgia,Fluoroquinolone Toxicity
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    ReplyDelete
  27. I’m Mark Russ , I contracted HIV in 2009, I was told by my doctor that
    there’s no possible cure for HIV. I started taking my ARV’s, My CD4 was 77
    and viral load was 112,450. I saw a website of Dr. Imoloa also I saw a lot
    of testimonials about him on how he uses herbal medicine to cure HIV. I
    contacted him and told him my problems, He sent me the herbal medicine and
    I took it for 7 days after then I went for check-up and I was cured. The
    medicine has NO SIDE EFFECT, there’s no special diet when taking the
    medicine. He also cure DIABETES, EX BACK, ALS, HEPATITIS B, CANCER, HERPES
    1) If you want your ex back.
    (2) If you always have bad dreams.
    (3) You want to be promoted in your
    office.
    (4) You want women/men to run after
    you.
    (5) If you want your own children
    (6) You want to be rich.
    (7) You want to tie your husband/wife to
    be
    yours forever.
    (8) If you need financial assistance.
    (9) How you been scammed and you
    (10) and if you ant your herpes cure back
    want to recover you lost money
    (11) CANCER,
    (12) DIABETES,
    (13) HIV&AIdS,
    (14) URINARY TRACT INFECTION,
    (15) CANCER,
    (16) IMPOTENCE,
    (17) BARENESS/INFERTILIY
    (18) DIARRHEA
    (19) ASTHMA..
    Also contact him with the above.
    and lots more. You can reach him on drimoloaherbalmademedicine@gmail.com or
    Whatsapp +2347081986098 all thanks to dr imoloa he is really a great man .

    ReplyDelete
    Replies
    1. I am here again to say a big thanks to Dr.Abaka for making me a complete
      man again, i was infected with herpes for 5 years i have been seriously praying to God and searching for cure. I came here last month to search for solution to my problem and i saw a comment of people talking about different doctors and God directed me to choose Dr.Abaka and i contacted Him, he sent me a medicine and directed me on how i will take the medicine for 14 days, i did so and went for a test and my result came out as Negative. i am so happy, i shared tears of happiness and i have taken it upon my self to always testify about how God used Dr.Abaka to solve my problem. I am a clean man now, without any virus if you are infected with any disease like HIV, AIDS, CANCER HERPES or any other disease you can also be happy like me

      by contacting Dr.Abaka through his Email:
      drabakaspelltemple@gmail.com or call or whatsapp him any of the numbers +2349063230051.

      Delete
  28. I’m Mark Russ , I contracted HIV in 2009, I was told by my doctor that
    there’s no possible cure for HIV. I started taking my ARV’s, My CD4 was 77
    and viral load was 112,450. I saw a website of Dr. Imoloa also I saw a lot
    of testimonials about him on how he uses herbal medicine to cure HIV. I
    contacted him and told him my problems, He sent me the herbal medicine and
    I took it for 7 days after then I went for check-up and I was cured. The
    medicine has NO SIDE EFFECT, there’s no special diet when taking the
    medicine. He also cure DIABETES, EX BACK, ALS, HEPATITIS B, CANCER, HERPES
    1) If you want your ex back.
    (2) If you always have bad dreams.
    (3) You want to be promoted in your
    office.
    (4) You want women/men to run after
    you.
    (5) If you want your own children
    (6) You want to be rich.
    (7) You want to tie your husband/wife to
    be
    yours forever.
    (8) If you need financial assistance.
    (9) How you been scammed and you
    (10) and if you ant your herpes cure back
    want to recover you lost money
    (11) CANCER,
    (12) DIABETES,
    (13) HIV&AIdS,
    (14) URINARY TRACT INFECTION,
    (15) CANCER,
    (16) IMPOTENCE,
    (17) BARENESS/INFERTILIY
    (18) DIARRHEA
    (19) ASTHMA..
    Also contact him with the above.
    and lots more. You can reach him on drimoloaherbalmademedicine@gmail.com or
    Whatsapp +2347081986098 all thanks to dr imoloa he is really a great man .

    ReplyDelete
  29. All thanks to Dr. Imoloa if not for him I don't know what will have become of me today. I married my husband who was HIV positive like myself. We accepted it as fate since there is no cure. Two years after our marriage my life was torn apart when our family doctor diagnosed me of genital herpes virus I know it was from my ex whom I have dated years back. I became very worried because I don't know what will be my husband judgment when he finds out. I searched everywhere both on internet for cure but no success until my husband started suspecting but still he wasn't sure. I don't want to loose my marriage I prayed everyday with hope that there is a cure. I searched without rest blogs, websites, everything google says about herpes and cure and peoples comments one evening after work I was surfing the internet on herpes cure I saw a friend who was giving testimony on how DR. Imoloa have helped cured her of her herpes virus I immediately contacted her to confirm if her testimony was real. She told me it was. She also told me about African Herbs and Herbalist and Dr imoloa. She then gave me Dr. imoloa contact, which I contacted him immediately. He told me about his Herbal Medicines and how he has helped many people get healthy with fruits and vegetables and also cured many with his Roots and traditional Herbs, I was interested. He prepared and sent me Herbal medicine for both HERPES & HIV through DHL I used this medicines for both HERPES and HIV carefully as was prescribed by him for 1week and 4days without my husband notice. I waited for a month then went for medical test in a different hospital and I was both herpes and HIV negative I felt reborn. I showed my husband my result and told him everything including DR imoloa. He contacted DR imoloa who also sent him HIV Herbal Medicine. He used this Medicines for just 8days, then we both went to our family doctor who confirmed my husband HIV negative and me still negative. Our family doctor, Dr Paul is a good Christian and often advice his patients to use natural remedy. Based on confidential he do introduce some of his patients to DR imoloa for Herbal cure. If you are sick and want the right Herbal Medicine contact DR imoloa on drimolaherbalmademedicine@gmail.com. you can also reach him on whatssap- +2347081986098. GOD bless you dr imoloa, you are really a great man.

    ReplyDelete
  30. Who would have believed herbal medicine could cure FIBROID? I suffered fibroid for a long time and getting pregnant was a problem, I had pelvic pain, heavy menstrual bleeding even hospital could not help. Until I read about doctor Uduehi online, I contacted him for help and behold I was cured. I have gone for test severally at the hospital and was proved negative which means I am free from fibroid and I am also pregnant at the moment. You too can be cured if having such problem. His contact: uduehiherbalcare@gmail.com phone/WhatsaPP: +2347084878384

    ReplyDelete
  31. Dr. Iyabiye is a herbal specialist he treat/cure HEPATITIS and CIRRHOSIS and other deadly diseases. My name is Russel and I was ones a victim of chronic hepatitis B and liver cirrhosis, I got cured with his medication and I am safe and free now. I am testifying to his great work so that you too can be safe from hepatitis or any life threatening disease. His contacts are: iyabiyehealinghome@gmail.com Call/Whatsapp: +2348072229413

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  32. Hiv disease for the last 3 years and had pain hard to eat and cough are nightmares,especially the first year At this stage, the immune system is severely weakened, and the risk of contracting opportunistic infections is much greater. However, not everyone with HIV will go on to develop AIDS. The earlier you receive treatment, the better your outcome will be.I started taking ARV to avoid early death but I had faith in God that i would be healed someday.As a Hiv patent we are advise to be taking antiretroviral treatments to reduce our chance of transmitting the virus to others , few weeks ago i came on search on the internet if i could get any information on Hiv treatment with herbal medicine, on my search i saw a testimony of someone who has been healed from Hiv her name was Achima Abelard and other Herpes Virus patent Tasha Moore also giving testimony about this same man,Called Dr Itua Herbal Center.I was moved by the testimony and i contacted him by his Email.drituaherbalcenter@gmail.com OR info@drituaherbalcenter.com. We chatted and he send me a bottle of herbal medicine I drank it as he instructed me to.After drinking it he ask me to go for a test that how i ended my suffering life of Hiv patent,I'm cured and free of Arv Pills.I'm forever grateful to him Drituaherbalcenter.Here his contact Number +2348149277967...He assure me he can cure the following disease..Hiv,Cancer,Herpes Virus,Hpv,Pile,Weak Erection,Lyme Disease,Epilepsy,Glaucoma.,Brain Tumor,psoriasis, Cataracts,Macular degeneration,Cardiovascular disease,Chronic Diarrhea,Lung disease.Enlarged prostate,Osteoporosis.Alzheimer's disease,
    Dementia. ,Bladder Cancer,Autism,Colorectal Cancer,Breast Cancer,Kidney Cancer,Leukemia,Lung Cancer,Tay tach disease,Non Hodgkin Lymphoma,Skin Cancer,Lupus,Uterine Cancer,Prostate Cancer, Seizures, fibromyalgia ,ALS,Hepatitis,Copd,Parkinson disease.Genetic disease,Fibrodysplasia disease,Fibrodysplasia Ossificans Progressiva,Fluoroquinolone Toxicity Syndrome,Stroke,Hpv,Weak Erection,Liver/Kidney Inflammatory,Men/Woman infertility, bowel disease ,Huntington's disease ,Diabetes,Fibroid.

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  33. Thanks to this great herbal doctor who cured my friend of HIV/aids, his name is Dr. Iyabiye. My friend suffered HIV for so long that she lost her job and became stranded financially because of HIV antiretroviral drugs she buys every time. Until 2 months ago when I heard about this doctor and I did contacted him to help my friend, he administered his medication on her and she was confirmed cured and free at the hospital after the treatment. I came here to inform the general public and to safe people from this life threatening & killing disease. Contact: iyabiyehealinghome@gmail.com (+2348072229413 / +2348158577300)

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