Catching Her Breath

New test allows runner to break boundaries on the track

A hacking cough and loud breathing during exercise are not normally associated with an elite athlete. But, Candace Wollert was a contradiction – competing nationally in the 800 meter run and breaking records at the University of Wyoming – all while struggling to breathe.

When Candace started running in college, she developed a deep cough that only went away when she stopped running. Her chest also burned and felt raw. Doctors diagnosed exercise-induced asthma.

By her junior year, Candace was taking five different asthma medications and throwing up weekly during hard practices. The tipping point came when her coach saw her struggling and made her stop running.

“I remember thinking, ‘If I can just make it 200 more meters …,’” she says. “But I couldn’t do it.”

With guidance from the University of Wyoming, Candace came to National Jewish Health, where she saw Tod Olin, MD, a pulmonologist who specializes in exercise medicine.

“It was a relief to think I would finally know what was causing this,” she says.

Dr. Olin has developed a sophisticated approach to a test called continuous laryngoscopy, which allows doctors for the first time to watch the vocal cords during exercise. Since Candace’s symptoms appeared only when she ran, and resolved within seconds of stopping, this new test was crucial to understanding her problem.

That test helped deliver a new diagnosis for Candace: vocal cord dysfunction (VCD). During periods of intense exercise, her vocal cords nearly closed, leaving her struggling to get air through a small opening. A speech therapist at National Jewish Health taught Candace techniques to keep her vocal cords open. She no longer takes asthma medications, except for an inhaler she uses only occasionally.

Many people like Candace are misdiagnosed or do not have a complete diagnosis. Between 2005 and 2008, one out of four asthma patients referred to National Jewish Health didn’t have asthma at all. Another 70 percent had other conditions in addition to asthma that were undiagnosed and were not being properly treated.

 “We spend a lot of time and resources treating people for asthma in this country, and for some, it’s just the wrong diagnosis,” Dr. Olin says.

“I thought that I would always have a hard time breathing,” Candace says. “It’s much better now,” Candace says. “My legs get tired before my lungs do.”

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