A triath­lete’s breath­ing mys­tery, solved

The Denver Post - - LIFE & CULTURE - By Cindy Sut­ter

Spe­cial to The Den­ver Post

Triath­lete Tyler Evans kept push­ing him­self harder as he trained with a high per­for­mance team at the U.S. Olympic Train­ing Cen­ter in Colorado Springs.

Then, the 24 year old from up­state New York hit a wall. And not just any wall. As he pushed him­self harder, he found it dif­fi­cult to breathe and suf­fered chest pains. Things came to a head last year in a race in Florida.

“I tried to push through the symp­toms. I was not phys­i­cally tired. I know I’m in good shape,” he says. “I was in a good po­si­tion (in the race), then out of the wa­ter, I got onto the bike and couldn’t hang on to nor­mal power levels. I couldn’t fin­ish the race.”

Look­ing for an­swers, he kept train­ing.

“I was try­ing to push my­self harder in prac­tice to prove it was a fluke,” he says. “As I worked harder, it got worse. When I was in the pool, at times I was at the point of black­ing out. Things would get closed in, and I couldn’t breathe.”

He went back to New York and saw a doc­tor there, who gave him a 10-minute stress test. Evans com­pleted it with ease.

“The doc­tor looked at the re­sult and said, ‘I don’t know why you’re here,’” Evans says.

He be­gan see­ing var­i­ous doc­tors, even as his con­di­tion wors­ened. Some thought it was asthma, which he had been di­ag­nosed with as a child. He knew it didn’t feel the same.

On a run in March, Evans suf­fered se­vere chest pains. He tried to jog back to his car and found he couldn’t even do that.

“I had to walk slowly back to my car,” he says. “I didn’t know what was hap­pen­ing. I thought I might be hav­ing a heart at­tack. It was the ul­ti­mate low point.”

Evans went to Cleve­land Clinic, where he un­der­went test after test on his heart and lungs. Doc­tors found noth­ing wrong.

“Of course it was good that noth­ing was wrong with my heart and lungs,” Evans says. “Psy­cho­log­i­cally, it was a very horrible thing. These doc­tors are the best in the world, and they’re not find­ing any­thing. Was it re­ally all in my head?”

On the last day in Cleve­land, he saw an ear, nose and throat spe­cial­ist who ob­served that Evans breathed more with his head and neck than with his di­aphragm. The doc­tor sug­gested he go to Den­ver’s Na­tional Jewish Health.

Dis­cour­aged and tired of the many tests he had un­der­gone, Evans al­most didn’t call for an

ap­point­ment. When he did go to Na­tional Jewish, the nurse did a stress test while draw­ing ar­te­rial blood to look at his oxy­gen levels.

The nurse then told Evans: “I know what you have.”

She asked if he ob­jected if she brought in Dr. Tod Olin, di­rec­tor of the Pe­di­atric Ex­er­cise Tol­er­ance Cen­ter at Na­tional Jewish. Olin had Evans be­gin the tread­mill stress test and then put his phone cam­era up to his face to record what was go­ing on.

“He said, ‘I’m 95 per­cent sure I know what you have. Come back next week,’ ” Evans says.

That’s when, after more test­ing, Evans learned his di­ag­no­sis: ex­er­cise-in­duced la­ryn­geal ob­struc­tion, also called vo­cal cord dys­func­tion. In those who have the con­di­tion, the throat in­ex­pli­ca­bly closes dur­ing very stren­u­ous ex­er­cise. The first prob­lem, though, is get­ting a di­ag­no­sis. Most peo­ple never ex­er­cise hard enough — above 85 per­cent of ca­pac­ity — to know they have it, Olin says.

He adds that aware­ness of the con­di­tion is higher in Colorado, where many elite ath­letes train, than in some other ar­eas of the coun­try.

“Tyler is such an elite ath­lete that no one could cause the prob­lem to ob­serve it (in a clin­i­cal en­vi­ron­ment), Olin says.

Vo­cal cord dys­func­tion was dis­cov­ered at Na­tional Jewish in the 1980s, and Euro­pean stud­ies put its preva­lence at about 5 per­cent of the pop­u­la­tion. The con­di­tion has been treated with speech ther­apy, and over­seas, surgery is some­times used. Olin, how­ever, has pi­o­neered a new treat­ment. It be­gins with al­low­ing the pa­tient to see his own throat in real time dur­ing stren­u­ous ex­er­cise. Olin then teaches the pa­tient a breath­ing tech­nique

Tyler Evans trains in the pool at the U.S. Olympic Train­ing Cen­ter in Colorado Springs. Evans, a triath­lete, was re­cently treated by doc­tors at Na­tional Jewish Health in Den­ver for vo­cal cord dys­func­tion. Pro­vided by Na­tional Jewish Health

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