Swimmer Returns to Pool After Re-Learning How to Breathe

By Amy Zimmer on October 23, 2012 10:00am 

YORKVILLE — Johannah Coffey got in the pool recently at the Asphalt Green recreation center, marking the first time she’s been physically able to swim since the winter.

Coffey, 27, joined the rec center’s AGUA Masters swim team in the spring of 2011, but by last February, she could no longer do laps for more than 10 to 20 minutes before breathing became too difficult.

So, she gave up her favorite pastime until now, after basically re-learning how to breathe.  

A diagnosis of exercise-induced asthma many years ago — which landed her in the ER a few times during high school while playing basketball or swimming — turned out to be a more complicated voice disorder called paradoxical vocal cord motion (PVFM). It’s an unusual behavior of the vocal cords in which the airway partially closes instead of remaining open.  As the larynx closes, it becomes a struggle to breathe. 

Coffey spent several months working with an internationally recognized speech-language pathologist and voice scientist from New York-Presbyterian/Weill Cornell Medical Center on a behavioral treatment program that enabled her to control the location of her breathing.

“Growing up, I always had to be careful with my breathing,” said Coffey, an engagement manager for a financial software company from the Washington, D.C. area who now lives on the Upper East Side.

“I really have never known [anything] different though, so I do not know what it would feel like with normal breathing," she said. "My mom said that since I was about a month old, I have had breathing problems."

She was diagnosed with asthma some time between the age of 3 and 5.

“In high school, my breathing problems got worse and the medication I was on no longer was working,” she said. “I ended up in the hospital a few times after basketball and swimming.”

She suspected something other than asthma was the problem, but was never diagnosed.

The condition got worse when doing cardio and started to impact her quality of life earlier this year.

When she went to see her internist for a check-up and mentioned her history with breathing problems, the doctor referred her to ENT expert Dr. Jonathan Aviv, who diagnosed Coffey with PVFM and referred her to his colleague Dr. Thomas Murry, a professor of speech-language pathology at Weill Cornell Medical College.

“It is not very common,” Murry said of PVFM. “But it is more common than one might think because it is often misdiagnosed [as asthma or allergies].

"Johannah is a good example. She was on medication even though [she] had a normal pulmonary function. We’ve had patients getting allergy shots for years but still have problems breathing.”

A 17-year-old, who recently came into his office with PVFM, described her conditions to Dr. Murry: “I feel like it’s my last breath in life,” he recounted.

Luckily, that wasn’t true. 

Many athletes have this problem with their vocal folds, especially runners, swimmers, soccer players and other athletes who tend to be active indoors, Murray said. More of them tend to be women, but he said that health experts don’t know why that is.

Murray began Coffey on his series of increased resistance breathing exercises while inhaling as she lay on her back with a book on her chest. The goal was to take the location of her breathing out of her chest and shoulders and into the lower abdomen.

“To be perfectly honest, I did not see how the exercises were going to change things, but they definitely have,” said Coffey, explaining that it took about a month before she noticed any difference.

She came to his office eight times between April and August and was given exercises to do twice a day, Murry said.

“The breathing exercises were surprisingly very difficult,” Coffey said. “I now notice a huge difference.  I notice little things that I did not know were related before learning about PVFM. For example, I would have a hard time breathing through my nose for any extended amount of time, but now it’s not an issue.”

She is hoping to start swimming and working out regularly once again, she added.

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