Shortness of Breath

Many people struggle with shortness of breath during exercise. They are often given a diagnosis of asthma or exercise-induced asthma but treatment sometimes does not help. In order to evaluate breathing difficulties during exercise, it is essential to recreate your symptoms with an exercise challenge. We feel the key to finding the answer is to obtain good objective data via cardiopulmonary exercise testing as well as pre- and post-exercise lung function, and upper airway visualization. Our clinic brings together experts in Sports Medicine, Otolaryngology, Exercise Science, and Speech Therapy to diagnose and treat the underlying problem causing your shortness of breath while exercising.

If you exercise and you find that your symptoms are limiting your ability to perform at your best, we want to help you reach your full potential.

Tests We Offer

  • Continuous Laryngoscopy with Exercise
  • Spirometry
  • Exercise Induced Asthma Provocation
  • Cardiopulmonary Exercise Assessments

Exercise Induced Laryngeal Obstruction

Often when people think of breathing issues, they associate the issue with asthma. Research has shown that up to five percent of adolescents suffer from a condition known as Exercised Induced Laryngeal Obstruction (EILO) formally called Vocal Cord Dysfunction (VCD). EILO happens when the vocal cords block the airway causing shortness of breath and a decrease in the ability to exercise. Athletic activity is not the only cause for an episode of EILO; stress and anxiety are also very common triggers. An individual with EILO will typically experience a rapid onset of symptoms, tightness in the throat, struggling with inhalation (breathing in) and high pitched breathing sounds (stridor) during intense physical activity with a rapid recovery once activity is stopped. EILO is a very treatable condition once it is properly diagnosed and managed.

Continuous Laryngoscopy with Exercise (CLE)

CLE testing involves placing a small flexible camera (nasolaryngeal scope) via the nostril which is then secured in place and held by a head-gear. This allows continuous visualization of the upper airway while exercising. Once placed, the patient is asked you exercise via treadmill, bike, or rowing to provoke symptoms. Cayuga Medical Center’s Shortness of Breath with Exercise Clinic is one of the few places in the world to offer this testing.

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Getting Started

  1. Make an appointment with Dr. Getzin for an initial consultation
    If traveling, you will be asked to provide pre-Shortness of Breath Clinic information that can be reviewed by Dr. Getzin to determine if you are a candidate for our Shortness of Breath Clinic. This will include a chest x-ray, complete blood count, ECG, and spirometry: pre- and post-bronchodilator. Please contact our office to schedule an appointment.
  2. Exercise induced asthma testing
    Typically you will be running on a treadmill, riding a bike, or rowing on an ergometer.Our team will test your lung function at baseline and then again after exercise to see if exercise provokes and asthmatic response.
  3. Continuous Laryngoscopy with Exercise (CLE)
    Once again you will exercise to provoke your symptoms. CLE testing allows direct visualization of the larynx during exercise to help with diagnosis of Exercise Induced Laryngeal Obstruction (EILO) which is commonly misdiagnosed as asthma. We are one of the few clinics in the United States performing CLE.

Meet the Team

Adrian Western, MS ATC
Anthony Spinelli, MS ATC, CEP

Frequently Asked Questions

What do I bring to test day?

On the day of testing you will need to bring athletic clothing and shoes. You will also need to bring a form of identification and insurance card.

Can I bring my coach?

Yes, feel free to bring your coach.

Will my insurance cover it?

In most instances insurance will cover all testing. It is always a good idea to check with your insurance company to ensure that you are fully covered for testing.

Will I be able to share information with my doctor?

We encourage you to share this information with doctors involved in your care. We will fax a copy of your final report to your referring provider and primary care physician.

How long will the testing take?

Testing typically takes about an hour. This can vary from person to person depending on findings during the testing.

Will I leave with an answer?

At the end of your visit we will discuss our findings with you and outline a clear treatment plan. In most instances, we will have a diagnosis by the end of testing, but there are occasions where more testing is needed.

What do I do to improve after I leave the shortness of breath clinic?

After testing, we will provide you with recommendations to help with your shortness of breath. These will be reviewed after testing and included in you final report.

How will I exercise at the clinic?

Usually we have our patients run on a treadmill; however, we try to best replicate when symptoms occur so we are able to test you in a variety of ways including biking, rowing, and swimming.

Should I continue to take my medication prior to testing?

We ask that you discontinue medications that are currently used to treat your shortness of breath. Below you will find a common list of medications and how long you should be off of them prior to testing. Please check with your physician or call the Shortness of Breath Clinic if you have any concerns.Short acting medications (should not be taken for 24 hours prior to testing):

  • Ventolin, Proventil (Albuterol)
  • Xopenex (Levalbuterol)
  • Brethaire (Terbutaline)
  • Alupent, Metaprel (Metaproterenol)
  • Tornalate (Bitolterol)
  • Maxair (Pirbuterol)
  • Combivent (Ipratropium and Albuterol)

Long acting medications (should not be taken for 48 hours prior to testing):

  • Beclovent, Vanceril, Qvar (Beclomethasone)
  • Pulmicort (Budesonide)
  • Flovent (Fluticasone)
  • Azmacort (Triamcinolone)
  • Singular (Montelukast Sodium)
  • Accolate (Zafirlukast)
  • Zyflo (Zileuton)

Where will my testing be done?

We test our patients on the 5th floor of the Island Health Center building at Cayuga Medical Center Sports Medicine and Athletic Performance. Address: 310 Taughannock Blvd Suite 5A, Ithaca New York 14850

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