|Craig Zalvan, M.D.|
If a child has been diagnosed with asthma but traditional medications have little or no effect, it may be time to consider a new diagnosis—and a new course of treatment, says Craig Zalvan, M.D., clinical professor of otolaryngology at New York Medical College (NYMC). According to Dr. Zalvan, particularly for girls ages 12 to 17 previously diagnosed with sport-induced asthma, it’s entirely possible that they may actually be suffering from paradoxical vocal fold motion disorder (PVFMD), a lesser known often misdiagnosed breathing disorder that results from abnormal movement of the vocal folds during breathing. In his groundbreaking study involving a group of adolescent girls with PVFMD, Dr. Zalvan, identified a holistic and effective treatment for the disorder that may just revolutionize treatment for this disorder.
Dr. Zalvan’s study, “A Trigger Reduction Approach to Treatment of Paradoxical Fold Motion Disorder in the Pediatric Population,” was published in the Journal of Voice in September 2019. According to Dr. Zalvan, PVFMD is most often found in children who tend to be extraverted, involved in sports at a high level and have a number of stressors in their lives. Approximately 5 to 20 minutes after PVFMD sufferers begin exercising aggressively, they begin “wheezing” and have to stop their activity. “This is not a real wheeze, it is actually stridor—breathing inward against a closed voice box that is in spasm,” Dr. Zalvan said. “They are nearly all diagnosed with asthma and treated as such for months to years with little or no improvement.”
In his study, co-authored by Jan Geliebter, Ph.D., professor of microbiology, immunology and otolaryngology, resident research coordinator of the Department of Otolaryngology and course director for medical microbiology, Raj Tiwari, Ph.D., interim chair and professor of microbiology and immunology, and associate professor of otolaryngology, and Erik Yuen, NYMC School of Medicine Class of 2020, Dr. Zalvan explains that PVFMD is likely brought on by a number of factors with an inflammatory, neurological and psychiatric basis. The treatment approach consisted of implementing a mostly plant-based, Mediterranean-style diet, alkaline water, specialized breathing therapy and psychotherapy to help with stress. Of the 24 patients tested, “we were able to improve the shortness of breath, or dyspnea, in more than over 70 percent of patients and had significant improvement in function, ability to perform their sports and most were able to stop using their medications,” said Dr. Zalvan.
In 2017, Dr. Zalvan’s work with plant-based diets gained national media attention—from ABC, TIME, Good Morning America and The New York Times—with his study which indicated that the symptoms of patients who suffered from laryngopharyngeal reflux (LPR) greatly improved after implementing a plant-based diet as an alternate method of treatment to a proton-pump inhibitor (PPI).
According to Dr. Zalvan, adult PVFMD patients who were similarly misdiagnosed with asthma can also benefit from this plant-based diet treatment. “A recent study published in JAMA which studied approximately 600 adults, found that 30 percent of the adults treated with multiple medications for asthma did not actually have asthma,” he explained. As a result, medication use was stopped in more than 90 percent of these patients. “Bottom line, all that is called ‘Asthma’ might not be asthma.”