breathing problems

Hi. I have always been an athlete.  I have run track since freshmen year without any problems at all.  Junior year, I started having breathing difficulties.  I figured it was from having mono, but the problem still exists today, a year later.  When I run hard, I make a lot of noise when I inhale.  It is not wheezing because I do not whistle, it is just super loud and all my friends say it sounds like I'm about to die.  The breathing lasts for about 10 seconds after the first few intervals of running, but afterward, I make the noises while I run. Then it lasts about a minute or two when I finish a work out.  I know it is not asthma because I have never had the problem before, and it does not effects my exhaling. what do you think is wrong?

[National Jewish Health]

Your conclusion that this is not asthma, because you have no expiratory wheeze, is probably correct, especially since you are keenly aware of the symptoms being inspiratory.  Inspiratory noise, whatever term one uses to describe it, is usually an indication of what we call upper airway obstruction; the obstruction located in the mouth, throat, voice box including the vocal cords or the windpipe.  The obstruction can be caused by a mass, by large airway collapse, by vascular disorders or by a functional disorder such as spontaneous vocal cord paralysis or a condition called vocal cord dysfunction (VCD).

You should arrange for consultation with a specialist, either a pulmonologist or an ENT doctor, for a direct examination of your voice box.  Such a specialist might want to conduct the examination before and after exercise and may want to get a magnetic resonance image (MRI) of your upper airways, including the voice box.  A good, non-invasive screening test for upper airway obstruction is a simple breathing test called spirometry with both inspiratory and expiratory flow-volume loops.

You should discuss the above with the consultant and not put-off the evaluation very long.  We would welcome a follow-up from you.

Good luck.