My 2018 – Exercise Induced Laryngeal Obstruction

An introduction to EILO

Although it’s a grey area as to when my Exercise Induced Laryngeal Obstruction started, it took it’s biggest toll during last year’s winter training, which then carried over into this past season.

Exercise Induced Laryngeal Obstruction (EILO) is a condition in which the supraglottitic structure collapses and closes over the larynx during high intensity exercise, sealing the airway so you are unable to breathe. It occurs due to a trigger that the individual athlete has, for example anxiety or stress. My trigger was an anxiety based one of feeling failure or self doubt. Like many anxiety based conditions, EILO is not constant or formulaic with whether or not a breathing attack (similar to a panic attack) occurs. Sometimes it could take one subconscious thought to set it off, other times it would be a build up of multiple things that would lead me to mentally “crash”.

These attacks usually lasted anywhere upwards of 3 minutes, however during training or, worse, a race scenario this would mean having to completely stop whatever I was doing. This made training hard where I would often find I couldn’t get the maximum benefit from it, which lead to a season of not only fighting my brain during races, but also not having enough stable training to carry me to where I wanted to be throughout the race.

Early Season Races

Several of my early races, as you may have gathered, did not go to plan, adding to the feeling of failure. Big events such as the Youth Tour Of Scotland almost broke me, being away from home without Dad or Mum to help me, and once more nowhere near as strong as I needed to be to contest for a podium.

However, there was some hope. The South Region Omnium Qualifiers, which I would be competing in, were also early season. Omnium races are typically short, testing both strength (something I lacked) and tactics (something I did have). Due to this, I was able to win two of the four rounds, and podium a 2nd and a 3rd in the other two, despite my struggles with EILO. This led to me winning the Southern series and qualifying for the National Omnium Finals. I believe helped me keep pushing through and not giving up on everything.

Discovering EILO

Approaching mid-season, still severely troubled by the EILO, my Dad researched what i was going through as at the time we still did not know what it was that was happening, only what it did and when it did it.

We had previously gone to the doctors to enquire about it, but as it is a condition with very little research there was little the local doctors could say or do for it.

After some researching, Exercise Induced Laryngeal Obstruction seemed like a highly plausible answer to what it was i was going through.

Having found out what it was it could be, we looked further as to what we could do to overcome it, as most research seemed to have be done in America. However, we did manage to find a Consultant in London called James Hull who had been researching the condition.

Dad contacted James Hull via Twitter, and in a matter of days I had an appointment up in London to be examined at the Royal Brompton.

Trips to London

My first trip to The Royal Brompton in London was an examination, which involved a few tests and talking through how I felt and exactly what symptoms I had.

The most memorable test by far was the asthma test. This involved doing a peak flow test (blowing as long and hard as possible into a tube that records on a computer) before taking 10 puffs of salbutamol from an inhaler and waiting 15 minutes. These were a very shakey 15 minutes due to the high sudden intake of salbutamol! The doctor said that a 15% increase in my peak flow test would mean i most likely had Exercise Induced Asthma, however any less would indicate EILO. My results came back as only a 2% increase, and that meant asthma could be ruled out.

I then spoke to a Doctor about how I felt before, during and after a race as well as other stresses, and we went through the actions I could chose to take in order to overcome everything.

After this day I was referred to see James Hull again in London a few weeks later, this to be tested during exercise.

This next trip involed quite a lot more than the former. In order to test whether it was definately EILO, I had to do some efforts on a training bike; with a camera in my body angled to view my larynx. The camera went up my nose, and then down the throat – held in place by some interesting headwear!

So after a briefing of all this I was then changed in cycling kit and ready to had a camera pushed in my nose and into my throat.

I cannot begin to explain the feeling of it. It felt extremely alien and a bit painful is the best way to put it. The nurses were very patient and after a very awkward and painful few minutes it was in place and strapped to my head.

I then hopped on the exercise bike and began to do some minute efforts with Jame Hull examining what my larynx and surrounding muscles were doing.

After a few efforts, the camera was removed from my body and the ending conclusion was that I was experiencing EILO.

I was then able to use a shower before visiting a Speech Therapist who helped create a plan of action towards a resolution. We sketched out some breathing exercises to do on the bike as well as some speech exercises to strengthen my larynx and vocal chords. We also spoke about how to gain a better Positive Mindset that was able to cope with pressure and anxiety, whilst allocating ways to counteract any negatives.

Moving forward

After the second visit, it was in my hands to work hard and implement the plan. I practised the speech exercises each day (usually in my room with loud music playing so as not to feel too embarrassed) and whilst training i would try using the breathing patterns recommended.

Progress, like any sort of recovery, was not instant. I didn’t wake up after a week of practising the prescribed plan to find myself completely fine. It also didn’t not happen and then never happen again. For the most part it was frustrating, to be doing everything I could but still see no change, and to be completely fine one week but be back at square one the next. But eventually, it became more frequent to not have an attack than to have one. After that it might only affect me on the rare occasion whilst riding. And then, in some of the later season races in which a few months ago I would’ve definitely had an attack, I didn’t. And I got around the races with no difficulty. It was nice to ride what would be my final race of the year, the National at Pembrey, and take a top 10 placing.

Now and the future!

This brings me to now, entering a winter of training, one where I know the EILO condition exists, but where I am in control and so much better than this time a year ago. Sometimes I do get the occasional attack, off and on bike, however they are nothing like they were and I have a better grasp on how to deal with it. I am eternally grateful for all the help I received from Jim and the team at the Royal Brompton in London that has got me to where i am now, where i have the ability to move forward in both training and life. I’m looking forward to pushing on and a better season in 2019 with Liv CC Halo Films.