Breathing easier

The new continuous laryngoscopy during exercise (CLE) test helps patients get the treatment they need to safely return to their favorite sports

New testing is helping patients take their sport to the next level

“As a kid growing up, I wasn’t a sports star. I loved soccer but wasn’t very good at it. The way my patients feel about their sport is the way I felt about medicine growing up. And it’s just a little piece of joy every time I get to give them back their sport without the barrier that they’ve been facing for years, in many cases.” – John Robertson, M.D.

Pediatric pulmonologist John Robertson, M.D., has created a new, innovative exercise program that is helping his patients breathe easier.

The patients he sees are typically very driven teen athletes. They train multiple days a week for hours at a time, and every time they do, they experience respiratory distress that stops them in their tracks. And yet, they love their sport so much they keep at it. But they can’t take their sport to the next level if they can’t breathe.

“Typically, before they see me, they have seen their pediatrician, have been through a lot of asthma medications that haven’t worked, they’ve seen a cardiologist and their heart is functioning normally,” said Dr. Robertson. “Sometimes they have seen other pulmonologists. Unfortunately, nothing has found the problem they are suffering from.” This is where Dr. Robertson works his diagnostic magic.

In February 2022, he performed the first continuous laryngoscopy during exercise (CLE) test on a pediatric patient in Texas in his Cook Children’s office in Prosper. This is a component of the new exercise program to diagnose and treat exercise-induced respiratory problems.

One of the most common types of respiratory distress he sees is called exercise-induced laryngeal obstruction (EILO). This is where the vocal cords or other structures in the voice box inappropriately come together or close when the patient is in the middle of an exercise, making it suddenly very difficult to breathe and continue with training.

CLE is the best test to diagnose EILO. During this test, Dr. Robertson will view a child’s voice box and vocal cords with a scope while the child is exercising. But the vocal cords are not the only thing causing the problem. It can also be caused by asthma or exercise-induced dysfunctional breathing. The exercise test is important in diagnosing the patient correctly, so they can return to the sport they love sooner rather than later and don’t spend time on a treatment path that won’t work.