Dr James Hull, Consultant Respiratory Physician at the Institute of Sport, Exercise and Health (ISEH) - part of HCA Healthcare UK - joined the ISEH in July 2020. Here, he speaks to us about how he is currently helping patients who are struggling to return to sport after recovering from COVID-19, and talks about the respiratory condition which is often being misdiagnosed as asthma. 

When did you first realise you wanted to work in respiratory medicine?

I’ve always had an interest in respiratory conditions, particularly those which affect athletic individuals - something which I think stemmed back from when I studied exercise physiology as an undergraduate. Fast forward a few years, and I’m now a Consultant Sports Respiratory Physician at ISEH, where I treat patients with wheeze, breathlessness and coughing in the context of doing activity and sport – often endurance sports such as running or cycling. I also work at the Royal Brompton Hospital, where I see NHS patients who are suspected to have asthma or who are struggling with a chronic cough. 

What would surprise people about respiratory health and the conditions associated with it?

Around 70% of the people I see at ISEH come to me looking for a second opinion after suspecting they have been misdiagnosed. For example, some of my patients will have received medication or treatment for asthma, when in fact in many cases, they actually have a much lesser-known condition called exercise-induced laryngeal obstruction (EILO). This is a condition where the voice box closes during vigorous exercise and actually affects as many as one in 20 athletic individuals. Symptoms include difficulty breathing, chest discomfort, feeling that your throat is being constricted, wheezing and a cough.  

For those patients with suspected asthma, at ISEH we have comprehensive testing facilities. These tests allow us to make a secure diagnosis of asthma and to also rule in other conditions, such as EILO. If it is asthma, then we can give the best treatments and if it is another cause then implementing new breathing techniques, with our specialist sports respiratory physiotherapists, can be transformational

How has COVID-19 impacted the care you provide?

As a respiratory physician, a lot of patients have been coming through my door who have had COVID-19 and are struggling with breathlessness and are looking for a solution. It's important for us to do all of the necessary investigations to understand whether the affected person has scarring on the lungs from COVID-19 which is causing the breathlessness, or whether it is in fact more to do with the way the heart muscle is working, or whether there could be a blood clot on the lungs. 

In some cases, patients who have had COVID-19 who come to ISEH will simply require medical reassurance and that their breathlessness will improve in time. If deemed appropriate, we can also offer these patients physiotherapy support to help get them back to the level of physical activity that they were used to – which in many cases is elite athlete level. 

Why should a someone choose to be treated at ISEH?

ISEH was set up to provide the most holistic approach to diagnosing and treating sports injuries and illnesses. The care we provide is for anyone from elite athletes and exercise enthusiasts, to recreational and amateur athletes who wish to achieve their performance goals and aspirations, as well as anyone involved in recreational physical activity, in order to support their overall health and wellbeing.  

When we see and treat and patients at ISEH, they benefit from: 

•         MDT approach to their care 
•         State-of-the-art on-site diagnostic imaging (assessing patients whilst they exercise) 
•         Range of therapies  
•         Reconditioning gyms 

To book an appointment with Dr James Hull, click here.
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