Possible asthma diagnosis... questions???

Hi,

I am new to the site and know very little about asthma.

I recently went to my doctors as I keep getting a tight chest and sometimes wheezing. Especially after doing classes at the gym. These symptoms do go away by themself after an hour or so. It has been happening for the last few years but it has gradually got worse.

My doctor said that it may be asthma and asked me to do a peak flow diary for 2 weeks, recording twice a day (see results below). She also gave me a blue ventolin inhaler which I have used after exercise and it is brilliant. It works almost straight away.

I have only used the inhaler after exercise as I don't wan't to over-use it. Incase the peak flow results do not indicate asthma.

If i use the inhaler before exercise will it stop me getting a tight chest and wheezing or does it only work to stop these symptoms once they have come on?

I quite often wake up in a morning with a tight chest, this often goes away on its own after a few hours. Can i use the inhaler when I get up in a morning or would I be using it too much?

Peak flow results:

Fri 1st: 7am = 370 / 7pm = 450

Sat 2nd: 7am = 350 / 7pm = 440

Sun 3rd: 8am = 380 / 6pm = 470

Mon 4th: 8am = 380 / 7pm = 450

Tue 5th: 8am = 370 / 6pm = 450

Wed 6th: 7am = 350 / 7pm = 440

Thu 7th: 7am = 380 / 6pm = 460

Fri 8th: 7am = 340

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Hi Emma and welcome!

I'm not a doctor or anything (and even if I were couldn't diagnose on here, and you're not asking for it anyway) but it does seem like asthma is at least a sensible possibility, especially since the peak flow is lower in the morning - I've read that that's supposed to be classic with asthma, though not everyone has it. Have you done readings before and after taking your Ventolin? The diary might not have space for it but your doctor would probably be interested to know what it is before and after you need reliever.

You should use the inhaler when you get symptoms and feel you need it - so if you have a tight chest in the morning, take it - particularly since it helps you. That's what it's there for, and even if you don't have asthma it's not a problem to take it. It's not really going to harm you though you might feel a bit jittery - much better to take it and banish symptoms - and yes, you can take it before exercising even if you don't have symptoms to lessen the ones you get afterwards (though if you have them afterwards anyway you can still take it again).

Basically the issue with using too much Ventolin isn't that it's bad for you as such, but that it shows your asthma isn't under control - if your doctor thinks you're needing to take the blue one a lot, she'll probably recommend you try a preventer so you can calm things down a bit.

Hope this is useful - as I said I'm not a doctor but this is basic info I've learned from having asthma and being on here which I hope is helpful to you. You can ask your GP when you go back but as you're new to all this and your GP may only have so much time, it might be worth ringing the asthma nurse helpline on here (number top left) - they're really good and will answer your questions - I imagine you must have lots with being newly diagnosed. And just have a look round the forums as there is a lot you can learn from here as well.

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Thank you for such a quick reply!

Yes I did test peak flow 10mins after I had finished in the gym then approx 15 mins after using inhaler, my GP also asked me to do this (sorry I forgot to mention it).

After gym=340 / After inhaler=420

After gym=360 / After inhaler=430

After gym=360 / After inhaler=440

After gym=320 / after inhaler=380

I will have a go using the inhaler before the gym next time. I do often wake up with my chest feeling tight although not every morning. I might try using the inhaler then too.

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Can anyone tell me what to expect when I go back to my GP next week?

Will she be able to give me a diagnosis of asthma from the peak flow diary or will there be more tests at the appointment?

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Hi,

I think it depends on the doctor really! She might find that the PF diary is enough to make a decision, along with asking you about symptoms etc since she last saw you - depending on how often you've used the reliever, she may decide to prescribe you a preventer and see if that helps; with asthma the diagnosis can sometimes be made on response to medication so it's possible she could do this even if she isn't yet 100% sure about asthma.

On the other hand, if she has any further questions it's possibly she might want you to have spirometry (blowing into tubes basically - a more fancy peak flow test which also measures some other things); you'd be more likely to have to make a separate appt for that though as I think it's with the asthma nurse.

And she might also want to listen to your chest again - I've had some drs who like to do that whenever they see me for asthma even if symptoms aren't different from last time, though in my case I had (and have) unresolved symptoms (and tbh they never got anything useful out of it as I don't wheeze).

Sorry not to be more helpful but this does seem to vary between doctors, so I'd say you'll have to see - she might do a repeat of last time but might not. Good luck though and let us know how you get on and what she decides; if she wants to do any more tests you can ask about them on here.

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Hi Emma.

Can't really add to Philomela's posts. Seems to have covered everything I might say.

PS Peak flow tests with asthma nurse are quite easy and not something to be worried about.

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Thanks guys, I just really dont know what to expect, I am new to all this!

I have my appt this week, its with my GP not an Asthma nurse (i think), so we will see what she says.

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Hope it goes well, let us know! I hope you have a good GP as that really does help, to have someone who listens and answers your questions.

And I am not new to all this but I often find I don't know what to expect from appointments so you're not alone! Wish I did but they always manage to surprise me it seems.

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Hi again!

Just an update... I went back to my GP yesterday with the peak flow chart I had done. She said she had originally suspected exercise induced asthma from my original visit but the peak flow chart I had done was 'classic of asthma' because of the 'morning dips in peak flow'. As well as the blue reliever inhaler I already have she has also started me on a brown inhaler called Centil, 2 puffs twice a day. It contains 100 micrograms of Beclometasone dipropionate per puff.

She has asked that istart another peak flow chart in 2 weeks and then go back to see her after I have completed the peak flow chart for 2 weeks.

Is this likely to be something that I need to take for the rest of my life? And can anyone tell me if the dose sounds appropriate?

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Hi Emma,

Sounds like a useful appt then - having asthma isn't great but it's actually much better to get a diagnosis quickly if you do have it. It's good that your PF seems to be a pretty good guide to how things are as mine isn't nearly as useful and it gets a bit annoying.

I can't remember exactly but that dose of Clenil (that was what mine was called, same medication inside) sounds about right to start with; I think I started on that then went up to the next inhaler strength.

Asthma can come and go so you might be on this for a while, you might end up just needing the reliever occasionally, it might go away for a bit or you might need other medication, or more medication, to control things.