So many questions-! Potential asthma diagonsis

[GreatGateway]

3 years ago, I had some serious breathing problems and heart palpitations begin. They still occur today, sometimes more often than other times, but always with specific circumstances. A Chest X-Ray recently showed I have Air Trapping in my lungs, and an A&E visit saw my O2 levels briefly dropping to 84% sometimes, but this info was withheld from me until just recently. We trialled a blue Albuterol/Ventolin inhaler and saw mild improvement. I really, absolutely do NOT want asthma! If I have it, my dream career is over, and I have to live with my one phobia in life - a chronic illness that may strike/maybe even kill anytime. I have some questions in that regard:

- There's no doubt my blue Ventolin inhaler helps, but it only helps for an hour or two tops. Are there conditions besides COPD/Asthma that it can help? Everyone keeps saying anxiety is possible, and there's no doubt I'm a severe hypochondriac, but would bronchodilators help that? (Tried CBT/Hypnotherapy/Mindfullness/Medications to no effect)

- I can't get the technique right with a Volumatic spacer. I have to use an Aerochamber Plus instead. Am I missing out on too much medication using this kind of spacer?

- Yesterday I had the worst of my attacks to date. It felt like my throat closed over, I couldn't feel the cool of the air running down it. My heart raced even though I was at rest and each time I tried to inhale it got worse. Yet I never cough, wheeze, whistle or get a tight chest. Even my GP says this is unorthodox. We know it isn't Vocal Chord Dysfunction because the techniques don't work for me. Could Panic/anxiety cause asthma-like symptoms without actually influencing or triggering pre-exisiting asthma? (Just so you know, it is NOT hyperventilation, we have sufficiently proven that)

- The only thing that helps me besides blue inhalers is to put tension in my shoulders/lower and upper back/neck. For example, if I hunch over at a laptop, the tightness makes me feel better. To that end, showers as an example make me worse, because the tension is lost and when my body relaxes, I have immediate difficulty again. And I do mean immediate. Is it right for symptoms like this to come and go with small changes in posture/tension?

- I also have LPR Reflux; how would I know if this is the cause of my breathing difficulty? And if it is, would inhalers still help it anyway? In the past I have also had severe eczema.

- My family is extremely unsupportive, leaving me behind when I struggle to walk during attacks, telling me its all in my head, and that I "haven't died yet, therefore it's not asthma." My history of hypochondria doesn't help either. What can I do about it?

Thank you for any help and answers you can offer. I'm only 24, and I'm terrified of having a disease like this for life when it's so debilitating that sometimes I can't even stand up, speak, eat, or walk.

[madmazda86]

Some of these questions are quite complex and best answered by a medical professional. But if your blue inhaler is not sufficient to relieve your symptoms then you may need steroidal assistance, speak to the asthma nurse at your doctor's for advice on this as there is a care pathway for this sort of thing. They can help you understand the steps along the pathway and set up an Action Plan for you to follow to help you feel more in control. I can understand your disappointment with your situation, it is frustrating to be confronted with the idea of permanently needing medication for a long term condition. I was really disappointed myself when my childhood asthma returned to haunt me as an adult and I needed to go back on inhalers again.

Another thing that can help is to understand the triggers for your episodes and avoid them. Again your asthma nurse can talk you through the list of triggers - make a note of what you are doing at the time of your episodes to help you isolate potential triggers. For example, mine are humidity, concurrent infection, swimming and time of day (triggers affect me more at night than the daytime).

[GreatGateway in reply to madmazda86]

It's not just a case of disappointment, I'm downright distraught. I fully admit my LPR has caused me to almost take my own life twice in the past - as mentionned, chronic illness is one of my biggest phobias in life. The thought of having a 2nd, worse chronic health problem is likely to break me. That's why I'm desperately trying to rule out asthma by any means necessary.

[Hidden in reply to GreatGateway]

GreatGateway, I know this must be hard for you - it comes as a shock to many adults who are suddenly faced with the fact that they might be asthmatic. My situation is a little different. I've gone through my life (and I'm now in my fifties) with two medical conditions. The first of those, asthma, took five years to diagnose (I was eight and a half when a paediatrician finally diagnosed the condition) and I really wouldn't want to repeat those very early five years; I can still recall what it was like and the impact it had on my life as a young child being an undiagnosed asthmatic; life improved quite a lot once I was on appropriate medication. The second medical condition (which is the result of a genetic mutation inherited from my father) is something called joint hypermobility syndrome/hypermobility type EDS. Again this went undiagnosed for years (over fifty years in fact - I was diagnosed just one and a half years ago). There is no cure for either of these conditions, and very little can be done at all about the second, other than strengthening my muscles to support my joints, and being careful about what, when, and how much I eat; reflux and irritable bowel syndrome can be a problem for some of those afflicted by this condition.

How have I coped/lived with them? Well, by trying to look for the positives - not easy when I was a young child finding it hard to keep up with other children and wondering why other children did not have the problems I had. Now, however, I can look back on those years with a rather more objective eye to look at the impact they have had on my entire life.

My asthma is now pretty much completely controlled and has been for years. I am able to live a pretty normal life. Admitted, this is not the case for all asthmatics, but it has been so for me and there are many other asthmatics out there who will say the same thing. Yes, I need to take medication twice a day; yes, I need to have a ventolin inhaler within reach at all times, and take a little more care when I go down with a viral infection, but that's not so hard.

I can also say that there have even been times when one, or the other, has proved to be the metaphorical 'silver lining' to the dark cloud. I'm an exercise induced asthmatic, so I've never been able to cope with endurance athletic events (anything beyond a hundred metre run is likely to cause problems). Aerobic exercise is tough for me. Again, this is not the case for all asthmatics (my younger son, for example) but it is for me. This was understood by my mother and, just as importantly, my secondary school. I was encouraged to do ballet (which I still do) and gymnastics instead. Cross country running was a non starter (the school would have ended up calling an ambulance) so I was never made to do it. Strength is a major requirement for both ballet and gymnastics; all unknowing I did the two forms of exercise that would help my hypermobility the most. It was also just as well I could not do cross country running; my knees are susceptible to injury thanks to the hypermobility and cross country running would have been one of the worst things I could have done.

Now, in my fifties, I am still able to lead a very full life. I do ballet and Pilates; I can go on walks; I have travelled both in the UK and abroad. I have two children. The key to being able to do all this has been understanding and controlling my medical conditions.

Your first line of help has to be your local GP. Then there is the asthmaUK helpline, and, of course, those of us on this forum.

Whatever you do, please don't despair.

[madmazda86 in reply to GreatGateway]

Well if it turns out you do have asthma there's not much you can do about the fact that you have it. It's not like you can order your lungs to stop messing about (oh how i wish i could XD)

The best way to live with any long term condition is to try and own it as much as possible. It will not be the same day in and day out. It is different for every person. You need to find out how it is for you, your triggers, the good and bad days/times, and how much your medication can do for you. By exploring and knowing your symptoms you can understand what's happening to you and how to appropriately use your medication to stay on top.

It's also possible that you may not have asthma - a trial of a bronchodilator does not guarantee that is what you have. If it does significantly improve your symptoms or your peak flow then there is a good chance asthma is the diagnosis, rather than a panic attack. You're going to need to trust the judgement of your medical professionals on that one - if you stop taking your blue inhaler because you don't want to have asthma, it's not going to make it better. Believe me, I know

Asthma is characterised by lung inflammation - good medication compliance is the absolute best way to reduce the impact of it on your life. I'm writing this post to you at 4am because it's a nice thing for me to concentrate on instead of the shitey night cough I'm having to deal with because I missed my steroid inhaler for 5 days in a row over Christmas. Such an easy thing to do but I sure am suffering for my mistake. Now my lungs are inflamed, I'm still having lots of problems even though I went back on my steroid inhaler and maxed out the dose. That's my asthma action plan - I take my brown inhaler 4x a day from September to April and I'm able to take the summer off because I have little to no symptoms then. I don't need my blue inhaler unless I'm exercising, so if I start needing it more frequently that's my cue to up my brown inhaler dose, which maxes out at 8x a day. If I'm still needing my blue inhaler throughout the night at maxed brown inhaler dose (like I am just now, abooo) then it's doctor time for oral steroids. That's the steps I take to enable me to remain in control of my condition. Yours will undoubtedly be different but you need to find out what they are. This will help you to keep flare-ups to a minimum so you can go about your daily life and enjoy yourself When I'm actually good with my medication my asthma only bothers me when I'm unwell. I'm on a netball team and play with no problems except when I've been messing around with my inhaler dose. So it is possible to live life to the fullest with something like this, but you have to be willing to take charge!

[Hidden]

I have reflux issues, and until I worked out how to tell the difference between asthma and asthma like symptoms caused by the reflux, I found it hard to distinguish between the two of them.

With me, if reflux is the issue, then I will have breathing difficulties within half an hour of eating food (any food, but some foods - anything fatty for example - are worse than others). I also found that exercising helped in this situation, which was extremely unusual in someone who is known to be an exercise induced asthmatic. I've had asthma for fifty years and I know my condition well; what happens when reflux sets off breathing difficulties is almost opposite to what is normal for me.

I'm assuming you know that raising the head end of your bed by about six inches can help with reflux at night (don't rely on heaped up pillows, you'll slip down off them during the night). I'm also assuming that you know not to eat anything three to four hours before you go to bed (to give your stomach time to clear), and to avoid doubling up, slouching, bending over, for at least an hour after you've had a meal.

Otherwise, I agree with what madmazda86 has said. You need to go back to your doctor/asthma nurse, and discuss what is best for you to bring your condition back under control which, from what you describe, it clearly is not at the moment,