Mild asthma? No asthma?

[Orbitolina]

I wonder if other people recognise this:

- occasional flare-ups of probably fairly mild breathing problems; often no problems at all when just sitting and fairly out of breath when walking.

- flare-up lasts about 3-6 weeks with fits of breathlessness mainly happening at night, rarely at day unless the night before was particularly bad. Outside of flare-ups no problems at all for months apart from occasional mild chest tightness (feels like side stitches) which usually lasts for 1-2 weeks and is only noticeable when walking or in milder cases only when jogging.

- Mild breathlessness during  flare up means: it's not possibly to completely exhale when just breathing normally and the breathlessness is similar to walking uphill on a high mountain (low oxygen) or free diving for too long. It is however possible to get past this exhaling blockage by using just a bit more force. There might be a very mild wheezing.

- as peak flow measurements use force they show now difference between having breathing problems and no breathing problems. I must say though that I have not done a measurement yet while I was walking wit breathlessness at it's worse. Spirometries when I'm not having problems are normal as well. I only ever had one while in a flare-up, in a glass cabin before and after ventolin, which apparently showed a difference. Unfortunately, this was not in the UK and I don't have the report and no way of getting it.

- both ventoline and formoterol work well. However, in pretty bad nights during a flare-up I wake up and might need to take meds up to three times.

-Experimenting with omeprazole now as I think it's possible to have reflux without really noticing it. Current improvements might be a coincidence though.

Is there anyone here who can relate to this? Any idea what this might be?

[Hidden]

Hi Orbitolina, all this doesn't sound mild to me..you need to have a good check up in this country if you are her now, or see a respiratory specialist wherever you are..Flare ups just mean your asthma is not controlled so you need to look into it. Take care xx

[Orbitolina in reply to Hidden]

Hi happylondon.

I live in the UK now. My problem is that my doctor seems to think I have panic attacks at night which are causing these problems (I used my running HR sensor at night now to show that my heart rate doesn't substantially change between sleeping and waking up with breathing problems). Plus peak flow measurements are fine also when I have breathing problems. Spirometries are normal as well when I don't have breathing problems and for some reason I cannot have one while having these problems. There's nothing that indicates there is a problem for my GP. My lungs apparently sound free as well, xray is fine. But then again, the wheezing is usually absent and only sometimes appears when I'm breathing normally and not when I'm breathing a bit stronger as my gps asks me to do. And when I do that I break through the mild blockage.

[Hidden in reply to Orbitolina]

Ok next week I am having a heart ultrasound to see if the heart contracts properly, it can lead to breathlessness, ask for one.

Are you panicky?? Stressed?? Do you think he's right?? I don't have any of those tools but I know if Im stressed or asthmatic i know if I have a cough and mucus..

Good luck!! Take care xxx

[Orbitolina in reply to Hidden]

I had a heart ultrasound before, and it was ok. And no, I'm not panicky or stressed out. And to provide proof that I'm not I'm wearing my HR sensor at night. My resting HR might be around 45-50 (I'm fairly sporty), and when I wake up with breathing problems it's at 55-60, which is not really what you would expect during a panic attack. Then it goes up to about 80 when I go to the loo and get my inhaler, and goes down to 60-55 again when I curl up again. I don't hyperventilate, can think clearly, no tight throat, nothing that would indicate panic.

Honestly, if my gp thinks that the only symptom to diagnose panic is shortness of breath, then the same lone symptom of shortness of breath might indicate asthma or really anything else that can be associated with it.

[Granny56 in reply to Orbitolina]

Perhaps you have hypersensitive airways, dust, insects, or changes in temperature could trigger a night-time attack.

Although your HR sound ok to you, if your normal is sinus bradycardia then its a significant jump in your case, when it is as high as 80 bpm. Have you monitored your HR pre and post inhaler?

[Orbitolina in reply to Granny56]

Sensitive airways: that might be true, but would 1-2 attacks be triggered for pretty much every night for 3-6 weeks, and then not at all for months, until the next flare-up of 3-6 weeks? Especially this doesn't make much sense to me.

========

Well.. I have a fairly low minimum HR from working out a fair bit, but a massively high maxHR. Thus my heart rate seems to go up quite a bit from just walking. On the other hand I can run and still sing along to music at a HR of 180. This is just normal for me.

My heart rate does go up from using an inhaler as well, but I didn't take one until I woke up with breathing problems. It doesn't seem to help taking it before going to sleep anyway.

[Granny56 in reply to Orbitolina]

Have you been checked for sleep apnoea?

[Orbitolina in reply to Granny56]

Good idea! Something to check out. Does sleep apnea really cause such prolonged problems into the next day? I do have the feeling though that my husband would notice. He's been waking up easily when I make a noise and seems more panicky than me since this whole mess started in 2014.

[Granny56 in reply to Orbitolina]

Do you snore?

britishsnoring.co.uk

nhs.uk/conditions/sleep-apn...

[Orbitolina in reply to Granny56]

Not that I know of.

[Granny56 in reply to Orbitolina]

I would suggest that you monitor HR and peak flows pre and post inhalers, take plenty of fluids to help losen secretions and perhaps a hot steamy bath before going to bed. Make sure your bedroom is airy but not cold and swap feather pillows for something synthetic. Take this data to your GP.

How do you take your inhalers, as you need them or on a regular basis?

I find that lying a hot water bottle accross my chest (bronchial tree) in combination with drinking lots of water helps. Maybe it would help you too?

[Orbitolina in reply to Granny56]

Good advise! My peak flow doesn't change at all pre and post inhaler. But then the 'lung blockage' I experience is fairly mild and I can just blow through it and can deal with the more severe shortness of breath associated with that well enough (I used to free dive). I see it's higher after I return from a run, but otherwise I get about the same numbers morning and evening, on normal days and during an attack.

I only use the inhaler on a need-basis as they do have side effects. And besides, my GP has not given me anything for daily use.

[Granny56 in reply to Orbitolina]

Perhaps regular inhaler use for a wee while might do the trick. Speak to an asthma nurse or your GP, this way you can control the asthma and exclude it as a  possible cause for the breathlessness you describe.

Other things to consider are various types of anaemia, vitamin and mineral deficiencies such as iron or folate which can cause breathlessness.

[Orbitolina in reply to Granny56]

I'd rather not before I've gotten a proper prescription as I do have some side effects with both ventolin and symbicort (swollen nose) and really need to try something else if there's a need to take medication regularly. But that means my GP finally needs to believe me that I have breathing problems I really don't know what to do about this anymore.

Anaemia and the likes: I know. I'm taking oral iron and B12 shots due to reoccurring deficiencies. Another of those things that my GP doesn't believe because serum B12 and serum iron are fine and I'm not anemic. Yes, guess what: I'm not because I'm substituting and because those tests are useless to detect many deficiencies Gosh, I really wish I had my old medical reports! But I lost them when moving to the UK.

[Granny56 in reply to Orbitolina]

I don't understand, you describe asthma symptoms yet do not appear to want to get it under control. All medications have side effects but unfortunately when you have a disease like asthma it needs to be treated with conventional or complimentary medicines or therapies. Either way the objective is to bring the disease under control.

For me the logical process would be to tame the asthma, correct deficiencies and then investigate for other possible causes. This means, taking the medicines you need and not experimenting with proton pump inhibitors such as Omeprazole which you mention in your initial post, especially if you do not have a diagnosis of a gastrointistinal disorder. If you think the breathlessness is due to reflux, then ask your GP to investigate this. If you substitute iron and B12 and your levels are within an acceptable point on the range scale, then in my opinion the problem is solved and you are no longer deficient. If as you say these are recurrent deficiencies, then perhaps leaky gut syndrome or an endocrine dysfunction might play a role. 

Both iron and B12 def can affect the o2 carrying capacity of red blood cells and could cause breathlessness but so can many other things like angina. You really need to discuss these issues with your GP before the source of your problem comes to a head.

[Orbitolina in reply to Granny56]

Granny, I know. The problem mainly at the moment is that my GP is not doing anything. I was standing in her office, could hardly speak two words and she sent me on a blood test first to discuss the results a week later. That was during a flare-up in November. Since then I'm trying to get referred to a specialist, but nothing! She even told me that 'I don't need the inhalers' that I still have, and about my question whether I should then call 999 two times per night I only get a shrug. I really don't know what to do anymore. I'm not getting any treatment at all!

Yes, of course I'm desperate and try things on my own! Look, if I was in a more urban area with some GPs to chose from I would change doctors or ask for a second opinion, but I don't have that choice here.

[Granny56 in reply to Orbitolina]

asthma.org.uk/helpline

Call the helpline for advice and perhaps the nurse can speak with your GP on your behalf. This way you might be taken seriously.

All breathing problems are potentially dangerous and asthma is a killer. If contacting the helpline does not prove useful then I would call the emergency services when you experience the next severe attack.

[Granny56 in reply to Granny56]

Forgot to say try the blue inhaler Salbutamol first, one of the side effects is an increase in Heart rate, however you mentioned previously that you are normally bradycardic so that shouldn't be an issue. However, one of the side effects of asthma is death. If you believe your breathlessness is related to asthma then don't waste time in seeking help.

Good luck!

[Orbitolina in reply to Granny56]

Thanks a lot. I will certainly contact the asthma.org helpline. Maybe they can help.

Salbutamol: well, my side effect is a swelling of nose and throat, which is not really what you want when you have breathing problems already Plus I get so shaky and confused that I cannot work anymore for several hours, tell anyone coherently what my problem is should the need arise, nor participate in traffic. I always thought I can deal with any type of medication and never get any side effects - until I met ventolin (and a purple disk inhaler which gave me bleedings from all sorts of openings and hundreds of tiny bruises).

[Granny56 in reply to Orbitolina]

It would appear that you have sensitivities, all the more reason to get checked for hypersensitive airways disease. 

The asthma helpline can point you in the right direction and if your breathing problems are asthma related, they can advise you on potential medications that might be suitable for your needs.

As I said previously, get your asthma under control and then you can assess whether the breathless persists which if it does means looking for another cause.

I asume since you have been prescribed asthma inhalers, that you have a confirmed asthma diagnosis?

[Orbitolina in reply to Granny56]

Sensitivities? Quite possible. I remembered something the last few days of which I didn't think in many, many years... seems to be a family taboo of sorts...

I was born very post-mature. During birth I inhaled some fluids and apparently spent the next few weeks in a more specialized hospital due to this.

Furthermore, I have no baby photo where a parent is not holding a cigarette, and they each smoked one during even the shortest car ride, without opening the window. I do wonder whether my mother smoked during pregnancy, but I guess I know the answer.

And I grew up 2 miles from a small coke factory, which was responsible for a big percentage of the population having all sorts of lung problems.

Thus it looks like my lungs got a fair amount of beating during childhood. It's almost surprising that I had to be 40 to get problems

[Granny56 in reply to Orbitolina]

I belive my lung problems are also partly due to passive smoking when I was a child and to environmental factors. All we can do is to stop this from happening again.

[Triggerina in reply to Orbitolina]

You can be asthmatic and not wheeze. Like me and many others. 

[Orbitolina in reply to Triggerina]

Thanks a lot Triggerina. I guess I want to recognize myself in others as I'm so fed up with this. Thus excuse me for asking: is it possible to have a normal peakflow during a mildish attack? I think my measurements were down slightly during the first ever, but not since then anymore.

[Orbitolina in reply to Orbitolina]

Reply to self: I guess the readings are normal because it's just a couple of very strong blows. what I would need is a test that measures the airflow just during normal breathing, not during a forced exhale...

[Orbitolina in reply to Orbitolina]

First reply here (for my own bookmarks when at home): healthunlocked.com/asthmauk...

[Triggerina in reply to Triggerina]

Yes it is possible ,for me anyway, to be aware that my breathing is a bit tight and to feel breathless yet sometimes my peak flow will be fine. Peak flow is a guide and a general trend to help with control. 

[Orbitolina]

Right, no idea what happened but I had no breathing problems at all last night. I see two, maybe three potential reasons:

- The PPI IS working and silent reflux is a/the cause of this

- coincidence

- I upped my oral iron intake over the last few days again. At least in the last two flare-ups things always got better and vanished when I started taking oral iron. My iron levels always dropped fairly quickly when not taking iron, but not towards levels where I should be having problems (ferritin 26/24) according to my gp. However, this time I did not stop taking it mostly, only forgot it every now and then.

[WHOA]

I used to have massive asthmatic problems now I am totally controlled. Trick was vitamins and cod liver oil.  It is a known issue about magnesium and Cod liver oil to reduce inflamation of lung cells.  Read about magnesium and asthma on google and the benefits of cod liver oil.  Simple but it reduces magically asthma triggers.

[Wheezycat]

That sounds like how things were for me, pretty much. Though on meds I wasn't totally convinced there really was anything wrong. Then I got a bad viral chest infection last February, a virus that was doing the rounds. It took me months to get over it. Then I had an encounter with pollen, I think, though I don' have hay fever. Something was affecting my breathing badly. Then a cold. Then I was sunk. In hospital 4 days with an acute asthma attack. I have learned I need to take my very mild (as I thought) asthma more seriously! In hospital they put me on Omeprazole for the same reasons as you. I am much more medicated now, so those 'small' symptoms have largely disappeared. And I have now taken myself off oneprazole, just to try to reduce the quantity of meds I am on (unwanted side effects), but kerping an eye carefully with my peak flow meter.