Asthma/hyperventilation

[Melanie1989]

Hi everyone,

I have had asthma since aged 3 but never caused me a problem till april last year... i couldnt breathe and my oxygen dropped to 90 gp called ambulance... Had a second attack in november, no wheeze oxygen at 100 but hospital brilliant and treated me seriously and was kept in for 2 days... I then had another attack last week and phoned 111 who took 11 hours to ring back! As you can imagine i was getting stressed and took myself to hospital before they could ring back as my chest was so tight. Again no wheeze oxygen at 100 and even though ABGs showed hyperventilation i was treated and diagnosed with acute asthma exacerbation and kept in overnight... The day i came out i actually started wheezing and got really short of breath, phoned 111 who told me to go straight to a n e. Suprise suprise my wheeze went when i got there and oxygen levels fine, only as the nurse saw previous hyperventilation on screen she refused to treat me and told me it was panic.. I had to wait 5 hours to see a trainee dr who said the same thing... I begged for a nebuliser as soon as i had it i was fine!

What is weird is that although my oxygen levels are perfect and even to much on the abg, my lactate level is high which shows not enough oxygen to the tissues...

Is this asthma or just panic as thanks to my last visit its really put me off seeking help..

[Minushabens]

Without knowing you it's really hard to say what might be going on exactly. There seems to be an 'anxiety' element to the symptoms you report, but I know from my own experience that if I start to panic that I'm going to get wheezy you can be pretty sure I will!

Asthma management is very much about being able to read your body & interpret such information as you can get hold of in order to judge what is happening & take appropriate action (be that an extra inhaler puff or a 999 call).

It sounds like you would benefit from spending time talking through, reviewing and evaluating the episodes described to see if other options were available, or if you were reacting well to how you felt. Easier said than done, to be honest, but maybe start by trying to fix an extended appointment with whoever the specialist is at your local surgery. They ought to be able to get hold of hospital notes & work with you to help you react as well as you can when you feel unwell. If anxiety/panic is a factor, it's important to try & manage that as well, otherwise one thing will perpetually bang into the other.

Good luck & I hope that helps a bit.

[Melanie1989]

Hi thanks for your reply,

my gp thinks the asthma sets off the hyperventilation but i dont generally feel that panicked which is weird. I have an appointment with a consultant and respitory nurse soon, so will discuss it with them. I just feel like im going crazy as asthma treatments work so well...

[Lysistrata Administrator Community Ambassador]

Ahh this really annoys me when drs do this - I've been there! And had simiar problems. I do not wheeze and also do not panic or get anxious about my asthma (amazing how some medical professionals consider they know better than me about my emotions...). I also find if anything stress improves my breathing, and affects my stomach instead. I have however had all those scenarios you mention.

You may get anxious to some.extent but equally everything you describe could be down to the asthma. Hyoerventilation may be related to anxiety but also is normal in asthma as a physiological reaction. You breathe faster to compensate and this will show in an ABG - all sorts of compensation can occur but you do meet some people who just look at oxygen ans carbon dioxide and completely ignore context and compensation, and also think all hyperventilation is psychological. They clearly knew the asthma side of it the first two times you were admitted and sounds like your GP gets it too.

Very silly of that nurse and dr IMO to look at thr past hyperventilation thing and not treat just because of that. You would think the resulting admission those times would clue them in but even if it were panic the previous time it doesn't mean it is every time! Though honestly it sounds like it wasn't panic at all the first two times even if you were understandably stressed.

[Melanie1989]

Thankyou so much for your comments its really put me at ease, was beginning to think i was going crazy! I spoke to asthma uk nurse earlier who said the same things as you and has reccommended i get all my information on an action plan so i can show a n e in case it happens again!