Why do people dismiss asthma triggers. Today I've had a very sore chest as was foggy very cold and damp. When mentioned this I got told it's stress. It must not be step 4 asthma obviously....😂
Asthma Triggers Cold: Why do people... - Asthma Community ...
Asthma Triggers Cold
There’s an awful lot of asthmatics out there who are very stressed then. I think most, if not all, of those on here and all those I know personally would admit that such conditions can (and often do) make life more challenging on the asthma front.
Sigh!
PS. Unless, of course, they meant your lungs were stressed by the conditions. Given your post however, I suspect not.
For some people, stress is a trigger, but I’ve seen plenty of medical people who jump to that conclusion.
And It is happening far too often, and not just in respiratory medicine.
Boy is that true. I have a friend who would have died twice if she’d listened to the anxiety thing. The first time, she had an ectopic pregnancy, very easily diagnosed with an ultrasound. She had to go to three doctors.
The second time, her “anxiety” turned out to be endometrial cancer.
I bet they don’t do that to men.
here are men on this forum lol
??? with life threatening pregnancies?
I once had an asthma consultant who spent a lot of time and effort trying to explain how my triggers, including cold air, weren't real - it was just that I expected them to trigger me so I felt symptoms. This was in response to me saying cold air had always been a trigger even when I was mild.
This really seems like an awful lot of wasted effort IMO. He claimed I had mild asthma and was neurotic and overtreated about half the time (the other half he was trying to get me on Xolair...). So he acknowledged I had asthma but went to great lengths to explain how a common trigger was some kind of convoluted psychological thing?! Mild asthma still has triggers!
Incidentally, I'm pretty sure my triggers in general are a) not stress (it can be for many but my lungs actually seem to like me being stressed) and b) not imagined - eg I have zero reaction to fake lavender scent but the real thing has a dramatic effect! You'd expect a similar reaction to both if it had a psychological element.
The next consultant claimed I only had one trigger and the rest were panic/made up. She'd never actually observed the effect or anything, just decided this.
I do now have a consultant who appears to actually believe I might have problematic asthma. I hope he does anyway - I'm still in his clinic for troublesome asthma!
When I read posts like yours I really do begin to wonder about the training of some of these consultants.
Mind you, I was told recently by a surgical registrar that I had mild asthma. I was horrified, particularly as I was due to undergo surgery (not asthma connected) and had no wish to have my asthma underestimated. I corrected him immediately and, from the expression on his face, obviously failed to keep the annoyance I felt at the mistake from showing. My asthma isn’t severe, but it certainly is not mild though it is well controlled. I was very tempted to warn him not to mistake one for the other. What I did point out was that the medication I was on was for moderate/severe asthmatics.
I have now checked with my local medical centre to try and find out where the idea that my asthma is mild originated from. Not from there it would seem, and it was recommended that I contact the hospital to get that mistake corrected. Problem is, I don’t know who to contact.
I gave up wondering a while ago. The first one in this post is a leading asthma researcher. Didn't seem to know how to deal with patients who didn't fit trial criteria - he kept telling me how his trial patients were xyz and I should be too. This is also the consultant who told me not to get medical help if my peak flow was above 50%, regardless of other symptoms such as being unable to move out of my chair or finish a sentence.
The next one at least had the dubious excuse of specialising more in smoking-related disorders than asthma. She once told me that even severe asthma could always be controlled but I didn't have it anyway. Wish my lungs believed her!
If the implications weren’t so serious the attitude of the researcher is almost laughable. How dare you not fit the trial criteria!
One of the things that really does concern me (and I know I’m not the only one) and that is over-specialisation. Specialists within in a particular field of specialisation have their place, but there is a certain amount of truth in the saying “the more you specialise, the less you know”.
Oh yes. I have noticed a disturbing trend among respiratory drs to know about 'their' area but be disturbingly ignorant in anything not directly relevant (though the researcher I mentioned made me fear for asthma research overall - it would be nice if they remembered that the results are supposed to be generalisable to.a clinical population, not just the carefully selected textbook types who fit criteria.)
The worst example I ever had was a respiratory registrar who told me that there was no such thing as asthma without wheeze and that the worse your asthma the more you wheeze. I did actually point out that the guidelines say the opposite. Pity the patient with silent chest who sees him...
The problem also is that the sub specialists tend not to be aware of their own lack of knowledge. I mentally groan when I get a general resp dr in hospital because they often seem 100% sure they know it all and won't be shifted however shallow their knowledge of asthma vs lung cancer (I am a resp doctor! I know this! Be quiet, patient!) The non resp ones seem a little more able to acknowledge that I might not fit the textbook definition and may even be able to guide them, as a repeat offender/expert patient.
Ugh to your surgical reg. You could perhaps approach PALS to start with and they may be able to guide you?
I can identify with doctors dismissing symptoms as "mild" or "caused by stress" and have come to the conclusion that unless they know I am (mentally) stressed or anxious then they really mean they haven't a clue! Occassionally the word stressed is used to refer to the bodies immune system being stress or overloaded. If I am thinking clearly I ask them what mental health assessment leads them to that conclusion.
As for specialities I think I'll have to ask them if they would like to tell me how to take my body apart and send the various parts to the 'right' specialist. It is lovely when a doctor or other health professional see you as a whole person, and an individual.
Guess I am feeling fed up with some doctors being sloppy in their thinking and the way they inappropriately jump to conclusions. My lovely GP has just left our surgery for pastures new and it is hard finding one of the other GPs as good at listening and seeing it as a partnership relationship - with you as the patient and them as the professional working together.
Oh yes...I massively mistrust it because I feel like it's a kind of catch-all for when they don't know the answer, and often they insist even when you say actually you don't feel anxious 'well your body does'. Errr I think I might notice? But then i get frustrated and upset because they're not listening and they take that as 'proof' that it is anxiety.
I do actually have a lot of anxiety around not being listened to and dismissed, due to previous bad experiences with medical professionals. Very hard to explain!
Ive run into a number of professionals whose training was clearly biased in favor of looking for things like anxiety. They’re just sure because the asthma is acting up you’re having a panic attack.
I wrote a note I hand to the paramedics. It points out, politely but clearly, that twice in Sept they were certain I was having a panic attack, and that in both instances, ER admitted me to ICU, and to please take this asthma attack seriously.
It ended discussion and they took me to the hospital, where I was admitted.
Putting things in writing has a lot of impact. Medical people take things put in writing seriously.
Oh the panic attack where you have no panic, but what could you possibly know about your own feelings?!
I created a detailed summary for hospital and paramedics, detailing that yes I do have asthma and this is how I present. It seems to work quite well mostly (and I get asked if my consultant wrote it). A couple.of times it has been ignored by absolute idiots who wouldn't listen or read it properly, but it has helped me not be sent home and not go down some random alternate diagnostic pathway, because I demonstrated that this presentation is typical for me in confirmed severe asthma attacks, even if it is not typical overall for asthma. As an asthma freak I really need this or they just ignore me! Or test me for other things I don't have- fair enough to rule out, but when I don't have them they then try to send me home without treating the asthma at all.
I have been told the same !!
Apparently it could be my vocal chords !! It’s so frustrating
I wish my new consultant could spend 24 hrs living alongside me ....and then just let him try and say I’m neurotic
Although VCD exists and is more common in asthmatics, I also strongly suspect it gets thrown out a lot by doctors who don't really understand it very well eg they think it's a kind of psychological condition a lot of the time.
I often wish I could swap lungs with certain drs. I'm not sure they could handle it...Also I don't think I'd want them back! The second bad one I mentioned who said I had one trigger actually kept going on about how she had asthma so she understood how I felt. It used to annoy me as she clearly didn't get it at all and had no concept that not everyone's experience is the same.
I do actually have VCD, or as it's now known Inducible Laryngeal Obstruction. I've been given some breathing exercises by the asthma nurse in clinic and then different ones by a respiratory physio after I'd tried those for a while- they helped enormously, so I wouldn't dismiss this treatment if it's available. The risk of side effects is very low compared to other treatments offered to people with very bad asthma!
That said, I was really stressed when my asthma deteriorated - I won't go into too much detail, but my employer/some people at work have been pretty vile. Then there was asthma related issues at work once my asthma was brittle - they refused to remove triggers of attacks and also refusing to send guidance to my colleagues on what to do to help when I'm having a bad attack and can't speak enough to call an ambulance for myself..... My disability employment lawyer has been one of the best things to happen to me in months as she is now insisting that this isn't OK and I need to be safe at work!
Do u go to the royal Brompton for the ? There is a consultant there who specialises in this for athletes
No, I'm still treated at my local hospital, although the Asthma UK helpline suggested the Brompton could be helpful if they can't get me controlled (as it was looking earlier this year). I've had a secondary diagnosis of fibromyalgia which is reducing my ability to move around even when my breathing is stable, so I'm pretty complicated to treat! At least the physio /reduction in stress from work has meant that I'm not having such severe attacks at the moment, but I can't be out in the cold AND moving - I can do one or the other, which is leaving me pretty much house bound when my other triggers are taken into account!
Personally, I know when I’m under stress and when I’m not. Since I’m retired, there’s really very little stress in my life except for the chaos suddenly having severe asthma brought to my life.
That’s not even a catch 22. Last Saturday night I thought I might have to call 911 from Wal-Mart, but the asthma came first and then the stress.
When the paramedics get there stress decreases because I know I’m going to be all right. So tired of arguing about this with people who don’t me as an asthma patient. It means they have preconceived notions not based on my particular state at the time. They could make treatment mistakes.
Tell me about it! I've had paramedics tell me I need to breathe more slowly, but not how to do it... Some are brilliant and reassuring, others are so irritating that they make me angry!!
I’m glad you have a new consultant!
It’s true that stress and anxiety can have all kinds of crazy effects on the body. But to imply that asthma is caused by stress is nonsense. When i had an appointment about 6 weeks ago, I saw a doctor who I hadn’t seen before. She said my asthma is due to anxiety. (So, stress? Therefore it’s all in my mind?) I was diagnosed with asthma as a baby. I’d like to think I wasn’t too stressed or anxious back then.
Ugh...That's the view of someone who doesn't even understand how asthma works! Stress might be a trigger but that's not the same as causing asthma! Also, if stress triggers asthma, that's *still asthma* even if triggered by something psychological.
Also, I get fed up with this idea some drs/others have that because asthma causes SOB and so can anxiety that means they're basically the same thing. Errr heart failure causes shortness of breath ans that's not asthma or anxiety...
It really fries my cookies when people do that.
Oh stress... the catch all trigger! Why don’t you just try to relax a little and it’ll all calm down 🤨🙄😒
Stress *is* one of my triggers, but only 1 particular type of stress...exams! Particularly final year, graduation/job dependant ones! (Glad that’s finally all over with!😆) I can go to an academic board to appeal a unlawful suspension, I can deal with angry/upset parents of kids I coach, I can survive interviews intact and I can cope with people telling me that I ‘don’t take (my) condition seriously - don’t (I) know (I) might die (from asthma)’ and be fine, however if it’s an exam my lungs just go to pieces. Easily dealt with - up steroids a day or 2 before and do regular vent on the day of. The next day I’ll either be absolutely fine or in hospital depending on my adrenal crash 😅.
However one of my old docs just couldn’t understand that most of my troubles came from multi-layered triggers (dust plus cats plus cold weather etc) - if I so happened to say the s word then that was the sole cause of the attack. One time she tried to get rid of me still wheezing, SoB and PF low cause I said ‘...and of course I’m slightly stress atm cause I’ve got my dissertation deadline monday week’ when asked what had triggered the attack (mainly snow storm/cold weather). Luckily an AN came round and stop her discharging me instead I got transferred to the resp ward for a few days 😅
I really wish people wouldn’t blame everything on stress - no it doesn’t help but rarely is it the only cause of (any!) issue 😤 I think there is a lot of confusion between asthma attacks and panic attacks... if you’re stressed then obviously you can only have panic attacks (duh! 🙄😒)
Ah the joys of the multi-layered triggers!!
Unless I’ve got a raging infection I can normally pick out two or three things that have happened together to set things off. And even with the infections there’s often something extra that tips things over the edge! 😅
Thankfully my team (and most of the other resp drs who know me!) do actually appreciate this is the case now and tend to ask me for my list of triggers as they know I’ll have thought about them and probably sussed them out by the time I make it to a resp ward!
But the catch all of “stress” is incredibly annoying 🙄 and as you say, it doesn’t particularly matter if stress is the trigger - it is still asthma! It shouldn’t make a difference if it’s an allergy or stress or something else entirely in the general initial treatment! Only potentially in the long term management.
Because people who don't have asthma can't possibly understand and I think it is a mistake to expect them too? You know how you feel and that's enough. We all understand. x
The problem is that medics should understand this, but they don’t always seem to. I’ve been very fortunate in that over the past twenty plus years I’ve had very sympathetic GPs, and on the one occasion I did get referred to a respiratory consultant it was at the request of a consultant in another speciality who seemed to think his assessment of my asthma was better than mine, so he recommended that I see a specialist in respiratory medicine to get my asthma reviewed. Waste of everyone’s time; the respiratory consultant came down on my side.
I once described physicians as being like detectives. Like a detective they have to use evidence to solve a case. Any decent detective knows that you if you ignore the evidence given by your star witness you are less likely to sort out what is going on. In a medical situation the patient is the star witness. There are good physicians who do understand this, but those who don’t need to learn to do so.
Ah this is a totally different issue. I was just replying to the poster.
Ah - point taken:-).
Though I suppose the follow up is that given that some medics don’t seem to understand that cold and damp can be a problem it’s not terribly surprising that members of the general public can’t get to grips with the issue either. I’ve never encountered that attitude, but I have a lot of sympathy for those asthmatics who do.
I am only mild asthmatic but I do have copd as well. Fortunately I have never ended up in hospital with either so can't comment from experience. I have been horrified to read of others experiences on here though and hope I never have to go through anything like this x
I think it is useful if non-asthmatics understand the.idea that we can struggle with things that they don't. Eg if you live with someone it helps if they understand that you need a warm bedroom at night and can't sleep with the windows open in winter, or can't tolerate air freshener in the house. My life is definitely easier with people understanding the effect my triggers can have and not just dismissing them as stress!
when you can't breath you are entitled to be stressed
Too true!
I have suffered from asthma for the last 25 years no one belived the triggers that brought on an attack deodorant's,hairspray,cigarettes all types of cleaning agents cats dander mold cold air, in hospital regularly. meds all types of inhalers breathing tablets steroids by the bucket load antibiotics the one thing that changed and helped me was magnesium citrate I take 400mg every day triggers gone peak flow went from 180 -540 having a cold is so different now all the symptoms with one difference I can breath no asthma no hospital stays
Well that's funny. I generally only feel stressed when I've got unreasonable work loads. However that hasn't been the case for a few years now yet every January apart from 1 in the last 20 years I get an asthmatic cough. As soon as the cold weather properly sets in on it comes. This year it never went away and despite treatments I've still got it.
Hi I found out I had asthma over the phone, this was a previous Drs surgery I was at. They rang me and said you need a chest X-ray you have asthma, then losing said form several times. Have been told it's allergic/ mild asthma. Usually find it's certain perfumes, aerosol deodorant cold windy weather still learning about other triggers.
These are mine too perfume, cold and aerosols, paint.Have an allergy to preservative found it lots of stuff paint shampoo conditioner wipes makeup loads of stuff. Still ppl don't take seriously.
yes well people think you are making it up
I was in hospital with another episode of asthma getting all there treatments antibiotics steroids 80 mg per day oxygen inhalers the worked the patient next to me had a bed bath then used a deodorant spray brut I took a very bad reaction to this could not breath placed in intensive care for 2 days when I got back into the ward the doctors and nurses would not except that a deodorant could cause that so even with taking all there meds they did not stop my trigers
Cold damp weather & Infections. When I landed at hospital I could not talk and this nurse said your having a panic attack i signed to write it down for him. All I got was why do you want to write in a patronising voice. Grrrr. I thought I would die before they realised I was having a server asthma attack. Thank god for this passing paramedic who grabbed a Dr and said she's having a server asthma attack. Scooped me up and put me on a bed. That was my first experience of going to hospital with it. They kept me in for a week. Thankfully it was another seven yes between emergency treatment. Just had a three night stay in October. It upsets me as people who I work with don't get how scary and life threatening it can be.
The thing gets me is i went to this professor in hospital who said after i was there for 3 days would you give me a call and we will get to the bottom of this i said feck this guy knows what he is on about i went and at 100 for each visit he said we will try this tablet we will try this tablet we will try these all more poisonous then each other only made me sick and then said they do that to some people ??????????
Oh, the good old triggers conversation. ‘So what triggered it today?’ One day I will actually reply, ‘how long is a piece of string?’ I describe it as layers of a cake, foggy conditions, getting over a cough and cold, stress, still recovering from a previous attack, hormones, etc. Unless someone buys me a giant hamster ball to live in, I doubt I’ll ever avoid all my triggers! 😂