Intercostal muscle pain with asthma symptoms

[louisebugsy]

Hey everyone, so my asthma has been rubbish badly controlled by me at times and it’s not being taken seriously by medical staff.

I’ve been told so many times by drs and gp’s that’s they highly doubt I have asthma because my sats are alway within an acceptable range.

This has driven me insane and I’ve been on a bit of a rampage. So I work in the ambulance I go to many asthma attacks ect and yes a lot are having an attack but have good sats this isn’t uncommon at all and in fact your sats only drop when you are becoming unable to compromise and your body isn’t able to cope with the pressures being expected of it. Stable sats are very common in younger asthmatic.

Sorry I went of topic slightly. So one of my main symptoms I get before anything thing else is intercostal tenderness and I mean the whole intercostal area and even just feeling for the intercostal space causes pain. I know it’s not caused by coughing and I’m pretty sure it’s to do with my asthma.

I was recently put on salmeterol that’s on top of my fostair 200/6 and montelukas, salbutamol. After I very very prolong asthma episode i went 3 months with asthma symptoms and low pf. I’d also had a chest infection which forced me to go to my gp.

This helped massively and I felt better after a course of steroids on top.

Because I haven’t maxed out my possible meds they won’t refer me to a respiratory specialist.

I’ve been yo-yoing my pf for the last two weeks I’ve been symptomatic but managed to get on with it and work. I’ve had my rest days and not felt like doing anything feeling fatigued and not sleeping well.. this was they same nights I had poor pf.

I ran out of my sulmeterol inhaler Saturday and though I’d be ok until Monday but I was wrong I’m far worse today than I’ve been in a long time. When to pharmacy to collect inhaler and they said it wasn’t ready (I ordered it two weeks ago) so I had to go around the drs and ask to have a prescription sent over. I’m doing so I was being more and more out of puff so the reception said she would have the dr call me sometime today.

I’m using my blue so much if I have to do something is wipes me out. Can’t breath. At rest with my blue I can calm things down but that’s literally no talking, can’t eat drinking move my intercostal pain in intense like being squeezed by and elastic band or a snake. It’s constant and building. I’m starting to feel concerned but I have my blue close by. I’m having to use it every 30mins or so.

Dose anyone else have this issue with the intercostal muscle tenderness? X

[Js706]

Hi,

Sorry to hear that you’re struggling so much and not getting much help from your GP 😞

Being put on salmeterol alongside fostair seems really odd? As fostair already contains a long acting bronchodilator. I would have thought they’d have been better off either trying a different combination inhaler or something like spiriva as an add on!

It also seems really weird that they won’t refer you unless you’re maxed out on meds! They should be referring you before that point (in fact, I’m pretty sure the new guidelines that came out last month say they should consider referral if a combination inhaler and montelukast have failed). And if they won’t refer for that reason, then surely they should try more meds! 🙄

I also feel your frustration with the whole “good sats = no asthma” thing. It’s so frustrating trying to get across that they shouldn’t really be waiting until your sats start to drop to do something...

And yeah I think I know what you mean with the intercostal tenderness. I don’t know if I would necessarily call what I experience “pain” but definitely when my asthma starts to kick off I feel really, really uncomfortable in that area. And the muscles don’t seem to want to move properly because they’re sore/tired out (I know they are working fine, it’s just the best description I can think of!)

[louisebugsy in reply to Js706]

Hi, thank you for getting back to me, I’m still waiting for a gp to call me so I can get my inhaler. I know I’m on the sulmeterol because my blue isn’t effective. Im having to use it every 30 or so mins on a bad day. Which isn’t good. Since being on the sulmeterol I hadn’t needed my blue until recently but was aware the sulmeterol is to be used as a prevent not a reliever I still having to use my blue for that I’m currently 75% below on pf. Staying still and doing very little is helping and taking my blue but as soon as I have a conversation or even climb the stairs to the baths doing the washing ect i feel my chest get worse and I’m

Out of breath so I’ve given up today!

I’ve tried everything today but nothing is lasting long enough, I’m literally getting 30mins ish relief with my blue. I can calm my breathing down with my blue but then I literally have to do nothing. I feel like I’m not serious enough to warren emergency treatment but at the same time I’m so on the fence with my asthma. The pain in my chest is probably better described as a uneasy feeling achy ness it can get intense and you don’t want to breathe deeply because it’s is so sore and uncomfortable. At times I do get sharp stabbing globally I’ve had this randomly the only plus side all this salbutamol has sorted my wheeze but I feel exactly the same other than that. I used to think feeling like this was normal until I was diagnosed and I go through periods of kore good day than bad but the. I start getting more bad days. Then they change my meds and I’ve have a period of coping great and slowing but surly my pf starts dropping and I get symptomatic. I have a new pf meter it’s call smart pf this is great as although I can blow a higher score when I do hit amber i am genuinely Amber I have the symptoms to go with it and I’ve had several days in amber not he last two weeks. But I had my own personal best input in the setting not the expected as when I good I’ve smashed that. And proved it!

But because even when I in amber I can be at my expected blow level which the gp states they can’t do any referrals ect because I can still blow what’s expected on the chart even though I can blow of the 100+ over the expected. Drives me made! My personal best on the tube peak flow is 480 (430 my expected) on the new peak flow meter I have my PB is 545 and that was since starting the sulmeterol. Go just phoned me and il have my inhaler ready this afternoon. Finally.

[Js706 in reply to louisebugsy]

Ugh I know exactly what you mean when everything is so exhausting!

It might be worth ringing up your GPs and trying to chase them up or ask for an emergency appointment later to get seen and checked out. If you say you’re a struggling asthmatic they should find an appointment for you on the same day!

I know it’s difficult when you don’t feel you’re bad enough for emergency treatment but asthma UK does say that you need to be seen if your blue isn’t lasting 4 hours. Have you tried doing the 10 puffs at a time through a spacer and seeing if that helps a bit more? I’m sure you already know this working in the ambulance service but pf is only one indicator - so if you’re still struggling to talk and get about the house then you need seeing really!

Hope you get some relief soon!

[Junglechicken in reply to Js706]

Mine are very tender to the touch today, especially between my rib cage. I’ve had it on and off for 4 months, it started just before my severe attacks. I’ve talked to my GP and specialist who believe it could be inflammation in my lungs that is pressing on a nerve or muscle. It gets better if I stop breathing in (which unfortunately is unavoidable), prodding it and with paracetamol. I completely understand not being taken seriously because you have good stats. One of my GPs doesn’t even think I have asthma just anxiety! Despite the fact that I spent the first 7 years of my life either in a hospital or on a neb. Also since I started on Seretide my PB has increased and on average my PF has jumped from 75% to 92% . Funny that isn’t it🤔

[Js706 in reply to Junglechicken]

Nah, that sort of response definitely wouldn’t happen in asthma 😉 must just be anxiety 😂

Who would have thought that asthma might improve with asthma treatment?!

[Junglechicken in reply to Js706]

To be honest JS706, I was starting to believe myself that I wasn’t asthmatic! This flare I didn’t respond initially to oral steroids and it took three weeks after starting Seretide for the attacks to stop. However I realised that the last attack was the last day of my steroids, so they possibly did have an effect I maybe just needed a few more days of them.

[Js706 in reply to Junglechicken]

Ugh yeah I know the feeling! I’ve had attacks/flares that do respond normally and I still get convinced I’m not asthmatic sometimes! So definitely know what it’s like when nothing is behaving and others are telling you it isn’t that! 😞

Ah yes - quite possibly! I used to find if I’d left stuff a bit too long then I would often need a bit longer on steroids etc than normal for them to sort things

[Junglechicken]

Mine are very tender to the touch today, especially between my rib cage. I’ve had it on and off for 4 months, it started just before my severe attacks. I’ve talked to my GP and specialist who believe it could be inflammation in my lungs qthat is pressing on a nerve or muscle. It gets better if I stop breathing in (which unfortunately is unavoidable), prodding it and with paracetamol.

[louisebugsy in reply to Junglechicken]

I couldn’t help but chuckle at the “it gets better if I stop breathing” I found a steam room great on holiday I was completely symptom free for the time I was in there. No sooner on was out it’s was back. I wish I could see a specialist xx

[Junglechicken in reply to louisebugsy]

I’m the other side of the coin. Can’t cope in the wet heat of steam room but the dry air of winter is perfect

[louisebugsy in reply to Junglechicken]

I’ve not had any issues with winter. I really struggle on night shifts. I’m at my most symptomatic working nights and I swear that was this episodes trigger. I took all My meds with me and took when I had the time ok 2am rather than before bed ect and then I take my morning lot when I get I at 8am before I go to bed. Yeah is messed up I know. I need to prove this though before I tell gp.

[Junglechicken in reply to louisebugsy]

Go on the Asthma UK webpage. They have some great info that you can print off and shove in the face of a medic like I have done. Especially about PF being ONE of the ways of establishing a problem. The British Thoracic also have guidelines about features of attacks that may not follow the norm. I fail to understand when you have a person setting in front of you wheezing and coughing up mucus (sorry for the graphic), racing heart rate which is a symptom of a severe attack, why some medical professionals don’t think that’s a problem. According to my GP I once had a five hour panic attack (pardon?) which just so happened calmed with 10 puffs of salbutamol 20mins after administering. It’s madness!

[louisebugsy in reply to Junglechicken]

That’s my argument, walked to pharmacy 5min walk had to use my inhaler which isn’t normal for me so short of breath I struggled to string a sentence together, my shoulder are hurting. I’ve managed to get controlled my my chest feels like it’s ripped out! Finally home and taken my sulmeterol inhaler. I know it not a recuse inhaler but the sooner it’s in the soon it can help. I have read through the asthma uk website and spoken to the nurses. But my problem is my job. I’ve never needed a Ned. To be fair it probably would of help is some on my attacks. I don’t see myself as an emergency even when I’m struggling I’m the classic “ it will pass” person, the type of person I tell off in my job. Unless you compromise there isn’t anything they will do. If I go to hospital and my obs are fine I will be sent home. Unfortunately it how the system works. It’s not right be if you knew how many people waste hospital time you’d understand if you not obviously sick then you don’t belong. GPS are the same it’s like heart attacks not every has the same symptoms some people don’t have any! We take in all chest pain because of this. Why can’t asthma be treated the same. Sorry I’ve gone of on one now. I can’t even laugh 😟 xx

[RD23]

Ahh the old SATS saga! My SATS have only ever dropped once to 70% when I had a really bad allergic reaction, with my asthma they’re always 99-100% and I’ve been told sooooo many times that it can’t be my asthma because my SATS are fine. Yeah but that noise coming from my chest that sounds like a broken boiler might suggest otherwise! 😂🙄🤦🏻‍♀️

I get what you mean, when my chest is bad it feels like there’s something in the middle that I can’t push my breathe past if that makes sense? The respiratory physiotherapist told me to try pursed lip breathing, but when my chest is tight I struggle with this. After an attack I get really sore ribs and I find a bath in magnesium salts and/or a hot water bottle help, that and gentle rib stretches if I can manage it.

Hope that helps xxx

[louisebugsy in reply to RD23]

Are yes.. I didn’t think I was alone. So I’m feeling a bit better now. I managed to eat dinner without feeling like I’m suffocating. I tried stretching earlier head up above head and pushing chest out but that was fair to painful I can manage it now with discomfort but my shoulder at paying the price for the episode today.

I have Epsom salts for the horse (3kg tub) and I was wondering if soaking in them would relieve the post asthma body... plus what do you class as an asthma attack I’m always glass half full with my asthma denial you may call it still. But I guess because I’ve always had it I don’t see it as anything other than normal? If that makes sense? my asthma just got worse and worse until it starting becoming more unbearable and no longer ignorable. It was only a fluke I was diagnosed when I wash if it wasn’t for my surgery I would have continued to believe it was in my head as anxiety ect. The usual dr fob off story.xxx thank you xxx the hot water bottle im going to try now x

[Junglechicken in reply to RD23]

Ooo I might try a hot water bottle for my poor chest. Thanks for the suggestion

[RD23]

Glad to hear you’ve managed to eat and are feeling a little better.

I find the salts help and I have my bath water really hot but I’ve always done that! Did I mention a u shaped pillow? I’ve got one that I lie on when I’m bad and I find that helps, my left side always aches worse than the right though for some random reason and at the moment, I can’t lie on it.

I tend to call it an attack when I’ve had the a&e blues and twos treatment, which is most of the time! If I can get myself out of it I tend to just refer to it as a wheeze. I’ve had it since I was two but it wasn’t too bad when I was little, then puberty and hormones kicked in and it got worse and in the last ten plus years it’s as if my windpipe has just gone totally nuts and is in some kind of rebellious phase! I get what you mean though, I’m that used to it that I think I can come across as blasé, I can pretty much always muster up a smile and my approach after is very much, well it could be worse. But that’s my coping mechanism, I have to be like that as I find I could very easily start to feel sorry for myself but then it’s getting myself out of that. Does that make sense? The smiling is also mine and my mum’s way of gauging how bad on the asthma attack scale I am. She knows if I can muster up a smile I’m struggling but I’m not the worst I’ve been, but if I can’t smile she knows I’m really bad.

[Junglechicken in reply to RD23]

That’s so interesting my discomfort is usually on my left side too when it gets bad.

[RD23 in reply to Junglechicken]

I sometimes wonder if it’s because I’m left handed so maybe the dominant side of my body works harder? 🤷🏻‍♀️I’ve had a CT scan in the past to look at it as the left lung doesn’t appear to work as effectively when I have an attack but they didn’t find anything! Who knows?

[Junglechicken in reply to RD23]

I’m left handed too! Curious and more curious

[louisebugsy]

Well the right lung is bigger guy. It’s the main lunge the left is much smaller as the hearts in the way. I hope that helps? Sorry is my medical knowledge kicking in. Working on the ambulance does have its perks 🙂 so I do use a pillow a lot when I can’t sleep I lay on my left side, I prop a pillow under my torso and learn over slightly on it this massively helps. I never knew why though xx I’ve not been sleeping for serval nights possibly brewing my asthma up for today xx

[EmmaF91 Community Ambassador in reply to louisebugsy]

Erm... strike that, reverse it... heart sits to the left, so it’s the left lung which is smaller - Left loathes Lobes so only has 2 😉

[louisebugsy in reply to EmmaF91]

Haha can you believe I woke up at 3am realising what I’d just said! Oops

[EmmaF91 Community Ambassador in reply to louisebugsy]

😂😂😂... was wondering when you would! I basically have left/right dyslexia so this is definitely something I’d say... but not gonna lie was especially amused by the ‘medical knowledge kicking in’ comment cause knew you’d realise and be mortified 😅😂

[RD23 in reply to EmmaF91]

Makes sense! I never thought of that xxx

[Echoblue]

Hi louisebugsy, I know what you mean re the intercostal muscles. I describe mine as like a really deep bruise. Not painful if you don’t touch it, but really uncomfortable to lean on or touch. Actually makes me feel a quite queasy to rest my back on a chair, bed etc so for past 9 months been so hard to properly rest. I have regular physio and he has just started acupuncture to try and help the poor muscles along!

I wish you well x

[EileenCl]

I don’t know if this helps, but i’ll add my bit too! I agree with all that has been said about peak flow etc. I had awful soreness in my intercostal muscles, really painful if I breathed deeply, and at times this was with me all the time. For various reasons (which are too numerous to mention here) I decided that sulfites were a trigger for me. I virtually cut out (as far as you can in the modern world,) sulfites, mainly by not having wine, dried fruit and sugar, and I have had no more soreness. The asthma is still with me, but I am sure the sulfites were part of the problem with the muscle soreness. Hope you are better today.

[RD23 in reply to EileenCl]

I might look into that and see if it will help.

[robert1957]

Hello louisebugsy

To help you understand what you are going through please research the Vagus nerve it might help also if you research magnesium deficiency and symptoms of magnesium deficiency

[louisebugsy]

So Ive only made it a week. I’ve been really active this week working and spent 42 hrs away over the week end but took all my inhalers ect I bit earlier on my night shift because I’m going over my 12hrs protection on my salmeterol. It seemed to help a bit better ect. Yesterday a little wheezy and a bit puffed but I gets lots done and it wasn’t effecting me. Today my pf was great this morning woke up symptom free (working 18:30-06:30 to tonight)the weather is damp and a little cooler. Fed the horse but noticed the exhaustion taking it out of me. It feels like the air was thick to breathing in and my lungs are starting to hurt even though I’ve taken my blue I’ve taken all my inhalers as normal and nothing obvious has changed. It’s like just breathing through your nose after a run. I really didn’t know what going on with me right now. Anyone else had this feeling?