Methacholine Challenge

[MrsCMK]

Just a quick one from me...

Has anyone here had to do the Methacholine Challenge?

I had a reversibility spirometry year the other day which came back negative (because my lung inflammation has settled as the hot summer weather has passed), so my consultant wants me to do this challenge to finally prove to the board that it’s asthma so that I can start biological treatment.

I’m super eager to get the confirmation I need and start the treatment during the winter/spring so that when summer comes, my quality of life is better.

[Js706]

Yep I’ve had the methacholine test it wasn’t the most pleasant but wasn’t horrendous either. I wrote quite a long post on my blog a while ago about my experience of it:

ainteasybeingwheezy.blogspo...

[MrsCMK in reply to Js706]

Thank you for sharing the link! I just read your blog post and it’s answered all of my questions- so informative ☺️

[Js706 in reply to MrsCMK]

Glad it helped! Hope you don’t have to wait too long for the test

[Swimmingaddict in reply to Js706]

This is very useful. I am due to have a lung function test and Mannitol Challenge Test next month and I am very anxious about them. I had a bleach triggered asthma attack in front of the asthma nurse during an appointment and she was worried enough to ask my GP to see me. So more than 12 hours later (the next day) I saw the GP, and no wheeze, so therefore she is not convinced I have asthma, and clearly knows more than the asthma nurse?! So now I have to have these tests, not to help me, but to prove her point and I am worried about my inhalers being taken away when I know they make a huge difference to my ability to exercise and my peak flow (I know that isn’t always the gospel).

[Mogget]

Fingers crossed for you!! A challenge (in my case mannitol) was the key for me finally being approved for Xolair. Other tests before that were negative.

Hopefully you react and are on the road to biologicals very soon 🤞

[Lysistrata Administrator Community Ambassador]

Crossing fingers! I have done one histamine (negative, due to stupid instructions on stopping meds), one mannitol (positive, I checked the med instructions myself), and now gearing up for yet another mannitol because my consultant is considering some exotic solutions and wants an 'up to date' one to take to the MDT meeting - I can't have biologics because I don't have the right kind of asthma. I think I won't be moving far the week before!

I think Js706 has pretty much covered it but my input would just be to triple-check you're stopping all the meds at the right time as I find it's complex with different types at different times before, and they don't always give helpful instructions. I think I found Papworth's most helpful when googling (I had to do it again because my letter this time doesn't cover my Phyllocontin).

Good luck, hope you get the result you need and can get onto biologics!

[Mogget in reply to Lysistrata]

Might I ask what exotic solutions are being considered?

[Lysistrata Administrator Community Ambassador in reply to Mogget]

Bronchial thermoplasty! Consultant very unsure but says no other options currently - hence looking for more tests before he takes to MDT. Just hope it's not all dependent on the challenge...

[Mogget in reply to Lysistrata]

Ah interesting - I did wonder if it might be that! From what I’ve read and seen online (though I haven’t gone in-depth) it’s really helped some people. Is it something you’re keen to try (I guess so if you’re all out of other options)? Surely you don’t need another mannitol challenge if you’ve already reacted to one..!

[Lysistrata Administrator Community Ambassador in reply to Mogget]

You would think!! I don't think it is required either by NICE etc but consultant isn't that familiar with BT I don't think. He didn't mention challenge in appointment but then it was in letter and I got appointment through.

I would like to give BT a go but atm it seems like there are so many hoops I don't know if it will ever happen. I have weird asthma so think my cons wants to convince himself this is the right thing to do - he keeps talking about limited evidence base, but I think a lot is not knowing who it works for.

[Mogget in reply to Lysistrata]

I hope it does happen for you and I’m sure you will fight your corner, especially if there aren’t any other options. It’s a delicate balance between advocating for yourself and trusting in your consultant.

[Brittleasthmatic]

Hi! I recently about a month ago had the methacoline challenge test done. I was super nervous and had it booked ages ago but as I was on steroids they couldn’t do it and had to postpone so this added to the nerves. It wasn’t as bad as I thought it was going to be, but it wasn’t exactly the nicest thing in the world. First I think they make you inhale through a neb type device saltwater twice and then the methacoline solution. They have about 10 doses on a table to fill in how your breathing test results decline ect - but they won’t do them all if you start showing symptoms. After the first dose of methacoline I was quite wheezy and the nurse straight away gave me a salbutamol nebuliser which reversed it and stopped the challenge. So mine only lasted about 5-10 minutes if that! The nurse said she’d never seen someone react so quick. I too am waiting for biologics and they wanted to do this to make sure, like you.

I have a follow up appointment tomorrow at the severe asthma unit to discuss things and probably tell me more about future treatment.

Hope your ok and try not to worry

If you ever need to talk to someone who understands I’d be happy to talk with you

Best of luck,

Chloe x

[MrsCMK in reply to Brittleasthmatic]

Thank you for this! I hope your follow up appointment went well 🤞

[Margerita]

Yep I had the test which I was dreading but shouldn’t have it was fine got stopped on the second round. Have now been on mepolizumab for a year for eosinophilic asthma and it’s changed my life 😊

[MrsCMK in reply to Margerita]

I love hearing success stories like this!!

[Shellc]

Just a thought do u mainly get out of breath when u do exercise , if so look up eilo, not many doctors know about it

[MrsCMK in reply to Shellc]

Hey. Not really, I do get a little breathless when I exercise but I think I can put that down to being unfit- haha. But thanks anyway 👍🏽

[MrsCMK]

Hi all. Thank you for all of your advice and comments. In some strange, sick-minded way, I’m looking forward to this challenge so that I can finally start Xolair!

From everything that I’ve now read, I think that the previous spirometry tests I’ve had done would never have resulted in much because even during an attack, my peak flow rarely moves much. Only a small number of times I’ve experienced a big drop (which in fact is only 20-30% for me).

I’m expecting to receive my appointment letter for this within the next couple of weeks. Fingers crossed and thanks again for the advice 👍🏽

[SophPete]

Hi , I’ve performed literally hundreds of challenges ( various types) on people and a few on myself. It seems to me that the hardest part is withholding the medication you have been asked to, for the required time. The challenges themselves are far less arduous and quite short lived . Most people have told me that their usual episodes of asthma are more severe than those they have experienced due to challenges. Hope this helps with any doubts!