Asthma attacks, panic attacks and what to do?

[Twinkle912]

Hi I'm new on here so thanks in advance for any help/advice. I was diagnosed with asthma about 14 years ago. Last week I had my second asthma attack this year- thankfully whilst on Facetime to the 111 Dr so he called the ambulance and I went to A&E again. I usually manage my asthma well and am not too bad checking my peak flows when I start to feel a tight chest, increasing my Clenil to 4x 2 puffs daily and using my Ventolin as in my action plan. Problem is that I also have panic attacks on the back of my asthma attacks. How can I tell the difference? I knew that my asthma was getting worse as cough, tight chest (like a lead weight) increasing, waking at night with breathlessness, needing my reliever more etc. My panic attacks seem to be uncontrolled rapid breathing, shaking, tingling/sore and straight fingers .

After my asthma attack last week my breathing started to get more difficult again the next day- over a few hours I had an increasingly tight chest again- so I followed my asthma plan and took 5 puffs of Ventolin then again 3-4 hours later but after an hour it was still difficult to breathe and the lead weight was sitting in the middle of my chest again. My daughter, who is a staff nurse, phoned the practise nurse (Asthma clinic) who told us to go to A&E again. When we got there I was told that I was just anxious and sat trying to control my breathing for what my husband says was 40 mins before going back outside for air as I just couldn't get breath aka goldfish out of the bowl moment. The nurse then came and got me and put me in a room with the windows open to help me to breathe (if I could have hung out that window for air I would have done). As I had a clear chest and no wheeze they said that it was just anxiety. So when am I having a panic attack and when is it an asthma attack? Any advice?

I am really confused as I have never been wheezy and rarely have a chest infection with my asthma- barking cough like a seal- yes, breathlessness -yes, lead weight on chest -yes. To be honest I rarely ask for help - or go to the doctor -apparently it drives my family nuts as I am always "fine" but after this past week I need to get myself sorted as I'm not fine- going upstairs this week has knackered me.

Since my asthma attack in Feb - I've exercised more, lost weight, practised my breathing exercises and do QiGong most days - I'm trying to control things, but I need clarity on what to do and when. This past week hasn't been my best and its not like me to be sitting about not able to do things. Any advice is appreciated- thanks.

[Lysistrata Administrator Community Ambassador]

Hi and welcome!

Sorry to hear you're having problems. To me it comes across that actually you DO know the difference between your asthma and panic attacks and have a handle on what to do.

However, the hospital has now confused you by saying stupid things about asthma which are not true. You do not need to wheeze to have asthma and a lack of wheeze does not automatically mean the problem is all anxiety. This seems to happen even to people with no history of anxiety or panic attacks, so I suspect they may have seized on that even more if they knew you do have panic attacks and thought that asthma needs a wheeze every time. I feel like of all people, you are in the best position to know the difference between asthma and anxiety because you've experienced both!

Although I think you have a handle on it, this post may also help for telling the difference: healthunlocked.com/asthmauk...

How is your breathing now? Do you have a good GP or asthma nurse you could talk to who won't put everything down to anxiety automatically? You may find it helpful to chat things through with the AUK nurses who are lovely and have time to listen and explain - they're available Mon-Fri 9-5 on 0300 2225800 or WhatsApp - 07378 606728.

[Twinkle912 in reply to Lysistrata]

Thank you- I'll have a look at the info. I've an appointment with my Asthma clinic this afternoon so hopefully get some more info there too x. My breathing is better thanks just a bit cream crackered

[hilary39]

I agree with everything Lysistrata said. I wheeze very little except for on forced inhales and even when I am in the throes of debilitating attacks, my chest is often silent and sats are usually normal.

So many of us on here say the same thing so I think it's just unfortunately an example of one of those textbook norms doctors and nurses learn about and absorb and think are true for all patients (e.g. patients in a severe attack will present as wheezy, struggling to finish sentences, will be pale or blue etc.) In reality, severe asthma often manifests in the small airways which make much less noise and are much harder to treat (even small droplets from inhalers can be too big to fit in the airways which is why we have to blast our entire bodies with steroids to get the inflammation to go down). That inflammation of the small airways is one reason severe attacks can take weeks or months to get over.

I have had a few panic attacks in my life (on planes in bad turbulence ) and felt anxious and my heart was pounding and I felt a sharp impending sense of doom. I was breathless (hyperventilating during one of the attacks) so I can see how that could feel very similar to an asthma attack but like Lysistrata said, it sounds like you can actually tell apart your asthma vs. your panic attacks quite well at this point.

It's so hard to have a chronic condition and to have to advocate for yourself to doctors and nurses when you know your own body well (and it's doubly hard to do so when you're feeling poorly!)

Keep talking about and learning about your asthma--it's the best way to feel empowered and to make sure you're following the right steps during an exacerbation.

Take good care, hope you find some relief soon.

[Twinkle912 in reply to hilary39]

Thank you - much appreciated - been moved on to Fostair so hopefully I'll get some control over my asthma- so good being able to talk to others as it is so strange that I'm saying that it is my asthma and being told that it is just me being anxious and panicky- they feel different but I don't think that I have had the 'wheeze' sometimes a whistle but rarely. Thank you again.

[CaroReub]

I’ve always been really bad with my preventer clenil, and just relied on my blue which I only need to take before I do cardio exercise or have been around cats as I’m allergic for 30 odd yrs. In March with covid I thought I should take it more often. Throughout the summer I’ve been for chest X-rays and s/W my docs several times due to non wheezy breathlessness. I thought it may be anxiety due to covid, or that I’d had covid and not known. To cut a long story short I told my docs last week I’d use my brown inhaler religiously for a month and get back to them if I didn’t improve. My anxiety and breathlessness and nightmares was worse than ever since that convo and my boyfriend suggested it may be the clenil. Looking back it’s only been since I’ve used it often that I’m getting this problem. I’m not suggesting this is right for you but it may be worth seeing if you have the same pattern. I’ve not took it for 4 days and I’m improving daily.

[CaroReub in reply to CaroReub]

Ps chest X-ray was clear

[Twinkle912 in reply to CaroReub]

Thank you - hopefully with the Fostair I'll get on better. I hope that you feel better soon too.