SOB but peak flow doesn't change and asthma tests don't show anything severe

[monox]

Hi,

I'm kind of desperate right now and thought that you guys might have some ideas regarding my problems.

Roughly 3 Weeks ago I started having trouble of breath from time to time. In my case inhaling feels much worse than exhaling. Also my throat starts feeling harder when I have SOB.

I don't have any wheezing or coughing. Also no feeling of tightness in the chest either.

I went to the ER pretty quickly as I've never experienced that before.

I did a simple body plethysmography, which was normal. Also an Xray, which was fine aswell.

The doctors said that the SOB might be related to my reflux sypmtoms (They gave me pills against reflux)

After I went back home I pretty much had SOB all day and went to my GP, which gave me a Salbutamol inhaler. That sometimes helps but at best only for 2 hours.

Then I went to the hospital again and did a couple of other tests. Another body plethysmography where they gave me Salbutamol and monitored if my FEV1/FVC was better, but it only increased by 1,2%.

Then I did a bronchial challenge test, which didn't go that bad, I only showed some symptoms once the concentration was really high. The doctor said that some people als react to that eventhough they don't have asthma.

The last test was a FENO test, which was also normal.

They also gave me a Peak-Flow-Meter which I use roughly 6 - 8 times a day. The Peak-Flow is always between 590 and 615. They also gave me a Symbicort Inhaler, which I currently not use. I used it two times where it didn't seem to work all that well, it seemed to calm me down though. The doctors said that the placebo effect might also play into that.

Since then I experience SOB sometimes, but not nearly as intense like it was two weeks ago.

They took my blood to see if I'm allergic to anything, but I'm still waiting for the reports. I was diagnosed with house dust mites almost 10 years ago, but didn't have any smyptoms regarding to that, also I stress tested myself breathing in dust and it didn't change anything.

Another thing that might be important is that I still have some minor reflux symptoms. Furthermore I'm really stressed right now due to my living situation and also my back and neck hurts a lot.

Also if I put my shin on my chest the breathing gets much easier, I have no idea what's up with that.

Next steps are to get an appointment at a lung specialist and a gastrologist.

[twinkly29]

Not all shortness of breath is asthma related, in fact most will be other things. It doesn't sound like asthma given everything you've said but that doesn't help with what it is.

Reflux can indeed cause asthma-like symptoms. It's one of several things that can look and feel like asthma but don't respond to asthma medications or treatments.

Stress and anxiety can both do the same - and of course can then add to a problem because it's worrying even if they weren't the cause initially.

Breathing exercises done when you feel short of breath might well help as they help to regulate the breathing.

blf.org.uk/support-for-you/...

Different exercises work for different people so you might need to try out some different ones.

[monox in reply to twinkly29]

Thank you so much for your answer, this already makes me feel better, because I basically worry about having asthma (even though the tests don't even show that) all day which makes everything even worse. I will try those breathing techniques and maybe some other exercises (yoga etc.). Also I will probably start to search for a therapist aswell.

[ChrissieMons in reply to monox]

It looks to my amateur eyes that your problem is more likely to do with your anxiety than a purely physical issue. Even if I'm wrong, which is quite likely, you'd benefit from seeing someone who can help you reduce that anxiety by whatever means is appropriate for you. It doesn't hurt to explore all the avenues.

[monox in reply to ChrissieMons]

I can definitely see that it is an anxiety problem and honestly I hope for it at this point aswell, because that should be something I could improve with the right help.

[Itswonderful]

Even if you are still having o my minor reflux symptoms it can trigger breathing problems. Remember that reflux contains acid from the stomach which will burn the skin lining your airways. It takes time for this to heal and if you are still having a little reflux it is still burning the skin. Most people have to change what they eat and when they eat and also how much they eat and how fast they eat to get the reflux under control. The medicine helps but cannot do it without your help. It may be useful for you to keep some Gaviscon Double Action Chewables near by all the time and then you can suck one if you get the slightest hint of reflux. You could also take one before bedtime. It also helps to raise the head of your bed slightly. Hope you feel better soon.

[monox in reply to Itswonderful]

Thanks for your answer aswell, I already started to change my diet quite a bit, but I'll get an appointment at a gastrologist aswell. I'll also look if I can get those Chewables, as I'm actually not from the UK.

[Itswonderful in reply to monox]

T he y are Over The Counter medicines. You can get them from Amazon but if you feel uncomfortable please check with the doctor.

[MrsCMK]

If it helps, my experience with asthma is very similar to yours. My asthma symptoms presented as shortness of breath. I used to wheeze a lot but a few years before my diagnosis, I was prescribed Montelukast for this to help control my allergies and the wheeze went.

I didn’t get a crackly chest, I didn’t have a cough and didn’t have any experience with coughing up mucous either (apart from when I got a chest infection). My peak flow rarely budged either, always hovered around 320.

Spirometry, plus other tests all came back clear, indicating no asthma.

I finally saw a respiratory consultant who knew that my symptoms, albeit non classic, were related to my allergies and reflux, and referred me to an asthma specialist who is an absolute legend! One appointment with her and she got the ball rolling for Xolair.

I was sent for a mannitol challenge test and even though “I passed” I suffered a nasty attack afterwards which was quickly reversed as I was still at the hospital. I technically passed the challenge but my specialist concluded that although my symptoms aren’t textbook, that she was confident it is allergic asthma.

I’ve been on Xolair since (for 16 months) and my health has never been better. I don’t even experience my classic hayfever symptoms either.

Everyone’s experience with asthma is different and sometimes asthma can be difficult to diagnose if symptoms don’t present in the classic manner. I know my experience isn’t quite the same as yours but the knowing the similarities may help. I hope you feel better soon

[monox in reply to MrsCMK]

Thanks for your input aswell.

Sadly I can definitely see some similarities, but I really hope it's not asthma in my case.

May I ask if you did a FENO-Test aswell?

[MrsCMK in reply to monox]

I did but like the other tests, they came back not indicating asthma.

In my situation it was unfortunate that my symptoms weren’t textbook but also that the tests came back clear too. Luckily for me, I had a specialist that was very experienced and understands that it’s not so black and white.

Do you mind me asking, when your symptoms are bad, how do they present? Do you experience “attacks” at all?

[monox in reply to MrsCMK]

I used to experience attacks before I stayed at the hospital for three nights, now it's just a subtle feeling that I have some trouble breathing sometimes, but it's not nearly as bad as it was before. As they didn't really do anything with me at the hospital I suspect that my mind is also playing into this.

So currently the symptoms are pretty mild. Also it feels better after I've used the peak flow meter, I don't know why.

It has been like this for little over a week now.

[sciencepotato in reply to MrsCMK]

I have very similar symptoms to yours! I'm under severe asthma clinic and they still haven't helped me! I wish I knew where to get a good experienced specialist!!

[HannahBenson]

Hi monox ...I agree with the other responders...stress and anxiety can make breathing difficult but reflux is a very common cause of breathlessness. Symbicort is a steroid inhaler and I take it everyday for my asthma but it is not suppose to be used like albuterol which is a fast acting bronchial dilator and can open the airway immediately for relief. Symbicort works over time taken on a steady basis to control asthma. The only asthma you need to be afraid of is the one that you do not have under control. I would find out if you do actually have asthma...I would assume the physician that prescribed symbicort thinks you do. You need to concentrate on getting control over your reaction to your situations...the ones that are causing you all of the anxiety. Sometimes you can't change a situation but you can try to change your reaction to it. If possible, get some counseling and see if that will help you. Hope you will be feeling better soon...good luck!

[ReedB]

Hi monox, looks like you've had plenty of advice but may also be worth looking into vocal cord dysfunction if you say you throat gets tight x

[Gsrb]

I had a similar things few years ago and it turned out to be reflux from stress. The only thing that helped was a liquid medicine so maybe you could try