Shortness of breath

[In_the_bardo]

Hello, forum. I’ve experienced increasing shortness of breath in the past three years, which resulted in a mild asthma diagnosis and a reliever prescribed for exercise (I’m an otherwise active 38 year old). Persistent and worsening problems led to steroid inhalers of increasing strength and then finally a lung function test in October, which confirmed continued inflammation and some air trapping. Now on fostair for the past 6 months. Peak flow improved immediately by about 100 ml to a resting 700. But here’s the thing: I still get symptoms, and they no longer seem to correspond to the logic of (my) asthma.

The sensation of shortness of breath that I felt in the first year or so of asthma diagnosis has now changed from a generic wheeze to something that feels like a shallowness to my lungs, as if there’s a hard stop when trying to take a deep breath and I can no longer reach the bottom quarter of capacity. This leaves me trying repeatedly to take a full and satisfying breath, something I can achieve maybe one in five attempts.

The other change in experience is that, where previously my reliever would reliably resolve my wheeze and so my shortness of breath, it doesn’t seem to help with the sensation of not being able to achieve a full, satisfying breath.

The stranger shift is in what triggers my symptoms: for several years it only came during exercise (I’m a runner), but since being on a steroid preventer, I’m no longer troubled at all when on a run, but every time I go for a walk I experience the strange, restrictive shallowness to my lungs, to the point when I often can’t talk comfortably at the same time as walking. This seems to be back to front, running 10km surely more demanding on my breathing than a stroll around the block.

I guess the question in this increasingly lengthy post is: does anyone identify with this experience, with a qualitative shift in how you experience asthma (specifically the sensation of not being able to access the bottom of your lungs) and also the seemingly counter-intuitive circumstances in which symptoms arise (specifically when I walk but not when I run)? It’s been a quick and an unsettling journey for me from being fine to daily shortness of breath and steroids, and I just wonder if I’m missing something…or whether it really is just boring, common or garden expressions of asthma.

(Also, to be clear, I’m lucky: some of you folks on here have to be like Seneca in your stoicism and I’m deeply aware that my own story is fairly light in comparison.)

[In_the_bardo]

Oh, last quick note: before, when short of breath, my peak flow would drop, my reliever would restore it. Now, when I feel I can’t take a deep breath, my peak flow remains at a constant 700, a reliever does nothing to add to my peak flow and often nothing to relieve the sensation of shallowness in my lungs.

[Nonpoin87]

Yeah these are the general symptoms I get mainly. It feels like the diaphram is constricted. When I first started getting asthma symptoms it was actually like this, I thought it was the food I ate that gave me a gassy stomach or something.

Could be that your lungs are air locked in certain areas so you are not fully expelling the air. I can usually tell this is the case as emptying my lungs before using a asthma inhaler is slow and wheezy. Bit I generally can breath freely after

The rescue inhaler relaxes the Airways whilst the inflammation and mucus production is still happening.

Maybe a seasoned asthma sufferer will pop by though.

[Rattle]

Hi

I had some similar experience & symptoms about 4 years ago, when I noticed I was getting short of breath & huffing more going up hill and upstairs.

I have had asthma since I was 4 so I recognise how that feels to me and this was different.

My blue/reliever inhaler didn’t make any difference either.

My gp first gave me another steroid inhaler (Fostair instead of Pulmicort which I have had for 20+ years)

When that didn’t make any change he prescribed Montelukast. I insisted on getting a referal to a respiratory specialist instead and paid privately for an appointment and tests (x-ray, CT scan).

The respiratory consultant diagnosed Bronchiectasis , mainly in my right lung with mucus plugs & and blockages that had caused some of my right lung to be ”cut off”.

I had a bronchoscopy (on the NHS) to check out the blockages which fortunately all were mucus-like and cleared by a ”wash”.

I am back on using my usual asthma inhalers (pulmicort & bricanyl) and have a so-called rescue pack of 2 weeks of antibiotics on standby in case of any chest infections/flare ups.

Now very much back to my normal.

Important to keep fit & away from colds, flus etc otherwise no special medical treatment for the bronchiectasis.

Good luck with finding help!

[Dean_jeff_]

I’ve been dealing with this mate feels like I’m being smothered most of the time. Drs say dysfunctional breathing

[In_the_bardo in reply to Dean_jeff_]

Think you’re probably right. Would be interested whether you’ve found anything that helps.

[Dizzy412]

Is it worth contacting your go or asthma nurse. See if they can check out what’s going on. Asthma is so totally variable from person to person and also for an individual. Mine varies a lot too.

[Tugun]

Hi,

I would have to go with Rattle. Check it out further. There are many possibilities and sometimes when a doctor finds a "reason" it may not be the right reason but they rarely budge from it. It's a puzzle that your lungs work better when you are running rather than walking. Could the swing of your arms when you run allow more movement in your lower lungs? After a particularly bad flu I had to visit my chiropractor (who also works on muscles and ligaments). He was able to release my lower ribs to allow more movement and allow my diaphragm to move more freely. I'm not sure exactly what he did but I noticed a huge difference.

I can't take preventers because they seem to dry out my lungs and my breathing becomes much more laboured and I don't feel as if I can cough up the phlegm. I was once on prednisone for a short time when I had swine flu. It helped then - but only then.

An x-ray or CT scan as Rattle suggested sounds like a good start to rule out other possibilities.

Then the question is also why did the shortness of breath begin? The medications are great for managing the symptoms but sometimes finding the cause can benefit much more.

[Poobah]

I'm with Rattle also. Moving beyond the asthma diagnosis appears to be necessary to establish why you're experiencing additional symptoms of breathlessness despite good peak flow results. Tests would be needed to drill down to what's going on and I would start with the health professional who usually deals with your respiratory care. Express the affects that this is having on your day to day life and how it appears to be deteriorating.Ideally a referral to a respiratory specialist is the way to go in order to access the necessary tests and treatment, whether that's medication or physiotherapy. All the best.

[Dalton1]

Hello, I had similar problem... To keep the story short I was diagnosed with asthma when I was a kid and in my teenage years it was all good until summer 2019... Out of nowhere I keep getting everyday chest tightness and strange sensation in my lungs like the air that I breath in cant get to all parts of my lungs (but my peak flow doesnt drop).

I was predescribed fostair 100/6 and I take it once in the morning and once on the evening which helps alot and it did improve my peakflow when I started using it (700 all the time when I feel fine and when I dont never drops).

I did all kind of tests that you can imagine and it was all fine... My psychiatrist says I have psychosomatic asthma and that I should go on antidepressants which I refused.. I am not feeling anxious nor do I panic anymore when symptoms start...

Not sure what this is but I am fighting it for almost 3 years now... please let me know if you find any solution

[In_the_bardo in reply to Dalton1]

Interesting timing. I’m going for FeNo tests tomorrow to see if there is still inflammation present in my lungs. If yes, then I just need to up my asthma medication. If no, then the working theory is that the asthma is controlled, so the sensations I’ve described in my first post are due to dysfunctional breathing (as Dean Jeff suggests in an earlier reply).

Dysfunctional breathing makes sense, given the arc of this: undiagnosed asthma for a year or two, breathing pattern adjusted to accommodate asthma, asthma diagnosis and treatment removes asthma component, dysfunctional breathing remains and so continues sensations of shortness of breath and restricted lung access (which I confuse with asthma symptoms/in the dark of the night assume it’s something catastrophic).

Anyway, I’ll report back after tomorrow.

[Dalton1 in reply to In_the_bardo]

Okay, let me know. GL