Hi hope everyone is ok. Just looking for some opinions and advice really as I am confused when it comes to my breathing.
If you are in a bad mood or not feeling very patient the below might annoy you but I am just trying to be honest and describe my experience.
Basically for the past 12 years since I was 23 I have had chronic rhinitis with polyps. The polyps tend to be small but the rhinitis and congestion is bothersome. Latest sinus ct scan showed plenty room for airflow so the consultant didn’t think surgery would help. I use nasal steroids and an antihistamine daily. All allergy tests have been negative
In the back of my mind over the past several years I have been worried about developing asthma - my gp said I am at high risk due to nasal polyps plus my dad has adult onset asthma/polyps
Over the past year I have had anxiety including some health anxiety (which I hate to admit because everyone puts everything down to this). I also has some throat symptoms (tingling below adams apple, pressure after eating and chest tightness) which was partly put down to reflux. I have had a nasoendoscopy, barium swallow (showed dysmotility but gastro doc wasn’t concerned). Also spirometry was normal.
At times though I find it very hard to distinguish between physical symptoms and wehetehr they are significant or not. For example today all day I have had a congested nose and a slight feeling of pressure in my throat. Nothing too bad
I went for a 15 minute run earlier (I am trying to get out more/overcome my anxiety) and towards the end and after stopping my chest did feel slightly tight which made me anxious. Combined with my congested/wheezy nose and pressure feeling in my throat it really did make me think I was having asthma symptoms. I was getting anxious due to these symptoms about 15 mins after my run and having visions of my chest getting tighter and closing off etc.
I tried to be objective and ask myself am I having typical symptoms of wheezing - (a little but was mainly whistling from my nose/nasopharynx).
Chest tightness - a little but the pressure feeling in my throat could be exagerrating this impression. Coughing - no . Resp rate - normal. Peak flow was the same rubbish reading I have always scored - 300
I tried a puff of salbutamol (provided by my gp to try) and feel a bit better but still have the sensation of pressure in my throat.
I guess I just have a lot of fear and find it hard to distinguish between harmless symptoms and significant ones. Just looking for advice on how to deal with this rationally.
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Blueforest23
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your post is very well written Blueforest. I don’t think anyone here reading it would be irritated by it. Of course struggling to breathe causes anxiety. It’s a truly awful feeling and as far as I’m concerned, quite normal. You are not alone in trying to separate anxiety symptoms from asthma symptoms. Have you tried any breathing exercises? I found these so helpful. Is your reflux under control? If it isn’t , and there is such a thing as silent reflux, it is really worth sorting that out. Just remember that you don’t have to apologise for being anxious or struggling to breathe. Your experience is as valid as everyone else’s.
Thanks. I complain to my family a lot about my nose so I automatically assume that everyone else is sick of hearing it lol. I go on at them when they say it’s only a blocked nose (and by itself isn’t urgent I know) but when you have daily symptoms and changes in the lining it’s different from the type you get with say a cold.
I have tried breathing exercises I prob should make an effort to do them daily
As for the reflux it is a lot better than it was it tends to come in bouts
breathing exercises can help with blocked nose and sinuses. Nose breathing is recommended wherever possible by asthma specialist clinicians. Yes reflux comes in bouts though it’s possible to have silent reflux, so it’s happening but you can’t feel it. It can cause breathing problems. In my case, I didn’t realise I had reflux all the time and like you, I thought it came on periodically. I chose to change what I ate, ate smaller amounts, ate more slowly, no eating between meals and I now I also eat earlier in the day so I don’t go to bed with a full tummy. I also discovered that dairy wasn’t my friend. Lots of changes but all those things put together have improved life, for me anyway. I hope you get some relief soon. Best wishes.
This must be very worrying for you and in my view you should not be left to try and figure out your diagnosis on your own - which is understandably distressing.
It may be helpful for you to be referred to an asthma specialist to do some tests to confirm whether you have asthma or not. From your description this may be the case.
Different kinds of asthma are called phenotypes, and one of these kinds of asthma/ phenotypes is where it’s combined with nasal polyps which seems to persist and if it does and if it becomes more severe there is a biologic treatment called dupilumab that is effective.
So it’s important for your diagnosis to be clarified because you need to have this clearly detailed in your medical record so that you can access appropriate treatment in tge future should you need it.
So I suggest you ask your GP to refer you to a severe asthma clinic for a thorough assessment that takes your medical history and that if your family into account.
If you do have asthma, then you would need to be on anti-inflammatory treatment now rather than just the reliever ( salbutamol) which is only intended for short term symptom relief and which doesn’t treat underlying asthma inflammation.
Hi thanks yea I have read about the different phenotypes that is what has been scaring me the type with polyps/eosinophilic I have read tends to be severe and occurs in 60% of those with rhinitis and polyps, so the only sense I can make of this is that I have a 60% risk of this type of asthma. On blood tests my blood eosinophils are always on the high side too 0.6. I think this is part of my issue - fear of an initial asthma attack starting at any time and all the panic that comes along with it. I can see how people might think I’m going a bit over the top but I am just being honest with my fears (just had to correct this as a I accidentally typed farts instead of fears 😆)
Spirometry results are normal at the moment I have not been told that I need to be on inhaler steroids but yea any significant worsening of my symptoms and I’l def push for them.
As I'm not a medic, I can't comment on what might be wrong and you have had lots of tests, so I think that if asthma were an issue, it would have come up. What are you doing to calm your anxiety? Anxiety can certainly make breathing difficulties much worse. Do you have a therapist/counsellor? I know if you could take a pill to remove all the issues, it would be wonderful, but there isn't one. However, I think you'd find talking therapy, with the right person, could help. Don't be put off it you've tried one and it didn't work, as you have to find a person who suits you. You might also find acupuncture or another alternative therapy good as well. Good luck!
Thanks, yea I do think at the moment anxiety is a large part of the issue it’s just the sinus, throat issues don’t help. I can relate to the other poster when they said that their nasal issues can make it feel like they are not taking in enough air. This being said I know that it is still very different from asthma.
Believe it or not I have had CBT for generalised anxiety (this is me recovered 😄) and health anxiety was touched on. As you said talking therapy can be very good so I am looking into this too. I guess remaining calm and reducing negative thinking is useful whether you have asthma symptoms or not.
Have you rung the Asthma UK helpline? I found them really helpful when I was first going through the process of being diagnosed with asthma - no question is too stupid to ask them, and they are incredibly knowledgeable - they also gave me some great advice on what to ask my GP, and it's thanks to them that I finally got onto medication that is keeping my asthma well under control.
I would keep pushing for a proper diagnosis and treatment. While it's true that stress can make you feel breathless (which I think should be taken seriously anyway if it's happening often because it's still really horrible), stress can also trigger asthma. In fact, it's one of my biggest triggers - any sudden shock or distress has me reaching for my reliever!
Also, you don't have to wheeze to have asthma - I always thought you did (and was told this by some doctors) but you don't. In fact, I hardly ever wheeze and never when I'm feeling really bad - wheezing is usually a sign that I'm heading back toward normal!
Have you tried doing a peak flow before and after using your reliever? The GP who finally diagnosed me said that if there was a big difference, it was a very good indicator of asthma, since other causes of breathlessness didn't tend to be influenced by Ventolin.
NB: I don't get any pressure in my throat any more since I started using a wedge pillow - it took a bit of getting used to, and I have to use another pillow on top, but now I sleep really well. Might be worth trying - we found one online for about £15.
yes the asthma helpline was very useful though she didn’t seem so sure whether my symptoms were asthma related
The symptoms are the issue ie how do we distinguish between early asthma symptoms and anxiety. It is a question I asked the nurse on the helpline so didn’t get a definite anxiety but she emphasised the classical symptoms ie wheeze, tight chest and coughing. If you don’t get any of these it can be quite hard to identify. I did test peak flow once after 2 puffs of salbutamol it increases by about 30-40
I have no answers I’m afraid, but the asthma nurses here might be able to shed some light.
I was just wondering if you take anything like Lanzoprozole? Before I started that I used to get a tight throat and sometimes a lump in my throat as if something was stuck there.
Like you, I also have problems with my nose - I’m due an appointment at ENT soon. This came about because I mentioned to respiratory consultant that it always felt a bit blocked and I had noticed that sometimes when I thought I was getting short of air that I found that when I breathed through my mouth I was ok, I was getting air.
As someone has already mentioned keeping a peak flow diary might be useful - this would shed light if there was any variation. Twice a day would suffice, the same times everyday.
Also, are you aware you can take more than one or two puffs of your blue inhaler?
It always annoys me somewhat when medics ask are you feeling anxious. I mean. What do they expect- No, no. Not at all. I just slowly suffocating but I’m fine with that. My survival instinct hasn’t kicked in at all.
When asked now I use concerned or very concerned or I’m aware I’m in trouble/big trouble.
Agreed. I mean, what kind of response are they expecting? "Oh, I'm feeling marvellous. Breathing is such a boring thing to do normally, I'm really happy when it gets difficult as it makes it more interesting." (Unfortunately, I never have sufficient breath to make these kind of sarcastic remarks when they most need making 😜)
I did speak to a asthma nurse from here a few months ago when my throat issues were at their peak and I was thinking it was asthma (she was very good they genuinely take the time to help don’t they).
I take omeprazole which is helping, the gastro doctor said he thinks I can come off so I have cut down to every other day)
I totally relate to the blocked nose thing somehow it makes your lower airway feel compromised too but if you pinch your nose and mouth breath you realise that air is getting in
That’s a good point, I have noticed that everytime the word anxiety is mentioned their whole perception of you and the issue seems to change too. Believe it or not it is possible to have anxiety as a consequence of physical issues.
Yea my understanding with the blue inhaler is 1- 2 puffs then wait for 2 mins before taking another if need be. I may be wrong, I’ve been taking just one followed by slow breathing
I don't have any real answers except you seem to have your head screwed on... which is good
And doctors don't always get it right.... im living proof that more than one team got it wrong
For the last 7 years (I was diagnosed asthmatic as a child but had a 7 year symptom free spell ) ... I had referral after referral and doctors telling my it wasn't asthma, it might be asthma, no wheeze not asthma ... it was my heart and like you it was anxiety.... they where wrong
They believe I have a mucus producing asthma coupled with large airway collapse (dynamic collapse) .... but that means I don't present with typical symptoms (don't very often wheeze, very often get chest infections) and have also been told my spirometry is normal (it is if you don't know what your looking at)
So be persistent and don't accept " no" for an answer and ask to be referred if your not convinced their right ... I wasn't and kept getting referred and re-reffered and moved up/around different departments... It was the severe asthma clinic that put the pieces together (but it's taken 7 years)
It is when I spent months thinking I had heart failure.... one of the doctors said that "your issue isn't your lungs , it must be your heart" .... and doctor Google gives me "cardiac asthma" .. so at that point I wasn't even 30 with heart failure (in my mind)
But I know have all of the pieces and know what's what... the issue I have now is that I don't present in the standard way because the two conditions don't play nice together and the airway collapse is rare as rocking horse poo ... so most doctors still haven't got a clue about it
Hi, Health anxiety is a nightmare because it makes you 2nd guess yourself. Even worse, others 2nd guess you and you end up not knowing whether you are having real symptoms or imagining them, or making them happen yourself. It's just horrible to deal with.
The fact of the matter is, something IS happening. What that is, is the tricky bit. It sounds like a bit of a mystery that you will need some time and patience to figure out. Don't rush yourself.
I know there is something that can go wrong with the vocal chords or voice box or something (I'll try to find it and add it to this comment) that can affect breathing or the sound of the breath when exercising. There is a certain type of breathing technique that makes it go away. You inhale slowly through your nose and blow slowly out through your mouth with your lips making a small hole. Try that over and over after a run if you have problems. See what happens.
If I were you, when you have any of your other symptoms, I would sit still and do meditative breathing for 1 minute and see what happens. Do the symptoms stay or go. Do you notice anything else? Do they happen with certain foods or activities or times of the year? Could they be allergies? Could it be anxiety? I've had that and it does cause very real symptoms.
Finally, if you take salbutamol, try taking your peak flow first, note the number, then take salbutamol, note the number again. Has the number increased or stayed the same? That might be interesting data to present to your GP.
Sorry I can't help more but wish you the very best.
vocal cord dysfunction. You are correct. It is not well known in general medicine. But breathing techniques do help. There is one called The Silent Yawn. Also a wick sniff and blow will open vocal cords.
I’l be honest, as I said I’m not entirely sure what is going on it might very well be reflux/anxiety and a congested wheezy nose but at the moment my first issue is hyper focus and fear of developing asthma. It’s a fear of it comming on suddenly the thought fills me with dread a bit. I find the threat of struggling to breath and lack of oxygen hard to manage mentally. It is also a fear about losing my hobbies of running (which I have cut back on lately) and being sporty.
I have been reading lots of research on the condition I have ‘chronic rhinitis with polyposis’ and about 60% of people develop asthma too which tends to be severe (with polyps). My dad has polyps asthma and my blood eosinophils are always high 0.6 which are apparantly risk factors for progression to asthma. Aside from my concern above my second issue is ruminating over the what if’s with being active and enjoying exercise (I ain’t that good at much else lol) I basically feel that my life will very limited and that I will live under this shadow. At the same time I shouldn’t be moaning as millions of people have chronic illness but just have to push on me find a way to cope.
So there is the above going on psychologically along with the current throat/reflux issues
I suppose the two are very closely linked mind and body
Hello Blueforest. I had allergic fungal rhinosinusitis . One of the causes was a deviated septum. Rhinitis is often accompanied by post nasal drip as well. Very unpleasant. I had an operation to correct the septum and remove the accumulation of fungal residue which had accumulated in the nasal cavities. It wasn't the easiest thing to go through but it made life much better.
Having a constant blocked nose can cause a lot of discomfort in the throat and chest. I was always gulping for air. It sounds to me like your symptoms from rhinitis are quite significant even though the doctor doesn't think it warrants an operation. I'm no expert but maybe getting a second opinion on whether you could benefit from an operation might be in order. It is normal to feel anxious especially if your breathing is impaired.
Thanks Cas, the ENT doctor went off the sinus ct scan as it only showed mild obstruction he didn’t feel I would benefit from surgery. From my understanding it is the immune system creating the inflammation in the nose/causing blood vessels to swell/congestion etc
Someone on here did send me a very useful YouTube video on ensuring proper application of the nasal spray, as this is something no one shows you but can make a lot of difference. It also covered the influence of the way we breathe on inflammation apparantly slow calm breathing through the nose lessens congestion as opposed to fast. It’s very interesting and looks at the simple things that people can change to help their symptoms, I’l post it when I find it.
I do this approx 4 times a day only because the consultant said to. I use sterimar hypotonic spray solution I don’t find it helps, if anything it sometimes feels a bit like I’m just adding water to mud if that makes sense.
Vicks nasal spray helps me instantly but you are not supposed to use it for more than a few days. I’m not sure of the max amount of times you can use it but at one point I was using every night.
Soz literally just seen Yr reply.its a soft plastic or silicone bulb designed specifically for nasal/sinus wash.I'd not be doing it 4x day,especially as its not helping.once,maybe twice whn it's clogged up.i use a steroid nasal spray and take antihistamines.my son has it v bad & his uoung son has it+asthma.my son runs,but has to mouth breathe.
There's a forum called " this stuff works" or something similar.truth is most people find for bad rhinosinusitis,nothing vlears it,just at best,reduces symptoms.umay find it useful.
I'd tackle Yr anxiety,perhaps cbt again? Increasing Yr running,keep fit will help too.
On aluk read up on " controlled breathing".it's useful to calm anxiety but also if having breathing probs.its a technique used for vcd/ilo too and does work xx
Yea re the rinsing I got told to do it 4- 6 times per day by ENT but I realised it way drying the passages out further. So I’ve now switched to isotonic/less drying and just doing it 3 times per day. In between I will squirt up moisturising gel. lol it’s like having this artificial thing attached to my face which I have to look after all day.
Nasal steroids dry it out (expecially combined with central heating) so I try to moisturise. It’s easy to forget basic care for sinuses because unlike the skin you can’t see the condition of them and the reaction to treatment etc. You can only go off your perception of how things feel.
Thanks for your reply, I hope your son gets some relief. I think we are closer to better treatments it’s just they need to be more accessible and cost effective
Yes spray does dry it up a bit but that's a bonus for us.sons had 2operations to widen sinus openings,stripped bulky inflamed linings of sinuses and attended to deviated septum but only had short term relief so he takes 2 antihistamines( at least),nasal spray+ manages to put up with it.im on biologics for asthma+ they're changing it soon,to potentially help rhinosinusitis too.im going to ask if they have an option for cases like my sons. Gd luck x
Have your sons tried steroid nasal drops? The steroid sprays don’t help me much at all, yet the drops are really the only thing I can somewhat rely on. I don’t know if they work better because they get into the sinuses better (with being drip form) or if it’s just the increased strength. I have tried using the spray as a liquid and pouring it in my nostril but it doesn’t have the same effect.
Without the drops I’d be one of those having to take oral prednisone and surgery.
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