Provisional diagnosis...does it sound like allergic asthma?

[IrisLion]

Is daily, chronic phlegm a feature that many people here experience with asthma?

I have a provisional asthma diagnosis from GP, and have been on the lowest dose of reliever and preventer inhalers for three months. I am also taking an antihistamine (allergic to pet dander- I have two pets and have done all my life) My peak flow is around 420 at best/normal, and when I feel a bit worse/coughing more, it sits around 350. I am in my mid-forties. I don't wheeze or feel particularly breathless, but the reliever inhaler does help relieve the cough and shift phlegm when it's bad. I have had one night where I woke up very breathless and used four puffs reliever to feel like I could breathe better. My chest always sounds clear to my GP, and a chest x-ray was normal.

The cough followed a 'mild' covid infection last summer. Since then, I have coughed up mucus every single day. Mostly yellow/light green, but once or twice a week it can be dark green, almost grey. It is very thick/rubbery/stringy usually, but the darker it gets, the grainier it gets, almost like gravel. I would say it's at least a couple of teaspoons every day, but frequently I can cough stuff 10 or 12 times. I can say cleaning is a trigger for the darker stuff- either in my own home or when I clean for someone I work for, who is pet free. Sometimes, the phlegm seems stuck in my nose; and throat, really hard to shift it.

In terms of the allergy, I am not experiencing runny eyes or nose re: antihistamine, though I also have a lot of clear mucus mixed with the yellow stuff and need to blow my nose frequently. If I talk for any length of time ( I speak a lot for work) mucus will clog up my throat (I find this pretty embarrassing) I also often have times where I feel like I am coming down with something (like cold/fever) but it passes without full-blown symptoms after a few days. I also experience constant, unavoidable stress through my personal circumstances caring for family members who are very unwell, which I guess could be a trigger?

I do now have a referral for spirometry; and GP is now querying if it is really asthma as not a lot has changed so far with meds. I am wondering about GERD, as I do get the occasional episode of heartburn now and my partner has said I am coughing in my sleep too.

I realise I've given heaps of info. I am mainly just interested if other folk have asthma with this sort of profile (as opposed to seeking any differential diagnosis)

[Collienut]

Hi IrisLion, has a sputum sample been done to check what or if bacteria grows? Is the spirometry being done in hospital and going to be read by a consultant? It sounds like you need to be referred to a respiratory consultant. x

[IrisLion in reply to Collienut]

I’ve actually no idea who deals with or assesses the spirometry test/results. Doc yesterday was wavering about resp. Referral but decided against it.

Yes, I’d have thought a sputum sample would be common sense but they’ve not mentioned it. I can ask about that at next appt. If nothing changes.

Thanks for replying

[d2read]

IrisLion, you have given a lot of information, and I wonder if you have given as much, maybe also combined with a detailed journal of PRECISELY what you were doing, what chemicals you were around (while cleaning), etc?

There are many different types of asthma and no one on this or any other website should be implying, or flat-out stating, that you "sound" like you have/don't have asthma.

That being said, there are a number of things you can try that might help while you wait for an appointment and tests. (I would encourage you to make detailed notes about what you are doing, where, when, what is around you, and take photos on your phone of the phlegm you cough up at different times of each day.)

Deal with things you can control. In your bedroom -- when was the last time you replaced your pillows and how often do you wash them? Buy a mattress encasement -- it's a giant zippered sack that fits snugly over your mattress and zips closed to help reduce dust mites etc from triggering your coughing. Launder any drapes or remove them and replace with blinds. Get rid of all clutter in the bedroom, dust thoroughly and often, launder rugs . Get rid of air fresheners, perfumes, aerosols of any kind, use baking soda and vinegar to clean the bathroom. Clean or replace filters for air conditioners/heaters.

If your pets sleep with you, bathe them regularly with a hypoallergenic animal shampoo. I know they may resist this, but it might make a big difference in how well you sleep.

Use the same principles everywhere else -- keep books and other items inside cabinets, closets or drawers that shut.

Eliminate anything that has a fragrance, catches dust, can't be easily washed.

Keep a list of what you are doing to improve your environment and show it to your doctors, in case they have more ideas.

Good luck! Let us know how you do!

[IrisLion in reply to d2read]

My bad phrasing- I was more driving at do other people experience these sort of symptoms with a diagnosis of allergic asthma. But I didn’t word it well. I was just curious because my own symptoms don’t seem to ‘fit’ completely with what I’ve read so far. I wouldn’t have took it as a diagnosis/confirmation for myself, just (weird) reassurance that I’m going along the right lines. I’ve been reading through lots of the forums and starting to get a sense that there often aren’t diagnostic certainties for a lot of people, though, so maybe I need to work on accepting that too!

Those are all useful suggestions on the diary and managing the environment, thanks for those.

[d2read in reply to IrisLion]

I understand -- so much about allergies and conditions like asthma are not well understood, although more is being learned as they make progress with genetics and understanding the impact of environmental factors.

It's also difficult because so many people take as scientific fact something that they read online, often posted by someone trying to sell something or push a particular political agenda.

It's good to ask questions, including of your physicians -- they can make mistakes, too, or be lazy about keeping up with new findings in the field. Which can be dangerous for patients.

I'm someone who despite being well-informed, relied too much on a physician I knew and trusted and those he sent me to -- for too many years. As a result, I have serious, permanent damage. What I should have done was go for a second opinion early on, and then a third if necessary. If I had, my prognosis overall would be much better. That's on me -- and why I urge people to ask questions, track their results and learn everything they can about their diagnoses.

[IrisLion in reply to d2read]

I’m really sorry to hear what happened with your health and your doctor, that is awful.

I am definitely going to ask re: sputum culture and keep pushing it, even though they want me to go away, it seems! And symptom tracking might help them get a better picture, too.

[Gwalltarian]

In addition to the above as you mention heartburn at times: This year- after taking it for 10 or more years - I stopped taking Omeprazole for acid reflux which then caused big problems with acid and reflux. It triggered my asthma immediately - breathing difficulties, coughing a lot and producing mucus. You could mention the heartburn to your doctor and try taking rennies or something initially to see if that reduces your symptoms - or some of them. I also find that some of the inhalers cause mucus production.

People recommend vinegar as a natural alternative for cleaning but I react to vinegar asthmatically when used in that way. Find the right cleaning products for you.

[Headoverheels]

Hi IrisLionMucus was a real problem for me too about a couple of years ago.So unpleasant that I was able to remove it from my mouth.

My son suggested that perhaps my diet was making it worse so with this in mind I did wheat free for 6 weeks...followed by Lactose free for the same length of time. I am delighted to say that now I am on a Lactose free diet and the mucus has improved enormously!