Asthma ?

[V_92]

Hi All,

i'm a 30 year old male. Non-smoker (never smoked and don't drink either). I was told since I was a kid I have asthma Asthma but only recently learning more about it now. I was coughy as a kid and you could say my asthma was uncontrolled but I always felt fine.

I had a bout of coughing up bloody mucus 2 years ago. Had a CT scan which was reviewed by a respiratory consultant and consultant radiologist who said it's an Asthma flare up and looked like a had abit of a chest infection too.

It recently happened again a month ago but stopped after taking my inhaler again.

I then recently did a Spirometry and FeNO test, which is where it gets weird. Both of these tests came back normal and indicate I do not have asthma. I spoke to the consultant again today and he said Asthma's a clinical diagnosis as opposed to just relying on tests. He thinks I have asthma but it's mild. It's a little weird he says mild because I'm on Fostair 200/6 now which is a high dose from what I'm reading ?

Anyway, I find this a little weird and confusing, anyone else on their lung health journey seen something similar or have any ideas on what I should do next ? Should I really be getting a second opinion on this, as could there be something else causing this ? I think I've got Sinus issues and that's what might be the cause of all of this. I did break my nose during kickboxing back in 2016.

Any advice would be appreciated.

Thanks,

[jillygirl]

I personally would get your sinuses checked as that can certainly cause your breathing problems . Good luck.

[V_92 in reply to jillygirl]

Ah thanks ! He saw my nose today and said it definitely looked like it's been broken in the past so advised to see a doctor who specialises in ENT, maybe that might give more light.

[jillygirl in reply to V_92]

That sounds promising, keep us informed. 😊

[Homely2]

If your asthma is under control your feno test could well be normal, and if they just did a basic spirometry test, if everything is under control that may well show as normal.

Asthma shows on tests easily when it is out of control.

I first was diagnosed with asthma when covid meant my local hospital was not doing spirometry or feno tests. The asthma nurse simply said that if the inhalers work then you probably have asthma. The consultant later said much the same.

[V_92]

Ah okay, yep could be. Just thought it was weird because I was a little wheezy too (recovering from this horrible virus that's been going around) so was expecting to show a positive FeNO but I was considerably lower than the limit, wasn't even close. Also was a little weird the spirometry was still normal given I wasn't 100%. Physio made me do quite a few of them just to make sure it's accurate.

Weird thing about inhalers is - In the morning I do a Peak Flow and hit about 640 and even after the inhaler I do it again and it doesn't really change ? Fostair is a 2 in 1, so has the short acting bit in there too.

It's super strange haha. Really not sure what to make of it all.

[jillygirl in reply to V_92]

I am the same with the peak flow, I only have one lung and it started as 200 now the regular

number is between 250 nad 300. Even when I think ii am struggling to breathe it still gets to 250. Like you say weird. x

[hypercat54]

I thought peak and flow is a better test of asthma? At least that's what I was always told and I have been diagnosed with it for around 35 years. Have you had one of these?

[V_92 in reply to hypercat54]

Hi, So I do my Peak flow daily and have been doing so since I've been taking my asthma more seriously. It's generally around the 600 - 640 mark without the inhaler. Most times I can get it to 630, sometimes 650/660 but it's around that range. I think this score is individual to everyone though, so I don't think it rules out asthma. I just find it strange why my score doesn't improve after taking an inhaler ?

[strongmouse in reply to V_92]

Fostair is a long acting medication so you wouldn't necessarily see a change after taking it. It has a duel action of preventing asthma as a long term medication and helping to relieve any asthma symptoms (the short term part). If it is working you won't necessarily have any symptoms.

You might notice if you stopped taking it, which I don't recommend! Asthma UK suggest using a 'Step Up - Step Down' approach to asthma. If my asthma seems well controlled I will try taking just 1 puff twice a day instead of 2 puffs twice a day. I will soon know if I need to increase it. Springtime and summer are especially bad for me as allergy to certain pollens excerbates my asthma. My normal peak flow with medication is around 360 (about right for my age and height plus gender). When I had 'flu a few years ago it dropped down to 120. A course of oral steroids on top of asthma medication helped.

I get allergic rhinitis and gastro-oesophageal reflux which both exhacerbate the asthma, so I take medication for these to minimise affect.

[V_92 in reply to strongmouse]

Ah okay, I've been getting really bad acid reflux over the last couple of year, to the point where even if I touch one specific point on my chest I get pain right now. Getting this checked out now.

One thing I would say is - I did find this helpful video on youtube related to diaphragm breathing. I didn't realise that sitting at a desk and having your arms hunched forward for a long time can put tension on your diaphragm and means you're not actually using your full lung capacity.

I did this for two days so far and I kid you not, my peak flow has actually gone up to 700. I'm not sure if that's the inhaler also working it's magic but tbh, couple days ago, I was still around the 630 mark but now, I'm consistently at 700. Just to be clear, I'm 5ft8, so definitely not got big lungs.

youtube.com/watch?v=3HfDRC1...(Not working as expected?)

[strongmouse in reply to V_92]

Always worth checking your breathing and doing any exercises which help. Unfortunatley I am only 5ft, female and 70 yrs old with a hiatus hernia, and a few other health issues! Agree about sitting hunched over desk for any length of time not helping. I'll take a look at the video.

[Hellodolly]

Hi there

There is a test called the methacholine challenge test which would settle the question of whether you have asthma or not. I had this question arise , was given this test, then a diagnosis of bronchiecstasis instead of asthma. It helps if you have a respiratory consultant in charge of all this.

Good luck!

[V_92 in reply to Hellodolly]

Ah that's interesting. The consultant said the CT scan would conclude whether I had bronchiectasis or not. When I had the scan first the report back came as suspicion of mild bronchiectasis from the hospital but the respiratory consultant (same one I saw recently) reviewed the scan with another consultant radiologist at the private hospital and said there's no convincing evidence of bronchiectasis based on the scan. He said my symptoms were to do with something called tree in buds caused by infection. The respiratory physio I done the Spirometry with said also said bronchiectasis would show on the spirometry he made me do but there was no sign of it.

[Hellodolly in reply to V_92]

It’s all super confusing . I too was diagnosed from a ct scan with different consultants saying different things. Ask them about the methacholine challenge perhaps.

[Karenanne61 in reply to V_92]

One of my original diagnoses was bronchiectasis, copd, and asthma. Now , apparently, I don't have bronchiectasis but thickening of the bronchial walls, and only minimal emphysema. I did question the changes and was told it's how scans etc are interpreted. That doesn't help us though. Just leaves us very confused.

[MiniGirl22 in reply to Hellodolly]

Hello dolly. I have bronchiectasis and asthma since born. I was told yesterday asthma may not be causing my sob. May I ask please what treatment you have now asthma has been ruled out? Thank you and wish you well.

[Hellodolly in reply to MiniGirl22]

Hello

I do respiratory physio on myself with a flutter machine. I have had several sessions on this at the hospital. I have rescue packs for chest infections and regular lung function tests.

Best wishes

😊

[Pwkav1]

Hi im on fostair 200 asthmatic since age of 7. I had a lot of asthma attacks when i was younger with pneumonia which left me with asthma. My peak flow which is normal for me is normally about 340 when i have a chest infection it goes down to 200. Which is low for me. I do hope you get to the bottom of this. Was it the hospital who diagnosed you asthmatic as it was with myself. Your peak flow of 630-40 even 650/60 sounds quite high for an asthmatic but im not a doctor. You do need to get second opinion if its asthma or not. Ive had sinus problems all my life i suffer allergies have sinusitis allergic rhinitis and deviated septum. Ive never been hit in my nose so ENT reckons i was born with it. Hope it helps. Karen xxx

[V_92 in reply to Pwkav1]

Ah okay. I did have chest infections as a kid too. I'm hoping I can get to the bottom of it. I'm not sure who diagnosed with asthma tbh. It may have been the GP. I did go to the hospital once when I 20 because. They called me into the hospital but said I just need to take a steroid inhaler going forward. I think I might get a second opinion. The consultant wants me to do another CT scan but given I'm 30 and had one at 28. I'm worried about the radiation. I know it's extremely low i.e 0.0001 risk or something but the risks make me feel anxious.

[NLGA]

I blow 650-700 but I have asthma I also believe since covid or the 3rd vaccine I have developed something else as I now have a high heart rate and breathing difficulties then I go about 2 weeks of no problems only for it to return again

[V_92 in reply to NLGA]

Ah sorry to hear you haven't been feeling well. Ah okay, maybe I do have asthma but like my peak flow is high for my height, age, weight, which is what the Respiratory physio said.

[Alberta56]

Hello V92, I was diagnosed with adult onset asthma in my 40ies and given an inhaler and a nasal spray. For years I had no trouble except a bit of hay fever. Then about15 years ago I started getting chest infections and ended up diagnosed with bronchiectasis. It sounds to me (and I'm no expert) as if you are in the stage I was at for many years where the asthma was only a very minor nuisance. I' d suggest that you take your inhaler regularly, exercise regularly and eat healthily. Just get on with your life and don't bother too much about the asthma. Try to avoid chest infections- keep away from people with coughs and colds if you can. Good luck.

[V_92 in reply to Alberta56]

Yep for sure - I do try to do all those things. I'm more so concerned if I've just got some allergy and therefore taking inhalers for a long time increase your risk of other health conditions. I know with time medication will evolve and change but I think I'm getting anxiety from taking medication and wondering if actually what is the root cause of all of this.

[Alberta56 in reply to V_92]

I think only a medically qualified person could answer your concerns about the long term use of inhalers. I was advised to lay off the use of my nasal spray, Avamis, and only to use it if the pollen count was sky high, but nobody has suggested to me that inhalers can harm you, apart from making your skin thin. I suppose the good outweighs the bad effect. I am gobsmacked by your peak flow readings. Not many people on this site have such a high one. Long may it continue.

[Digger0]

I was originally diagnosed with asthma in the late 1990's by a consultant - basically take this inhaler and if your cough disappears you have asthma. It was not until I had C***d in April 2020 with 10 days in hospital that I was correctly diagnosed with Bronchiectasis. I usually had 5+ chest infections every year (summer and winter). Now, nearly 3 years on, and on the correct meds, I have not had any chest infections - fingers crossed!

[V_92 in reply to Digger0]

Oh do take it easy ! I guess the thing I find interesting about chest infections is I get them and then recover from them without antibiotics. I do always cough up green sputum but this has cut down since I've been taking the inhaler but I think the game changer for me was the nasal steroid spray. That really brought it down. I'm continuing to use that and see where that gets me, but I've been seeing an improvement since I started using it.

[Digger0]

Take it easy? Not me! I am like a spring chicken again having had a hole in my heart mended in Auh 2022 (and I'm 71). My husband and I volunteer with the Peak Park checking on ancient monuments out in the hills

[Mavary]

H! I’ve got mild asthma too. I’m using Fostair and I find it’s very good for keeping infections down. It doesn’t necessarily make your breathing better. Have you got some Ventolin because that probably would help with the breathing.

[V_92 in reply to Mavary]

Oh - Yep. That's encouraging to hear. I don't take any short acting inhalers because I don't feel the need to ? But apparently Fostair being a combination inhaler has some of that short acting inhalers in there. I don't really feel breathless a lot tbh. Maybe because I'm active or try to eat healthy ? I don't know. I guess all I can do is try my best to be positive and take care of my health.

I guess I'll just keep taking the inhalers. The doctors are the experts tbf and I did have an episode of coughing up blood. They say it could be a viral infection or inflammation in the airways (i.e asthma) and coughing for a long time can irritate this.

[Patk1]

Perhaps he means that,due to the fostair reducing inflammation,you have mild asthma. That would also explain normal FeNo- it shows inflammation/asthma under control.have also got a salbutamol inhaler? I take antihistamines,steroid nose spray + sometimes decongestants for sinuses.

[V_92 in reply to Patk1]

Oh could be ! But the spirometry was normal too ? They said not to take my inhaler for 12 hours prior to the appointment to get an accurate result of what's going on but I did about 5/6 blows and they were normal. I don't take Salbutamol - I may have taken it once years ago because I was told I had asthma as a kid.

I'll just wait it out, see what the doctor says. Everyone's case is individual I guess. Doctors will know a lot more about this than non-medical people like myself. I can just try and do what I can for now, whatever that is haha.