Dysfunctional/Distorted Breathing;Asthma Please help me

Had asthma since I was 2 with at its best 2 attacks per year which prednisolone would clear up. Recently it has changed and I can't seem to get rid of this breathlessness with no wheezing. Was in hospital earlier in year and had various tests including the heart and thankfully they were ok, it was put down to the pollen season. At the follow up appointment they did a dog allergy test and said if it was positive I should get rid of my dog (test came back moderate). Thanks for everyone's replies to my post ""Desperate to Keep My Dog"". I improved for a while and have not been well since October. I was at A&E last week and they gave me more steroids and antibiotiocs. When I went back to my GP he said once again my lungs were clear and he wondered if I had dysfunctional or distorted breathing and I should come off the steroids as they would not work anyway (and they weren't). He has given me a letter to take to the consultant whom I see again in 4 wks as he says sometimes this ""condition"" can be overlooked. I am getting really anxious which will only make things worse. Considering Buteyko. Any advice gratefully received.

9 Replies

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  • I have dyfunctional breathing muscles on top of severe uncontrolled asthma. I dont know about gps knowledge of it mine wasnt even found by chest cons at local, was diagnosed by chest cons at specialist lung centre. It can mimic asthma symptoms and is had to differentiate between the 2 especially during an attack. It still isnt widely recognised and at the moment tratments are experimental. If you do have buteko will do more harm than good. Basically your breathing muscles are out of sync, its not something you do consiously, its thought that over time usually after bad attacks your body gets used to breathing differently to cope with asthma synptoms and so this becomes normal too you.

    This can be over looked but can also go alongside so make sure the cons explains and investigates this.

    Good Luck

    Andrea xxx

  • Hey

    I too have muscle dysfunction diagnosed by the same consultant as andrea. Mine was very severe when I was first diagnosed with it, I had low oxygen levels because of it and my dr couldn't do much about it so I asked for a referral to the Brompton in London. They too were quite puzzled by it but they believe its a coping mechanism therefore the worse your asthma/lung disease is the worse the muscle dysfunction will be.

    I have a Fibrosing lung disease which isn't reversible and theres not much they can do to ease my symptoms so after long discussions they decided to give me an NIV, a non-invasive ventilator to use at night. My muscle dysfunction as since improved but my lung disease is still going downhill and I'm still on oxygen 24 hours a day but now due to the lung disease.

    As andrea said treatment for it is very hit and miss, what works for some may not work for others. Alot of it depends on how the dysfunction is actually affecting you, for example it can affect the way you breathe out, which messes up your carbon dioxide levels or in my case the way you breathe in which messes up you oxygen levels.

    Deciding to go on a non-invasive ventilator for me was quite tough as I knew it'd help but I also knew I'd be on it along time and non-invasive ventilators after long term use can suppress your need to breathe causing even more trouble and making you more dependent on them. Please note also that these machines are only given in severe cases and I had alot to think about before accepting the offer of one.

    So much more research needs to be done into this condition and so many drs don't understand enough about it yet.

    Any questions PM me,

    Tks xxxx

  • Carla, ask your consultant about vocal chord dysfunction. I suffer with this and usually misdiagnosed as asthma. I spent 21/2 years being pumped full of asthma drugs that weren't doing any good at all until my consultant at RBH came up with VCD as a possibility.

    This can cause breathlessness as your vocal chords go into spasm and therefore it is difficult to breathe properly. It is something that can sit alongside asthma and mimics the symptoms.

    Good luck with the consultant

  • Hi Carla,

    Sorry to hear you've been having a bad time lately, those steroids are not fun, are they?

    I think it's important to clarify what your doctor means by dysfunctional breathing, as it's not a precise medical term and can have many different meanings. As Andrea and Tks have said it is possible to have respiratory muscle dysfunction, in the sense that your respiratory muscles are weak and/or are not working in sync, but that is quite rare (although possibly underrecognised) and difficult to treat.

    Vocal cord dysfunction is of course another possibility and often co-exists with asthma, and that can be treated to an extent by seeing a speech therapist for training in breathing in such a way that the vocal cords do not go into spasm.

    The most common form of dysfunctional breathing in asthmatics, though, is hyperventilation or overbreathing. To an extent this is a normal and automatic reaction in an asthma attack, to increase the rate of breathing in order to maintain the oxygen levels in the body, and if we didn't do it we'd all be in trouble a lot sooner during an asthma attack! (and lack of hyperventilation is actually a danger sign in a severe attack) However, occasionally it is possible to hyperventilate too much - it often happens if we panic although it can occur when you don't feel that you are overtly panicking. If this happens it can actually make the asthma attack worse as breathing faster can cause more bronchospasm. It also can cause symptoms such as tingling of the fingers and lips and spasm of the hands and wrists, although this doesn't always happen. Once you have done it once it can become a habit or a learnt strategy in an attack.

    If you have ever been to A&E during an attack and had a blood gas done, that can be useful to try to diagnose hyperventilation. Otherwise, it can be pretty difficult to diagnose as there are often no abnormalities found in between attacks, but a doctor taking a good history of your attacks should be able to get a good idea of whether or not it is a problem for you. It can be treated with breathing exercises, usually done by a physiotherapist, to try to retrain you not to hyperventilate.

    It sounds like perhaps your consultant needs to go over things in detail with you again and see if they can shed any light on it. If they do think that some form of dysfunctional breathing is contributing to your breathing problems they can make the appropriate referral to try and get it sorted.

    Please don't try Buteyko without discussing it with your consultant first; as others have said, if done in the wrong circumstances it can make things a lot worse. You need a proper diagnosis from your consultant first.

    Hope this helps

    Em H

  • Hi Carla,

    I wonder if your GP has merely made a suggestion of the possibility of something other than asthma which is causing “distorted breathing”. Remodelling of the airways appears to be quite common in chronic asthma and this can result in non-reversible breathing problems that cannot be reversed by taking asthma meds. I am not a medic and neither do I suffer from chronic asthma, however, I thought I would offer my observations which may help a little. But, as EmH says, it’s important that you get your GP to clarify his comments.

    Take care,

    Derek

  • Breathing Exercises

    Thanks for all your advice and comments. My doctor thinks that anxiety could be a factor in my problem making me hyerventilate. I don't see the consultant for another 5 weeks. I will ring the asthma helpline for advice on breathing exercises I could do in the meantime but would appreciate any advice you have yourselves on breathing exercises.

  • Carla you tell me one asthmatic that wouldnt panic to some degreee when fighting for their breath? It sounds like your GP hasnt ruled out asthma but thinks anxiety could precipitae your asthma to some degree, in this case relaxation techniques would be more beneficial to you. Please dont try any breathing techniques till you have seen your cons and discussed with him as if not a problem can do more harm than good.

    Good luck

    Andrea xxx

  • Hi Carla,

    As Andrea rightly points out having an asthma attack is a very frightening experience and it is very difficult to stay calm and focused. Most asthmatics who have experienced bad attacks have panicked and/or hyperventilated at one time or another - I used to hyperventilate when I first started with asthma as a teenager. The problem is that hyperventilating too much in an acute attack can worsen the bronchoconstriction due to the rapid movement of air, in much the same way as doing a peak flow can make some people wheezy. It then becomes a vicious circle, with the increased wheeziness causing more panic and making the hyperventilation worse, and so on.

    As Andrea says, it would be best I think to wait and see your consultant before doing any breathing exercises - if you do them and you are not actually hyperventilating you could do more harm than good. There is no harm though, in trying a couple of other things: distraction can be good in a mild asthma attack as a technique to take your mind off the breathlessness and your breathing pattern. Getting someone to talk quietly to you about something different, watching TV or listening to a favourite piece of music can help. Obviously only try this in a mild attack - if you are too breathless to speak or eat, are getting worse and are not getting any relief from salbutamol you need to be seeking medical attention not watching telly!

    The other thing I have found useful in the past are general relaxation exercises, NOT aimed at changing your breathing pattern but at relaxing you generally. Find a comfortable position on your bed or in an armchair, in a semidark and quiet room. Focus on each body part individually, starting at your toes and working up. Make sure each part of you is totally relaxed before moving on to the next. Some people find tensing and then relaxing each body part is useful to do this. If you do it properly it should take at least ten minutes to do your whole body. Try to do it at least once per day or more often if you can. This exercise does not directly modify your breathing patterns so is not harmful, but it is very effective at relaxing you generally, which might help to reduce hyperventilation if that is a problem for you. It is also good for people who don't hyperventilate but are generally anxious.

    Hope you find some answers and some of this helps

    Em H

  • Just read this thread. Its very helpfull!!

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