No morning dip on PEF, can I have asthma??

I am a 38yr old male, never smoked, and have been having random chest issues over the past year or two, and recently finally went to my doctor as they seem to be getting more frequent and more extreme...

Basically I am fine day to day, week to week, sometimes for weeks or even months at a time...

Then when it occurs, I start to feel my airway narrowing and I have to put much more effort into breathing, then my breathing gets very raspy and rattly, and I start a deep husky/barking continual cough which gets so intense that if driving I sometimes have to pull over as I am coughing out so much I can hardly breathe in, and I cough up lots of phlegm which is clear and just like thick saliva really....

This couging lasts from a few minutes to usually no more than 10-15mins...

Then the coughing finally fades to once every few minutes, but my airway still feels narrowed, and my chest and breathing are still very wheezy and raspy for another half hour to an hour or so and i have an odd taste in my mouth.. not very strong but sort of metallic tasting....

I started logging when it happened and realised quite quickly that it only ever happens on cold days, mainly early in the morning usually between about 7-10am, when I go out from somewhere warm like a house or warm car/van out into the cold or damp air..

Once the warmer weather comes, it happens a lot less, usually not for weeks...

Although last month we were on holiday in Majorca and although very hot, the hotel pools were still very cold, and several times upon jumping in for the first time from dry I was instantly freezing and the drop in body temp brought on my symptoms...

Its also come on once or twice when going into Asda on a very hot day and standing in the fridges aisle browsing...

Its definately going from warm to coldair that triggers it....

So I thought maybe I am developing asthma?? So I booked an appt...

There is no immediate close family history of asthma, although my fathers three brothers all have it but he doesnt, and my sister has bad excema..

I did have very bad bronchitis at about 2days old and remained in hospital for a week or so and its left me weak chested, whenever i get a cold or flu virus I ALWAYS end up with a bad cough that I cant shift that leads to a chest infection that I cant clear, and I always need antibiotics....

Anyhow I explained all this to my doc and he listened to my chest at the time, which of course at the time was clear and healthy sounding, and he gave me a PEF meter and told me to take morning and evening measurements and go back in 2 weeks...

I did this, they were always around the 680-700mark, which from googling appeared good for my age and height (6'4"")...

during this 2 weeks though I had 4 episodes, and I used the PEF again then, and for all of them my PEF read was around the 450mark, noticably down on normal, and I also video myself on my phone to be able to show the Doc exactly what happens as it seemed easier than describing it to him.

I went back at the end of the two weeks, and he listened again to my chest which was again fine at the time, and he viewed the video on my phone and he agreed it was a very bad cough, and i showed him my PEF chart (with the 4 huge dips where the episodes occurred and I pointed them out to him, but he didnt seem overly bothered about them)...

and he just said as I didnt have a 'morning dip' that I DO NOT have asthma, end of story, and he didnt want to pursue that avenue any further, and wouldnt give me any medication or inhaler etc, not even just to try when it comes on to see if it helps........

He said my chest is probably just easily irritated by the cold, and its just something i'll have to live with....

I am unsure whether to settle for that or see another doctor for another opinion??

Does anyone on here have asthma but dont have a 'morning dip' on a PEF meter or is he 100% correct and I cant possibly have it??

3 Replies

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  • The finding hard to breath make me thing there sint asthma as asthma tend to have a problem breathing out..

    The phelm thing the colour and type ypou describe is more associated with acid reflux..

  • It wasn't 100 percent clear to me from misterbarlow's post and what he says whether he has trouble breathing out or in...I know I've been asked this and actually, when it's not happening, haven't been sure, but thn I thought and realised I get a feeling of being SOB in general and sometimes the effort of breathing when it's worse, but it is getting the breath out - I just hadn't analysed it much until I was asked.

    Misterbarlow, firstly welcome to the forum! Secondly, I would say definitely get another opinion! You may turn out not to have asthma, but as far as I know (and I'm not a doctor or anything) if you're having PF dips during episodes and they're brought on by change of temperature and cold air, then they should at least be considering it. Morning dips I think can be a classic sign, like wheezing, but not all asthma presents with either or both; it sounds like your dr is refusing to acknowledge that asthma doesn't have to present with all the classic symptoms, but there are people on this forum, like me, who have been diagnosed with asthma (eventually...it took some effort at times) and don't have either.

    So I think it's worth seeing someone a bit more open-minded who will listen more to your family history and what you say about symptoms (snce as you say it's possible to be fine when you see the dr) and realise asthma doesn't always present the same way! Hope you do get somewhere whatever it turns out to be as it's not fun having the symptoms!

  • I googled acid reflux

    medicalnewstoday.com/articl...

    What are the symptoms of acid reflux?

    Asthma - gastric juices seep upwards into the throat, mouth and air passages of the lungs

    Chest pain - part of the heartburn sensation

    Dental erosion

    Dysphagia - difficulty swallowing

    Heartburn - a burning feeling rising from the stomach or lower chest towards the neck

    Hoarseness

    Regurgitation - bringing food back up into the mouth

    I have asthma and what you described sounds just like my symptoms and nothing like acid reflux

    do you have an asthma nurse at your surgery?

    I got a lot more sense out of my asthma nurse than my doctor

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