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no wheeze, no asthma

I'm still coughing a lot, waking myself up coughing, waking the whole family up coughing, not being able to sleep due to chest tightness, needing my salbutamol too often, retching from coughing, painfully tight chest and upper back, shortness of breath, blueish purpleish lips after coughing fits, etc.

I finished my course of pred today and the only difference seems to be I'm not coughing to the point of throwing up any more. I'm still not sleeping through coughing, chest tightness, etc. my GP is great with everything else, apart from my asthma so it seems.. she's said that because I have no wheeze, I have no asthma. I'm on antibiotics for pneumonia, my PF is down to 340 from 500 (after salbutamol which my gp was fully aware of) which can and has been dropping to 200-220 on a morning, apparently you need need to wheeze and you need to drop your sats to be asthmatic, my pulse was 132 with 94% sats. I always thought that if you'd dropped your sats, it was a bad sign? I've been told to go to A&E if it gets any worse.

I feel like a fake and I don't know what to do with myself, I don't want to go to A&E over the whole ""no wheeze, no asthma"" thing, yet I'm tempted to take it up and go with my next attack without going through a stupid amount of salbutamol first? surely there's people who are ""asthmatic"" who genuinely need help more than someone who has NEVER wheezed, yet responds to asthma treatment? how do you deal with the whole ""no wheeze, no asthma"" thing?

6 Replies

You do not need to wheeze or drop 02 to be having an asthma attack. Then again, not everything that coughs or wheezes is asthma either.

When I had a really bad cough last Oct/Nov, my doctor didn't jump to the conclusion it was asthma even though he knows I am asthmatic. He kept an open mind and looked at other possibilities as well. It does no good just assuming that every thing wrong with breathing is always asthma, even in an asthmatic. Treatments need to match the actual problem and will do no good if they don't. I even got tested for whooping cough (pertussis).

Perhaps in this particular case your doctor thinks that your cough is related to the pneumonia and not asthma? Pneumonia can make people feel really rotten and it can take a long time to get better.

In any case, using a stupid amount of ventolin is just not a good idea. In the worst case it could give you a heart attack because ventolin speeds up the heart.

If you need more than a reasonable amount of ventolin ( as defined by your doctor ) you need to see someone with medical training and not try to treat yourself. Whatever you need to feel better, is likely not yet more ventolin. Whether it is steroids, a different antibiotic, or something else entirely, it is best to let a doctor decide and not make decisions on your own.

The next time you see your doctor, it might help to ask her when you should be feeling better. If you don't feel better by that time, then make another follow-up appointment. If you aren't well and your doctor is good, she'll also want to find out why you aren't better.

If you really feel your doctor is just not listening or is stuck in a model of asthma that doesn't fit your particular asthma, perhaps you could ask your doctor to confer with the consultant who is managing your asthma?

Or perhaps you could write/email your cons and ask them for advice about how best to deal with your GP since she is the one that handles things between appointments with your cons?


I'm not trying to be awkward, I usually can tell the difference between my ""infection"" cough and my ""asthmatic"" cough. my ""infection"" cough is usually a really rattly smokers like cough, I've had people comment on how rattly it sounds, my ""asthmatic"" cough is usually really chesty and wheezy, I don't wheeze normally, but seem to make up for it in my coughing. it seems to be the asthmatic cough which is causing me to retch and things.

I've been recommended to use my inhaler 6x every 4 hours to try keep on top of things, I'm using that + a lot more between.

I don't have any contact details for my cons outside appointments, I have an appointment with him on the 5th, I'll ask about getting something sorted to ""prove"" I'm a nonwheezing asthmatic.


If you have a peak flow of 200-220 (from best of 500), pulse 132 and sats 94% and you've blueish lips after coughing fits then you need to go to A&E. This isn't a time to worry about them saying ""no wheeze, no asthma"". You're obviously really poorly and you can't go on trying to manage as you are as it's really dangerous. Please go and get some help now.

Hope you're feeling better soon


Yes, that drop of PEFR means you're currently achieving only 68% of your best - I think a trip to A&E would be very wise. They can check you out and pass on their findings to your GP.


thank you lovelies, I'm ok at the moment (PF is 320, I used to function on 280 before I found the right meds) if I go blueish/purpleish again and/or it drops any further, I'll get myself help.


sorry to bump this..

I finished my pred yesterday and I'm a big emotional mess today. is it ""normal"" after burst courses? :'/


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