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Doctors are testing me for asthma, so many questions!

Hello everyone, apologies if this is a little long winded but I've not been able to get this out of my mind all week.

I have previously been treated for GERD. I was given a tablet which took away all the symptoms. Around the end of summer I noticed some of the symptoms started to pop back, mainly - a really tight chest and the feeling that I can't breathe properly. I was becoming out of breath walking to the bus stop (a 4 minute walk) and sometimes even out of breath just talking.

The doctor had told me over and over again that this was all caused by inhaled stomach acid from the GERD, but after trialing another medication and a similar effect, all but the breathing problems cleared up - She decided to try some breathing tests.

So she did a peak flow test, which she described as "pathetic" and sent me for a chest X Ray and booked me in for Spirometry (Which sadly isn't for over a month)

The chest X ray had to be re-done as I was told I had long lungs, which was a shocker because with my current tight chest I thought I must have tiny lungs.

Given that there's a history of allergies and asthma in my family the doctor said it's possibly that and I'm at a total loss for what to think.

My auntie who suffers pretty bad asthma bought me a peak flow meter and told me I should be able to blow 600. The worst I've done was 475(ish) and the best was 525(ish) but strangely I blew the 525 when my chest felt tight, how does that make any sense?

I have so many questions... firstly, my symptoms vary a lot. I have good weeks and bad weeks, what do I do if the day of my spirometry appointment is a good week?

I don't cough, or wheeze (well very infrequently), and I thought these were the hallmarks of asthma?

Cold air is supposed to be a trigger, but cold air often makes me feel better. Conversely, humid and warm air makes my chest feel tight, surely that doesn't make sense?

I'm 24 years old, I gave up smoking at the start of 2017 because of this exact tight chest feeling and the impact it was having on me. Over a year later I still have it, and I don't smoke.

I must admit, I'm really very concerned as to what this is...

Any input or advice is greatly appreciated because I didn't even know what asthma was until about a week ago (I thought it had something to do with peanut allergy... :( )

13 Replies
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Firstly don't listen to your auntie to get 600 you would be an Olympic athlete and to describe it as pathetic is DERISORY, and she should be struck of the General Medical Council.

All asthmatics have good and bad weeks, just take your spiro as it comes.

Everybody has different trigger, which is probably why it is difficult to cure.

I note you have given up smoking, thank you on behalf of all of us, have you taken up an e-cig

Finally wait until you have seen a REAL qualified doctor, then post the results.

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It is all very confusing when you start! Just to clarify, your auntie is not a dr but she was the one who gave you a peak flow.meter (no reason she shouldn't, just to be sure we have it clear). You can find charts online which tell you what your predicted peak flow is for your age, sex and height. 600 is not unreasonable for a 24-year-old man - I don't know if you are male or female but men usually have higher peak flow than women, even when height is accounted for eg for a woman and man of the same.age and height, the man would likely have a higher best peak flow reading than the woman.

HOWEVER these values are all population averages - your own personal best may take a little time.to find out. Mine (I am female, early 30s, 5'8) should be around 470 and actually my best is 630! This is probably because I have done a lot of singing and used to play a wind instrument. Regular sport, even if not Olympic level, may also increase your personal best. It would be worth finding a chart online and recording your peak flow twice a day at about the same time to show the GP. But peak flow is just one factor as it measures one specific thing. Some GPs and nurses rely on it mzybe a bit too much and it should be just part of thr picture including how it responds if you have medication. Mine is all over the place and often doesn't relate to how my asthma is!

Spirometry can be normal in asthma if you are having a good day, as you say. Asthma can be very variable! Make sure if you are on any inhalers to look up and check when to withhold them before the test if needed (they are supposed to tell you and often don't). They should really do reversibility testing ie give you a reliever inhaler, wait a bit then do the test again. Sometimes they won't do this if the first part looks ok but they should and you can try politely insisting they should do it anyway - like peak flow, spirometry csn vary and the reversibility is a better test than just one set.

Re triggers, it does vary a lot. I also get a tight chest with humidity but cold air is a problem for me - however others find it isn't. There are some.common triggers but if they are ok for you it doesn't mean you don't have asthma. Everyone assumes I am.allergic to cats but not all asthma is allergic and cats etc are fine for me! Also wheeze is NOT required for asthma though many drs think it is...

Sorry this is so long but hope it helps. Feel free to ask more if you need.

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Here's a peak flow chart that should help but PF shouldn't be looked on as a target and can vary a lot from person to person. As an asthmatic what you look for is a deterioration in PF from your personal norm as an indication of asthma management.

peakflow.com/top_nav/normal...

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I have had asthma all of my life (64) and I can also get a good PF reading when my chest is not good.

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Hi TD888

Asthma is really variable and not everyone gets the same symptoms. Many people don't have a wheeze. Here's some information about symptoms: bit.ly/2myTUrC.

It’s important to remember that if your results come back normal after a test, it doesn’t completely rule out asthma. Because asthma symptoms can vary over time, it could just mean that on the day of the test your airways were not as narrow and inflamed. You may need to take the test more than once, or take a combination of tests, to help your GP make the right diagnosis.

There's some information here about tests used to diagnose asthma. bit.ly/2sm3ro1

If you have any questions, do give the Asthma UK specialist nurse team a call on 0300 222 5800 (M-F, 9-5) they can provide advice and support on what to do next.

Hope that helps,

Dita

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hello, welcome to the forum, yes that's a lot of questions asthma is a confusing condition and that's what this forum is here for to take some of the confussion and difficulty out of asthma.

firstly everyone's asthma is different so don't compare it to the 'norm' some asthmatics are affected by the summer months, some the winter months and some unlucky ones have trouble all year round. Peak Flow readings good and bad are different to each person for example, my best I've ever done is 320 and my worst has been like 120 whereas someone else is good is like 500 and there bad is 400. It is a disease with a lot of variation depending on the person

we all have good and bad days.

good luck wish i could tell you more but got to go x

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H I'm able to continue now, sorry about that

GERD can be linked to asthma issues too

I have acid reflux and bad asthma it's one of the things that is linked up with it, so you still probably have GERD and asthma too unfortunately

Basically what I was saying is that no two asthmatics are the same you can have a room full of asthmatics and the chances are their all different and we all have our good and bad days

Good luck let us know how you're getting on and if you have anymore questions just ask or if you're just needing emotional support through this just ask it's not the easiest of conditions it can be quite annoying at times but hopefully you will get the right treatment and diagnosis to not have too many troubles but we are here whenever you need it someone will be able to help

Xx

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I shouldn't take issue with auntie, if I were you - just let it ride. PF is only one of many diagnostic tools and you need to listen to your consultant for the best advice. If you don't have one, talk to your GP about seeing one. A General Practitioner is just that - general - and cannot be expected to know everything. You need a specialist. Although you are not at your best at the moment, you are not an emergency case and I'm afraid you just have to wait for the NHS' wheels to grind slowly, your way. If you persist, you should get a diagnosis you can live with. Have a good look at the asthmauk website for information, but don't diagnose yourself as that can be inaccurate. That is what the specialist is for.

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Thank you all for the responses, it's been most reassuring. To confirm my auntie isn't a Dr, but she was diagnosed with adult onset asthma herself and when she heard of my symptoms she went out and got me the peak flow meter and advised me to do it daily.

I am keeping a diary to show my GP next time I see her (Despite the 'pathetic' comment she's a very good doctor, we share a bit of banter) I've decided to do the diary twice a day and rank the tightness of my chest from 1 to 10 and breathlessness from 1 to 10, adding in any readings if I get really bad symptoms in between. So far noticing I seem to suffer more in the middle of the day to night time and I've noticed that my symptoms are varying a lot through the day (most days).

Thank you for the links Dita, they are extremely helpful.

It's not confirmed asthma by any means, just suspected at this point, but I appreciate all the help.

On the peak flow, I'm noticing that often with a tight chest I can still blow a high result, I hit 550 earlier today when my chest was about a 6/10. (10 being so unbearable I can't stop concentrating on it and 1 being practically non existent) So I'm not sure it's going to prove extremely useful for me.

Roll on the 6th Feb so I can get this spirometry done, crossed fingers are appreciated.

Once again, thank you all for the replies, it's much appreciated :)

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6th Feb today, obviously, and it was my Spirometry appointment today. Here's how it went - Badly.

They did relaxed breathing, which I did just fine. The problem was the forced breathing, I couldn't manage it. I ran out of air so quickly that the machine just said "Sudden stop" and wouldn't count the result. We tried well over the recommended 8 times and I got so dizzy, but we managed one just about passable result. We did not try it with an inhaler to see if there was an improvement, not sure why. On the bright side, she did give me a lollipop, which made me feel better.

It's odd because the last week or so I noticed a decline in my symptoms, I was blowing a good peak flow all week (Rarely below 530) and yet I still couldn't manage this test.

So where that leaves me now I have no idea. It's clear that there's something wrong, but I feel no closer to an answer at all.

Meeting with GP tomorrow to see where we go from here, thank you all again for your responses, they were most reassuring.

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The problem I find with spirometry, is that it only gives them a there and then indication. I am on steroids just now and done mine today. And got a good high reading. Yet when I was at the dr’s on friday. My peak flow and oxygen were down. I am wondering if I hadn’t been on prednisolone and done the test, would it have been lower.

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I am consistently rubbish at doing spirometry technique wise and have had many sessions like that! I can handle the asthma nurse's little one now but the main size agghh. The more I am.struggling the worse my technique! Have always found it odd since I played a wind instrument to grade 8 and have been singing for years which I would have expected to help my technique! I do find the exhaled nitric oxide much easier as you get feedback from.the screen, though still hard when struggling.

The point of all that rambling is that I wonder if the difficulties you had are a sign in themselves. It is a shame they didn't do the reversibility as you may well have improved, but they seem to have this block about only doing that if you get a usable but less than expected results. I think for asthma they should do.it anyway as some people may have surprisingly high results - not everyone is average. As Scoobs87 says, spirometry is also very much a snapshot.

I hope your GP keeps trying to work out what's going on. Keep us posted.

PS I never got a lollipop. :( Jealous. I did used to get myself a really big cookie afterwards though.

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Spirometry isn't easy it's quite hard to do it's easy to understand what to do but physically doing is hard

I dread spirometry because it's so hard and I have a hospital appointment next week and I know my readings are going to be bad cos I just came off steroids and I'm wheezing a lot again

So dw about how badly you did

And I've had many tests done for many different reasons and quite often I don't get anything out of them because they haven't revealed anything so I'm still in the same position as before the test

Hope you get some result out of the tests and with the chat with your GP

Good Luck

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