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Asthma attack but no measurable clinical indicators!

MMBJI
MMBJI
13 Replies

Hi all, I had an attack on Sunday- 2 nebulisers at home with paramedics, then taken to a and e, 3 more nebulisers then discharged with a week of steroids. All the time O2 sats were 100%, no wheeze, chest completely clear, good air entry, etc. From the Drs perspective - nothing wrong, other than it being visible that I was struggling to breathe. Back to asthma nurse yesterday who was baffled, no additional treatment options, just got to wait it out.

Anyone else had a similar experience?

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EmmaF91

Hi

Sorry to hear this. Do you do PF? And if so was that something that was affected? Often asthma starts off as an exhalation issue (so poor air exit) so if you’re not a PF user at all it may be something to check out to see if there’s and affect. Also do you know what triggered the issue?

The other thing to ask is was it really an asthma issue... there are lots of asthma mimicers out there, and they aren’t always spotted. For example if you felt like you were struggling to get air in rather than out, maybe anxiety was giving you issue... if you found your breathing was noisy even tho chest was normal maybe there’s an element of VCD/ILO going on... maybe you have something else going on with a different system (reflux etc) and that caused a SoB... all these can trigger asthma issues, but cause also cause their own issues! If you found the nebs didn’t really do that much to help calm the SoB then it’s more likely to have been a mimicer. As you said other than the SoB this didn’t present like a typical asthma issue, so if things haven’t calmed or it reoccurs this is just an idea...

I hope this all makes sense and is helpful 😅. It may be worth giving the AUK helpline a call and seeing what they think happened. I hope the steroids have kicked in and are helping.

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MMBJI
MMBJI
in reply to EmmaF91

Hi, Thankyou for all the suggestions, I’ll give it some thought and further investigation.

My PF was 250, usually 450. It was the outbreath that was hard. Then both in and out.

My asthma check is due, I’ll discuss your suggestions with the nurse.

Thankyou again. 🤞steroids kick in soon!

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EmmaF91
EmmaF91
in reply to MMBJI

Sounds like a plan then. Asthma is a very complex beast, which can be different for everyone, and can get comorbidities which can make it act/sound different to normal (hence the alternate suggestions 😅)... even now (4years severe asthma) my lungs still go off and do random things that I can’t always explain 😅. Was just a couple of ideas for you to research and if you find one which is ‘oh that sounds like what happened to me’ then it gives everyone a head start 😅. But sometimes our lungs can just be weird so don’t read too much in to a one off 😉😅

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Lysistrata

Hi, just wondering if the nebs helped you breathing-wise? And did they improve your peak flow? Peak flow isn't exact but 250/450 sounds like there was something going on asthma wise, especially if after nebs that went up and you also got some relief for breathing. Did you have any other symptoms like a cough or tight chest?

As.Emma says sometimes air exit can be the issue at first and that's not always picked up. I have had times when they say oh things look good but eg my HR will be up and there are other subtle things, plus if I have nebs they will usually make a difference to symptoms and peak flow at least for a bit. My peak flow is a law into itself and doesn't drop in a useful way that necessarily reflects the attack level, but it does usually respond to nebs most of the time even if that increase doesn't last.

Would definitely be worth thinking about all this and maybe jotting it down for when you see the nurse - especially whether the treatment helped you at all.

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EmmaF91
EmmaF91
in reply to Lysistrata

Good plan. The more info you give your team the better an idea of what went on they have. If you can write it all down. Symptoms, PF scores, how you reacted to meds, etc etc. As Lysistrata said a dropped PF is a measurable clinical indicator for asthma... esp when you know it’s reliable for you!

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MMBJI
MMBJI
in reply to Lysistrata

Hi, yes post neb PF was 350. The relief just didn’t last long. Thankyou for your help. Reaching for notebook now to make notes for the nurse! 😉

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CANINE12

When I have an asthma attack I compensate really well, my sats don't drop for a good while but then they will drop the more exhausted I get. This seems to be the pattern with me, my carbon dioxide levels will rise however before my oxygen sats drop. Also my peak flow isn't a good indicator of an attack, when I last ended up in A&E it was at the top of the amber zone yet my sats were 90.

Everyone will experience an asthma attack differently, some people here don't wheeze when they have an attack for example.

The Asthma UK helpline nurses are excellent, it's worth speaking to them or chatting via Whattsap. They have reassured me in the past with regards to my sats not dropping.

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MMBJI

Thankyou, asthma is a variable beastie!

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Melanie1989

My asthma is similar, my sats usually dont drop, but my hr is usually sky high which is usually blamed on nebs but that is a different story 😂

Asthma is weird and can present in strange ways. The auk nurses actually gave me a good analagy and said basically my heart was like a back up generator, so it senses not enough oxygen was getting in so beat faster to maintain o2 which was why my sats were good.

The body is amazing at compensating, and asthma isn't as text book as dr's like to make out. Keeping a peak flow diary will be helpful, but the best thing is to go by how you feel.

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Junglechicken

Hi Melanie1989. This sounds so like my symptoms! Talked to AUK nurses and they also said that a fast heart rate is the heart compensating for the lungs. It usually feels like it’s going to bounce out of my chest, so much worse than if I have a panic. Always have perfect stats during an attack. Heart rate goes down once I get a good dose of salbutamol.

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Tess007

Yes I get this quite a lot ,I decided to buy my own oxygen as I knew I needed it and the medical professionals are not getting it ,hope this helps

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Buffafly

I am finding this discussion really useful as I have had a similar problem but minus the paramedics. My asthma often takes the form of uncontrollable coughing as breathing in is fine, out not. So I have been using my inhaler all Sunday, trying to ration it, and relief only lasting a couple of hours, seen doctor Monday who said 'No wheeze, SATS fine, peak flow ok, not asthma, just a virus'. Your posts reassure me I should at least call 111 next time, thanks.

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MMBJI
MMBJI
in reply to Buffafly

It’s all a bit hard work isn’t? My daughter only coughs, never wheezes, occasionally gets short of breath.

Such a variable condition, varying levels of understanding from drs , so many of us afraid of seeking medical assistance if it’s not “bad enough “.

Gah! 😬 I feel 111 is definitely a good way to get justification for seeking help. 😁

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