Asthma cough but no wheeze at all - Asthma UK communi...

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Asthma cough but no wheeze at all

Frazzle
Frazzle

Hi guys, I’m new here but was looking for some advice.

I’m 16 and have had asthma for about a year, it’s not controlled at all and I have about 5 attacks a week (I see my asthma nurse regularly and we are trying to work out what to do) . 9 days ago I ended up in a&e after a call to 111 because I have a horrendous cough but no wheezing. They admitted me, I had a high temp and low oxygen, they did nebs and started me on a week long dose of pred (8 tablets 5mg).

Got discharged and went to my gp 7 days ago who put me on a steroid preventer inhaler and increased my oral steroids to last for another two weeks.

It’s been almost two weeks now since admission and steroids started and its only got worse. It doesn’t feel like an asthma attack because although it hurts to breathe and it can be a little tough talking I am not wheezing and my chest sounds clear, just coughing every 5 mins to the point I struggle to get air in.

parents can’t take me to a&e due to difficult circumstances and also because they believe its just a virus and I need sleep.

Any advice on what to do?

31 Replies
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Hi Frazzle,

Sounds like you need to get an ambulance and go to A&E. Do you have a reliever medication that you are taking? A reliever medication is something like Ventolin medihaler (blue) or the Easyhaler salbutamol (which is the medication in Ventolin) Bricanyl is another reliever. Take it now and when needed.

You may need antibiotics or, if it is a virus, an antiviral medication such as Tamiflu. Don't delay seek further investigations immediately. Every 5 minutes is not good. Sounds like you need more than sleep. You don't muck around with asthma.

You can have asthma without a wheeze. Cough variant asthma is one type and there is also silent asthma (no wheeze, no cough). Silent asthma, in particular, can be missed by medical professionals (emergency services, nurses, doctors) who are not used to that type of asthma. Basically your chest feels tight and heavy and it's difficult to get air in (or out).

Speak to your parents straight away. You need to get checked.

Frazzle
Frazzle
in reply to Tugun

Thankyou for your reply,

just about made it through the night, no sleep but oh well.

I take salbutamol and currently have to take it every 30-40 mins with my spacer in order to try and relieve my chest tightness a little bit.

Really interesting to hear about silent asthma, I do sometimes wheeze but every bad attack I have had I have had a silent chest!

Hi Frazzle,

Was going to tell you to ring the Asthma_UK Nurse but it's a week-end. Is there an after hours call line where you live? Please show the below to your parents. Asthma can get worse quickly. I personally wouldn't wait until Monday.

Frazzle
Frazzle
in reply to Tugun

We have 111 which is a nhs advice line, who I am going to give a call now.

Tugun
Tugun
in reply to Frazzle

Great!

Although it shouldn't have to be like this, you're probably in a situation where you need to get control yourself. If your parents' situation is too 'difficult' to listen & help, you need to start thinking self-preservation here.

Firstly, not all asthma comes with a wheeze, so the absence of one tells you nothing.

Secondly, you clearly have a significant problem, be it something long-term like asthma or a COPD-type illness, or shorter-term such as a virus or infection. Either way it's dangerous not to take appropriate action. If you have got a (probably blue) reliever, does it help? If not, I'd be asking for one.

I suspect if you don't see a rapid improvement soon, you probably need some specialist help to get to the bottom of it all, which would probably include various scans, x-rays, etc. to try & establish what's going on. In the short-term though, if you're in a bad way, it's 999 (or get someone to take you to A&E if available) every time.

I hope you soon feel better anyway!

Frazzle
Frazzle
in reply to Minushabens

It’s definitely asthma, had lung function tests and spirometer tests done, irs just really badly controlled at the moment.

I use salbutamol normally about twice a day but currently it’s every 30-40 mins, I know this isn’t good but it does help a little bit.

I had xrays, bloods, and arterial blood gasses dome when I was admitted. Xrays clear and no sign of infection on my bloods. Very weird!

Thank you!

Minushabens
Minushabens
in reply to Frazzle

Do you use a spacer to take your salbutamol? If not it might be worth getting one as they can improve delivery of the drug.

Frazzle
Frazzle
in reply to Minushabens

I use an aerochamber spacer.

Minushabens
Minushabens
in reply to Frazzle

Is there anything else you can think of that could be a trigger? Any pets, mould or damp at home, smokers, dusty environment - did you improve in hospital? Your situation is clearly complex & we're not doctors, but if it's not a virus/infection & they have largely ruled out other causes then there's very likely a trigger going on somewhere.

Do you have any friends/relatives you could stop with for a few days just to assess if a changed environment helps?

Frazzle
Frazzle
in reply to Minushabens

I have allergies - latex, pollen, dust. But the house is cleaned every other day to minimise the risk to me (something i am very grateful for!)

Improved in hospital but I put that down to the neb and not necessarily the environment, migjt be worth a look into.

No one else to stay with currently but I’ll keep that in mind

purple64
purple64
in reply to Frazzle

Do you have another inhaler apart from salbutamol ? I have symbicort as a preventer and ventolin as back up. My signs are coughing and a very sore chest due to inflammation.

If youre needing your salb that often you need hospital. Even if it is caused by a virus its flaring off your asthma, so you need more help (my own virus led to 3 days in hosp this time and i consider that a short stay for if im not well 😅).

Do you do PFs? If so and your numbers are at 50% or lower of best then you definitely need to do something like you action plan should say.

Remember is you cant walk/talk/eat/sleep normally, 10 salb doesnt relieve the issue or doesnt lst 4 hours you need more help.

Im not sure whats goong on with you family, but youre health is the most important thing to worry about. If you dont feel like you are controlled you call for help. Unfortunately asthma kills 3 a day, its a scary thought. So if you have the signs of an asthma attack ive said above you need to get help asap. If things arent improving or youre feeling worse that that first admission please get help.

Hope you manage to get the right help soon x

Frazzle
Frazzle
in reply to EmmaF91

Thankyou for your reply,

My usual pf is around 450, currently sitting at 220-250, not horrendous but no where I want to it be either.

Family is complicated but I can’t let that get in the way you are correct. Going to ring 111 and see what they feel is best to do.

Thanks again xx

EmmaF91
EmmaF91
in reply to Frazzle

Your dropping below 50% despite the overdose of salb you’re taking. You are bad enough. Skip 111 and call 999. 111 will hear sob and send ambo out anyway. And ambo would rather you call early and not need too much than waiting til youre stupidly bad and they have to go into meltdown.

Good luck and let us k ow how you get on

Hi Frazzle,

I agree with Emma. Time to go to A&E.

I agree with a&e. Hope you are able to see someone soon.

I agree with what others have said here, I wouldn’t waste time with 111, go straight for 999 because you’re clearly not coping with symptoms at home and need more medication.

And remember that just because your bloods were clear of infection etc when you went in a bit over a week ago doesn’t mean there isn’t one lurking now, so it’s definitely worth going to get checked out.

I don't have the knowledge to give you practical help but wish you all the best Frazzle. I'll add that your ability to keep a cool head and clearly explain the problem in well-written posts on here is admirable.

I can't add much to what everyone else has said but glad you're getting help as I agree you needed it! I hope you're being treated promptly and improving

Just a side note to say it's pretty common to have normal x-rays and bloods even in a severe attack if infection is not the trigger. Although infections do affect me, most of my attacks are not from that so I will often have bad attacks with normal X-ray and bloods. Often it's hard to pin down the trigger, as it might be something like the weather changing or a combination of triggers rather than just one. I also do not wheeze generally with attacks (and have had some doubt about asthma because of this as it is still seen as 'the sign you must have.) I sometimes do cough but wouldn't say I have cough-variant, just that asthma can show a range of symptoms even at different times for the same person - sometimes I have more coughing attacks and sometimes more tight chest.

Also to add that while you may know this, if you're ever in doubt about whether to go because your peak flow doesn't seem 'too bad' - if you have the other signs like not being able to walk and talk properly and salb not helping, don't wait for your peak flow especially if it's not budging with salb! It can be useful but shouldn't stop you if things are otherwise bad (sorry if you know this already but just adding it because above you said it wasn't 'too bad' before Emma said it was below 50%!)

You've had lots of other useful advice which I would just be repeating, but thinking of you and hope you can get some better control.

Hi Frazzle, I do hope you followed the advice and sought urgent help and that you are now getting that help. Please do let us know how you are 🤞🏻🤞🏻🤗 gentle hugs for a speedy recovery

Frazzle
Frazzle
in reply to Echoblue

Got help and currently admitted, thankyou all for the advice☺️

Echoblue
Echoblue
in reply to Frazzle

Thanks for the update. Take care and best wishes for your recovery x

EmmaF91
EmmaF91
in reply to Frazzle

Glad to hear this Frazzle, hope you start to feel better soon! Take your time and try not to let them discharge until you feel better/safe to do so Xxx

Wheezycat
Wheezycat
in reply to EmmaF91

I am so glad to hear you are getting help. It is not easy, so I am sorry to hear you are largely on your own in dealing with this. I hope your parents begin to see how serious this can be. In the meantime all the best to you.

Frazzle
Frazzle
in reply to Wheezycat

Thank you! Families are complicated and sometimes it’s just easier to go it alone rather than deal with emotional baggage on top of any current stress. Just been discharged from hospital with a really good plan :)

Wheezycat
Wheezycat
in reply to Frazzle

So glad to hear! Hope you are feeling better as well.

Glad to hear Frazzle. All the very best.

A few immediate thoughts:

1) you may need to change your medication regimen. Are you taking daily antihistamines, a nosy spray, and a controller inhaler? If not, you may need to add one or all of these. If you already take those, you may need to up the meds or add another-

2) it's great that your parents clean your home regularly. Is there any chance that there are still allergens in your house or school? It sounds like something in your environment is setting you off. If you don't have an air purifier or HEPA vacuum at home, those are two great things to have on-hand for all asthmatics. They hugely help improve air quality.

3) do you and your parents work from an action plan? It could be a good way to get you all on the same page

asthma.org.uk/advice/manage...

4) it's normal to have severe asthma without a wheeze. I have really bad asthma and frequent attacks but rarely wheeze. It's a common myth that you need to have a whistling type wheeze as an indicator of an attack.

Good luck and take care!!

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