Here's another long post... I've been having a persistent cough and breathing difficulties for some time and my GP thinks it's asthma. I'm 31, non-smoker with no history of chest infections or other respiratory problems and no known allergies so I'm a bit puzzled as to how or why I'd develop asthma now... I'm looking for some advice I guess.
A couple of nights back in January, out of nowhere, I woke up struggling to breathe/wheezing. After a trip to A&E, I was told it was a panic attack. A month later, I developed a dry cough that worsened over a number of weeks; I could feel my airways becoming inflamed. Next thing I know, there was A LOT of phlegm blocking them. The symptoms would worsen, then improve without an obvious trigger but wouldn't go away. It almost feels like an 'episode', starting with a cough, then chest tightness, then heavy breathing, followed by phlegm/productive cough. It comes on gradually and it leaves me utterly exhausted, like I've been dragging something very heavy. No wheeze though. I've had it at rest and I've also had it after physical activity.
I was given Ventolin in January but it wasn't 100% effective so at the end of April I was prescribed Clenil Modulite 100. I can see some improvement and will be speaking with my GP in another week or so. She said I should see a specialist because all tests I've done look fine: blood tests, X-ray, spirometry, ECG, echocardiogram. I'm also using a peak flow meter and my stats seem consistent, though there's a slight drop when I feel breathless (10-20%). Taking Ventolin makes some difference to the stats but not much.
I don't know anyone who has asthma and I've always assumed that there would be a trigger, which is why I'm slightly suspicious of the diagnosis at this point. Any advice would be much appreciated
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If it were a panic attack, I don't see why you would be wheezing. The wheezing etc might have died down by the time you reached A&E so the doctors would have heard it. it would be a good idea to see a specialist. When you go dot-point the salient facts so that the specialist has a good idea of what has been happening. Keep a diary of your peak flow. A pulse oximeter measures your levels of oxygen and may be helpful.
A couple of questions: Is there any pain involved? Is the phlegm only in your lungs not in your sinuses or nose or a sore throat? What do you mean heavy breathing? Do you use ventolin at that stage? Does the ventolin help to produce the productive cough or does it happen by itself? When do you start to use the ventolin?
I see that you've had your heart checked so it's good that it's not that. Definitely suggest you go to a specialist.
Thanks Tugun - you're right, by the time I reached A&E I was feeling fine so no one could work out what had happened.
There was some chest pain with the cough, yes. Clenil must be helping because the cough and chest pain have largely disappeared and I'm producing a lot less phlegm. My sinuses/nose/throat are fine now but my nose does get blocked occasionally. I'm suspecting an allergy and have been using a nasal spray on prescription.
The breathing part is what worries me. I'd describe it as the feeling you get after running or when you walk a long distance on a very hot day. It takes me longer to fill my lungs with air compared to how I breathe normally. When I feel fine I don't really notice I'm breathing, but when this happens, breathing becomes something I have to focus on.
I take Ventolin as soon as it starts. I'd say Ventolin helps to a point, it makes it easier to clear phlegm but there isn't much of that during an attack. Most times I have to wait for it to disappear on its own. I'll need to make sure I arrange to see a specialist next time I speak with my GP.
Late onset asthma can happen unfortunately and there's no rhyme or reason to it.
I agree that you should keep a diary of your symptoms, how many times it wakes you each night, worse and best time of day and peak flow results. The diary will help you see any patterns. Keep taking the Clenil as it builds up effectiveness over time.
Take your peak flow before you take your Ventolin and again about 20 minutes after.
The phlegm needs to be addressed so talk to your GP & ask for something to ease that. Phlegm will irritate the lungs and the sooner you can treat it, the better. Secondary bacterial infections should be avoided, hence the need to treat early.
Asthma takes all forms and can be caused by different biological factors. The hospital tests will help identify the type of asthma that you have. That will definitely help design your treatment plan.
If you don't think the Clenil has helped after about 6 weeks then speak to the GP about a combination inhaler (contains steroids and long acting bronchidilator). With the current lock down it may take time to be seen at the hospital so make sure to use your GP to help you cope with your symptoms in the meantime.
Good shout Poobah! I keep a tally of my PF stats and have started writing down my symptoms each day but it's a bit sporadic at the moment.
Clenil has helped reduce the cough and phlegm, I've been on it for 11 days and hopefully there will be further improvement.
From I've read, asthma seems to affect different people in different ways. I think I'm finding it uncomfortable because it happened so suddenly and I'm still trying to figure out what helps etc.
As the other respondents to your Post have remarked (or hinted at) your central question is a difficult one to address.
It may help to come at it from a slightly different angle.
It’s sometimes useful not to go with a particular label (such as Asthma) but think in terms of a more general one. I personally prefer to think of myself as suffering Respiratory Issues (lets call it RI). OK, my profile may fit closer with Asthma than (say) Bronchitis, Allergic Rhinitis, or something else, but each Suffer often has overlapping stuff going on. (I found it quite Illuminating when, a couple of years back, I read that NICE couldn’t even agree on a definition for Asthma).
The Therapeutics for one form of RI are very often the same (or similar to) those for another. (And it’s finding the effective Treatment that’s important).
Also, suffers often have a mix of issues or triggers that don’t put them neatly under one label or another. Each persons biology / microbiology vary to a marked degree, due to genetic and environmental differences in their history, plus their current circumstances and habitat.
It may well take further investigative work, blood tests, imaging, spirometry, plus several meetings with doctors, consultants and nurses, to find the best treatment for you at this time. That treatment may end up being short term, or long term, and may change as you change in age, environment or circumstances. Some folk even improve or get better quickly without explanation.
Getting to a better place may take a little while plus a fair bit of trial and error.
Taking steps to increase control over lifestyle and environmental factors often make a significant difference: e.g. avoiding cigarette smoke, keeping the nest (and workplace) free of dust & allergens, avoiding minor infections (which, it seems, trigger around 80% of exacerbations), healthy eating, taking exercise, weight management etc.
Another significant factor, is adopting and sticking to measures like using a Spacer with Inhalers and ensuring your Inhalation Technique is good. There are estimates out there that suggest a high percentage of Suffers are getting far less Meds into them than they need, simply due to poor Technique. Others are failing to improve due to missing doses of meds or failing to take them to a strict schedule.
Thanks Matman, I have a feeling this will be a journey. I started using a spacer recently and I might be imagining it but it seems to help. I'll also be changing my routine so I do more exercise and am reviewing all the possible triggers I can think of to see how I can avoid them. I guess I'll have to keep going at this!
As Poobah said late onset asthma does occur & for no obvious reason. I was diagnosed aged 58 or 59. I was given Ventolin & my peak flows dropped like a stone. It turned out that the propellant used in them upset me. As soon as I was put on a dry powder inhaler things improved greatly. Not everyone likes them, but they've been brilliant for me.
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