Pain in back, between shoulder blades...

[Willow7733]

I have been having trouble getting control of my asthma for a month or two now. I have a question about back pain. I have a point between my shoulder blades that hurts every now and then. Is that something that happens to anyone else? I usually get a bronchitis this time of year, but so far it hasn’t developed. Maybe the pain is related to that? I am not sure.

[d2read]

Hi, Willow,

I’ve had the most severe forms of asthma for my entire life (I’m 64), and I am very familiar with what I’ve called my “lung pains” since childhood (none of my doctors have a better term). In my case, despite considerable study, doctors have never linked the regular pains I get (with or without asthma or other lung exacerbations, like URIs/pneumonia etc) to anything specific.

Part of it, I believe, is simply mechanical. We asthmatics breathe differently, which is why many of us have substantially larger rib cages — we have to work harder with every breath to exhale the carbon dioxide. This is most noticeable during an asthma attack, when the muscle pain in my upper back can be really severe. It’s why so many childhood asthmatics have a parent or caregiver that rubs their back for hours at a time. Heating pads help as do gentle stretches and curls.

One other possible cause can actually be scarring, although I understand from physicians it’s relatively uncommon to find that degree of scarring in patients treated in the US or western Europe today.

I have a particular spot in the front upper quadrant of my right lung that pinches with every breath I take. It can be a sharp, piercing pain when I am sick, aggravated by deep coughing. But although I report it to my doctors so they are aware of it, it has never been linked to anything.

Always report changes in your body or possible symptoms to your doctors, but otherwise don’t worry about it.

Try the heating pad, though — I have one that turns itself off after 20 minutes. In fact, I’m going to go use it now — I’m slowly coming out of an attack.

Be well.

Debbie

[Willow7733 in reply to d2read]

Hi Debbie! That I you for such an informative response! When I think of scarring, that could be. I have had really bad instances where I was sure I had pneumonia (I was in my 20’s and too busy visiting friends or doing fun things to go get help) where I felt like I was drowning - so much so, I had to sleep sitting up at a 90 degree angle. The coughing and wheezing was so bad it scared me. But I touched it out. I am positive that those times I did more harm to myself than good in not getting help that I really should have gone for. Maybe that is what I am feeling now? At that age, I wasn’t interested in taking care of myself - I was away at college and on my own and just enjoying that time. I am new in this city where I am working now, and my GP is very new (only had him for the last three years) and know s nothing about this. I should let him know, and let him know of what I am feeling these days. I never knew of lung changes and scarring back then. It does feel like a stretching type of sharp pain whenI breathe in. It bothers be quite a lot these days. Always there.

[d2read in reply to Willow7733]

Willow, don’t beat yourself up about being a silly young adult.

You were unlikely to have been anywhere close to sick enough to cause scarring.

The kind of sick they’re talking about means weeks or months, sometimes years, with truly terrible levels of infection — the kind where they cough up huge gobs of blood, lose large amounts of weight, become so weakened and run a constant fever. And the scars are readily apparent on X-rays.

I’ve found that gentle back stretches (I have regular physical therapy) help. So does Tylenol. Just remember to tell your doctor about any changes or concerns, take care of yourself the best you can, and never underestimate how much a soak in a hot bath, or a massage/back rub can help.

And try not to focus on the pain. Acknowledge it, recognize that it’s the familiar one and not a new one that might indicate a new problem. Then I visualize making a newspaper sailboat (the kind children make), put the pain on it, and visualize it floating away down a creek. It’s a helpful technique.

[Willow7733 in reply to d2read]

I am thinking maybe over the past 20-30 years this has been going on. I have a fear of doctors. I will not go see them. Nope. I was just diagnosed with asthma in the past 4 years (when I moved here and had to go see my new GP, and who noticed I was having trouble breathing). There were so many times through the years I should have gone to get some antibiotics or medication to help me. I am sure I did myself more harm than good. But more than likely, this pain is another start of a bronchitis type thing I get three times a year. It always happens this time of year when fall starts. Then in the winter. And again in the spring with all the pollen floating around. I really need to take care of myself better. And why be so nervous going to see my GP? He and I get along really well! He is SO funny. And he has never treated me like I was wasting his time going g to see him...but I still get so much anxiety going. Now, with everything over the phone, it is worse!!! It takes me two weeks to get the nerve to call his office to get refills on my prescriptions! It makes no sense - I work at a hospital in the ER. lol I am fine at work. And you would think I would have less anxiety over the phone. But no. It is worse for me. I just give up most of the time and hope for the best.

[d2read in reply to Willow7733]

Oh, wow!

Then you know that asthma can be fatal? Have you seen someone die from an asthma exacerbation? Have you watched as doctors have fought with every tool they have, knowing what they must do will likely cause permanent long-term damage, but there are no other options?

Willow, you know you have an anxiety disorder that might ultimately cause your death — or permanent disability (I’m in that category). DO SOMETHING ABOUT IT!

You also realize that the very fact you posted on this site means you want help, don’t you? Otherwise you would have stayed in your cocoon of denial.

So take a deep breath and ******** DO SOMETHING!

Write your GP a letter and send it — copy and paste what you’ve said here if it’s too hard to start over.

“Better living through chemistry” is not just a snarky allusion to an old advertising slogan. It’s actually true. There are good medications now that can help with anxiety — some people benefit greatly. Others benefit from therapy and coping mechanisms. But to deny yourself AND EVERYONE WHO CARES ABOUT YOU is just wrong!

If you want a penpal who’ll encourage you, we can move our conversation to the private channels and I’ll try to help. But no one can do it for you.

And believe me, asthma is NOT the way you want to die.

Think about it. Seriously.

[Willow7733 in reply to d2read]

Oh I know. I work in ER and have been there when patients came in with asthma. I have also seen first hand people who have died from Covid, as I also pick up shifts in the intensive care. My father died of pulmonary fibrosis in March - that was five years watching the best thing that ever happened to me, slowly suffocate to death. It is not a good death by any means. Phobias are not rational and not something people have on purpose. I guess that is why, if I am around, when patients come into the ER with an asthma exacerbation, and the staff are not to kind or sympathetic...I go out of my way to be. Because I know. And I admire their good judgement and their strength to get help when they need it - something I severely lack.

[d2read in reply to Willow7733]

I'm so sorry about your father. It's truly horrible to watch someone you love in pain and not be able to help, but then to lose them. Layers of pain tightly wrapped.

And I get it about phobias and anxiety -- really, I do. I've had my own challenges with anxiety, and with struggling with a disease that has robbed me of the life I worked so hard to be able to live (I have HyperEosinophilic Syndrome - HES, and now eos asthma and emphysema on top of the severe, difficult to control asthma I've had all my life). I'm also a huge believer in being kind -- when sympathy and being kind can help, and not hurt.

But my earlier point about the motivation behind you writing in stands: You must, on some level, want to make a change and have a better quality of life or you would continue to ignore the pain you've ignored all these years.

Years ago, I had a great marriage counselor, who taught me something I've found is applicable in a lot of different situations. Maybe it will help you.

She said, "If you looked back at the past 15 years, ignoring the highs and lows and just focusing on the average, and then projected those 15 years into the future -- would you want to repeat them? Knowing that there would be some great highs, and some terrible lows, but the years would average out the same? Would you want to spend the next 15 years of your life the way you spent the past 15?"

So, Willow, do you want to have your lungs and asthma and anxiety limit your living and joy, or do you want to figure out a way to deal?

Good luck!

[Willow7733 in reply to d2read]

Thank you. Your words have helped me so much! I am still in shock that my father is gone - he was such a big part of my life. He was my best friend. And he would tell me the same things you are telling me now. When I moved to this city for work , he would actually call me just to ask “Did you make an appointment with your doctor?” Lol My answer was always “No....”. I thought it was silly he was pushing me when, here I am, in my 30’s! But he was right. What good is it to just try to ignore a problem, when doing so only makes it worse? Am I helping myself? No. Life could be so much better! I can’t sleep through the night (which is affecting my work whether I admit it or not). I can’t do the activities I normally enjoy. And all of it could be helped if I would just drop the anxiety of admitting I need it. What is the worst that could happen? lol

[d2read in reply to Willow7733]

I completely understand the paralysis. There’s even a kind of comfort to be found in the familiarity of anxiety. But I hate to see you waste your life, and possibly harm your career and relationships, by letting the anxiety win.

You are young enough to have just begun to realize how terribly fast time goes past. It only speeds up from where you are. Don’t let the life you want, the relationships you want, be sacrificed.

To give you an example: I couldn’t have children. Perhaps if I had not allowed my anxiety to make excuses for why not to have a new committed relationship after my divorce, I might also would have explored new medical treatments and alternatives possible with a supportive partner.

My point is that you have the ability to get the help you need for asthma — and you are guaranteed NOT to get it unless you fight the anxiety battle.

I am sure you will find, as I have, that you can build a supportive network of friends/family/medical team. And each gain can bring greater strength and incredible new opportunities. They will feed on each other in a positive way, just as the anxiety does with the negative.

So I urge you to take one step — just one — with a reward for doing so. And then a second. And a third. There will be times when things go backward (I’m just recovering from another month-long asthma attack and the tremendous physical downturns as a result of having to go back on prednisone) — and that will be frustrating, and at times flat enraging. Sometimes I want to throw a good old-fashioned “hissy-fit”, laying on the floor kicking and screaming my anger out. But it won’t help.

Find a way to comfort yourself. Build a support network, a friend or maybe a colleague, who you can confide in who will help you deal, and then call that therapist, and get into see the allergist/pulmonologist.

And write back and let me know how you are doing. You are welcome to write me through this platform, or use its messaging section. Or you can write me through my blog at AsthmaOdyssey.com.

I think you’ve already taken the first step by posting here. Now take the next!

Hugs,

Debbie

[Willow7733 in reply to d2read]

I am going to have to do something to get this flare under control - I am starting a new job next week in neurological ICU. I need to get some sleep. I just don’t know how to start the conversation when I call my GP to tell him my problem. I am always telling him “I am fine “. I will figure it out.

[Nesiar78 in reply to d2read]

My daughter has severe asthma and i believe anxiety whenever she has an asthma attack she puts off going to doctor till she cant get no air. She scared me so many times. Once she had doctors rushing in and out of room they ended up putting this thing that forced air into her lungs it was really uncomfortable for her. Im scared for my daughter she was a premie when she was born at 7 month's. She uses her rescue inhaler way to much. I really wish she coukd speak up and really tell doctor everything

[d2read in reply to Nesiar78]

How old is your daughter now?

When I was young, I would put off going to the hospital until I would literally turn blue and be completely unable to speak from lack of oxygen — because I hated it so much. Back then — in the 1950s & ‘60s — it was common for doctors to not explain things to adult patients, much less children. So hospitals to me were terrifying torture chambers, where they would hold me down and hurt me. I would beg my mom not to make me go, determined to make my lungs do better, as I would get steadily worse.

That is not how doctors or hospitals operate anymore. If you do find a physician who doesn’t communicate well with you and your daughter, you need to find another doctor!

I know how challenging that can be! But you have to keep trying — and showing her by example how you conquer your fears to do things that scare you.

[Nesiar78 in reply to d2read]

Thank you well now she is 22. She recently was having an episode and she reached out to me in time for me to get her a babysitter and drive her to nearest hospital which is 30 min away. I wish i could trade lungs with her. I would.

[d2read in reply to Nesiar78]

At 22, and with a young child of her own, you might suggest a couple of things that might help her learn to control her breathing (which helps during an asthma attack, but also helps keep one calm if one is starting, so you can do what you need to do to get help).

The first is to learn a type of breathing that is somewhat counter-intuitive, called "pursed-lip breathing." Asthmatics and those with diseases like emphysema breath differently than other people. Our problem is in exhaling -- our respiratory muscles have trouble forcing out the carbon dioxide that builds up. Until our lungs can rid themselves of the CO2, there is little room for the new, oxygen-rich air we are trying to inhale.

It turns out that there are different muscle requirements, and it's really hard to teach someone a new way while they are already struggling to breathe. So it's helpful to learn, and practice, pursed-lip breathing whenever you are short-of-breath. There are lots of videos on YouTube -- here's a favorite from the American Lung Association: youtube.com/watch?v=7kpJ0Ql...(Not working as expected?).

I promise when you start this, you are going to think, "THIS is some special way of breathing? What a crock!" But there are actual differences in the biomechanical processes used in inhaling and exhaling. Doctors and physical therapists have tried explaining it to me at least half a dozen times and I still don't understand it -- BUT IT WORKS!

The second thing is to learn meditation and yoga. No matter where you live, there are probably people in the area who practice it and/or teach. If not, see if there are Zoom classes available that she (you both) can do in your own homes. It doesn't matter what her level of fitness is, there is a level of yoga appropriate. But she should discuss the appropriate TYPE of yoga for an asthmatic with her physician before starting.

If yoga isn't available, another excellent one -- in fact the one I am now doing -- is TaiChi, which is about slow movements and control. I am now disabled and have a lot of problems with balance, so this is something I can do in a chair and it gradually is helping me control those movements better.

I hope these help her (and you) deal with the asthma, and the stress, better. Good luck!