and you have quite a good peak flow... BUT you are struggling to take deep breaths and feel tight and heavy chested
then how are doctors supposed to believe you and not think you are over reacting? if you called an ambulance and they listened to your chest and it was clear but you told them you were struggling, would they think you were fussing over nothing??
or would your OBS/SATS show something was wrong? (at least i think that is what they are called, the various things the monitor says about you like heart rate etc)
I don't really wheeze and my pf's stay pretty high.
When I was in trouble my sats were low - I think that's how they could tell. I wouldn't call an ambulance or go to A&E unless Ventolin was having no effect though. When things get bad I tend only to need to see my GP asap. I guess I am lucky.
I have similar. No wheeze, slight dip on peak flow and good saturations. When dr says this I tell them
I don't wheeze normally and ask them to assess air entry into the lungs. Usually this indicates how my lungs are coping. Plus extra work of breathing puts pulse, temp blood pressure and respirations up. So I ask if these are elevated..... Thankfully my last visit to a and e I had a wonderful dr who said ur one of those non wheezers before he even listened to me ... That comment was reassuring as I knew I had a dr who knew wot he was doing.
hi
It can be annoying when your symtoms don't look the norm. Sometimes i have a wheeze sometimes i don't but still have a full blown asthma attack. Sometimes thats evident by oxygen levels, high bp, resp rate etc.
Doctors also to learn to look at you physically and can see if your distressed. There are a few threads about asthma without awheeze on here. So your not alone.
Gill
gussypoo, what do u mean by ""access air entry"". how do they do that? xxx
The problem with asthma is there is no sure way to be 100% confident that it is asthma as the signs good be something else and as some of us are aware there are things that asthmatics are more likely to have for example hyperventilation syndrome and vocal cord dysfunction which can mimick the signs.
There are signs of resp distress but things like the elevated pulse and blood pressure can be just a side effect of salbutamol. SAT's usually decrease but in some chronic severe asthmatics it can stay high for a long time. Blood gases can be more accurate as will show the blood pH etc.
When I have an attack my SATS drop a little a first then pick up on nebs, but I retain CO2 and my lacate goes through the roof and air entry is decreased. I drop like a sack of spuds so at a moment notice can require ventilation.
Air entry can be measured by listening to ther chest. When I am having a severe attack the air entry is reduced due to the smaller airways closing down completely and in very late stages you can't hear the movement of air at all. Unfortunatly you cant listen to your own chest.
i dont wheeze either but i was diagnosed as a baby and have never wheezed
the reason i posted this is because a friend of mine doesnt wheeze as well and i rang an ambulance for her once and when the ambulance crew came, they listened to her chest and said it was clear with no wheeze or anything and asked her if she wanted to be taken to A & E for more tests, but they didnt insist on it as they told her she was fine. however i did not believe them as she was complaining of a heavy/tight chest and not beeing able to breathe properly, but she is the quiet kind who would never have said anything if she didnt feel it was serious.
i have never called an ambulance for myself, or been to a & e, but it made me scared of doing so, as i dont wheeze either and i hate to waste peoples time or to be told that there is nothing wrong
It is very hard for ambulance crews to work out if its asthma as if your not used to severe attacks the thought of ambulance alone can cause panic, not saying your friend panicied but they woulld leave anyone at home unless they felt it wasn't appropiate. Most asthmatics I went to I left at home if there breathing rate came down with instructions to call back if we are needed and follow up with GP/Asthma nurse.
Your friend if left at home observations were likely to be normal
Yes there is people out there that think all asthmatics wheeze in the ambulance crews are particually bad at this and your sats are fine so dont need O2.
yes this can be difficult and annoying, espically when your trying to get doctors to notice and take control of your asthma, same with me i struggle to breath all day, every day. but i dont wheeze. doctors always say my peak flow is good at 250 when is in fact is not as used to be 400.
if your struggling just keep on at them to sort it out as that is all you can do, that is what i am doing as none of my meds are working so trying to get a refferal, nebs or oxygen and stronger meds
Sinead, having oxygen at home wouldn't make any difference to your Asthma symptoms all it would do is bring your oxygen levels back up if they have dropped due to a severe Asthma attack or chronically severe asthma. Patients who need oxygen at home are very rare, rarer than those who have home nebulisers even. Nebs at home (as they have widely been discussed on here) are not the usual treatment until all treatment options have been exhausted and a plan is usually given by a consultant about its use and when to go into hospital if they are not helping as much as they should. Hopefully if you get referred they will be able to find a combination of treatment which gives you better control.
Wheeze is one asthma symptom of many, though it is the most common. Not everyone with Asthma will wheeze and not all wheezes are Asthma. As mentioned air entry, your oxygen saturations and other observations will help indicate how you are doing, please don't hesitate to see a doctor or call an ambulance if you are having an asthma attack and your blue inhaler isn't helping - poor symptoms over a good peakflow are more important to take notice of if you are not feeling well.
simi x
i knew that there were many on here that did not wheeze, but didnt realise there were that many!! thank you all for your wonderfully kind and helpful replies! i feel alot less alone and a lot more confident about calling for help if i ever need it if you guys can get it with no wheeze etc. then so can i!
hopefully i will not need to ever visit the a & e or hospital, as i have never done so so far and have had diagnosed asthma for a year and undiagnosed for at least 3 years before that. but there have been a couple of times when i rekcon i should have gone but held out with uncountable puffs of my blue inhaler instead. next time i reckon i wont waste it.
i just dont like to be the centre of attention and lately i have seen big notices on ambulances saying ""DO NOT WASTE OUR TIME"" and it has scared me
Hi Lizzie, breathing difficulties in general are considered a medical emergency, an Asthma attack is considered an acute difficulty in breathing. Paramedics would (or at least should) be much happier to assess a person whose symptoms aren't too bad than for that person to wait a long time for it to get much worse and difficult to treat. People call out ambulances for silly things, an Asthma attack not responding to salbutamol is not so silly now is it? And if its more your Asthma getting chronically worse then you could make an appointment with your GP.
I do have severe asthma and everyday i struggle to breath and feels like i am not getting enough oxygen as feel so weak, well i am not being allowded to feel this bad and struggle to breath everday and will make sure i get somthing to help and make sure my doctor does somthing as i am fighter and very stubborn
A hospital consultant can normally tell you the severity of your Asthma and just because you feel you are not getting enough oxygen in doesn't mean that is the case, from your profile it seems there are still different medications which you can try. People who might need home oxygen are assessed for it and have had a long history of severe Asthma attacks or other respiratory condition where oxygen levels have dropped very low or that they have chronically low oxygen levels which they can find by doing special blood tests called arterial blood gases or checking your oxygen saturations with a pulseoximeter. Like I said before oxygen wouldn't make any difference to your Asthma symptoms such as cough, wheeze, tight chest. Hope you do manage to get control of your Asthma.
I have oxygen 24/7 and home nebs as my regular daily medication :/
hi lizzie
i totally understand your concerns as i had the same problem, i was diognosed with asthma 2 years ago and i dont always wheeze when having an attack. On the last occasion i was stuggling to breathe and felt like i had a heavy weight pressing on my chest, but i had no wheezing. after 10 minutes of none of my inhalers working i called the ambulance. when they arrived they said it wasnt a asthma attack becouse of my chest was clear and then asked if i wanted to go to hospital which in turn scared me more as surely they should be telling me whether you should go or not!! But i chose to go as i was really struggling, they gave me a paper bag to breath into which calmed my symptoms a little then was put on the nebs for a couple of hours which seemed to do the trick!! i cant say if this treatment would work for your friend but the doctors at the hospital are much more informed and trained than most ambulance staff so its still worth the trip to a&e
Can I just add that Paper Bags must not be used to treat asthma attacks, ever! They are now not even used for Hyperventilation or panic attacts either!
Kate
i know i freaked when i heard the paper bag thing too!!
so if it was not an asthma attack- according to them - then what did they suggest it was?
You see that is my problem- i am shy and if they said: would you like to go to hospital? i would be like erhmm... no id rather not thank you.
nebs scare me. i have never had them! when you say a couple of hours of nebs, does that mean you get the nebuliser treatment for a whole two hours??? and how long does the average person on here take to feel better from them?
with nebs, it really depends on the person, sometimes 1 or 2 will sort me out, other times, it can take up to 3-4 hours to get attacks down again. By that time, I am usually exhausted and just want to have some sleep.
Don't worry too much about nebs, when the time comes (and touch wood it never does as it isn't always the most pleasant of feelings) the doctor will give you as much as he/she thinks you need at the time, but it really has to be stressed that these days home nebs arent a weapon of choice anymore.
is it like breathing in salbutamol constantly? does it taste nasty or can you not really tell?
thanks for your information everyone sooner or later i will probably have to experience it but hopefully no time soon! i guess i am really lucky i have never had an ambulance/been hospitalised considering how much i struggle! I am so glad i have all of you on here to talk to.
kind of, its like a really strong inhaler. Salbutamol isnt that unpleasant but ipratropium nebs, now that is a completely different animal, theyre nasty and taste awful, even when just propelled by air from my compressor.
s_lizzie, Hopefully you wont ever need nebs, but if you do please don't worry about it. I have always found them absolutely fine, and I get such good relief from them, much more than puffing away on the inhaler (that's my experience anyway). xx
angievere I am confident that if i do i will be ok nothing scares me more than not knowing what to expect- i think that is what i struggle with the most with asthma is that i dont know when its coming and when i am going to be feeling fine. i see people all the time being hospitalised for it and being about to go on step 3 i realise now that i am becoming one of the statistics and that sooner or later- if something drastic does not change, I will have to have neb treatment for an attack. maybe i wont of course, but all of it scares me. doctors scare me and hospitals more than anything. but educating myself on my condition seems to ease my fears a little and that is why i am on this forum i guess: to feel less alone and more in control
It's good to know what to expect if you are unlucky enough to end up in hospital.
However, I don't think that being on step 3 means you're always more likely to end up in hospital. It should mean that your asthma is better controlled, shouldn't it?
Also, are you going onto step 3 without having had spirometry/other tests? When I was being assessed as to why step 2 wasn't working I had these tests and part of it involved seeing the effect a nebuliser had.
gamba
did you really have all that?
well i told my gp that step two was not working so she told me to come back in two weeks and tell her if clenil was still not working well enough and she was add on something else (which i believe would put me on step 3)
however that was before xmas. i went on holiday etc and waiting for an updated HC1 form to come through the post for my free prescriptions. so by the time i see her again it wont be for another 2 weeks. and i am awake 2 nights a week with symptoms and take my blue inhaler a few times a week.
but never in all this did she mention anything about more tests? then again she has not given me a asthma plan or anything either so my hopes are not too high.
i desperately want my asthma under control and would rather not add on anything else, because i want to join the police. but i believe that the add on might help. It is very important that i do NOT end up in hospital for any asthma related thing so that i CAN join. *sigh* i am feeling down about it all...
sorry for the rant!
I did have all those tests but I guess it's because I was being properly diagnosed for the first time.
Being new to asthma is probably why I got the tests, but also I didn't want to take drugs without knowing what I was taking them for.
Different GPs have different approaches to asthma, but if it's affecting your life that much you probably deserve better info and understanding than you're getting,
Is there an asthma nurse at your practice? Or have you tried ringing Asthma UK?
so you got put on step 3 from the very beginning of your diagnosis? with me it is more a steady but gradual upping of medication
I got put on step 3 after step 1 and 2 didn't work. Step 2 for a couple of months. At that point the dr sent me for tests to confirm asthma and I went on step 3.
I was put on to Step 3 after having tests (spiro/exercise/abgs) and my first ever attack which landed me in hospital. I was about 18 at the time.
Hopefully by stepping you up a bit you may get better control of things soon.
xx
so basically everyone was obviously tested FOR asthma to start with with spirometries etc. but then before step 3 everything was repeated?
but surely, after all the meds in step 2, doctors ought to be sure that its asthma??
I only had the one set of diagnostic tests. I got put on step 1 for bad hayfever and when that didn't go away they tried step 2... It went on too long to be bad hayfever...
I was diagnosed by my symptoms, a personal and family history of atopy, a peak flow diary and a trial of treatment. I'm on step 4 and haven't had spirometry done, but I doubt it would show anything unless I was symptomatic anyway as reversibility testing doesn't show much if I am well.
this is getting really interesting
i was put through a blood test and spirometry from day one, before i was even given the brown inhaler. I was unsymptomatic on the day of the spyrometry test but it still showed a significant increase in the reversability test- enough to diagnose asthma i presume. Therefore i assume no more tests will be done before i go on step three.
it seems as though different GPs take completely different paths in diagnosing. I just think it is random that if they diagnose asthma without the tests in the beggining, that they should do so later on? what if they find you did not have it? its a bit late then after being on inhaled steroids for ages for something you dont have?
skip to page 17 of the pdf for diagnosis in adults
when diagnosing asthma in adults, the doctor will asses the likelihood of asthma by looking at a variety of factors suche as the pattern of symptoms, the patients medical history and take into account their family history. From this, they will decide on whether the probablility of asthma is high, intermediate or low. High probability patients skip straight to trial of treatment, response to treatment confirms diagnosis. Intermediate probability patients have further tests followed by a trial of treatment if tests indicate asthma. Low probability patients are tested for other inllnesses, but if these prove negative asthma may be reconsidered.
In my case, my symptoms fit asthma reasonably well, although I am a non-wheezer but I cough constantly instead and I have very high peak flows with my recent PB at 720L/min (I was told it's probably because I play woodwind instruments and used to swim a lot). I have a strong history of allergic illness and both my parents have some mild allergies. Wide variation in my peak flow diary indicated reversibility and a good response to salbutamol when symptomatic and a partial response to inhaled steroids confirmed the diagnosis. After that it was a case of adjusting my treatment to get good control which I did achieve until the first of this winter's cold snaps but that's another story. As for the reversibility test, it seemed to be a bit of an after thought and was performed after I'd got good control and when I wasn't symptomatic so I don't think it was really a good indicator of anything other than my good control at the time really, it was more to complete their paperwork.
Any of that any help?
yes thank you that makes it all clear. I have no background history of asthma so that makes sense. that was before i found out my father was not my biological father- so any family history is now forever out the window lol.
but it all makes a lot of sense now thank you
yeah lizzie is the same with me, there seems to be no history of asthma in my family that i know off, but then i dont know about my dad side, but ever since i was a baby i seem to be the only one in my family with it
i think im step 3 or 4 because i was on just a blue but then i needed brown stayed on that for 2-3 years then i needed additional treatment so they added a green but after 1 year that still was not working so they put me on singular which helps a bit but not much. i also have asthma that runs in my family and other atopic diseases so i was ok to diagnose it took awhile because i didn't wheeze but after having the blue inhaler for a month they relised ot helped so i was diagnosed with asthma now they are reffering me to the hospital for tests and things (i think thats step 4) so thats how they found and are trying to treat my asthma what i find weird though is that my attacks are mainly moderate or mild i don't seem to have attacks that require a nebulizer i used to be nebulised when i had breathing problems when i was a baby ...???
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