Hi, I've posted a few threads in here recently.... Newly dx'd with reactive asthma but that was from Gp's who did not run tests so I am seeing a pulmonologist on july 10 to have tests ran to confirm diagnosis and get meds right.
I do believe it's asthma based in symptoms too, etc...
For those of you who have been to a pulmonologist....
What tests will they run on me? What tests should they run to know 100% if I do or do not have asthma? Also, if it's not asthma and is something else instead such as COPD, how can they tell the difference? Any info would be great since I'm going soon and would like to know which tests they should for sure run/what to expect....
ps.. Are any of these tests painful/risky? I have to take a cab alone to my visit which is no fun but ya gotta do whatcha gotta do I guess.

Thanks again!!!

My asthma was diagnosed with spirometry. The test is very simple and quick. You basically take a deep breath and blow as forcefully as you can into the machine for as long as you can. The machine is basically measuring the amount of air you are moving with time. Then, you take a huff of albuterol (or other beta-2 agonist inhaler) wait 10-15 minutes for its effects to kick in and repeat the spirometry.

There are many parameters that can be determined from a spirometry plot, but if you show an improvement in peak flow and FEV (forced expiratory volume) of more than 10-15% that right there is fairly diagnostic for asthma. There are other tests (such as the "methacholine challenge") but I believe spirometry is now the standard. The nursing staff should give you some instructions about laying off the albuterol for at least several hours prior to the test. The key is your response to albuterol, so if you use it too close to the start of the test, the results will be invalid.

Knight Who Says Ni !

oh Joy..... I had miss my doc apt.

That kind of sucks but the last 4 days I have been feeling about 95% normal again (thank God) and have started backing off my steriod inhaler (for 2 days now). Hav not had to use my albuterol either.

Just a note;

Not sure if this would be of any importance to anyone......
Buuuutt.... I noticed my albuterol inhaler not kicking in as fast as it did when I 1st started taking it (probably cause i over used it out of fear of an attack)...
Anyway, I ended up getting a different inhaler called xoponex (spelling?). It's levalbuterol which is the exact same as albuterol but it does NOT have the extra (un-needed) stuff in it that makes you shake like crazy and your heart race, etc... I had taken this in a nebulizer for a week once but what a pain to lug that around every time you needed it.

This xoponex inhaler is great!!!

Anyway, the thing I have noticed which is weird cause I read they are the same thing is that when the albuterol seems to lose it's effectiveness with me, I switch to the levalbuterol (xoponex) for a while and it works great, then when it stops working as good, I switch back to the albuterol and it works as good as it did when I started for a while.
Anyone else have both inhalers and do this?
You notice a difference like this?

I think my asthma might be subsiding (thank God!). This was my 1st asthma attack and it was chemical induced (exposed to bleach fumes in enclosed area for too long) so maybe this will be a one time thing, maybe not. I STILL can't smoke a cigarette w/o having at least a mild asthma attack.
In a way, I'm glad cause I'm being forced to stop smoking like it or not and I could not do it any other way, it's just too addictive.

The good thing about missing my doc apt this time is that I had decided I wanted to go to an allergist instead since I was starting to feel clear/better.

Thanks for the info though!!!! If my asthma comes back - I'll be running to the pulmonologist!!

I hate to tell you this but,as an adult, if you have asthma, it never goes away. It may get better but it will never be cured. Get to the pulmonologist, get tested and get on an appropriate regimen of a daily prevental (your steroid inhaler) and a rescue inhaler (albuterol, etc). Asthma can be fatal. Don't mess around.

Hi t_panic411,

Thanks for info on your experience w/xoponex.
I am going to give that a try (I could do w/out the side effects of Albuterol)

What tests will they run on me?

1. Spirometry Test (you blow through an air hose) which measures how quickly air can be expelled from the lungs before & after Bronchodilator.

Or

2. Extensive Lung function Tests (measures static lung functions, Diffusion Capacities, & Flow Rates) which includes:
************A. Plethysmography - You sit in an airtight box breathing in/out through an air hose with & without resistance to calculate air volumes in the lung.
************B. Gas dilution technique - you are connected to a spirometer w/ a volume of inert gas (ex Helium) and you breath it in through the air hose.
um) and you breath it in through the tube/hose

What tests should they run to know 100% if I do or do not have asthma?
I believe its the Spirometry Test.
In my case,
One Pulmonist did just the Spirometry Test for diagnosis.
While another Pulmonist was more complete and did the Spirometry test & the above Plethysmography Test for diagnosis.


Also, if it's not asthma and is something else instead such as COPD, how can they tell the difference?
Also with a Spirometry test. Bronchodilators (drugs that cause the airway to dilate) are usually added to confirm the diagnosis. If the test result does not show improvement with bronchodilators, then COPD is very likely.

My research came up with the following:
COPD & asthma are different but cause similar symptoms
1. COPD causes permanent damage to the airways. The obstruction is 'fixed'/ irreversible. Persistent lung disease with features of airway narrowing. Chronic obstructive pulmonary disease (COPD) describes a group of diseases that cause progressive damage to your lungs. These diseases include chronic bronchitis and emphysema.


2. In Asthma airway narrowing is intermittent and reverses quite easily with medication. With Chronic Asthma inflammation that is not properly treated properly you can get airway remodeling (I believe this means lung damage/scarring)

**People with COPD can have an Asthmatic component
**People with Asthma can have an COPD component.


What are the treatments ?
Anti Inflammatories, Bronchodilators, etc.

Are any of these tests painful/risky
No

I've been off the steroid inhalerand only used my xopenex inhaler once since last time I wrote here......

One of you wrote that adult asthma never goes away (as in 100% heals) and even if you don't have an attack you still have asthma... You could be right for all I know...... It's spooky to think that but who knows.... So far I have been doing very well breathing wise. As if I never had the attack... So, maybe (i hope) because mine was brought on due to over-exposure to bleach fumes and some other bad irritants within a 24 hour period.
I have (in the last 2 weeks) been around (for short periods) all of these things that 1st caused me to have an attack before and I've been fine. Even cigarette smoke has not caused me to have an attack - I still can't stand to smell it now though so, no way will I start back smoking..... besides, that for sure would be pushing it!
I have since all of this had one Doctor tell me that he thought I just had "chemical pneumonia" -whatever that is... But he said you would treat it with steriods because it causes inflamation in the lung but it not becterial or a virus... sheeshhhh!!! The medical world is a never ending pain in the rear!
Anyway, I will never be without my steriod & xopenex inhalers (JUST IN CASE I need to start back up) cause ya never know when this stuff will hit ya! Better safe than sorry....
So, how is everyone?
I wish all of you great health and happiness!

t panic 411,

Just when I thought I was cured of astma, I had an attack. Maybe mine is getting worse with time, I don't know but, be careful. Are you on a daily preventer medication?

I have asthma attacks from laughing, humidity, approaching storms, outdoor pollens, cleaning solvents, viruses, and more. This is insane. I am on a daily preventer med (pulmicort) and I'm still using albuterol. I didn't have any trouble for about 6 months and then all of a sudden things went downhill quick.

Be careful, be sure to see a good lung doctor.

good news - i went to the pulmonologist at last.....
bad news - I have asthma. He said is mild asthma.
My numbers were a little lower than they should have been which is weird cause I was breathing fine that day and had been for a few weeks. I blew like crazy on that machine and still got slightly low numbers some how. I guess that machine really can tell even if you're a good breathing day and feel fine.
I forget the machine/test name. You have to breathe in and out deep and then a few long breaths into a big machine. Then do it all over again after you take 2 puffs of albuterol.
Right now, he's not 100% sure if it's due to allergies or to acid reflux/gurd or what ever it's called... So, we're trying singulair for a little while then doing the breathing test again to see if numbers are better. If not then we're trying nexium for a while and do the test again till he knows for sure what exactly is causing my asthma.
I still have not needed my qvar or any steroid inhalers (thank God) but I still have all the inhalers as back-up just in case.
I REALLY hope this is all due to gerd instead of anything else cause I can change a few things to help with that a lot.
It's soooooo weird how gerd of all things can cause asthma. I had no idea! But he's a lung doc and he said that the acids can get into the lungs at night when we're sleeping from the reflux and the irritation from it causes asthma in some people. Treat the gerd and the asthma goes away (if that's the only cause of a persons asthma).
I'll be seeing the allergy doc next week to see if any of this is allergy related. I can almost bet it is just because I seem to feel worse when there is high pollen, very hot, dry days yet seems to feel better when it rains or when it's wet out.

I have almost the same problem. My specialist said that I may have mild asthma. I already did an allergy test; it wasn't the nicest thing to do. After the test was complete, I was negative down the line. My specialist wants me to have an X-Ray and blood work done. He isn't sure what is causing my asthma symptoms. I have not been diagnosed yet. He wants the X-Rays done to see if it is GERD and the blood test done to see if I have some kind of virus. Anyways, what would happen if those tests come up negative? Should I ask him to perform a methacholine challenge?
I’m on Advair and it is helping quite a bit, but every now and then I get flair-ups. They are not as bad as before using the Adviar.

IF YOU DO NOT THINK YOU HAVE ASTHMA...see a pulmonologist and ask for a Methacholine Challenge Test.

After many years of asthma meds...my meds run almost $30,000 a year, my really wonderful Allergy Dr. ordered me to go find a pulmonologist. I did.

I appear to have Vocal Cord Dysfunction (VCD). It is often misdiagnosed, so see the specialists if you don't seem to fit any of the criteria. I hope to be cured and if I still have some asthma, it will hopefully be a minor amount.

VCD? Basically, during an attack...my vocal cords close when I try to breathe. Yours open, mine close. I am trying to breathe thru a very small straw. The real scary thing is ....when you realize an attack is happening, you have already exhaled and cannot seem to inhale. It will rock your world if it happens to you. I fell on my face trying to reach my oxygen 15 feet away.

Asthma? Maybe. Consider finding out for sure with a PFT, PST, Meth. test,
and so on. Don't waste years stuffing meds in your body like I did.

Good Luck.....

PS...I do NOT mean to imply YOU have VCD, but there are other very rare conditions you might have. Find out!!

Thanks for the info on VCD... I'd never heard of that one!