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Old 05-14-2012, 08:00 PM   #1
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How do you tell if it's really asthma?

How do you tell the difference between asthma, a regular cough from being sick, and plain old-fashioned anxiety/neuroticism?

Today I had major coughing bouts every two hours or so, when I had a phone conversation, or talked to my husband, and when I cooked dinner for him. The cough was deep, long, impossible to stop until it decided to let up on its own, and felt very wheezy to me. And my chest hurt afterwards. Normally I'd use the inhaler if I felt like that and not think twice about it, but this was six times in one day! Since last week I'm on symbicort, ventolin, a cough pill, and levaquin. Shouldn't all that medication be preventing this? I'm having problems 2 to 4 hours after using the ventolin, and it's supposed to last 6-8. But if I'm sitting quietly at my computer I'm fine apart from the chest soreness. Does this sound like I need to take further action, or wait it out for a few more days? I don't want to be neurotic about it, but should I be worried?

 
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Old 05-14-2012, 08:33 PM   #2
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Re: How do you tell if it's really asthma?

Call your doctor and make an appointment. It might be time for a course of prednisone.

Ventolin SHOULD last more than 2 hours, but it doesn't always. When I am flaring, I use my inhaler every 5 hours. That's when it wears off, I could set my watch by it. And when I'm doing something that places extreme demands on the lungs, like winter sports, it only lasts about 2 hours.

 
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Old 05-14-2012, 08:40 PM   #3
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Re: How do you tell if it's really asthma?

During some of my worst times, like what you seem to be going through, I've actually asked my doctors that exact same question.

With asthma it can be a tough call. Sometimes it takes a doctor actually listening to your lungs to tell. I know when I get upper respiratory infections it can really exaspirate my asthma. When I find my asthma traeatment isn't working, I've gone in to the doctor more than once in a week. Not being able to breathe can be really really scary. Sometimes they will give me additional breathing treatments. Sometimes I've been put on Prednisone when the other asthma meds aren't getting things under control. One year when things were really bad, I went in repeatedly over a period of weeks and each time found out I'd caught something else on top of what I already had. (very unusual for me.) Eventually, I also ended up with a nebulizer at home as well.

Anyway, my doctor told me to come in as frequently as I needed to until I was better. It made me feel like I truly did have a problem that needed to be resolved and that I wasn't being a hypocondriac.

If you really do feel like the treatment isn't helping and you are continuing to have severe problems, by all means go see your doc again.

If you have an upper respiratory infection, the antibiotics sometimes take a bit to kick in. In the meantime, you do need to get your asthma under better control. Do you have an asthma action plan? If not, you might ask your doctor about getting one established. Asthma action plans can help you decide when it is time to take further actions. I've posted on them a couple times and will bump one of my old posts. There is also a lot of good information on them on the web.

Wishing you well,
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Old 05-14-2012, 08:49 PM   #4
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Re: How do you tell if it's really asthma?

I really really REALLY don't want to have to take prednisone. It scares me silly and I've told him before that he can't give it to me because of the side effects... but if I feel like this in the morning I'll call the doc again and make another appointment. I was going to wait until I finished the antibiotic and go back if I didn't feel better. Actually I was going to go see him after I WAS better because I've been sick way too much this year and I want to see if there's anything we can do about it, but that's not going to happen in a hurry.

 
Old 05-14-2012, 08:58 PM   #5
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Re: How do you tell if it's really asthma?

It really is a fine line sometimes deciding what to do.

Do you take the Symbicort regularly or were you put on it with your illness? It may be that you need to be on a long-term daily asthma med.

I know what you mean about the Prednisone. I've found that I do better on the lower dosages. It is the higher dosages that cause me the most problems with side effects.

If your breathing problems continue, it might be worthwile to see a Pulmonologist as well. You really do need an asthma action plan in place if you have an asthma diagnosis.
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Last edited by MountainReader; 05-14-2012 at 08:59 PM.

 
Old 05-14-2012, 09:37 PM   #6
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Re: How do you tell if it's really asthma?

Quote:
Originally Posted by Kajikit View Post
I really really REALLY don't want to have to take prednisone. It scares me silly and I've told him before that he can't give it to me because of the side effects... but if I feel like this in the morning I'll call the doc again and make another appointment. I was going to wait until I finished the antibiotic and go back if I didn't feel better. Actually I was going to go see him after I WAS better because I've been sick way too much this year and I want to see if there's anything we can do about it, but that's not going to happen in a hurry.
I'm having a horrible flare up right now that I'm dealing with... I didn't want the prednisone but after 3 - 4 ER visits I sucked it up and took it.

I started initially on a Medrol dosepack, which is 4mg tablets divided up across your day to reduce the side effects. BUT after having read a number of studies myself (note I'm no doctor), but I do understand double-blind studies etc, being a bit of science nerd. It is often better to take a single dose of Prednisone daily in the morning with breakfast. The human body produces most of it's own corticosteroids early in the morning, so that is the best time to supplement with Prednisone.

The Medrol dose pack didn't really work for me, so they stepped me up to 40mg / day, then up to 60mg. The thing about Prednisone is that you just have to keep yourself busy, doing something. Keep expending all your energy. If you sit around, it makes you feel nervous and jittery and is unnerving mentally.

I'm severely allergic to pollen (just started this season), but after being on the 60mg, I felt great, and could actually live normally / Asthma-free for the week I was on it. I'm tapering down now, which is another story, because they need to replace it with something else that will control my symptoms.

People always talk about the negative side effects of Prednisone, and don't get me wrong there are tons. But up to 3 weeks of 60mg Prednisone hasn't shown to really cause any permanent negative effects. There are the temporary effects, like nervousness, slight insomnia etc.

No one looks at the positive side effects: It lets you breath! Once you're on Prednisone, rest assured your Asthma WILL be controlled. It gets rid of that anxious feeling of almost having an attack etc. Some other positive effects: Gets rid of dandruff / hair loss (both overactive auto-immune functions of the body). I've had sciatica nerve pain for years, and after my first Prednisone burst, it is pretty much cured.

Here's my advice, suck it up, take the Prednisone. Ask for the Medrol Dosepack -- Which is actually MethylPreniSOlone a more active form of Prednisone, and actually has shown to have lower side effects.

After the dose pack you'll feel better and feel like you're Asthma is more controlled. Heck you may even be able to start reducing your Symbicort and other meds.

Ask your doc about Singulair as well. It is an Anti-leukotrine medication, just another mechanism of action to reduce inflammation in the lungs and is very very well tolerated in terms of side effects (basically none).
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Old 05-15-2012, 06:37 AM   #7
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Re: How do you tell if it's really asthma?

I think I might have just been having a horrible day... I took my ventolin at 11pm and I slept all night long for the first time in a week. I'm very encouraged.

 
Old 05-16-2012, 04:03 PM   #8
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Re: How do you tell if it's really asthma?

I still don't know how to tell whether it's really an asthma attack or just a panic attack. I had a short episode this afternoon that could have been either and I still don't know which (except that it resolved in moments when I used the inhaler, and it hasn't recurred, which suggests hyperventilation)... When are you justified in calling 911? I'd HATE for them to get there and to say 'sorry, I'm fine now...' and to have to explain to DH why I wasted money we don't have, while somebody who really needed help couldn't get it, but if I really WAS in serious trouble and I didn't call them, I could die in my own livingroom.
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Last edited by Kaji; 05-16-2012 at 04:11 PM.

 
Old 05-16-2012, 04:20 PM   #9
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Re: How do you tell if it's really asthma?

I was at my Pulmo today, and I just asked her this question. I also have mild anxiety because my Asthma is new...

If you use your inhaler and breathlessness goes away then its probably Asthma. If it doesn't then it's a panic attack.

For me when I get a panic attack, I feel it in my throat and like the back of my neck and inside my head. But Asthma I can definitely feel down in my lungs... The Asthma wheeze is characteristic of Asthma...

Buy a peakflow meter. Check your levels when you're normal, then if you're at least 80% of your normal then you're fine. If you go below that, then you know it's Asthma, in which case you would use your Albuterol. If 2 puffs don't help either then it's a bad attack. If your peak flows are normal while you're having this breathless feeling then it's probably a panic attack... If it happens a few times you'll learn to tell the difference between the two.

Low peak flow or FEV1 numbers mean there is actual restriction in your lungs. Normal numbers mean that you just have a feeling of shortness of breath and you're hyperventilating.

I've pretty much switched off my panic tendencies due to Asthma by learned to tell the difference. The peakflow is a good way to judge whats going on. I once actually caused myself to hyperventilate because I used my inhaler too much. Hyperventilation literally means getting too much air.
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Old 05-16-2012, 04:31 PM   #10
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Re: How do you tell if it's really asthma?

Thank you Kenanali! You're very reassuring. Can I just walk into Walgreens and buy a peak flow meter, or do I need to ask the doctor to prescribe one? It might help me to know if I'm really having problems, or just thinking myself into it. I've had major issues with anxiety and panic attacks in the past, and I pretty much resolved them by constantly reminding myself that it was all just in my head. My panic attacks usually involve feeling like my throat is closing and compulsive hiccupping, but I'm feeling major anxiety over this whole asthma thing. I feel like having a panic attack right this minute, and a double-dose of ventolin a few hours ago didn't help.

I'm afraid of people in Authority over me, and you can't get much more Authorative than doctors and hospitals and all that fun stuff... I have as little to do with any of them as possible.

I'm going to try to get in to see the doc tomorrow. I'm working myself into a frenzy over this whole thing.
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Old 05-16-2012, 04:40 PM   #11
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Re: How do you tell if it's really asthma?

If you look up the 'Microlife PF 100 Peak Flow Meter for Spirometry with FEV1', that's the one I have. I love it.

And it's $38...
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Old 05-17-2012, 08:50 AM   #12
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Re: How do you tell if it's really asthma?

Thanks. The reviews on it seem to be a little mixed...

I plucked my courage up in both hands and made a doctor's appointment for this afternoon so I can have him check my lungs again and talk to him about this asthma thing. I need him to give me some concrete guidelines to know when (and how much) I should be worrying. Just handing me prescriptions and saying 'take this' doesn't work for me. I'm going to drive myself around the bend with my anxiety, or else I'm going to ignore something that shouldn't have been ignored because I'm more afraid of wasting everyone's time than I am of what's really wrong, and wind up on the floor some place because I should have gone to the ER. It's a toss-up! But I'm feeling a lot better today. I did NOT need my ventolin all night long and I haven't used it yet this morning. I think the symbicort is finally working, or my lungs have improved immensely.
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Old 05-17-2012, 09:33 AM   #13
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Re: How do you tell if it's really asthma?

What you need is an asthma action plan. That is a written document that lays out what you do for every evenuality. You can do a search here for a sample one as Mountain Reader put together a beautiful one.

 
Old 05-17-2012, 09:49 AM   #14
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Re: How do you tell if it's really asthma?

I'm going to talk to him about it this afternoon. Even if it never happens again and it's just because I've had bronchitis, I can't handle the uncertainty...
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Old 05-17-2012, 02:59 PM   #15
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Re: How do you tell if it's really asthma?

Just got back from the doctors. I expected him to tell me I was a hypochondriac and I was having anxiety attacks when I thought my asthma was so bad this week. But that is NOT what I heard. He was very concerned... He wanted me to see a pulmonologist TODAY! Of course he couldn't find somebody to see me on that short notice, but he got me an appointment for Monday afternoon. In the meantime I'm ordered to stay put and do nothing. When I'm sitting quietly in a chair in my air-conditioned apartment my breathing is fine, but as soon as I open the front door and step out into the real world and put any kind of strain on them, my lungs start to fail. I got so dizzy when he was checking my lungs with his stethoscope the room spun. And the same thing happened when I was getting my chest x-ray this afternoon (he sent me off for one.) He doesn't even want me left alone until I've seen the specialist! This is sooooooooooo not what I wanted to hear that I wish I'd just stayed home.
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