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ASTHMA

My pulmonologist said I might have some "underlying asthma" but didn't say for sure. Does anyone know what this might mean. I forgot to ask him. Stupid, I know. THanks.
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144586 tn?1284666164
Tammy2009 gave you great advice. You really need as pulmonary consult and the tests she suggested.
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1 Comments
I was seeing a pulmonologist at the time i posted the comments and I still am seeing him
746512 tn?1388807580
You can do the peak flow as often as you would like ;). I played with it a lot when I first got mine, and when I start to get a cold I will actually use it as often as every couple hours to keep track of symptoms.  

Methacholine challenge is the gold star and is a little more sensitive to asthma than just a basic pft - gives your doctor more information on the severity of the asthma.  Might be worth getting done for you.  

No way - we like questions!! :)
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Avatar universal
Oh and I forgot to mention in my first post that I did have a PFT but not a methacholine challenge test.
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Avatar universal
Ok. I am going to purchase a peak flow meter from walgreens tonight. How often should I use and record the results?  Morning and night, or three times a day? Microlife PF100 Digital Peak Flow & FEV1 Meter is one I found. Is that a decent one? I promise after this I won't badger you with any more questions. Thanks so much for taking time to assist me.
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746512 tn?1388807580
The reflux can cause airway irritation and definitely allergies and sinusitis (I have it too) wont help.

I tried singulair - did absolutely nothing for me, BUT it has lactose in it which is one of my allergies so .....

Ventolin is good to keep around in case of flare ups, you may find you have more problems during a cold, high allergen exposure or if your reflux flares up.  

Symbicort is a dual action drug and is a little bit of over kill I think for "a little bit of asthma" - I don't think you little the long acting bronchodilator.  You still may need an inhaled steroid but they should not give you the heart related side effects.  

With the related allergies I would talk to your doctor about trying the singulair - it may be enough to control your symptoms.  I would also buy a peak flow meter to monitor your lung flow at home (about $30CDN), helps you monitor at home.

Hope that helps!
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Avatar universal
Thanks for the reply. I never had an asthma attack. I just get a nagging cough and I sometimes feel short of breath when talking only. I think he meant "underlying" meaning I only barely show symptoms of asthma on a PFT but never had an attack. I do very difficult exercise and I doesn't seem hard at all. My breathing seems difficult only sometimes and I will cough up very clear mucus when I feel like this. I have chronic sinusitis and an allergy to two types of dust mites. I also have reflux that was found on an Upper GI. It could be the reflux or the dust mites I guess. Do you take anything like singulair? The pulmonologist gave me ventolin and then he gave me Symbicort 80/4.5. I only used it for a week because it raised my resting heart rate. I have had episodes of Ventricular tachycardia so I am afraid to use the symbicort. I wonder if Singulair will help?
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746512 tn?1388807580
You need to ask for full pulmonary function tests - including a methacholine challenge test.  This gives a much better idea how your lungs behave and whether or not asthma is the correct diagnosis.

Another way is to give asthma meds a trial run and see if they help your symptoms - if they greatly help, it is probably asthma.  If they do nothing - need to look into something else.  

I disagree with banshee86 - there is a large spectrum of severity in asthma and something is it not clear.  If you are able to identify and stay away from your triggers, the symptoms are gone (might even be able to stop all medication) and thus "normal", well what if you don't know your triggers and unintentionally are removed from it for the time being?  Then any lung function tests you do will be negative and thus "no asthma" - bring back the trigger (lets say you bring home a cat), symptoms come back but doctor assumes no asthma because the tests were negative .... If the tests are redone at this time - the results, conclusions and diagnosis will be completely different.

I had this personally happen to me.  I also did the methacholine challenge because I wasn't responding great to high levels of inhaled steroids and prednisone for a few severe attacks.  It came back completely normal - no asthma.  wtf?  I was advair, ventolin, atrovent, singulair, antihistamines you name it. I was starting to get my allergies under control so I was still getting symptoms from the leftover inflammation and gunk left in my lungs but the typical "asthma twitchiness" wasn't there.  This led the pulmonalogist to say I didn't have asthma.  He left me with my ventolin prescription and lots of refills, few refills for the advair inhaler but said to try and reduce it.  I panicked - There had been a few very severe attacks that year, what do you mean I don't have asthma?  It took me about 2 months to mentally be ready to slowly stop the meds but I did and the symptoms did not come back ...  right away.  I was good for the next allergy season (did have to use ventolin a lot but it was apparently a little good year for mould).

Then last year I switched jobs and moved 45 minutes south to a small town - now I'm back on inhaled steroids because the asthma came back.  It is definitely snow mould that is triggering it, my old job I was inside for 8 hours so could handle the time at home but now I'm driving around, in and out of my car so more exposed and its much worse.

I had gone through months where I had needed 3-4 asthma meds and times where I am on nothing.  I have been told I have severe persistent asthma, mild asthma, no asthma, reactive airway syndrome etc.  Just depends when the doctor saw me and where I was in figuring out my allergies.  My food allergies were the worse - especially since lactose is one of the worst, I wonder why prednisone would help for 2 days and then I would plateau only I finished the taper and THEN finish improving? Because the stupid thing had lactose in it!

Asthma can change from time to time when it is triggered greatly by allergies and can be hard to diagnosis if the doctor only sees you during those symptom free periods.  You can buy a peak flow meter from the pharmacist and track the changes yourself -greatly than 20% difference morning to night or greater than 20-30% change at any one time can indicate asthma.  It would help your doctor greatly it you could track it 2-3 times a day for a couple of weeks and then bring it back to show them.  

I know that was long and I'm sorry - just been in that situation a long time ago, many things I went through would for you to not have to.  Listen to your body and your gut instinct if you don't think something is right.  I tried to have a doctor tell me my breathing was not bad because my peak flow was over 200 - hello!  if it was under 200 it would be under 40% of my personal best and I would probably be in the ER not your walk in clinic.  I wasn't even wheezing anymore at that point - which is not good during an acute attack.  Lots of learning - read as much as you can.  

Please let us know how it goes and when you have further questions.
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10610562 tn?1411418414
That is a very bare bones diagnosis. I suggest going to another doctor if you can. As a 29 year asthma patient since birth, I can say you either have it or you don't. There really is not much of an underlying, or in between. Have you had your allergies tested, could be a reaction to something.A smoker maybe?
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