Diagnosed asthma but after 6 weeks pulmicort not working

[James D W]

I have almost the identical symptons as Clares, who posted the following in April (sorry I could not reply a comment & am  reposting).

>>Symptoms: Chest tightness (behind the breast bone, mainly in middle), shortness of breath for five months, (no wheeze). Often worse at rest than when excercising. - The symptoms are more or less constant and sometimes climax into a panic/asthma like attack.- ventolin brings no relief and can make me feel worse.<<

I would love to hear about your treatment/progress so far because we are symptons Twins. Can you comment back or email me @ ***@****? Thanks.

I have had difficulty in breathing for about 3 mos. It's pretty constant from when I awake and goes away at night. I tried to ignore it but after about 3 weeks it climaxed into my 1st panic/asthma like attack. My docs say I might have asthma. Chest xrays - clear, wheezing - none. Excercise does not worsen symptons. Just like Clares, PPI's, pulmicort and albuterol treatments do not make me feel substantially better. Although I dislike pills, xanax has made a big difference as an anxiety reducer, however I genuinely still feel short of breath so it can't be all mental. Just a note, I cough for about 2-3 mos after every cold for the last few years, and my difficulties began after latest cold. (stupidly played tennis in the rain while already sick!). Thank you very much for your comments, Regards James

[National Jewish]

In a person who has a normal chest x-ray and who doesn’t smoke the most common causes of cough are postnasal drip, chronic sinus problem, heartburn, and asthma.  A chronic cough can also be a side effect of a group of medicines used to treat high blood pressure called angiotensin converting enzyme (ACE) inhibitors.

Generally a cough caused by a cold lasts for several weeks.  Even though the cold is gone, sometimes the cough lingers for 3 to 6 months because the cold has caused inflammation of the airways of the lungs.  This inflammation is similar to the way asthma effects the airways of the lungs.  However the inflammation from the cold, and the cough along with it, will eventually go away without treatment.  When this inflammation is treated with an inhaled steroid, like Pulmicort Turbuhaler® (budesonide inhalation powder) that is used to treat asthma, it often clears more quickly.

Inflammation of the airways of the lungs could also be due to an allergy or ongoing exposure to an irritant, such as pollution or smoke.  Antihistamines should help if allergy is the cause.  Also some people start to have problems with asthma only after having a lung infection, especially when the infection is severe.  Often a cold can cause problems in the airways of the lungs.  The infection can lead to an increased airway irritability or hyperreactivity, which is often diagnosed as asthma.  If the irritability subsides, then the cough will go away over time.  If the irritability is just the triggering of ongoing asthma, then the symptoms will continue and ongoing treatment will be needed.

With asthma the basic problem is chronic inflammation along with tightness in the airways of the lungs.  This inflammation increases the sensitivity of the airways to a variety of things that make asthma worse.  These asthma triggers vary from person to person.  For some people infections cause more asthma symptoms, but for other people infections do not cause asthma symptoms at all.  Exercise is a common trigger.  Also asthma tends to be worse during the night.  Wheezing is the most common symptom.  However some people only cough.  Since your cough is continuing and is not being helped by asthma medicines you may want to see a pulmonologist.  This is the type of specialist to identify if a lung problem is the cause of your ongoing cough.

Diaphragmatic breathing can help you move more air in and out of your lungs.  This is the most efficient way to breathe and may improve your shortness of breath.  Learning this technique will help you to breathe slowly, regularly, gently, and smoothly all of the time.  Here are the instructions:
• Breathe in slowly and deeply through your nose.
• While you breathe in, count 1, 2 and push your stomach out.
• Place your hand on your stomach so you can feel your stomach going out.  This promotes the use of your diaphragm and your lower respiratory muscles.
• Breathe out slowly and deeply through your mouth.  Imagine that you are breathing out through a straw by “pursing” your lips.
• While you slowly breathe out all the way, count 1, 2, 3, 4 and let your stomach relax.  You can feel your stomach going in with your hand.
You often can get help with this type of breathing by taking an introductory yoga class or checking out a videotape on yoga that focuses on breathing and relaxation.