hard to breathe

[digz]

I was diagnosed with asthma when I was 8 years old. I’ve never had any major asthma attacks and my asthma seem to only be exercise induced. All my life I’ve only ever used Ventolin to relive the chest tightness and shortness of breath.  
I’m male 31 years of age and consider my self quite healthy. I’ve been involved in physical activity since I was 15. I play a variety of team sports from time to time and I actively go to the gym - 3 days of weights and a couple of days of cardio.

About 10 years ago I experienced this slight shortness of breath and tightness in the chest, it was like I couldn’t really fill my completely with air. This feeling usually happened to me when I caught a cold or had the flu and would always disappear when I got better. However it didn’t, taking ventolin seemed to do nothing.

It didn’t have an effect on the physical aspect of my life and I didn’t really think about it. A few times though when I’d go to sleep I’d concentrate on the SOB and would get worried.  At times it would take a while for me to sleep because I would just think about it. Sometimes I’d wake up in the middle of the night gasping for air and my pulse would be racing.  

During the day it didn’t affect me at all, and still continued to be active; running and going to the gym. The shortness of breath and tightness seemed to disappear when I started exercising.  

I kept living with this and dismissed it as just my asthma.

In 2003 I went for a 3-day hike and was feeling on top of this world. When I got home a few days later I had a severe onset of SOB accompanied with chest pain. The pain is like a burning sensation that is predominantly on the right side and would sometimes travel to the left and radiate to the right shoulder blade.  I panicked because the pain didn’t disappear for a few days and I went to ER straight away.  I felt like an impending doom was about to come on.

At ER they did
Chest XRAY - normal
Blood tests - normal
Blood Gas test – normal

After that I went to see a respiratory specialist who also sent me to a lung clinic

Spiromitery – normal
Chest XRAY – normal
Wired me up, made me run tread mill and monitored my vitals – normal
Injected saline vapour into my breathing apparatus whilst running so I started to wheeze – I have asthma.

So left the doctors with no real explanation for this continual SOB but my asthma.

I was off work for 3 weeks and felt really down.  It took me a good 2 months to get my confidence to start excising again and when I did get back into shape I felt just like I did prior to this emergency episode.  Just the constant SOB that lessened when I exercised.

2 months ago I felt that my cardio fitness was declining and that after about 15 minutes of interval running on the treadmill I would feel chest pain like the one I described earlier. Burning pain in the right chest that would migrate to the left and then to the back. This time it was accompanied with what I think is more sever shortness of breath. I kept going to the gym and it kept happening so much so that I was too scared to do any more exercise.

I went to ER again and they did the following:
Chest XRAY – Normal
Pulse Oximeter – 100 percent oxygen sat
Gave me an array of asthma medications – SOB and chest pain was still there

Went to ER again after 2 weeks of feeling the same symptoms:
Chest XRay – normal
Pulse Oximeter – 100percent
Doc thought it might be GERD and gave me antacid with local anaesthetic – symptoms still there. Doctor advised to see respiratory specialist again and if lungs are ok he suspects it might be my stomach oesophagus etc and recommend that I see a Gastro doc.

Respiratory Specialist:
Spiromerty rest – same results as I got when I saw him in 2003 no decrease in lung function
Hi res CT scan – no abnormalities at all – told me my lungs are fine.
He told me to just bare with it and it should disappear.

Went back to my GP she did blood tests to see if I have H.pylori and to see what the chemistry is like – results came back normal. My GP then referred me to Gastro Specialist.

I saw the Gastro Specialist yesterday and he has scheduled a barium swallow XRAY and an Endosopy.  I really hope to find the answer soon.

My symptom’s are as follows

Breathlessness/chest tightness on exertion – climbing stairs or running for the bus.
Burning pain on right of chest that migrates to the left and to the back

Some times I have a slight wheeze on exhalation when I wake up in the morning that disappears when I take ventolin, but for the most part doctors cannot hear any thing in my lungs.

Stomach/diaphragm area feels bloated.
Sensation of swallowing in my chest.
Burping
Tightness in chest after eating.
Can feel pressure on my lungs when I sleep on my stomach.
Out of breath when speaking long conversations.


I’ve been reading on these forums of people having this long term SOB with no explanation. So many things are running through my head, is it COPD is it GERD related, do I have hiatus hernia. Do I worry a lot, do I have anxiety.
I’m confused, worried and frustrated. It just seems like my life had just turned 180 degrees.

Any thoughts?
Thanks for listening.

[digz]

Thank for your input, just had my primary test with the Gastro doctor. I had a barium study done and the conclusions we all normal. No apparent heital hernia. No acid reflux. Doctor does not think i need an endoscopy.

My symptoms are still with me. Ive been reading a bit about this hyperventilation syndrome and some of the symptoms fit the bill.
I will ask my doctor about this...what do you think the next step should be

[Victoireh]

My first impression is that It does sound like GERD is aggravating things. But if that comes out negative I would say then that it is anxiety related, with over breathing.

[Flattman]

My first thought would be to look more closely into the GERD possibility.  From the tests and results you describe, it seems your asthma is well-controlled (No Advair/Flovent/Controller meds?).

The morning wheeze you mention... I'm guessing it's a noise you can hear without hopping up and grabbing a stethoscope.  Those audible wheezes involve the upper airway, for example from inflammation.  I'd expect that kind of thing with reflux.

Anxiety can make a huge difference, as well.

I'm a respiratory therapist -- Gastroenterology isn't my strong suit, in other words, but I do encounter (and live with) enough reflux masquerading as asthma that I'm familiar with it.