Can asthma be difficult to diagnose?

[snailb]

I recently started having breathing difficulties and thought it could be asthma so I went to the doctor. After asking some questions, listened to my chest and doing a test to measure my breath he said I don't have asthma but I'm wondering if he could have made a mistake.

I get a tight chest sometimes for several hrs, making it difficult to breath deeply. Anytime I smell perfume, air freshener, bleach or cigarette smoke I start wheezing violently.

I use very few perfumed products in my own home because they give me eczema and strong cleaning products have always given me a head ache. When at home I am mostly okay but it is making it very difficult to do simple things like shopping and visiting friends houses. I can't even pass someone wearing perfume in the street without wheezing. Sometimes the reaction is mild and passes on it's own but at it's worst it goes on for a long time and my fingers start to go blue. I really want to find out what the problem is and get treatment but I'm a little unsure what to do next. Should I rule out asthma and move on to other explanations, or is asthma sometimes difficult to diagnose?  

[snailb]

Just thought I'd update this in case any of those who offered helpful comments were interested in the outcome. I finally received a proper diagnosis of asthma.  The doctor prescribed ventolin and Budesonide inhalers. I was so happy to receive treatment. Unfortunately it turns out I'm allergic to budesonide. The doctor says I can't take it any more. I'm hoping doctors will be able to work out an alternative long term treatment but at least I have the ventolin inhaler which is very helpful when I can't breath :).

[Tammy2009]

The best test is a methacholine challenge.  I would ask for a referral to do this test.  It basically tests the reactivity of your lungs to a substance (methacholine) that causes mild asthma attacks. You breathe in increasing concentrations and between doses you do a standard breathe test to measure your peak flow.  If you react under a certain concentrations, it is considered asthma and would also indicate the severity of the asthma.

[ChitChatNine]

Welcome to our Community.  Yes, it can be very difficult to diagnose from what I understand.

C~

[snailb]

At the emergency room I think the doctor thought that I had had a panic attack. But I was actually very calm, not at all anxious. I was having extreme difficulty breathing so I probably would have have been pretty scared if I was in another place but I thought "I'm in a hospital, what's the worst that can happen". By the time I saw the doctor had already been given medication and was breathing okay, just a bit out of breath. I have a good friend who has panic attacks so I know they are a very real thing and often cause breathlessness but in my case it's not triggered by anxiety or stress and I'm not panicy, or anxious while it is happening so I think it has to have another explanation.

The allergist didn't think it was caused by a panic attack but he also said it wasn't asthma. I think he based that on my lungs sounding healthy and also  the same test you are talking about where he measured my breath before and after breathing a medication. So now I'm wondering if the results are definite or if asthma is tricky to diagnose in some cases. There may be other health conditions with symptoms similar to asthma it just seems like asthma is the obvious answer, particularly because there is a history of it on both sides of my family.

[TonysGirl26]

Sounds like asthma or anxiety maybe a little of both. They need to actually do breathing tests on you!! I had to go through a long test where I had to blow and hold my breath and breathe in some stuff. It recorded my breathing.  Go see another dr.

[snailb]

Thanks for your concern and help. It was actually an allergist that I went to. He said that it wasn't asthma and he didn't think it was caused by allergies but I could come back and get allergy testing if I wanted to. I haven't seen a GP yet because there is a six week waiting list and I wanted to see a doctor quicker than that so I went to this allergist who is a private doctor. Seeing as so far he has been expensive and not very helpful I'm not sure if I should go back and get the allergy tests or just wait until I can see a GP.

I also went to the emergency room one night, the nurses thought it was an asthma attack and put me on a mask with oxygen which also had some kind of steam thing coming out. I started breathing easier quite quickly and by the time the doctor saw me I wasn't wheezing any more. He also said I didn't have asthma but I'm not sure if that is just because I was already better by the time I saw him. He said I have breathing problems because of sinus inflammation. I was diagnosed with rhinitis years ago which makes it harder to breath through my nose so that is probably what he was seeing but it doesn't make sense to me that it would cause wheezing in my chest.

[geminigirl1963]

Yes, it's very possible to have asthma and have your lungs/airways sound perfectly normal when you are not having an attack.

Was it a pulmonalogist that you saw or your family doctor?  If you haven't been seen by a pulmonologist, you may benefit by seeing one - they would be better able to decipher if you do have asthma and how best to treat it.  To me, it does sound like you're having asthma attacks.

It also sounds to me like your attacks are definitely allergy related, so getting your allergies under good control would probably make a big difference in your breathing issues.  Have you ever seen an allergist?  Again, if you haven't, you may benefit from also seeing one of those.  They may want to do some testing to determine exactly what you are allergic to and from there decide what the best meds/treatment will be.

I wish you the best of luck - having breathing trouble is definitely no fun!

[snailb]

Thank you so much for answering. If you are asthmatic is it possible for your lungs to sound fine between attacks?

[Caryopteris]

http://www.mayoclinic.com/health/asthma-and-acid-reflux/AN02116

[Caryopteris]

It sounds like you are having asthma attacks, but were not having one when the doctor listened to your lungs.  

http://www.mayoclinic.com/health/asthma/AS00003