What to make of this

[infoseeker65]

Summary..... 45y.o. female who has only had 2 severe "asthma" attacks in my life, both related to cat allergy.  This past spring I was having chest tightness, SOB, and reduced exercise tolerance in response to pollen.  Went for a PFT......

FVC 109% (pre and post), FEV1 109%(pre)-112%(post)   FEV!/FVC 83%(pre) 86%(post)  So far normal.

Here's the kicker...FEF 25-75 shows a 15% increase post albuterol, and MVV goes from 111%-125% (12%).

I also felt better after the nebulizer.

The interpretation reads: No response to bronchodilator except in small airways- significance undetermined.  The recommendation was to use a rescue inhaler as needed.

2 things come to my mind.... I'm at about 85% FEV1/FVC  isn't that borderline for asthma?  I also responded positively to bronchodilation  even if it went from technically good to very good.

The pulmonologist felt that because it's so sporadic that he didn't want to label it to fast as asthma.  Does this sound reasonable?

I'm an avid scuba diver and I'm mainly trying to stay safe about it.  I'm not giving up diving!

[Seedamin]

I am new to this site and I found your post very interesting. I have recently developed very similar symtoms. Chest tightness, coughing (clear), chest pain. Was at the allergist with my son and decided to have her run some tests on me. My breathing tests came in initally at 77%. Chest X-ray was clear.  The scrtach tests showed pretty strong allergies to trees, weeds, molds and grasses. Some of those are pretty high in my area right now. Had a lot of congestion at first, so they put me on some antiboitics and Prednisone for 10 days. Also prescribed Clariton (OTC), Ventilin, Symbacort, Nasonex and Singulair all of which I am still taking. This has been going on for about 2.5 months now but has gotten a little better each week. The bad "attacks" are rare now. I was getting severe chest itghtness and pain on the left side of my chest when I coughed. Tightness is pretty much gone, but I still get a pain on the left side of my chest when I cough. The strange part for me is that I have havent had any problems since I was 20 (40 now) and that was bronchititus for a few weeks. I smoked for 15 years and quit 8 years ago. This just hit me out of no-where and hit me pretty hard. Its been about a month on the meds and my breathing tests are coming back at 88% now. I am a pretty active person. Run regularly, martial arts, and some weight training. Not sure what to make of this. Seems odd that it came on so suddenly.

[marieann288]

Many people can take Formoterol. I cannot. I tried it and noticed that I was having problems walking any distance. I went to a Saturday Garage sale with my husband and it took me forever to walk up the driveway. I was just out of breath and felt awful. Later in the week, I walked down a neighbours drive and went into tachicardia and ended up at the doctors. He sent me to the cardioligst and said NEVER to take that type of long acting asthma med again.  I keep the puffer to remind me of what it is. Also before I tried that one there was the purple disk one I tried I didn't like either and my doctor thought it was my imagination, but i quit anyways. It also had the long acting ventalin type med in it. Not my imagination according to the specialist.

For me Singulair is the best, but other wise the use of anti histamines and the brown puffer with the blue puffer when needed.Never had any heart problems with the blue puffer.

[marieann288]

I could never get a 100% positve diagnosis of asthma... but it has always been suspect. I can blow a peak flow better than most fully healthy people. It was not until I moved to the UK and was given singulair and my symptoms went away that I was told that giving the meds and having the symptoms go away was diagnostic in itself. That medication would not have worked if I did not have asthma. As I get older I realize I do indeed have asthma, but I find it hard to control because I am in a constant state of denial! I went for a specialist for a different issue and at the end of the conversation (i'm back in Canada and my 'coughing' has started up again) she told me I had uncontroled asthma.

[infoseeker65]

Thanks for all your responses.  I know it's safe to dive if I have normal post exercise PFT (which I haven't been tested for) and have not needed to use a rescue inhaler for stress or exercise induced episodes (which I haven't).  I guess I'm lucky since so far my only problems have been allergy related.

Thanks for the info on the formoterol.  I'll file that one away if I need it.

Well off to Fiji next month for some of the best diving in the world.  I'm looking forward to the RNR and the beautiful reefs.

[caregiver222]

It's nice to say "I'm not giving up diving", but you may have to choose between diving and death.  In death, for the next billion years you can dream about diving.

The bright side is, I am not convinced you have to make that choice.

Let's forget about terms such as "asthma", for a moment.

You are experiencing sudden onset shortness of breath, which grows worse (you haven't experienced where it may go) and it is relieved by albuterol sulfate.

I am not an expert on the course of this disorder, but I do know for sure it can be unpredictable. Very unpredictable. And these lab tests cannot tell you where things may go.

And the time to discover about that unpredictability is not when you are underwater, and have to wait before coming up to prevent nitrogen build up.

The use of a rescue inhaler "before scuba diving" is not the best idea. Not the worst, but if you must go diving, as a matter of life or death, for might try the dreaded oral prednisone. I would discourage the use of oral steroids under most circumstances.  If you are only diving for week of the year it is one thing. If you are diving every week, it's another.

I think you have to worry more about how you feel than the numbers on a test.

If you use albuterol sulfate remember it has a relatively short-half life. If you use it it may wear off.

If you are really insistent about cheating death I would suggest you have your physician prescribe formoterol fumarate inhalation powder. It is sold as the "foradil aerolizer".

It is long acting, and an alternative to oral steroids.  It should settle down your lungs for a good three to four hours after use.

[allmymarbles]

Just stick with the rescue inhaler. Use it when you have an attack and use it before you go scuba diving.