Frustrating visit to the dr regarding asthma. Dejected.

Tatooed Lady wrote:I have asthma. Had it since I was about 17. I also smoked from 16-26, now I really pay for it. I KNOW my breathing is restricted to some degree 100% of the time. Anxiety, allergens, weather and activity are 4 things that make it spike. During testing where I used one of those blowy things (cope with my girly terms please), I was told my breathing was fine. F.U. "Fine" for others maybe...but made me want to hit my inhaler. Which after use, made me blow like a Stihl leaf blower. But then I felt able to breathe without resistance. Problem being, inhalers give me the shakes. I HATE the feeling and only use them in emergency situations. Doc once told me that regular use will help build the muscle function or something. Yeah well...

Anyhow, apologies for the "oohhhhh, SHINY!" sidetrack. Basically it's a matter of YOU know your body best. Pay attention to triggers (smoke, pet hair, emotion, exercise etc)...then approach the doc with a better idea of what sets you off.

My reaction to the spirometry test was a lot like yours. After taking it, I needed to sit down because I was so light headed and had a very difficult time catching my breath.

Thanks for all of the replies. I'm going to try to find a plumonologist who takes my insurance for a second opinion.
I don't feel like I was being particularly insistent or out of line with my doctor. I do a lot of research before going into the Doctor's office because my health is of paramount importance to me, and I also find physiology extremely interesting. I generally really enjoy having conversations with doctors and I always maintain a dr/patient or even teacher/student relationship. I respect them a lot. This was a really strange experience that I've never had before. Even the receiving nurse was in a foul mood and mean to me from the jump, and she hasn't been before.

Interestingly, I learned last night that marijuana is a very effective bronchodilator. When I partake, I use a vaporizer so that no smoke is reaching my lungs. I had a eureka moment, because I've found that when I use marijuana and then exercise, especially doing cardio exercise, my normally shoddy cardiovascular endurance improves drastically. Unfortunately, marijuana is not medically available in my state, and I also wouldn't want to need to be high all the time just to bronchodilate.

tuzacat wrote: Two things seem to make it worse for me - dust and anxiety.

Omg...If dust set me off I'd be dead after the "hey, I'm gonna use a leaf blower to blow mouse nests out of the wall!" incident...damned men and their house cleaning shortcuts...

Tatooed Lady wrote:Omg...If dust set me off I'd be dead after the "hey, I'm gonna use a leaf blower to blow mouse nests out of the wall!" incident...damned men and their house cleaning shortcuts...

*raises eyebrow*

tuzacat wrote:Ryan, I have asthma - I don't wheeze and I don't cough. I feel tightness and heaviness in my chest and feel like I can't catch my breath. When I was first diagnosed I thought I was having heart problems. I'm a teacher and went to a workshop once before I was diagnosed about asthma and the nurse who was leading the workshop gave us all a straw and had us breathe through our mouths through the straw. She said that's what breathing feels like when you have asthma. It is a perfect discription of what happens to me when I am having an issue. Two things seem to make it worse for me - dust and anxiety. I would definitely get a second opinion. It couldn't hurt. Even if the opinion was the same as your current doctor's at least your would feel better about accepting it.

Plus 100!

I have been diagnosed with "mild" asthma... meaning that a few (maybe 6 or 7) times a year I get tightness in my chest. As soon as I take a puff of my inhaler it's gone.

Definitely get another opinion... I never had any tests... my doctor (GP) realized I was an adult and knew my own body... and gave me a script for an inhaler which alleviates the tightness. I do think Medicaid is the real culprit here which is such a stinkin' shame. Yeah... anxiety may be part of your problem but the tightness in your chest won't be alleviated by Lexapro!! You'll prob have to work really hard to see another doctor through Medicaid, but it just might be worth it.

LucyAnn1 wrote:

tuzacat wrote:Ryan, I have asthma - I don't wheeze and I don't cough. I feel tightness and heaviness in my chest and feel like I can't catch my breath. When I was first diagnosed I thought I was having heart problems. I'm a teacher and went to a workshop once before I was diagnosed about asthma and the nurse who was leading the workshop gave us all a straw and had us breathe through our mouths through the straw. She said that's what breathing feels like when you have asthma. It is a perfect discription of what happens to me when I am having an issue. Two things seem to make it worse for me - dust and anxiety. I would definitely get a second opinion. It couldn't hurt. Even if the opinion was the same as your current doctor's at least your would feel better about accepting it.

Plus 100!

I have been diagnosed with "mild" asthma... meaning that a few (maybe 6 or 7) times a year I get tightness in my chest. As soon as I take a puff of my inhaler it's gone.

Definitely get another opinion... I never had any tests... my doctor (GP) realized I was an adult and knew my own body... and gave me a script for an inhaler which alleviates the tightness. I do think Medicaid is the real culprit here which is such a stinkin' shame. Yeah... anxiety may be part of your problem but the tightness in your chest won't be alleviated by Lexapro!! You'll prob have to work really hard to see another doctor through Medicaid, but it just might be worth it.

Thanks, Lucy. The tightness in my chest and the shortness of breath that I experience is pretty consistent. I feel like I'm always breathing at about 70-80% of what I should/could be. Maybe it isn't asthma, then. I'm just frustrated because I'm pretty positive it has nothing to do with anxiety. It happens when I'm not anxious at all, which is most of the time. I take 2.5mg of lexapro daily now, which is an extremely small dosage and I have been for a while. I was just so frustrated and frankly kind of insulted to have it repeatedly suggested that my physical symptoms were attributed to psychological factors. It almost felt like my GP was saying "no, you're just making it up. it's all in your head." She doesn't even have any knowledge of the nature of my anxiety whatsoever, she isn't a psychiatrist and I've only seen her about anxiety once, when I was initially prescribed the lexapro in January.

Count me in as another person who rarely wheezes with asthma (only when it's REALLY bad) and my peak flows don't drop until I'm nearly dead. But despite this I have moderate to severe cough variant asthma. My triggers are fragrances (curse all you perfume and cologne wearers!) and smoke. Thank goodness it's not dust of I would be dead

I say find another pcp who will refer you for a pulmonary function test before assuming you don't have asthma. A competent pcp can handle asthma well enough, you probably don't need a pulmonogist. But I have my doubts about your pcp. And I'm quite sure there are asthma meds on your state's Medicaid formulary. Treating asthma is MUCH cheaper than chronic bronchitis and pneumonia despite the expensive meds.

you either trust your doctor or you don't. if you don't, find a new doctor immediately. see a pulmonologist, but be careful what you wish for. i have sleep apnea, asthma and copd (chronic bronchitis and emphysema). being tied to inhalers medically and financially is no fun.

Ryan,

Untreated asthma can be serious enough to kill. You need to see another Dr. Preferably a pulmonologist or allergy & asthma specialist. Your Dr is doing you a disservice by not at least giving you a rescue inhaler. I wish you better luck with your new Dr.

Jen

I was diagnosed with asthma when I was 19. Looking back, I had symptoms many years before, just didn't have the allergies back then that trigger me now. I am currently 42, so many years with asthma.

My main triggers for an actual asthma attack are a combination of allergies, cold dry air, hot humid air, and exercise. Combine any two, and I can produce an asthma attack. But only one, and I may have minor symptoms, but no gasping. Rarely ever any wheezing.

These are the symptoms I normally have:
I become "aware" of my breathing.
I run out of air in the middle of a sentence and have to pause in my talking to breathe again.
I get winded going up a flight of stairs (normally I do not).
Coughing - dry, different from a cold cough

I discovered a couple years ago that I can have an asthma cough without any other symptoms. For weeks on end. I coughed for 2 weeks straight, and my doctor prescribed cough syrup with codeine as I was coughing so bad that I could not keep my cpap mask on more than 5 minutes straight. And I was taking the cough syrup AND using cough drops at work to keep from coughing in front of customers. After a month break, the coughing starting up again and went 6 weeks. It was horrible. I finally figured out on my own that the cough was caused by a chemical spill in the car, and each round of coughing started after a longer roadtrip with more exposure to the poorly cleaned chemical spill. We recleaned the car, and I started taking allergy medication during road trips. No more coughing events.

I have two inhaler prescriptions. One is a daily inhaler - advair. This does help me noticeably as strangely, I can breathe through my nose better and keep my mouth closed more. And my peak flow is better (never close to normal, but better than without medication). My other inhaler is albuterol, and i only use it when I have an actual asthma attack, feel a difference in my breathing such as heavy feeling or running out of air, or when I have coughing that feels like asthma cough. I can usually tell right away if it helped. Then I may use it 2-3 times a day until that problem is gone.

I would definitely recommend a different doctor for another opinion. You may not have asthma, but it does sound like you have some type of breathing issue, and the doctor should be willing to consider options.

I agree with those suggesting that you get a second opinion. This is too important to be left to a single professional's opinion. It is also clear that this physician has lost credibility with you - even if he/she turns out to be right, it is in your best interest to get that second opinion.

Stop and be glad you didn't have a doctor who just gave you steroids (inhaler) and didn't bother to get the right diagnosis and see if you really had asthma. The lazy doctor easy thing to do might have been to give you an inhaler, ring the cash register and not worry about the side effects.

That doesn't mean the doctor is right or that you don't actually have asthma, but do realize that an inhaler is serious medicine, especially if you're going to be using it long term.

The question now is how to find out if you really do have asthma and what to do about your breathing problems.

archangle wrote:Stop and be glad you didn't have a doctor who just gave you steroids (inhaler) and didn't bother to get the right diagnosis and see if you really had asthma. The lazy doctor easy thing to do might have been to give you an inhaler, ring the cash register and not worry about the side effects. .

No, he just ignored the whole thing and prescribed more powerful anxiety meds..

"See the cup isn't empty, it has 2 tablespoons in it"

BlackSpinner wrote:

archangle wrote:Stop and be glad you didn't have a doctor who just gave you steroids (inhaler) and didn't bother to get the right diagnosis and see if you really had asthma. The lazy doctor easy thing to do might have been to give you an inhaler, ring the cash register and not worry about the side effects. .

No, he just ignored the whole thing and prescribed more powerful anxiety meds..

"See the cup isn't empty, it has 2 tablespoons in it"

So true. Like my old doctor who prescribed cough syrup with codeine (2 bottles) and then moved to a cough pill, but never determined the *cause* of the cough. I determined that myself later after 5 months of off and on coughing (more on than off) and repeated trips to the doctor. My new doctor told me that most non-cold, non serious lung issue cough is caused by allergies, asthma, gerd, or post nasal drip. Since you have all 4, let's get those under control, and you won't need a cough medicine. So much better now.

I was diagnosed with asthma quite awhile ago but hardly ever used an inhaler. I got to the point that I could not take a deep breathe without going into a coughing fit. After changing doctors, he had me see a respiratory specialist in house. My lung capacity was way under where I should be for someone my age and weight. So I was given a schedule and ended up using my inhaler every 2-3 hours a day and saw no improvement. My doctor told me to stop using the inhaler since it was doing no good. There are a lot of things that can cause breathing problems besides asthma. He first checked my heart and lungs. They were okay. Then came the sleep study and allergy testing which both came out with problems. So I am now on a AutoSv and can no longer eat lots of foods I normally took for granted. Best thing about it, my breathing capacity is gradually improving.

If you are not satisfied with the advice of your doctor, change doctors! I know you are limited in who you can see with your insurance so call around and see who is taking new patients on Medicaid.