I have asthma?

[livingwithcfids]

Today, I visited my local Allergy & Immunologist with hopes of finding new answers. I brought my CFS labs, and she told me they were of no clinical significance

Anways, she asked whether I ever had shortness of breath and I said on rare occasions, yes. A few minutes later her nurse brought in a spirometer to measure my lung function, then I inhaled a medication that would dialate my bronchioles.

Here is how I performed:
before medication

Parameter
FEV1[L] 73 %Pred
(suppose to be >80)


FEF25-75[L/s] 62 %Pred
(suppose to be >80)



after medication

Parameter %Pred
FEV1[L] 110 %Pred
(suppose to be >80)


FEF25-75[L/s] 136 %Pred
(suppose to be >80)



So she said that if after the medication, these initial scores increased by 12 points then I would have asthma (obstruction) and as you can see they increased by 36 and 74 points, respectively.
I was given two inhalers

 

[mellster]

These tests are highly dependent on the cooperation and general well-being of the individual. Usually you are used to the spirometer the 2nd time and less timid about using it. It depends on how much force you (want to) put in and how good your overall technique is. But that seems like a too big difference/improvement to ignore.

 

[*GG*]

Can't those inhaler have some seriious side effects? you might want to investigate that aspect.

GG

 

[WillowJ]

having a treatable disease could improve your functioning. Do you ever wheeze, or get coughing fits? If so and if the medicine helps these, or if it helps you breathe better, that would help you know it was a good diagnosis.

is one of the inhalers a preventative medicine?

 

[livingwithcfids]

She put me on a brand called ProAir HFA (albuterol sulfate) http://en.wikipedia.org/wiki/Salbutamol
I am not sure if it is preventative medicine, she just said when I feel shortness of breath to use the inhaler. Maybe Mellster is right-- ill get a second opinion. ggingues, yes this one has a handful of side effects including tachycardia, arrhythmia, flushing, myocardial ischemia, and disturbances of sleep and behaviour. Its a catch 22. Willow, I dont wheeze or get caughing fits, just S.O.B. I'm not sure if asthma comes with the CFIDS territory but if sure feels that way in my case. Maybe I can try something natural to see if it helps with relief of bronchospasm first, then try the inhaler...

 

[Valentijn]

It's certainly possible to have both Asthma and M.E.!

In my case, I probably had M.E. but got diagnosed with asthma. I did the methacholine challenge, and was so exhausted near the end of it that I was probably doing poorly due to exhaustion rather than asthma. I only felt crappy after exercising, after exposure to nasty chemicals, and when sick (and usually got sick after exercise - sounds familiar), so I got diagnosed with exercise induced asthma.

When I did have periods of breathlessness/light-headedness, the asthma meds never worked at all. Probably because it was mild or pre-M.E., rather than asthma. My peak flow meter always indicated I had excellent lung capacity Some asthma meds (advair, flovent) actually made me feel worse.

It sounds like your testing was better, and far less likely to produce false positives. The hard part might be distinguishing between your asthma and M.E. symptoms, and doing what's appropriate at the right time.

 

[valentinelynx]

She put me on a brand called ProAir HFA (albuterol sulfate) http://en.wikipedia.org/wiki/Salbutamol
I am not sure if it is preventative medicine, she just said when I feel shortness of breath to use the inhaler.

Albuterol is a "rescue" medication for asthma. As your doc said, use when you are SOB. What WillowJ is referring to is medication to keep the airways from becoming inflamed: these are steroid inhalers. Whether you need one depends on the frequency of your asthma attacks and how well your symptoms respond to the albuterol. For example, if you need to use the albuterol daily, you should probably also use a steroid to keep the symptoms in check. But if you only need it occasionally, such as when exposed to an allergen or some other stimulus that provokes your asthma, then you have less need for a steroid. Been years since I've treated asthma (as a resident), so please consult your physicianabout current recommendations. Hope this helps.

 

[maddietod]

My kids can have often had low-level asthma without any coughing etc. They would complain of feeling tired, or they would be a certain kind of grumpy. I'd make them use the peak flow meter........and then they'd be willing to use an inhaler.

If you go back to this practice, get them to give you a peak flow meter. Take readings after using an inhaler, and then for a few days, take a few readings when you're feeling good without the inhaler, to determine your baseline. The doctor should tell you how far below your baseline it's OK to drop, before using the inhaler.

If you have chronic, low-level asthma, you are likely to under-use your inhaler, because you're used to how that feels.

Good luck!

Madie

 

[WillowJ]

I lost my post. Will try to replicate but it's getting late and i don't promise to make sense.

I had methacholine challenge (the med made me sick, too, but the RT was very kind about it) and that was the only way we could tell I have asthma. Most of my difficulty breathing comes from weak lung muscles. Without methacholine, my lung function is not great but ok. It's great now with asthma meds. They have a different test for muscle strength, that one I have a poor result on.

The inhaled steroid helps with deeper lung inflammation, too, my somewhat ME-literate pulmonologist explained to me. It's nice that now when I crash I don't feel like I have a touch of pneumonia.

If you have chronic, low-level asthma, you are likely to under-use your inhaler, because you're used to how that feels.

This is probably the case with me!

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[taniaaust1]

Take care.. I want to share with you about my daughter as she has asthma but very unobvious asthma till it almost suddenly killed her. (they called her asthma "silent asthma").

My daughter for a couple of years had a slight cough but only when asleep but no other asthma signs at all.. never no wheezing even when she had a cold I never noticed any wheezing or breathing issues. Due to this sometimes night cough (only with cold air so she didnt have it in summer) I took her to quite a few different doctors who listened to her chest etc etc but she was always clear, she even seen a respiratory specialist who couldnt diagnose her at why she had a night cough and who missed her asthma.

Then one day I was doing the dishes and suddenly she was pulling on my dress. I told her I was busy and to go away and let me finish the dishes and I'll be with her in a moment.. but she just really pulled me hard then so I turned around. She was blue... she couldnt even speak, she was blue and terrified as she couldnt breath at all and was like gasping with no sound (thank god she got to me in time).
I grabbed her and ran with her to the car and rushed her to the hospital down the road. It was a sudden serious asthma attack (she was between 7-10 years old at the time). They kept her in hospital for a week.

Since then she does get wheezing at times and does have to use her inhaler (she's also on asthma preventatives.. she last year had another serious asthma attack at work).. but it still disturbs me how she nearly died with asthma when she'd never even previously been heard to wheeze and all the doctors missed it. Very minor asthma turning suddenly serious... Ive heard that this kind of thing is what kills many asthmatics as they dont expect it.

Take care. You are lucky the asthma has been picked up.

 

[WillowJ]

that's scary, Tania. thank you for sharing that. I'm glad a hospital was so near and your daughter was ok.

 

[bedman]

i ve been diagnosed with athma months after my cfs started (same test as you). must be related to cfs. mycoplasma? chlamydia? i refuse to use inhalers since i dont have typical symptoms.

 

[justy]

Just wanted to share my experiences/thoughts on the asthma diagnosis you have had. I have had asthma (mild) all my life, i have used an inhalor for many years both a preventer and a reliever. what i believe most strongly is that relievers are not a good thing to get into using on a daily basis. I have spent years trying to wean off mine. The reliever is basically a bronchodilator that dilates your airways immediately so that you can breathe. If you already are having no trouble breathing there is no need to use one, regular use leads to muscles around the airways becoming larger which in turn restricts the airways, another problem is psychological dependancy which is hihg in mild ashtmatics who use them.

I wish i had never started on mine as a child. Now my specialist thinks i have another lung disorder and probably dont even have asthma after 30 years of being told i do have it.

My thinking would be if its not broke dont fix it. You know if you can or can not breathe normally, saying you have asthma when you dont have symptoms that are bothering you sounds crazy. The drugs dont cure the problem anyway. If you are concerend you could keep the inahor with you for emergencies and do lung strengthening breathing exercises such as pranayama yoga breathing or there are other methods.
I used to keep ,my lungs healthy by swimming, but i cant do that anymore unfortunately.

Best of luck with it, Justy.