Asthma - misdiagnosed?

[661-Pete]

According to this news item, this would appear to be often the case.
http://www.bbc.co.uk/news/health-30997397
This is of some interest to me: I was first diagnosed as mildly asthmatic about 12 years ago, in my early 50s. I had been finding myself short of breath and wheezing at times, and my brother-in-law (himself a GP), noticing this, urged me to mention it to my doctor. Anyway, I've been prescribed the preventative (Clenil) as well as the reliever (Ventolin), on and off, ever since, and periodically I'm summoned to a meeting with my doctors surgery's resident asthma nurse (in fact I'm already due for the next appointment).

But am I really 'asthmatic'? I know I've had some problems with bronchitis in the past, despite my militant anti-smoking stance (in my younger years smoking at the workplace was endemic and you could not evade the secondary habit). My worst experience was some years ago on a car ferry, climbing the steps from the car deck to the passenger deck put me almost in a state of collapse, I could hardly move for the rest of the crossing. I took that experience to my doctor, but he opined that it was a bad asthma attack rather than a heart attack. Anyway, I had a check-up for suspected angina some time after that, and it came out negative.

Anyway, currently I'm off the Clenil and have been for several months. Last time I saw the asthma nurse, she said it was OK by her. But if the symptoms return, it takes only about two or three days for the Clenil to 'kick in' once more. If I don't really need any drug, steroids especially, it suits me not to take it! But I keep the Ventolin handy, just in case. Furthermore, it's a useful reliever if one has a heavy cold, especially with bronchitis symptoms (the doctor said it was OK to use it for that). As far as I'm concerned, at the present time, I'm not an asthma sufferer.

Please understand, I'm not belittling the sometimes gravity of asthma. A chap I knew died tragically young (and leaving two small children) from a sudden and totally unexpected asthma attack. The same fate befell the actress Charlotte Coleman (famous for her roles in Four Weddings And A Funeral, and Oranges Are Not The Only Fruit) - although in her case there were other factors. And it is certainly a risk to many cyclists.

Thoughts about this?

[annido]

I'm really pleased to read your post Pete because I can tell a similar story. Having suffered a nasty chest infection early last year which took several courses of antibiotics to clear, I was told I had asthma. In fact my symptoms seemed to come and go (wheezing, tight chest, reacting to chemical cleaners). I was prescribed Ventolin and then when I saw the asthma nurse, because I talked about getting breathless while hill climbing, she wanted me to go on Symbicort which I wasn't totally happy about given the long list of side effects to steroids and other 'dissatisfied customers'! I did give it a try for a while and then I stopped. I also don't like to take things unless totally necessary (typical cyclist probably!) and I haven't had more than an occasional tight chest since stopping.

The problem is the medics don't like you taking things into your own hands so I haven't been back to the surgery. I think people who die of asthma attacks often have more persistent and serious symptoms. There have been two asthmatics in my family, one of them died during an attack in his 20s, the other had asthma all her life and managed it with symptoms but no serious attacks. So I think I know what an asthmatic looks like and it's not me. However, the range of symptoms now included as asthma seems to have widened somewhat. I wonder if it's a kind of 'catch all'.

I do live somewhere (Thames Valley) where respiratory problems are an almost casually accepted phenomenon and I wonder about cycling and air pollution. I know that when I pick up speed, I tend to mouth breathe which I'm trying to stop and I wonder about the effects of air pollution on our increasingly crowded roads. It would be typical of our society to ignore the effects of too many vehicles pumping out exhaust and instead treat the victim and some are probably more vulnerable than others. Heart and lungs work together and air pollution can affect the heart too, the BHF has plenty to say about that.

So not sure where this takes the subject but it's good to feel not alone!

[Ben@Forest]

I had quite serious asthma as a child, including time spent in an oxygen tent in hospital on a couple of occasions. I was a relatively good runner but found that the wrong weather conditions (especially what I later found to be advection fog had formed) when there was a muggy, humid atmosphere really made me wheeze.

I found out that Steve Ovett was asthmatic and that interval training, getting progressively harder or more intense over sessions helps increase your (and certainly my) tolerance. I could run 3, then 5, then 9 miles etc before that wheezy, constricted chest feeling kicked in. I was even able to join the Army and was among the fittest men in the units I served in (but I was not in the infantry) - I ran long-distance and cross country for those units.

Part of the reason for being a very keen cyclist is that the training keeps the asthma feeling at bay. I know if I stopped doing physical activity I would have a far lower tolerance to when the asthma wheezing starts.

[Mick F]

I've always had it, though it's always been mild.
As a kid at school I was a good runner, but not a good distance runner because I couldn't breathe properly. I thought it was normal!

It was only in my mid 30s when my cycle commuting took me 17miles to work, and I found I had a tight chest for most of the morning, and it would return in the evening after the long ride home. Later, in my early 40s, I found that stress often brought on chest tightness, and eventually I reported sick.

I found I could breathe in ok, but breathing out was difficult, so I ended up sort of tight and my shoulders would move in and up and make it worse.

When I was first given Ventolin it was a revelation! I asked the Doc why everyone wasn't using it, and he told me that it only works if you're asthmatic, and "normal" people wouldn't notice it.

This "fact" was stated on the news the other day. If Ventolin doesn't help, you're not asthmatic.

I'm actually fine generally. Beclozone keeps my asthma at bay, but when I have a cold like I have now, I can't be far away from a ventolin inhaler, even overnight. I'll be fine again by next week.