Asthma?

[Dilbertian]

All my adult life I have been prone to coughing. I don't smoke, never have.

When I lived in London or any other large city I had a constant slight chesty cough, worse in the mornings and on exertion. If I had a cold it always 'went to my chest', I would get totally congested and it would linger for months.

When I lived in smaller, cleaner towns, my cough would disappear. It would only trouble me if I caught a cold. Then, as before, it my cough would get worse and linger for months.

Fitness doesn't seem to make a difference. In fact, in my 20s I went to the GP about the fact that this lean, fit, active woman could not run up a flight of stairs without doubling over coughing at the top. He was uninterested. (That lean, fit, active young woman is long gone!)

So I'm now over a cold and, as usual, coughing like a smoker for a few weeks. Several people, who I did not know had well-controlled asthma, have asked me whether I have asthma - because they have lingering coughs after colds, especially if they do not use their inhalers.

Is this likely? Is it worth going to the doctor about it? Would it make my life better?

[Wheresthebeach]

Get an appointment with the asthma nurse if your surgery has one. If not def your gp. If you need someone sensible to give you advice before you go call Asthma UK - here is the link. www.asthma.org.uk/about?gclid=Cj0KCQiAyp7yBRCwARIsABfQsnTITzoZczMgNXY--MIxfBWFnC9OCZak2ed-M51rL0U2plXbs8JTMc0aAjyzEALw_wcB. They have asthma nurses on the phone to help.

Sounds like asthma which is triggered by virus. You need to get it sorted.

[LIZS]

Late diagnosed asthma quite common. I was in my 40s. Came to the point where I was coughing so long and hard was being sick each morning, after a cold.

[MindyStClaire]

Entirely possible. That describes my asthma, only ever really a problem if I get a cold and then it really hits me. We know now my dad has been asthmatic all his life, but he wasn't diagnosed until he had pneumonia in his 50s.

Agree with asking to speak to asthma nurse if possible, they tend to be better than GPs IME, or at least less variable. But I don't know if you need to be diagnosed first to see them.

Asthma UK are great, I'd also agree with the recommendation of contacting them.

[Dilbertian]

Thanks for replying!

You need to get it sorted.

Why? Not being belligerent, but is it anything more significant than an unpleasant inconvenience?


Came to the point where I was coughing so long and hard was being sick each morning, after a cold.

It's rarely that bad. I have occasionally reached retching point in the morning, but never vomited from it. Just very very phlegmy.

[NoGravyForYou]

Uncontrolled asthma is extremely dangerous. Do you realise how many people die from it?

[midgebabe]

You should feel a lot better if you get it controlled. You are probably used to living under par and when the problem is fixed you will wonder how you ever coped.

[MindyStClaire]

Yes OP, you do need to get it sorted. For most people it's an inconvenience but three people a day die in the UK from asthma. Most of those won't have been the people for whom is a debilitating illness, it'll be people who didn't have moderate asthma under control.

Also, if it is asthma that's been untreated all this time, you may well find you feel better in lots of ways once you get it under control. More than once I've thought I've been fine, changed my inhaler and suddenly found myself with way more energy. It's hard on your body if breathing is a struggle.

[NeurotrashWarrior]

You describe me, I was better in my late 20s to mid 30s simply as I now know that's when our peak flow is at its best, and I was a managing it with swimming and apparently playing a wind instrument.

In my late 30s early 40s after my first child I had a number of coughs that needed antibiotics and never went. I'd cough and cough and cough. I was extremely fatigued. Many drs asked if I had asthma, I said no obviously...

Finally one horrendous cough triggered an inflammatory response that was so bad it felt like my whole lung was swollen and full of water. Steroids immediately sorted it out, only for it to return when they stopped. Blue inhaler did help a bit.

A friend told me to see the asthma nurse rather than the Gp and someone here suggested asthma UK who were really helpful. Asthma nurse listened and did a simple test and put me on a brown inhaler, which is what the Gp should have done.

I'm now on a different sort as I seem to need a long acting dilator.

Winter, cold air, exercise, smoke, fumes, viruses, pollution, bizarrely baking potatoes if using rape seed oil and a few other things are all triggers. Not pets, dust or pollen. There are different sorts of inflammatory reaction.

I rarely wheeze, just cough and cough, especially at 2 am, if I'm bad. But I've never been bad enough to go to hospital. (Yet!)

Its actually always been there. But much worse now. The energy I had when on inhalers was enormous; I'd been living in a chronic fatigue state.

Speak to asthma UK and see the asthma nurse.

[NeurotrashWarrior]

I normalised all my symptoms and was in denial/ not sure it was asthma for a long time simply as I didn't fit what my mental image of an asthmatic was.

[Fairylea]

I have adult onset asthma and it is exactly like this. If you don’t get it controlled it can suddenly escalate and you can die from it - not scaremongering, true. I’ve had 3 out of the blue truly dangerous and scary asthma attacks where I literally couldn’t breathe and it just started off initially as having an annoying cough which meant I couldn’t finish a sentence without coughing. It’s under control now though and most people are shocked when they find out I have quite severe asthma (I take Seretide 250mg twice a day as a preventer and the blue inhaler as a reliever when I need it).

[Dilbertian]

Wow! You're making me think of myself quite differently. I genuinely expected a 'YABU, don't be such a drama queen, asthma is more serious than a bit of phlegm' response.

[NeurotrashWarrior]

Not being able to climb the stairs without doubling over is rather worrying!

I also had normalised occasional breathlessness; not being able to speak properly on the phone for example, as if I'd run a mile.

[Dontdisturbmenow]

You could have described my daughter. Her first bout of ongoing caughing and breathlessness resulted an x-ray but she was then dismissed. As it was the second and third time. She then move for Uni to another practice, saw her new GP, she was referred to the Asthma clinic and sure enough diagnosed with treatment.

[Goldrill]

Me too. I swim competitively and am just used to coming last because I can't breathe. Had a cough a year or so back which never went away. Got fully checked out by doc, who said probably allergy and gave me antihistamines which didn't seem to do anything.
Went back to and saw asthma nurse who checked my spirometry results- which were all pretty good and she was umming and ahhing- and then she listened to my chest and put me on a big whack of steroid. Cough is gone; wheeze I have lived with for years is gone.
Great spirometry was because I'm a swimmer. Sadly I'm still coming last but now it's not cos I can't breathe, and most importantly I have lost The Fear.
Go see the asthma nurse!!

[NatashaGurdin]

I developed adult onset asthma after having 'flu one year but it wasn't identified as asthma until after many chest infections EVERY time I got a cold and coughing fits triggered by things like dust, cold/warm air (moving from one to the other), strong perfumes and air fresheners/cleaners, cigarette/cigar/pipe smoke (I'm not a smoker, never even tried it but sounded like I was 80 a day sometimes!) and tree pollen in the spring.

The reason they found it difficult to diagnose was I rarely did the classic wheeze, I just had coughing spasms which were only relieved by retching and sometimes actually vomiting, especially if an attack happened too close to when I had eaten.

Once I was prescribed inhalers my symptoms eased, first I was on a blue and brown then it was changed to purple and now I'm on Fostair two puffs morning and night which is pink with the blue as well although I was told the Fostair can be used in place of the blue one if necessary as well. I also use a spacer as recommended by the asthma nurse to deliver the dose as it gets more of the meds into your lungs.

I echo PPs above about how dangerous uncontrolled asthma is though. I ended up in an induced coma in ICU for a month in 2014 when I developed Pneumonia as a complication of asthma (and sepsis and organ failure). I do not remember anything from that year from the middle of August until the last week or so of November because I had to be sedated for so long as I couldn't breathe unaided, I had to have a tracheotomy to help with this and my family were told it was touch and go for a while until I could breathe unaided again.

I was in hospital for a further month when they took me off sedation and my family told me that they had drained a lot of nasty looking fluid from my lungs while I was unconscious. Since then the Fostair works well to control the coughing and the occasional wheezing I get (especially in Spring with the tree pollen, apparently a common allergen, grass and flowers don't bother me at all nor does animal hair although dust and perfume and cleaning fluids do if they are strong smelling. I've been told that the dust trigger could also be from house dust mites as well as actual dust and things have been better since I changed my carpets for hard flooring and got house dust mite protective mattress, duvet and pillow covers).

[NeurotrashWarrior]

Natasha, very similar to me. Also on Fostair now; the difference in energy after a week of using it last winter was amazing! Wow that must have been a very scary experience. Glad it's better controlled now. It shows how quickly it can go wrong. It's the only thing I worry about for myself re coronavirus as it sounds like exactly the sort of virus that really affects me, and my 7yr old too who has exactly the same sort of asthma.

It's chemicals and viruses that definitely affect me, the inflammation starts with a cough/ cold and then everything irritates. But sometimes the chemicals can cause the inflammation.

Another symptom I didn't know was a "thing" is itching beneath my chin. I've always had that and I do associate it with a very bad asthma exacerbation/ virus.

What I didn't understand is that asthma is inflammation, a bit like eczema. You need the steroids in an inhaler to keep the inflammation down. Some people (all?) also benefit from the long acting bronchial dilators that are in Fostair.

I can drop down to the lower steroid Fostair in the summer months but would be wary of a virus and would go back up if I caught one.

[NatashaGurdin]

Thank you NeurotrashWarrior. Yes it was a bit scary for my family, I of course had no idea until I came out of sedation. I will say that the sedation drugs they used gave me weird psychedelic dreams which I have only vague memories of! When I tried to describe them, all I could think of was the Beatles film 'The Yellow Submarine'!

The inflammation bit makes sense I suppose as it is thought that there are links between asthma and eczema isn't it. I do have small patches of eczema on my feet and on my right elbow which seem to flare up when I'm stressed about something. The Fostair is amazing, it really seems to help.

I do seem to have terrible post nasal drip and sinus problems which I think must all be related in a circular way! I use Sudafed (and similar own brands) sparingly because it (and they usually) contains paracetamol to relieve the sinus pain which is made worse sometimes because I wear glasses and sometimes they rest at just the wrong spot! I try to combat the post nasal drip by trying to sleep propped up rather than flat which seems to help.

I think there needs to be more awareness about how dangerous this common condition is, most people don't seem to be aware that there is a cough variant form of asthma which takes longer to diagnose because it presents differently to classic asthma. There are other more serious forms as well that require regular hospital treatment and yet a lot of people think it is a mild condition that only affects children. More education on it needed I think.

[Liddell]

I was diagnosed with Adult Onset Asthma when I was 40 after having a persistant cough.

I have the brown preventer inhaler and the blue reliever one.

My triggers are mainly household sprays/deoderants.

[LeekMunchingSheepShagger]

I am exactly the same op. I actually had some tests (peak flow etc) and a chest X-ray a couple of years ago and apparently don’t have asthma. I constantly have a chesty cough, wheeze a lot on breathing out and cough up phlegm. I should go back to the doctors again I suppose but as soon as they established it isn’t asthma they weren’t interested!

[Dilbertian]

I saw the GP today, and she also says it sounds like asthma. I've come away with a blue inhaler (1-2 puffs up to 4 times a day), a peak flow meter for me to take twice-daily readings for the next two weeks, and an appointment with the asthma nurse in two weeks' time to discuss the results.



I'll call Asthma UK on Monday, but in the meantime can I pick your clearly knowledgable brains?

If I take the inhaler regularly, can I expect my wet cough to go away? Will it stop after each dose and then come back in a few hours, or will it go away completely after a few days of treatment?

I've taken two doses so far, 4hrs apart. Each time, I felt lightheaded and then started shaking about 15mins after I took the dose. Will this go away as I get used to the medicine, or will it happen every time?

If the blue inhaler doesn't improve my cough, does that mean I don't have asthma?

[NoGravyForYou]

No the shaking won't always go away, I have been diagnosed 9 years now and if I have to take my blue inhaler in a reliever way ( as in when I've extremely chesty and a very rare amount of times when I've been having an attack ), I am still shaky for up to an hour. It is horrible, but is a common side effect.

[NeurotrashWarrior]

I'm really sorry but If you phone Asthma UK you'll find that you've been given incorrect treatment. And the asthma nurse will say so too. I'd bet an asthma trained pharmacist would say so too.

Blue inhalers should only be used as a reliever, they don't treat asthma. Asthma is treated preemptively with steroids so you shouldn't really have any symptoms at all.

She should have given you a brown inhaler, clenil, as a starter preventer. And actually asthma UK say you should have been given a short course of oral steroids to start too and the brown takes two weeks to build up.

The point of the diary and peak flow monitor would be to track how things improve on a preventer over 2 weeks. You'd expect to see a large improvement after 10 - 14 days. Mine went from around 350 to 440 over that time.

No the wet cough need steroids. Either oral or brown preventer.,

Honestly, (exasperated) this was exactly what happened to me; my asthma nurse marched out of my first apt and gave the Gp a good telling off.

I wonder if you can call the Gp and talk to the asthma nurse over the phone to check you're on the right medicine? I understand how you feel though, I was extremely confused and nervous. It was only through a nurse friend and asthma UK that I got correct treatment.

I found shaking did improve when I had been on clenil for a longer time.

[NeurotrashWarrior]

I'd record peak flow in morning and early evening before the inhaler, and then record 15 mins after for a few days. There should be a difference in the peak flow monitor. Definitely record all symptoms.

An asthma diagnosis is often based on a percentage difference between peak flow before and after using ventolin, I can't remember the calculation but asthma UK will talk you through it.

The only possible reason why she didn't prescribe clenil could be to let the nurse decide which one but I find this very short sighted, esp as you need to wait 2 weeks. You may start to get better simply as your body slowly gets on top of the inflammation but clenil would definitely speed this up.

[VicSynix]

This is very timely - I have also always been prone to coughs, slight breathlessness and so on but it never occurred to me that it was anything serious. In early January I caught a cold, it went to my chest and after about 4 weeks I suddenly became incredibly breathless - couldn't walk upstairs without catching my breath. I was also making such loud wheezing noises that I couldn't sleep. I got referred to the respiratory nurse, who asked me a lot of questions then gave me a peak flow monitor for two weeks. When I went back on thursday she was slightly alarmed as my highest peak flow was 280 and my lowest 200...

I now have a brown inhaler, two puffs twice a day for the next 6 weeks to reduce the inflammation and (hopefully) improve my peak flow and let me get some sleep as well! When I go back I'll have the spirometry test which I strongly suspect will mean I have asthma.

My nurse said that late onset asthma is far more common than you think but is very manageable. I second the advice of speak to an expert asthma nurse.

[Dilbertian]

What's the difference between wheezing for breath because you're unfit, and wheezing for breath because of exercise-induced asthma?

Is it normal to have a sense of pressure or tension in the bottom of your neck/top of your chest? Not painful, more just a sort of awareness? Because this coughing business has been going on for over 30y, it's my normal, and now I wonder whether what's normal for me is actually abnormal.

BTW I called Asthma UK , and they also said that I ought to have been given a preventer, not a reliever (but said in a very polite, non-judgemental I'm-not-actually-going-to-contradict-the-doctor way).