Àsthma, no wheeze?

[MrBennOfFestiveRoad]

I was diagnosed with asthma 25+ years ago, which had always been well controlled, other than when I got a chest infection after a cold. Last summer, I started waking up at night struggling to breathe/talk at the same time and after this returned after a course of antibiotics and oral steroids, was given Symbicort by my GP. All has been good until now when I have a chest infection, so am back to waking up breathless, am out of breath most of the time and have a sharp pain in my back, and Salbutamol is only working for about an hour. However, despite this, I never seem to get any wheezing, so always feel like a bit of a fraud in terms of asthma if I visit the GP, as they can't hear any when they listen to my chest - is this normal?

Take the asthma out of the picture for a second. You have shortness of breath (so severe you can't even talk) and pain in your back, this shouts for a chest X ray and a check up with a pulmonologist and/or cardiologist.

Asthma in this case, might just be a smoke screen irrelevant to what you actually have.

Go back to the GP and ask for a referral .

I've had asthma for 30 yrs and I hardly ever wheeze. Mine is tightness of the chest. Don't feel a fraud. Also, fwiw, I took symbicort for a year, found it utterly useless ( I think it is cheap hence the prescription) and gave me the most awful dry nose. Good luck. Be persistent. You know your body and I find asthma nurses (the ones I've come across) tend to be very set in their ways, I have rarely felt like I received adequate support without pushing.

Asthma doesn't always present with a wheeze. It's one of the symptoms it can present with but not everybody does.

You do need to go back and see your GP or asthma nurse as soon as possible with those symptoms though. The salbutamol should be holding it off for longer than an hour.

Thanks for the replies. I have now got some antibiotics, which I hope will sort it out. My GP's surgery doesn't really seem that clued up on asthma and the asthma nurse is impossible to get an appointment with other than an annual review, which has to be booked massively ahead.

The shortness of breath and pain in my back, I only get when I get a chest infection after a cold - the rest of the time, as long as I take the Symbicort, I now rarely have any symptoms other than a tight chest if I exercise in very cold weather, or am exposed to triggers such as dust. Incidently, Symbicort is actually really expensive and I have had persuade my surgery to keep me on it rather than the cheaper generic version that gives me a really dry mouth.

That's interesting, my gp practically foisted symbicort on me! I now take serevent and qvar, the combo works much better for me. I used to live os and my monthly non-subsidised inhaler bill was c€70 so I very much appreciate now being back in this country where there are pre payment Certs!

I'm really glad you got the antibiotics. I often find that they clear it up for me, I currently have a viral cough which is making me tight but which doesn't warrant the ab's just a week of steroids.

This sounds like badly controlled asthma.

Symbicort x2 x2 a day

Oral Steroids if it persists. If you ever need to use your reliever that much it's not controlled at all.

My asthma is getting shitter and shitter. I had a cold, no infection and I am still struggling with my lungs despite taking all the symbicort BUT it is important to take this every single day and never miss a dose. I'm back to GP Friday to switch to another inhaler as symbicort doesn't seem to help

And I only wheeze when it's very very bad. It's just tight. I do the cough test - if I can cough clearly and it doesn't feel tight I am ok. If I do s little cough and it's hard work then I need reliever

My (adult) daughter is a non-wheezing, poorly controlled asthmatic, she is under the care of the Difficult to Control Asthma clinic at our local hospital, non wheezy asthma is more readily recognised than it was when she was little. Do you increase your reliever medication at the first signs of a cold/chest infection and do you monitor your peak flow regularly?

THIs is a joke sounding but no one will give me the mouthpiece for the peak flow meter so I can't monitor it myself I can't get my mouth around the bit properly

My normal blow is 450. This usually drops to avoid 350/400 but the issue is, I just have random symptoms all the time. No way can I go to bed without taking reliever and lie down as it feels like my lungs just stick together otherwise. Usually during the day at some point I will very suddenly go tight, no warning, I take my preventor like clockwork. I just don't think it's the right one.

My daughter saw a respiratory physio who was able to help her quite a bit with some of the symptoms you describe, we did have to push really hard for a referral but it was worth the effort. It might be worth considering?

Sorry to hear that so many other people are suffering, it's such a horrible thing.

I take the Symbicort 2x2 per day and never miss a dose, I'm actually supposed to be trying to drop it to 1x2 per day but haven't managed to yet. I saw a nurse when I got the antibiotics, who said that they only give oral steroids for wheezing but gave me antibiotics as my chest was crackling, although the doctor has given me oral steroids previously and they really helped. The nurse also said that my oxygen levels weren't that bad for an asthmatic, which made me feel like even more of a fraud! I always feel like my asthma is pretty mild compared to others - I've never had to go on a nebuliser or been hospitalised, so I would feel like I was making a fuss if I tried to get referred, it's also almost impossible to see a doctor at my surgery - the Symbicort was originally prescribed to me over the phone after I'd had enough of being offered appointments 3 weeks later and made a complaint.

I hardly ever wheeze, unless I have literally run for a train (and then its a heavy heavy breathing but not necessarily a proper wheeze).

But I can have absolutely rubbish lung function (250litres of air) and still be bobbing around at top speed, when the norm for my age is over 400. But it means that if I slow down because I am struggling, I check my peak flow, and if it's 200 or less, I am to go straight to GP or A&E. But there may be no wheeze at all, just not getting enough air in.

I get chest infections most winter (the joys of post nasal drip complicating any cold), but almost always have steroid tablets as part of the treatment for that, even if there is no wheeze, as its about my lung function numbers at that stage.

I hardly ever wheeze but, like others, have a rubbish peak flow and get breathless rather than wheezy. Have steroids for when it gets bad.

I had Symbicort for a while with very little effect, then tried Seretide which was not much better but, a year ago, my GP changed me to Fostair which has really made an improvement. Apparently its selling point is that the particles you inhale are smaller than in most other inhalers so can drift further down into your lungs

I've had 2 colds this winter but to be fair, I haven't had to have anti b's or prednisolone once so like MrBenn says, I also feel a fraud!
But the fact I take my reliever so often is the sign it's not controlled. So it's not controlled but it's not that bad

I have asthma and very rare have any wheezing unless I have a really bad chest infection.
I was also told if your having to take salbutamol more than 9x a day a short course of steroids is needed

I've booked an asthma review on the back of this seen as I can't get my symbicort down to x2x1 either!

I was told you shouldn't take reliever more than 3 times a WEEK

I probably take mine 3-4 times a day