Tight chest and bad cough

[Jody]

How are your legs? I hope it isn't anything serious - good luck!

My legs feel fine. Other than the half hour struggling for breath/coughing everything seems normal again.

 

[ColinJ]

My legs feel fine. Other than the half hour struggling for breath/coughing everything seems normal again.

Ah, good - I missed the bit where you said it only lasted a short time (doing about 3 things at once and speed reading!) ...

 

[Jody]

Been to the doctors first thing this morning and he was great. Checked my chest, had a 5 minute chat and he said it was exercise induced asthma. I have a Ventolin inhaler to use before exercise and have to monitor the situation for a few months.

I spent some time thinking about this last night and reckon its been there a bit more than I thought. But I just put it down to not being fit or having an off weekend.

 

[mrandmrspoves]

Yes - exercise induced asthma sounds spot on. Probably triggered by your recent upper respiratory tract infection leaving your small airways more sensitive. You may find that this goes away completely in a few weeks, or it may be something that stays. A couple of puffs on the Salbutamol inhaler 15 minutes before exercise will help. Asthma is characterised by difficulty exhaling, which results in your lungs becoming overfull and then you can't breath in. People get scared by not being able to get their breathe - but you need to concentrate on getting the air out of your lungs fully so you can get fresh air in. Cold weather makes exercise induced asthma worse, so gentle warm up exercises can help. In really cold weather, breathing through a scarf or similar keeps the air warm and moist so can reduce symptoms. If your problems become more than occasional, a steroid inhaler is likely to be helpful.

 

[PK99]

GPs are crap. Rest and take it easy. If you go blue, time to go to A&E

My GP service is outstandingly good.

 

[fossyant]

My GP service is outstandingly good.

Mine is the opposite ! Looking at moving GP, but got that many blood tests and hospital correspondance, things will go missing if I move.

 

[vickster]

Request a full copy of your notes and then move practice?

 

[brand]

Sounds a bit like my asthma started. Although it was mainly hour long coughing fits. Late onset asthma is often coughing.
The inhaler may have been a life saver as the coughing fits were getting longer and longer. Doctor said little just said here's a prescription you have asthma. Never had one after that. Still a bit weazy in the morning and lots of phlegm but only when I forget to use the inhaler.

 

[Mark White]

Yes - exercise induced asthma sounds spot on. Probably triggered by your recent upper respiratory tract infection leaving your small airways more sensitive. You may find that this goes away completely in a few weeks, or it may be something that stays. A couple of puffs on the Salbutamol inhaler 15 minutes before exercise will help. Asthma is characterised by difficulty exhaling, which results in your lungs becoming overfull and then you can't breath in. People get scared by not being able to get their breathe - but you need to concentrate on getting the air out of your lungs fully so you can get fresh air in. Cold weather makes exercise induced asthma worse, so gentle warm up exercises can help. In really cold weather, breathing through a scarf or similar keeps the air warm and moist so can reduce symptoms. If your problems become more than occasional, a steroid inhaler is likely to be helpful.

A upper respiratory tract infection can give exactly the same symptoms as the OP describes. I am not a doctor, however I was on medication for asthma for more than 30 years and off it for more than 10. I've had more than my share of bacterial and viral chest infections, including one last week.

Salbutamol is a bronchodilator and should be taken in the event of symptoms of an attack. Becotide was the preventative of choice in my day. This was taken regularly to avoid having to use salbutamol, which can affect the immune system to the point where the body is unable to regulate its own natural immune responses and a physiological dependency can occur. So it really is something to take as little as possibly, whilst taking enough to control symptoms of attacks.

This drug works through the process of bronchodilation because asthma symptoms include bronchoconstriction, which is a tightening of the airways. The result is that oxygen cannot be taken into the body and the hypothalamus, which controls autonomic systems within the body including maintenance of a well balanced oxygen to CO2 ration, triggers the 'I can't breathe' response which can quickly escalate to panic, and an attempt to forcibly reventilate which is difficult given the bronchoconstriction. This leads to distress, rapid shallow breathing, and in extreme situations can make it difficult to self administer salbutamol. So again there is the danger of taking too much of it when merely a bit out of breath, and the danger of not taking it quickly enough when a real attack is in progress.

One approach to controlling asthma is to learn to deal with the 'I can't breathe' feeling. If the panic and distress are severe, then the resultant asthma attack can be dangerous, especially if salbutamol cannot be administered. If the 'I can't breathe' feeling can be experienced with a state of mind of 'I can't breathe right now, but I should remain calm and relaxed and go with it', much of the panic and distress can be avoided which can make administration of drugs easier, or even allow the attack to pass without treatment.

*This is a very simplistic statement to illustrate a process and it is accepted there are many different forms and severities of asthma where this process may be very different*

This approach is called the Buteyko Method. And E&OE, I'm happy to be corrected on any of the above. It's a long time since I did in depth research on this. But your point about concentrating on breathing out alarms me greatly. Unless you can clarify in some way, it flies in the face of everything I've ever read or experienced as a 'lifelong' asthmatic.

 

[mrandmrspoves]

your point about concentrating on breathing out alarms me greatly. Unless you can clarify in some way, it flies in the face of everything I've ever read or experienced as a 'lifelong' asthmatic.

Indeed, you and many other people who have asthma think that getting the next breath in is the important thing. " I can't get my breath!"
You will not be able to get more air into your lungs until you get rid of the stale air that is already there.
In a severe asthma attack the lungs become hyper-inflated - overfull of stale de oxygenated air and the chest cavity expands bringing the shoulders up. The sufferer will try to take in even more air, but can only take gasps as there is simply no where for the air to go.
Bronchospasm is characterised by the small airways (bronchioles) going into spasm and secreting mucus which further restricts the entry and exit of air. This restriction of air flow leads to the wheezing that is often recognised as a feature of asthma.(NOTE -absence of wheeze may indicate that air flow is too poor to create a wheezing sound, so should not be taken as an indicator that the attack is not serious)
One of the key measures used to monitor asthma and other airways diseases is a peak flow - which measures the maximum flow of air that can be exhaled. A more accurate measure is FEV1 (Forced expiratory volume in 1 second)

Where people have chronic chest disease, the hyper inflation of there chest due to inability to expel air from the lungs, leads to the feature known as "pigeon chest"

I hope this clarifies things for you - but if you are still alarmed I am happy to expand further.

 

[mrandmrspoves]

I would also point out that much of Mark's other post is inaccurate - so please do not read his post and change how you control your asthma as a result. (I'm not trying to have a go at Mark - but don't want anyone to put themself at risk - if in doubt talk to your GP or nurse at an asthma clinic)
Salbutamol does not have the side effects mentioned by Mark and the Buteyko method is flawed to say the least (it may have some benefits for some people - but this may be little more than a placebo effect.
http://www.sciencebasedmedicine.org/buteyko-breathing-technique-nothing-to-hyperventilate-about/