Do i need to be symptomatic?

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Simon Dean - 29 Oct 2007 08:49 GMT

What's the difference between Asthma and an Asthma Attack?

After my cold, I had a cough for a couple of months. I was considering
making an appointment to see a doc last week but thought I'd check it
out. Been round a few asthma related websites - concious that it was
some breathing related issue at least, and a few people have responded
that what I've described sounds like it could be asthma, just mild but
still worth checking out.

Of course, lo and behold, Im virtually free from this cough now. My
chest is still a little sensitive, but Im not coughing quite as bad as
last week.

Question is, if I did go to get my breathing checked out in a couple of
weeks when I don't have this phlegm, or coughs, will there be anything
for the doctor to find?

Do I need to be symptomatic before being checked out?

Or could my lung function be impaired without being symptomatic?

Cheers
Simon

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00doc - 29 Oct 2007 13:25 GMT

> What's the difference between Asthma and an Asthma Attack?

Asthma is a condition characterised by reversible obstruction in the lungs
caused by three components
- smooth muscle constriction around the airways
- swelling of the lining of the airways
- increased mucus production

An attack is an episode of symptoms. If you have asthma you are still
considered to have it between attacks (i.e. when you have no symptoms).

> After my cold, I had a cough for a couple of months. I was considering
> making an appointment to see a doc last week but thought I'd check it out.
> Been round a few asthma related websites - concious that it was some
> breathing related issue at least, and a few people have responded that
> what I've described sounds like it could be asthma, just mild but still
> worth checking out.

Cough can be a symptom of asthma. Sometimes it can be just a vaugue feeling
of breathlessness, chest tightness, or "air hunger". On the other hand, as I
said in my first response to Bri, a chronic cough and sometimes even
wheezing lastting 6 weeks or more is common after a respiratory infection
and not indicative of asthma. In that case it is acceptable, even proper,
to just treat the symptoms while the body heals.

> Of course, lo and behold, Im virtually free from this cough now. My chest
> is still a little sensitive, but Im not coughing quite as bad as last
[quoted text clipped - 3 lines]
> weeks when I don't have this phlegm, or coughs, will there be anything for
> the doctor to find?

Probably not. If you are now symptom free and never had wheezing/prolonged
coughing problems before then it is probbaly all just part of the normal
healing process from the infection and there is not anything more to do.
Recurrent episodes of wheezing and coughing, even if just with infections,
may indicate asthma and should be checked out.

> Do I need to be symptomatic before being checked out?
>
> Or could my lung function be impaired without being symptomatic?

Often the asthma tests will be normal between episodes but sometimes not.
When there is doubt I usually get them and see. Sometimes they do give
useful information - probably because many asthmatics have gotten used to
some chest tightness and don't seem to really know what breathing easy feels
like anymore. If they are normal I tell the patient that it doesn;t rule
anythign out and then try to get a repeat test when they are symptomatic. If
you have a known trigger like cold or exercise it helps to do it shortly
before the test. It is common for pediatricians to tell kids to "take a lap"
and then do the testing. Of course, it helps to have the spirometer in the
office.

Obviously, if you have doubts you should go get seen in real life.

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00doc

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Simon Dean - 29 Oct 2007 13:57 GMT

>> What's the difference between Asthma and an Asthma Attack?
>
[quoted text clipped - 3 lines]
> - swelling of the lining of the airways
> - increased mucus production

I guess it is difficult to make a diagnosis based on that, given that
these symptoms are present in many many lung conditions and complaints,
including such as bronchitis, or the sometimes prolonged effects after a
common cold.

I guess it's a question of, when does it start becoming asthma? Is that
when there are symptoms but no sign of a cause?

> Cough can be a symptom of asthma. Sometimes it can be just a vaugue feeling
> of breathlessness, chest tightness, or "air hunger". On the other hand, as I
> said in my first response to Bri, a chronic cough and sometimes even
> wheezing lastting 6 weeks or more is common after a respiratory infection
> and not indicative of asthma. In that case it is acceptable, even proper,
> to just treat the symptoms while the body heals.

Part of my problem is never finding a doctor willing to treat the symptoms.

>> Of course, lo and behold, Im virtually free from this cough now. My chest
>> is still a little sensitive, but Im not coughing quite as bad as last
[quoted text clipped - 9 lines]
> Recurrent episodes of wheezing and coughing, even if just with infections,
> may indicate asthma and should be checked out.

I thought I was pretty symptom free over the weekend. I've just come
into work and am finding myself coughing a bit more. It's more than just
a cough though. It feels like something tickling my lungs.

Last time I had a cough of this severity ( that I can remember ) was two
or three years ago. That took a very long time to clear up.

I've never had wheezing, but I gather that its lack of presence should
never rule out the possibility of asthma.

I have noticed recently, at least over the past few years, every now and
again it feels more laborious to breathe. I've been told Im a "mouth"
breather. I sometimes find myself waking up in the morning gasping for
breath.

Apart from that,and the time when I was fifteen and found myself hacking
and coughing after running between classes at school, I can't really pin
point any other noticable coughing times. but there could have been
other instances I've forgotten.

>> Do I need to be symptomatic before being checked out?
>>
[quoted text clipped - 5 lines]
> some chest tightness and don't seem to really know what breathing easy feels
> like anymore.

After this cold, I had coughing. I attributed it to the cold. After a
few weeks and it didn't go away, I put up with it knowing that I won't
be able to see my GP for at least two weeks. When I still have it two
weeks later, just as I was about to make the call, it starts clearing up.

I think I've passed my cold onto others, but no one else has been
afflicted with a similar coughing issue.

Maybe I should look at getting more colds just to double check?

If they are normal I tell the patient that it doesn;t rule

> anythign out and then try to get a repeat test when they are symptomatic. If
> you have a known trigger like cold or exercise it helps to do it shortly
[quoted text clipped - 3 lines]
>
> Obviously, if you have doubts you should go get seen in real life.

Cheers
Simon

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