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Are my symptoms abnormal?

Hi, I have come here for advice as I don't seem to be able to recognise my symptoms. I don't feel my symptoms are the normal tight chest/wheeze that is commonly thought of as normal asthma. My asthma journey started properly about 8 years ago where I suffered generally feeling appalling, a string of recurrent chest infections and sinusitis, I then ended up with pneumonia. I was 30 at the time.

My symptoms


Generally, I think my asthma is mild. I'm a 5'4" woman with a PF that normally is around 580-610. I rarely wheeze; if I do, it is right at the end of a forced exhalation. I never feel what I imagine to be "classically tight chested" a weight on my chest or anything like that. Most of the time I wonder whether I really do actually have asthma and question the diagnosis. That is until I have a flare, like today. I have used my reliever 3 times today, which is a rarity. Once this morning and again at lunchtime. At these times I felt mildly breathy...when I say breathy, the only way I can properly explain the feeling is that mechanically my lungs and muscles are all working fine and normally, but oxygen is just not getting into the blood efficiently. But at this point, it wasn't overly distracting.

Tonight when I got home from work I noticed that my lips were dark blue/purple. I didn't really feel oxygen-deprived and was just wondering how I managed to bruise my lips. I then thought it prudent to take my reliever again just to make sure it wasn't due to low oxygen. Experimentally, if you will. I checked my PF which was 600, but after doing the PF I felt breathless. When I began to consider my breathing I noticed I was, in fact, short of breath, yawning and sighing (deep, quick inhalations) a lot. After about 20 minutes of taking the reliever, my lips pinked back up and breathing improved. I also felt a lot more alert than I have done most of the day and breathing easier. Given that the salbutamol improved the condition it is obvious that there is asthma there, but I'm just finding it hard to recognize my symptoms.

Not a case of "classic asthma"


I keep waiting for classic symptoms and never get them, but missing things like blue lips as a marker of my oxygen levels, thinking that is just what colour my lips are, or that is just how I'm feeling that day. Whenever I see a GP about my asthma my PF is high, my chest is clear and so I feel like a fraud. I also feel like the Clenil inhaler does not really improve these general symptoms. Does anyone else not get "classic asthma" symptoms and so miss when they're actually on the turn because PF is still good?

Thanks Ceri

  1. Hi CGilders (Ceri), and thanks for your post, sharing the details of your present medical circumstances. You may be aware we cannot provide medical advice or diagnostics over the internet (for your own safety). In the most general of terms - your condition and the symptoms you describe (blue lips, peak flow rates, shortness of breath, etc.), may be attributed to other medical conditions besides asthma. Asthma is also one of those conditions that can affect everyone differently. I thought this article would help to underscore that viewpoint: https://asthma.net/living/asthma-not-one-size-fits-disease/.

    As well, not all patients with asthma present with wheezing: https://asthma.net/living/not-asthmatics-wheeze-not-wheezing-asthma/.

    Since you have not had any luck when you present to your GP physician, I wonder if you have considered seeing a specialist, like a pulmonologist? With a thorough medical workup, including full history, complete physical and diagnostic studies, a definitive diagnosis can be determined with proper and specific treatment suggested.

    What do you think?
    Leon (site moderator asthma.net)

    1. Hi CGilders (Ceri). Hi. As Leon said above, Thank you for sharing your asthma story with the community. I would say that I agree with what Leon said. I have had many patients who have had good experiences with seeing lung specialists, like pulmonolosts (https://asthma.net/basics/specialists/). Have you had this discussion with your GP physician? John. Community Moderator. asthma.net

      1. Hi Both,

        No I haven't really spoken to my GP about it as it's remarkably difficult to get an appointment and I feel like a total hypochondriac if I question heart function. I do have a generally slow heart rate and low BP, but Drs always just say healthy "young" female and that's that.

        I have recently been put into montelukast be that seemed to improve things in the short term. My nasal and throat symptoms have improved massively, but I still feel SOB intermittently, dizziness and just general fatigue most of the time, though the HR has increased on it, which is odd.
        Maybe I should just harass the doc?

        Many thanks

        Ceri

        1. Hi Ceri ( ), and thanks for your response and explanation. We appreciate you following up here!

          If you have concerns about your cardiac function, you may want to make certain to discuss these concerns with your doctor. No need to feel like a hypochondriac or think of it as harassing the doctor.

          It is really only a conversation about your health with the exact professional who is orchestrating your medical care.

          What do you think?
          Leon (site moderator asthma.net)

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