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Constant Constricted Breathing
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volcomrr posted:
I have been experiencing constant constricted breathing for the past 2 years and 2 months. It fluctuates in severity, but never goes away. It mimicks asthma, although I do have asthma, it's not presenting itself as my asthma symptoms, I even had my pulmonologist say a few weeks ago that he didn't think it was asthma anymore. I mostly "grew out" of my childhood asthma, as it rarely ever flared up after high school. The constriction feels like it's right at the base of my neck, right where that dip is in the center of the chest at the top of the ribs.

It began one morning, I woke up, and I was slightly struggling to breath, but it went away in 30mins. The next day, same thing happened, except it lasted 1hr before going away. The 3rd day, same thing, except maybe 1.5hrs, and so on and so on until it was 24/7. Any kinda of fragrances makes it worse, perfume, gasoline vapors, deodorant, detergent, etc.... Really anything can make it worse. Interestingly enough, beer makes it worse immediately after taking a sip, and the next day is always slightly worse. It's also worse when I wake up from sleep, doesn't matter if it's a nap or I'm actually asleep at night.

I've been allergy tested by an ENT and Immunology and I am only allergic to dust mites, and I have the appropriate covers on my mattress and pillows.

The pulmonologist originally thought it was asthma, so I've been on symbicort and alvesco, then just symbicort, then I quit that and the Immunologist said to take Qvar, but all of these steroids only make me feel slightly worse.

Another pulmonologist thought it was anxiety (which I said it wasn't) so I've tried Klonopin for a month and I've tried Lexapro for a month also.

About the last thing that I have tried is Prilosec OTC and Nexium. Granted, I only took each of these medicens for about a month, I still was dipping, drinking beer a little, and drinking coffee every morning.

Side note, this constricted breathing has happened to me before, it began in the summer of 07 and only lasted a couple of months. That was roughly around the time that I had started dipping and drinking coffee.

So as it sits right now, I'm back on Priolosec OTC 2 pills a day for GERD, I quit dipping yesterday, and quit coffee Friday. I'm not going to drink for a while.

My doctor thought that it was asthma originally because my PFT's were below average, I think my FEV1 was 70%, but I was born with broncopulmonary displasia, and it could be damage from that, but before this constant constricted breathing started I could breath like a champ.

There has been a couple times in the past 2 years that the constriction has gotten better, and it was only when I was sick. It was the same sickness everytime, a sore throat, runny nose, post nasal drip. As soon as that stuff went away, the constriction came back. I had an endoscopy done and she saw some leasons or little bumps in my throat near my vocal cords, but she said it was probably from post nasal drip.

ANYBODY have an idea as to what this is. This is so frustrating and killing my life.
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volcomrr responded:
Forgot to mention, CT scan and x-ray of chest, and ekg were all good.
 
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Aqua14 responded:
It does sound a little like acid reflux is irritating your lungs. When do you take your Prilosec? If you take it during the day, consider taking it at night with a couple of Tums to make it work faster. (This is a tip from my allergist that helped me, and maybe it'll help you too.) Reflux is known to worsen at night, and that would explain your morning symptoms.

You might also consider elevating the head of your bed.

Good job on quitting the smokeless tobacco (I assume that's what "dipping" is) and the coffee, which are both big reflux triggers. See how you do in about 2 weeks. You might also try taking 2-3 Tums when this kicks up to see if they help.

You didn't say -- does taking a couple of puffs from an albuterol inhaler ease your breathing?

Hopefully a few of these suggestions help. Many of us have reflux along with asthma (the two tend to go hand-in-hand), and it can be difficult to determine sometimes what's making our breathing worse. Take care and good luck. Judy
 
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volcomrr replied to Aqua14's response:
Thanks for the reply Judy. I take the Prilosec once at night (somewhere around 8-9pm) and then once in the morning (around 8am). Both are taken after I have ate supper/breakfast.

Head of bed is elevated 6". And yes dipping is smokeless tobacco .

Albuterol inhaler does nothing, kinda acts like the steroids, when taken and it seems to make things slightly worse. Back when I was in high school and I'd have a rare asthma attack, albuterol would kick in within a minute of taking it.
 
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Aqua14 replied to volcomrr's response:
Two additional thoughts on this:

One is, you might try OTC Zegerid instead of Prilosec. Zegerid is essentially fast-acting Prilosec (it's Prilosec with baking soda added). I find that Zegerid works better for me in the morning, whereas I can use Prilosec 2 Tums at night and that's fine. Zegerid's not yet generic so it's a little more pricey than generic Prilosec, but you might try Zegerid for a week and see how you do.

The other is, if you haven't been to a GI doc yet, think about doing that. The concern would be damage to your esophagus from the reflux. Also the GI doc might have different medications for you to sample.

Re: the albuterol, some people find that the new propellant used nowdays in inhalers (HFA instead of the old CFC) actually makes their breathing worse. It doesn't bother me, but there are lots of other folks on this board who have difficulties with it, so you're not alone in that.

Hopefully these thoughts help you. Take care. Judy
 
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choo_chu replied to volcomrr's response:
Inhalers can irritate gastric reflux, too.
 
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sgbl88 responded:
Has anyone discussed vocal cord dysfunction with you? Some VCD patients describe the symptoms you do with that. It is treated with speach therapy.

The association with you picking up snuff is interesting. You should really consider stopping that. The incidence of throat cancer from it is very high.

Feel better.
Sonya
 
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volcomrr replied to Aqua14's response:
Thanks, I'll take a look at the Zegerid. I'll consider the GI doc as well, as I have been for a while.
 
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volcomrr replied to sgbl88's response:
Yes, that's the reason that I had the endoscopy done (the camera that goes through the nose down to the vocal chords). While my symptoms were present (and are always present 24/7) they said that my vocal chords were open through the different sound tests so they didn't think I had VCD.

In my OP I stated that this constant constricted breathing had happened before, around the same time that I started dipping, which was within a month. I discussed this with the doc and he said he didn't think that dipping for less than a month would have caused anything that quick.
 
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Aqua14 replied to volcomrr's response:
I had one more thought, triggered by what choo_chu posted: bronchodilators, especially long-acting bronchodilators (such as the one in Symbicort), can promote acid reflux by relaxing the lower esophageal sphincter (LES), which is the valve at the bottom of the esophagus that closes off to prevent stomach acid from refluxing.

Some believe that the incidence of reflux in asthma patients is so high simply because the frequent use of bronchodilators permanently relaxes the LES.

Just a thought, hope it helps. Judy
 
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Mathchickie replied to Aqua14's response:
You are absolutely right, Judy. Symbicort is an amazing drug for me, but it causes such severe reflux I can take it only occasionally. My allergist claimed he'd never heard of reflux as a side effect of bronchiodilators, and my GI doctor has nothing to offer except PPIs, which are only partly effective.

The reflux drugs that actually act on the LES tend to worsen asthma. (Baclofen, Reglan.)


On the flip side, undertreated asthma can also cause reflux. The coughing, the violent movement of the diaphragm... My reflux was under pretty good control, then I developed asthma and I haven't been able to control it since.

And then reflux comes back around and irritates the lungs. Vicious cycle.
 
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sgbl88 replied to Mathchickie's response:
Thanks ladies. I hadn't thought about that, but it makes sense. Breathing is too difficult sometimes.

Sonya

BTW - day 12 of pred and I am finally starting to cough.
 
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Aqua14 replied to Mathchickie's response:
Thanks Mathchickie, I didn't know that about the reflux drugs nor that asthma symptoms can promote asthma.

The other thing that came to mind (OT for this poster) is that I've read that exercise can also cause reflux. Oh, but I'm NOT gonna give up my exercise, no way!

So thanks for the info! Judy
 
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Aqua14 replied to Aqua14's response:
Ack, I meant to say "asthma symptoms can promote reflux." D'oh!
 
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Mathchickie replied to Aqua14's response:
The exercises that are most likely to trigger reflux are ones that involve inverting the upper body, putting pressure on the abdomen, or squeezing the abdominal muscles. Stomach crunches are not so good, for example.

I've never heard of people getting reflux from, say, brisk walking.


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