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    New To Asthma and In a New Apartment Having Trouble Parsing Asthma vs Anxiety Apart
    ballardian posted:
    Hello all,

    I'm relatively new to asthma (I was diagnosed when I was a child but never managed it — not exactly sure why) I can only remember having 3 acute asthma attacks in my life a) when hiking in college when it was very cold, 2) when visiting some large polluted towns in China, and 3) most recently when trying to move into an apartment where many renovations had just been finish: notable the bathtub was redone only 2 days prior and the odor was still very strong. When I laid on the carpet for 30 minutes I had an attack which not only caused me not to be able to breath but also set of my anxiety to an all time high. After 8 grueling days of trying to make it work (air it out, run a chemical filter, getting the carpets cleaned, etc) we choose to break the lease and not move in. Anxiety was still so bad I gave myself physical problems in my GI tract as well.

    Anyway, we took a vacation, I calmed down and we started looking for a new apartment. We found one and moved in over this past week but I'm struggling with disconnecting my anxiety from the last apartment and any new one. This time we avoided all my known triggers which were pollution and VOC (and possibly cats). The place has all hard wood floors, plenty of ventilation, and doesn't smell of any chemical of any kind. I also got a AustinAir Healthmate+ just to help take the edge off of my concerns when moving in. (we call it the dalek "EXTERMINATE!")

    Anyway, so we've been in the space for 5 days and I'm still having a really hard time telling if a) I am having asthma from the space, b)if I am having asthma symptoms are they from the anxiety, and c) what are really asthma symptoms versus other sensations in my body in the same region. It has been about 1.5 months since I last stepped foot in the 'bad' apartment and I've seen a specialist who has me on 2x44mcg of flovent twice a day, zyrtec once a day, singulair once a day, and a steroid nose spray once a day. Rescue inhaler as needed. Honestly, I'm a bit scared to use the rescue inhaler because I don't WANT to be having asthma and I WANT to be able to live in the space of my new apartment (it is really nice).

    Over the past few days I've spent more of my time in the bedroom in my old bed because it feels like the safest space and I always feel like I can breath well in there and there have been times when I just started crying because I feel so bad for my partner I moved in with and not wanting to have asthma (I know not a realistic thing but that is how I felt at the time I suspect I'm preaching to the choir). Periodically I feel like the asthma is going to control me and periodically I feel like I can control the asthma. I think at this point my biggest 'concern' is not having asthma or managing it but being able to live in the apartment we rented (because I already made her give up one and I'm not sure another one would be better unless I know ALL my triggersâ?¦which I don't yet).

    I also have anxiety that can flare up pretty bad. I practice Taiji and Qigong to help keep it in check but once it wins out I have a hard time bringing myself back under control and I stop eating and drinking well and start noticing every little feeling in my body and 'hoping' it isn't asthma. In this case, I feel like it is flared up just because moving right now has been traumatized to being the same as asthma for me and I'm having one hell of a time parsing them apart.
    ballardian responded:
    Part II to the Story

    Right now the thing I feel the most often (and I've ascribed to NOT being asthma — although it could be) is when I take a deep breath at the end of the breath the muscles between my ribs hurt a bit, then on the exhale when I try to force it all the way out the same happens. It feels like the muscles of the ribs are reaching their maximum flexibility and therefore stop the inhalation and not that it is an inflammation of the inside limiting my lung capacity. At the same time if I do diaphramic breathing and don't try to use my chest I don't feel inhibited in anyway. (I concede it doesn't mean I'm not but I don't feel it like the other attacks I've had). I've had these same sort of ribcage feelings before after working out my ribcage a lot in Qigong so for the moment I've ascribed them to being 'not asthma symtoms'. I could be wrong and I could have been having asthma symptoms at the end of my qigong practices as well.

    Right now I believe my biggest trigger is my anxiety. If I start feeling like I might be having an asthma symptom if I go to bed I wake up feeling better (even 15 minute nap) in the same apartment. I've slept in 2 out of the 3 rooms and I woke up not feeling any tightness in my chest but periodically the rib cage experience. If I take a hot bath and calm down it helps as well. Yesterday I took an anti-anxiety medication that was prescribed for me and all day I had no more problems than the rib cage twinge.

    Last night I found out we have a gas stove (I knew we had a gas fireplace that is currently off) and I've heard that they can cause asthmatics problems. My partner cooked in it and I didn't have any worsening of symptoms after that. Went to bed no problem.

    The last piece of the story at this time is the for the past 1.5 days I've been quite lightheaded. It started after we went out to see a movie 2 nights ago and hasn't really left. I haven't been eating or drinking enough the past few days and right now that is what I THINK is the main cause but I was wondering if lightheadedness can be a symptom of asthma?

    I've got an appointment with my GP to look at addresses my anxiety on a daily basis for a period of time to get that trigger out of the way and I'm going to call my asthma specialist and ask a few questions about some of my experiences whether they are symptoms or not.

    At this point I don't really have a specific question as much as I'm looking to not feel so isolated in my story, some hope that I will be able to work through this (and hope that leaving the apartment is a last resort), and just hearing some success stories because right now all I feel is a string of set backs. Intellectually, I know this can be overcome and if I can find comfort in a home (hopefully) this one I'm certain I can work through it but right now it feels a bit bleak and like I'm dragging my partner down an unpleasant road with me.

    Thanks for listening and I look forward to hearing anything anyone has to say. I'm reading through the forums on my own as well to glean what I can from others words already.
    Aqua14 replied to ballardian's response:
    If this were happening to me, I'd chalk it up to stress temporarily worsening my asthma. Over the years I've learned how stress can really throw my asthma out of whack, and sometimes I don't even notice how stressed I am. Other things that can worsen my asthma are lack of sleep, so if you're fatigued that can contribute as well.

    So definitely consult your physicians, but see how you do the longer you live in your new apartment and get more comfortable with it. Consider getting a massage or doing other things to help you relax more (maybe a glass of wine with dinner?). And don't be afraid to use your inhaler! Easing your symptoms can also ease your anxiety and make you more relaxed.

    Hopefully some of these thoughts help. Take care and good luck. Judy
    amcate replied to ballardian's response:
    You say you are mostly looking to not feel isolated. You are not alone in this, though I'm not sure my story would be encouraging to you due to the severity of my asthma. I have found the emotional adjustment to be difficult.

    It takes time to learn all the triggers for your particular asthma, and it's mostly a process of trial and error. It's hard to say if the asthma causes the anxiety or the anxiety contributes to the asthma, especially since some asthma medicines have anxiety or moodiness as a side effect. Definitely ask a good physician with this.

    In terms of the pain between your ribs, the only thing I can relate to is that sometimes if I've been through a difficult exacerbation where I've have a lot of fluid in my lungs for awhile, I will get a sharp pain with deep breathing. I typically handle it with deep breathing and holding the breath about five times every hour to get some positive pressure in the airway. Then the pain will go away after a few days.

    I hope this helps.
    ballardian replied to Aqua14's response:
    Thanks for responding Judy. I finally was able to start turning the anxiety corner after a really intensive acupuncture appointment. After that for the first time I felt hopeful about living in the new place as well as living with asthma in general.

    My asthma dr gave me a peak flow meter to help calibrate my physical experiences with some measurable data to help piece apart what isn't faux asthma symptoms (anxiety induced or other) and what are real symptoms. I'm happy to say after a week of using it pretty much everything is faux symptoms at this time so that really helped.

    So I think temporary stress it was. Thanks for your words and they were helpful.

    ballardian replied to amcate's response:
    ::Nods:: thank you for replying. The emotional adjustment clearly isn't easy for me. I think I finally hit it on the head when I realized I wasn't scared of asthma per say as much as I was scared at the potential of my housing structure as being a trigger for it. Luckily, after 2 weeks of living here I'm comfortable it isn't so I can get to the real thing to deal with: asthma in general.

    ::nods:: Yeah my experience deffiently echoes your words about anxiety not clearing being a cause or a outcome of asthma. That is what has been hard for me most of my calming (for anxiety) things are breathing related and when deeply inhaling causes the very sensation I'm concerned about it is a vicious cycle and I didn't have any tools to break it. I've talked to my gp about it and I have a plan/tools now and was actually recommended to therapy to see why the anxiety is so crippling.

    That is good to know about the ribs. Mr Dr didn't seem to think what I described to him was asthma directly and luckily it has now passed after a few days. Thanks for giving me something to watch out for.

    Aqua14 replied to ballardian's response:
    That's great. I should have thought about using a peak flow meter. . .that makes perfect sense. I'm glad that you're doing better and hope that you continue to do well! Judy
    amcate replied to ballardian's response:
    Thank you for your response. I was diagnosed with generalized anxiety disorder as a teenager, then with asthma at 28. I'm glad you have some tools as well. I've also found that swimming helps, as it releases endorphins.

    You mentioned using a peak flow to determine what is actually asthma. I had a doctor suggest I do that as well. In my case, I had lived in a high pollution area, my attacks started with coughing, and then progressed downward. I moved to a small town, and whenever I coughed, I would take rescue medicine. The doctor there thought I was over interpretting the cough, and I told him I was afraid of a bad attack as I've had them before. So, he gave the peak flow meter to differentiate a normal cough from a cough that would lead into an attack. He reminded me I was not in high pollution anymore.

    The original instructions were that if the peak flow was in a green zone 80% or higher then it was not asthma. However, through the years this had to be modified to say that if I was coughing and the peak flow was borderline, then interpret it as asthma. If the peak flow was high and not borderline, even with coughing, then it's not asthma.

    Just be aware that the cut off point may need tweaking. Mine did so as to be more aggressive with the rescue medicines. Still, it does help.

    Sorry I didn't think to mention it before, but glad your doctor did.
    Mathchickie replied to amcate's response:
    The 80% cutoff can vary from person to person. Me, I can apparently feel even a small drop in lung function. I can tell the difference between 90% of my best and 100%, and my first few attacks were pretty scary. By using the peak flow meter and having spirometry in the doctor's office, I've learned to distinguish between a small drop in lung function and a serious one.

    The downside of being more sensitive than most people is that even small asthma flare-ups can be quite uncomfortable, the good side is that I don't think I'm ever going to have a serious attack sneak up on me without warning.
    ballardian replied to Aqua14's response:
    Thanks Judy. At this point I'd say I'm back to where I was before the big move/attack that set this all off. Doesn't mean I don't have work to do, or asthma to live with but my day to day experience is much better.
    ballardian replied to amcate's response:
    Ironically, I actually mentioned it to my dr and he thought it was a good idea I think what I mostly needed for my anxiety was the calibration of being in his office with the fancy spirometer, his opinion that my lungs were doing well, and then my personal best right there and then. That put the confidence in place for what it really meant.

    Thanks for the heads up about the need to tweak the green zone perhaps with some caveats through time It is good to know others have been in the similar spot as me.

    Another thing that really helped we being away from the new place for the first 2 days of using the peak flow meter so I got baseline of 'being somewhere else' So now that I've seen my pattern with the peak flow meter away from the new space I at least 'know' that this space is no worse than another space. That really helps with the potential anxiety.
    amcate replied to ballardian's response:
    I'm glad you seem to be doing well. It was a good idea you had about the peak flow meter-years ago I came up with a different plan of when to start prednisone as it consistently resulted in lower prednisone use on an annual basis. The doctor advised against it, but now my asthma doctor says what I was suggesting years ago is now incorporated into the national recommendations. You have good insight.

    I hope I don't make you more nervous, it's not intended, so ignore me if I do. I just wanted to clarify what I mean by the 80% cut off. I still use 80% as the cutoff between the green and yellow zone. If it's a high yellow zone, between 65-80%, I'll double inhaled corticosteroids, be very careful with triggers, and sometimes will use rescue inhaler every 4 hours for the first day.

    I already had the peak flow meter when I moved to the small town, but the doctor saw that the pulmonary function test was strong, I was not reporting any other symptoms, and the peak flows were also very strong, yet I was reporting using the rescue inhaler 2-3 times a day. I had just moved out of the high pollution area when there was an industrial accident, and very scary and real situation. He saw me a few months after being in a small town, and felt that given the whole picture, I was probably overusing the rescue inhaler. He then told me to get a peak, and if the peak flow was 80% or more, then don't use a rescue inhaler. It's complicated-he wasn't referring to the tradition green/yellow/red zones for an asthma action plan as I already had one. He was saying 80% as a cut off to determine if it was a true beginning of an asthma attack or just a normal cough so I wouldn't take rescue medicines unnecessarily.

    Then, a few years after that, I was having some problems with my breathing on and off, and people said I looked sick at work. I got home, was coughing, got my peak flow and it said 81%. So, I assumed it was not an attack. I went to bed, my thinking became cloudy and I was rather lethargic, I got irritated because the damn coughing wouldn't let me sleep, but because of cloudy thinking, it didn't even occur to me I might be having an attack. Out of irritation of not being able to sleep, I started a neb treatment, but shortly after lost consciousness. Fortunately, the mouthpiece stayed in, and continued delivering medicine. I all of a sudden woke up and coughed up a bunch of fluid. I took the peak flow 20 minutes after the neb, and got 65%. I told the current asthma doctor, "but the other guy said if it was above 80%, it was not the start of an attack." He said, "well, in athma management you can't really know for sure how something is going to react until you try it. So, now we know that you can be borderline in peak flows and only have a cough, but in fact be going into an asthma attack. So, now I'll readjust the instructions to say that if you are borderline peak flow with any symptoms, including coughing only, go ahead and take rescue medicine. If you peak flow is no where near 80%, like at 95%, then don't take rescue medicine."

    However, they've never changed the 80% cut off for the asthma action plan with regard to a green versus yellow zone and when to start doubling the inhaled corticosteroids.

    I'm sorry-it's complicated....through the years I've learned some nuances of the tweaking.

    Anyway, glad you are doing well. If I messed up and made you feel worse with being nervous then forgive and ignore me. I've found through the years that each time I go through it I get better at judging when to do what, and it gets easier judging how to pull myself out with the least amount of drugs. Still, I wish I had an absolute guarantee that if I do XYZ, everything will be good. I hate not having control.

    I wish you the best.
    ballardian replied to amcate's response:
    No amcate you didn't make me more nervous and thanks for the clarification. I think that is what I got out of it the first time I read it but I appreciate you taking the time to clarify it.

    I'm not terribly experienced with asthma yet but in the other endevors in life I totally agree that tweaking is a game of nuances and every time I go through something I'm better at dealing/judging with it as well. I appreciate you sharing parts of your story with me especially the last two paragraphs. Honestly, it helps for me to see that the path I'm heading down is working for at least one person and not totally off kilter.

    And that hope of the path rather than the XYZ to have perfect control is long term much more helpful. So thank you.

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