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    Help! Anyone every had "silent" bronchitis?
    NoMoreJim posted:
    I've had asthma for a few years now. It's been very well controled with symbicort 160/4.5 for almost the whole time. I've even been able to get down to using it once day(on my now retired allergists suggestion).

    In the last couple of weeks it seems it's been out of control. I've been waking up in the middle of the night with pain in my mid back, which happens when I'm having asthma issues. And I've been using my rescue inhaler every single day.

    I was sick a couple of months ago with a sinus infection, which required 2 rounds a meds to get rid of. after the second round I felt totally better, until about the middle of last week when this lung deal started.

    The only other piece of info that could be important in this equation is the fact that my husband has been sick for a month, he first had the sinus infection that I had, and now has an ear infection from the sinus infection...

    The problem is this, my asthma has always been silent. I don't wheeze. at. all. never have. I've had bronchitis once before and was told by the first doctor that I saw that it couldn't possible be bronchitis because my lungs were "clear".

    Upon my second visit, after another 10 days of suffering, another doctor said, well he could be right, it could be viral, or it could just be this is how it presents for you. 5 days of a zpack later, except for the little bit of SOB that is expected after bronchitis, I was 100% better.

    I've been pondering the idea that this could be allergy related, although I've had allergy testing and am allergic to nothing at I added an OTC allergy med just to see if I cold calm things down. which seems to have done nothing...

    I'm just wondering if anyone has any suggestions on how to approach this. I really really hate to have to go to the doctor, because I know that they are just going to say well you "sound" find. never mind the elephant that has been sitting on my chest for days now.

    Any thoughts or suggestions would be much appreciated.

    bresky responded:
    Hey I understand your frustrations, I have silent asthma, I never wheeze never have my chest will get tight and I am very symptomatic but when the dr listens it clear or tight. When I go in with my asthma troubles or if I feel I have an infection and am honest, 10% of asthmatics don't wheeze, however a lot of drs don't believe that. I do see a respirologist and it is confirmed asthma, I try and deal with one dr or at the same clinic as my chart has all the information from my specialist on file.

    I find being honest about the symptoms and also warn them about the chest sounds, let them know it isn't uncommon for there not to be wheezes may help. I know one time I was having a really hard time breathing the chest X-ray was normal, my chest sounds were tight not getting great air entry so they did a ct scan which showed three spots of pneumonia. Hope it goes well and they listen Bre
    amcate responded:
    If it is asthma (which it could be since you had a recent infection and infections can trigger asthma), then you might have to increase some of your asthma meds.

    When I was first diagnosed, all I had was a chronic cough. Family practice said that a person who was 26 with a chronic cough unexplained by all else and who was clear to ausculation (sounds clear) and clear X-ray was probably asthma or allergies or both. He wanted to refer me to an allergist/asthma specialist, but I had no money.

    Then, a few years later, all hell broke lose. Then there was what I would call wheezing, with a high pitch at the end of coughs, but it was never a prominent feature. Normally, it starts with coughing, then that clear frothy fluid comes up with the cough, then the lungs spasm in an out uncontrollably, and if it continues then I breath with the muscles around my neck, and can only say one word at a time. The lungs feel like they are burned from the inside out, and feel very heavy and tight. Then, it gets where I get really tired and it takes more energy to breath than the breathing gives me. Then I lay down, then lose of consciousness. That's at it's worse, and before I was on the medicines I now take. I normally increase meds before it gets that bad. But even so, wheezing is present some at the very end of the breath, but is not a prominent feature even though I get where it's hard to get air out of my lungs as the attack progresses. When I can get peak flows (which I'll do because sometimes I interrupt something as the beginning of an attack when it is not), they do go down. Often I can't get them until after nebs, but even so, they'll be around 65% of personal best (I'm normally 80-90%) after the neb treatment.

    If you don't have an asthma action plan, then you probably do have to see a doctor and if it's asthma normally they will increase inhaled corticosteroids or give you the oral kind. Perhaps someone board certified in allergy, asthma, and immunology would be more likely to listen? In my experience, they tend to listen better than other specialists, though they don't know a lot of other pulmonology diseases, like a pulmonologist would.
    JP4431 responded:

    Your lungs are probably still inflamed from when you were sick, so every little thing that irritates your asthma really hits you hard. I used to use Symbicort too, and it never really controlled my asthma...of course there is nothing silent about mine

    Recently, my doctor decided to stop the Symbicort and try Provair, which is a straight steroid. Before I had run out of my Symbicort, I got so sick that I could not breathe for about a week. I stopped taking the Symbicort and started taking the Provair, and I haven't felt this good since I was diagnosed with Asthma.

    It really reduced the inflammation and cleared up my lungs. If you decide to try it, let me know how it works.

    Good luck!
    runshox responded:
    This sounds all too familiar!! I went through this same routine, diagnosed with asthma about 2 years ago, I do not wheeze at all. Was getting sick sinus, bronchial, pneumonia, over and over. I had all the inhalers, predisone etc.. Then I was referred to a stomache specialist. Acid reflux can cause the same symptoms and worse. So not only did I have asthma, but also severe acid reflux which became worse by drinking "orange juice", which I was drinking all the time because I was always sick!! I ended up having what is called TIF surgery on my stomach. WHY, because for so long I coughed so hard I herniated my diaphragm and my stomach was pushing up above the diaphragm wall making the entire situation worse! I also started getting weekly allergy injections, because I actually do have mild allergies.
    I would go to a stomach specialist, if you do not treat the condition and it is related to stomach acid it can cause COPD.
    Good Luck!
    pinkpuffer responded:
    I have moderate asthma. I do not wheeze unless my cough is so tight it's almost like a croup cough. My chest hurts, it feels tight, my voice changes, and I get really short of breath. The fight with doctors is they want to hear a wheeze. So frustrating!!
    todaymark responded:
    It never ceases to amaze me that people with asthma aren't told there are 2 different types; Intrinsic and Extrinsic Asthma. Intrinsic asthma is the typical type that people are familiar with, the allergic kind were histamine is released to cause the reaction. Allergy tests will verify your allergens. Extrinsic asthma is caused by outside irritants such as pollution and anything that can be inhaled. Histamine is not released with this type of asthma but the irritation to the airways causes similar symptoms in people that are sensitive. It's difficult to know which is which without allergy tests. Treatment is the same depending on severity except that antihistamines don't really work for extrinsic asthma. Although there is a benefit to those with nasal allergies if an antihistamine nasal spray is used. Another drug many asthma sufferers aren't familiar with is cromolyn sodium that is used in a nebulizer or as a nasal spray. It's used prophylactically and worth a try. Asthma at best is annoying and at worst deadly. It's important to know all you can and if you aren't getting satisfactory answers from you MD do your own research. No one wants to be burdened with an illness but it's very manageable if you're well informed. Take it from an asthma suffering Respiratory Therapist.
    nowheeze replied to todaymark's response:
    I have had asthma my entire life and at 50, I'd like to think I'm pretty knowledgeable. But I have recently started seeing a pulminologist after having a CT scan (unrelated) that showed multiple lung nodules. He is said to be an excellent Dr. and I'm sure he is. He's taken care of two very sick friends and did a remarkable job. However, because I haven't been wheezing, he hasn't taken my complaints seriously. In the meantime, my chest is tight, I've missed a lot of work and and the stress of all of it, makes it even worse. All bc I'm not wheezing and my O2 is ok. If sobbing wouldn't exacerbate the condition, I'd break down and cry. My knowledge and articulate ability hasn't done much to help me. I am so fed up I could scream, except I can't.
    todaymark responded:
    Sorry for your struggles and lack of interest by your provider. I'm a Resp. Therapist with similar issues. I hope you've had full pulmonary testing, if not it's time to see a Pulmonary MD. Sounds like you have intrinsic asthma but it needs to be evaluated.

    I also don't wheeze but my problem is with air trapping that only pulmonary testing can reveal. This doesn't mean you can't have bronchial constriction, again without wheezing.

    There's something else to consider. Do you have problems taking NSAID'S, such as aspirin? You may want to experiment. NSAID'S have salicylates in them that are also found in multiple products, prescription drugs and food. If you have sinus issues, asthma and a salicylate allergy or sensitivity you could have "Sampter's Triad". The 3 issues together constitute the triad. It isn't all that well known but probably more common then you think. The only way to know is to stop taking or using products that contain salicylates. You'll have to do some research to the "Triad" and salicylate sensitivity. The amount of info out there is enormous. I even had to start making my own mouthwash and by salicylate free toothpaste. A Pulmonary MD will know this.

    You also need to start taking care of your sinuses. I have my biggest problem with asthma when I've had a cold that settles in my head. It's all connected and gravity works well. I use a Netty pot daily that works wonders and is simple and quick. There are also prescription nasal sprays that work well including a nasal antihistamine, ipratropium bromide and a nasal cortisone spray. You don't have to have allergies to have problems. With intrinsic issues your body responds to the environment with inflammation and not histamine release but the symptoms are similar, "airway constriction".

    By the way, Symbicort is mostly used for COPD. Again, a Pulmonary MD would help. There are multiple inhalers out there and it's not one size fits all. You could do your own research on this also. If you do find out you have Sampter's Triad there's a med for that too that helps called Singular. Even if you don't have it Singular can help. It's an indirect mast cell stabilizer.

    You're taking a combination inhaler in Symbicort, it's a steroid plus a long acting bronchodilator. I found that an inhaled steroid is all I need plus my rescue inhaler. In fact the long acting bronchodilator was a problem. My point is, one size does not fit all. I have the advantage of being able to tell my MD what I want to take but if you do your research, and there are plenty of sites, you'll be surprised that your MD will cooperate because they know all too well how everyone is different and don't respond to treatments the same way. Emergency situations are treated systematically but long term care is more complicated. Your education may help your husband also.

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