Persistent Cough and Chest Tightness: Is It Asthma?

Q: Persistent Cough and Chest Tightness: Is It Asthma?

Hello： First, please consult a pulmonologist to confirm whether you have asthma. <br>If there is no clear diagnosis and you are experiencing side effects from medication, it may be advisable to try traditional Chinese medicine for a period of time. <br>Focus on symptom improvemen

Suspected asthma with difficulty breathing and chest tightness?

Around mid-February, I experienced a mild cough with a lot of clear phlegm, but it wasn't obstructive.
I had to expectorate every half hour, and this condition persisted until the end of May.
One time after eating something spicy, I began to experience wheezing and coughing, feeling as if my throat was filled with phlegm (clear and colorless).
If I didn't cough, I felt short of breath for about 3 to 5 minutes, and I would cough occasionally, bringing up a small amount of phlegm (which made my breathing feel clearer).
I rarely had continuous coughing fits, and when I wasn't coughing, I constantly felt the need to expectorate, but I didn't cough while sleeping.
I also didn't cough when using the air conditioner before bed.
Both chest X-rays and pulmonary function tests were normal.
The doctor prescribed me a bronchodilator to inhale, along with cough suppressants and antihistamines.
After taking the medication, my phlegm and cough stopped, and my breathing was smooth, but I experienced palpitations and tremors, which led to severe insomnia, so I discontinued the medication.
Could this be asthma? I have never experienced this before and am currently receiving treatment from a traditional Chinese medicine practitioner, which has shown improvement.
However, in the mornings, it feels like my bronchi are constricted, and phlegm gets stuck in my throat, making breathing difficult.
I have to cough forcefully to clear the phlegm, and after breakfast, my breathing becomes easier, but I still experience chest tightness.
A one-minute breathing test showed 25 breaths.
Does this count as an asthma attack? Additionally, what can I do to improve severe insomnia caused by using bronchodilators and steroids?

sandy1209, 40~49 year old female. Ask Date: 2020/08/20

Dr. Yang Wenda reply Pulmonology

Hello: First, please consult a pulmonologist to confirm whether you have asthma.
If there is no clear diagnosis and you are experiencing side effects from medication, it may be advisable to try traditional Chinese medicine for a period of time.
Focus on symptom improvement first.
Additionally, it is recommended to avoid cold drinks and sugary foods in your daily life.

Reply Date: 2020/08/20

More Info

Based on your detailed description of symptoms and medical history, it appears that you may be experiencing a form of reactive airway disease, which could indeed be indicative of asthma or asthma-like symptoms. Your persistent cough, the production of clear mucus, and the sensation of chest tightness, especially after exposure to irritants like spicy foods, are all common signs associated with asthma.
Asthma is characterized by inflammation and narrowing of the airways, which can lead to symptoms such as wheezing, coughing, chest tightness, and difficulty breathing. The fact that your symptoms improve with bronchodilator medications (like the one your doctor prescribed) suggests that your airways are responsive to these treatments, which is a hallmark of asthma. The acute episodes of coughing and the need to clear your throat frequently also align with typical asthma symptoms, particularly if they are triggered by specific irritants or allergens.

The normal results from your X-ray and lung function tests are reassuring, as they indicate that there are no significant structural abnormalities in your lungs at this time. However, it is important to note that asthma can still be present even when these tests appear normal, particularly if the symptoms are intermittent or triggered by specific factors.

Regarding your experience with medications, it is not uncommon for some individuals to experience side effects from bronchodilators, such as palpitations, tremors, or insomnia. These side effects can be distressing and may lead you to discontinue the medication, as you have done. If you find that the bronchodilator is necessary for symptom relief but are struggling with side effects, it is crucial to communicate this with your healthcare provider. They may be able to adjust your dosage, switch you to a different medication, or suggest alternative treatments that could minimize side effects while still providing relief.

In terms of managing your symptoms, consider the following strategies:
1. Avoid Triggers: Identify and avoid known triggers that exacerbate your symptoms, such as cold air, strong odors, or certain foods. Keeping a symptom diary can help you pinpoint these triggers.

2. Use a Spacer: If you are using an inhaler, consider using a spacer device. This can help improve the delivery of the medication to your lungs and may reduce side effects.

3. Regular Monitoring: Keep track of your symptoms and peak flow readings if you have a peak flow meter. This can help you and your doctor assess your asthma control and make necessary adjustments to your treatment plan.

4. Consider Allergy Testing: If you suspect that allergies may be contributing to your symptoms, consider discussing allergy testing with your healthcare provider. Managing allergies can significantly improve asthma symptoms.

5. Explore Alternative Treatments: Since you mentioned that you are currently receiving treatment from a traditional Chinese medicine practitioner, continue to explore this avenue if you find it beneficial. Some patients report improvement in their symptoms with alternative therapies.

6. Consult a Specialist: If your symptoms persist or worsen, consider seeking a referral to a pulmonologist or an allergist. They can provide a more comprehensive evaluation and may offer additional treatment options, including inhaled corticosteroids, which can help reduce airway inflammation without the side effects associated with systemic steroids.

In summary, while your symptoms are consistent with asthma, it is essential to work closely with your healthcare provider to develop a tailored management plan that addresses both your respiratory symptoms and any medication side effects you may be experiencing. Regular follow-ups and open communication about your treatment will be key to achieving better control of your symptoms and improving your quality of life.

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