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Re: Fear
Jun 11, 2008
John, the similarity between asthma and anxiety symptoms is something I've really, really, really wanted to talk about with some people who have asthma for a while now. I'd really like to share my story, and I hope it isn't too much of a thread-jack.

I've had depression/anxiety problems for years, although depression is much more of a problem for me than anxiety. I was only diagnosed with asthma this past March, and I didn't have much testing, just basic spirometry in my GP's office, so I still have doubts about my diagnosis.

Two winters ago I started getting a lot of couple days long episodes of coughing, shortness of breathe, and figured it was a respiratory virus. By the middle of the winter I had a chronic cough, worse at night, triggered by cold. Coughing sometimes got so bad it led to chest pain, s.o.b. and wheezing. But a couple times in the past few years, I'd had episodes of rapid breathing, s.o.b., and such in conjunction with emotional stress--but always late at night. So, I thought that those were panic attacks and that the intense and constant coughing was probably psychogenic. But by the end of the winter, I was so ill and susceptible to infections that even going out for an afternoon of errands led to a couple days of fever, and a lot of interference with daily activities. I did think about going to a doctor, but didn't. It got bad so gradually, and I always had good days, and somehow it was easy to convince myself I was fine, and just imagining things.

When it got a lot better in the spring, I just forgot about it. Still had intermittent coughing, especially at night, but the pain and s.o.b. and wheezing went away, and I figured it was some kind of psychogenic cough. I guess I forgot how bad it was in the winter, and I was embarrassed to be coughing all the time.

This past winter it came back. Not as bad, and I didn't get sick as many times, or as severely, but the cough came back. And again, I was sure it was anxiety, or worry, or of some other psychological origin.

Then, one day, everything went wrong. The weather was terrible, fast, cold snow following some warm days, so the roads became slick with ice. I slid into the back of a car. Police report. Hours late. Childcare arrangements fell apart. For complicated reasons, ended up sprinting about four blocks in about twenty degrees (f). And then it happened. Extreme shortness of breathe. Tight chest. Huge amounts of mucous choking me. Wheezing and coughing. Well, y'all know what that's like, I guess. Got quite a bit better after a couple hours. Again, figured it was anxiety. Intensely stressful day.

Went home, got kid in bed, ate some dinner, poured a drink, called a friend. Talking on the phone brought it back. Ended up spending nearly the whole night on my kitchen floor. Couldn't breathe, couldn't move. To my embarrassment, ended up vomiting there in the floor from the intense coughing and inability to breathe. By morning it started to get a little better and I crawled off to bed. I was utterly incapacitated for the next five or six days. I had several more attacks like that, that would always get better, but never quite went away. By the time I got to a doctor I could barely walk. I couldn't say more than two or three words together without coughing or gasping. She sent me to an imaging place about fifteen feet away to get a chest x-ray, and it seemed like miles. Every time I go back to that office, I am astonished at how close it is. That day, it seemed so distant and hard to find.

But the spirometry said I was only mildly obstructed. Well, on the edge between mild and moderate obstruction. My lungs were fairly quiet. Chest x-ray was normal. They gave me a breathing treatment and an inhaler and antibiotics. A couple days later, added in Advair and Aciphex.

All that helped a lot, but I still had some trouble. A couple of weeks later I did pretty heavy-duty yardwork that I now realize was a bad idea, and started coughing. It felt worse than usual, and I had a bad feeling about it. I tried to go to urgent care, learned they were closed, but by then it was getting bad enough that I went to the ER. I self-reported as having "a cold, and a little asthma trouble". I ended up being there for several hours, and gettign treated for a moderately severe asthma attack. Sent home with six days of prednisone. The next day my doctor gave me more antibiotics, for a mycoplasma infection that had contributed to the whole thing. The ER also gave me a peak flow meter. I posted recently about that. The peak flow meter read absurdly high for me by the time I was done with the prednisone. Into the 700's. And once again, I questioned myself. I actually went off all my meds for a week because I was convinced I was somehow making it happen, that it wasn't asthma, just weird psychology.

An ER RT, resident, attending, and nurse, all agreed I was having an asthma attack, and I was still convinced I was just being anxious and histrionic. Finally last week I got a different model of peak flow meter, and it seems to be more helpful in giving me an idea of where I am. The week without meds took a toll, and I had some bad days, especially this past weekend when it was so hot. I'm doing better now, but I'm still frsutrated because I feel like all of these respiratory problems are not real. That they are a psychological reaction to something. I dunno.

But, yeah, I find it very difficult to cope with having emotional problems in conjunction with what I guess I should refer to as asthma. It's very strange that I've had this illness for at least a year and a half, that it has seriously impacted my life, that it has made me very ill on several occasions, including being too sick to walk and talk and take care of my family, took me to the hospital, and I still am not convinced it's real.

And, yes, I am beginning to work with a psychologist because the counselor I had been working with did not have the experience to realize how important this issue is in my life. I've been wishing I could discuss this with someone familiar with asthma for a long time now, and so I hope this very logn and personal post is ok here. Just, yeah, emotional issues and asthma. Tough combination.





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