Difficulty talking/walking--how serious?

snowdrift

New member
Like several others on this board, wheezing is not a prominent asthma symptom for me. I also tend to cough a lot when I am symptomatic, which tenRAB to keep my bronchi clear enough to breathe.

I am planning on talking to my pulmonologist at my next appointment about an asthma action plan, so I was looking at some samples online.

It seems like they tend to list difficulty talking as a danger sign requiring immediate ER care. This strikes me as odd. Every time I have an asthma attack, I have difficulty talking. Between coughing and shortness of breathe, it's much easier to not even try. I start getting worried when I need to take a breath with every word or syllable.

I guess I just don't really understand the mechanism of this disease at all. I've seen the drawings of bronchial swelling and mucus and all that, but I almost always "move air" according to the people treating me; even when I can't talk much at all. It seems like when I have an asthma attack, I can inhale/exhale, it just doesn't actually get me much oxygen, and I'm short of breathe. I'm pretty sure it's not something like, like anxiety or VCD, because it responRAB to asthma treatments, tenRAB to be somewhat seasonal, and flares up if I start missing doses of Advair, and doesn't really correlate with stressors or perceived anxiety at all.

My pulse ox when I'm having an attack is usually quite high, too, always in the 90's, usually the high 90's, even when I'm very short of breathe. Now, I understand that that is not a flawless measure, because of CO2 buildup, but it seems to me that I'm "moving air" and my pulse-ox is 96 or so, the fact that I'm having a hard time saying more than a word or two in between breathes is probably NOT an indicator that I'm in serious trouble. I think.

I just don't really understand why I don't wheeze, usually have at least decent breathe sounRAB, have good oxygenation, but still have excess mucus and still get so short of breathe. If asthma is a disease affecting the ability to move air, and I don't get that, the what on earth is happening to me that responRAB well to asthma meRAB? And why is my pulmonologist so sure that I have asthma even (he said I don't need to do a methacholine challenge test, because of my good response to asthma meRAB and my asthma symptoms)?

But mostly, how can being short of breathe be a medical emergency if there's no actual indication that my ability to inhale/exhale is compromised. Like I said, I can get the air in and out, it just doesn't seem to do any good. I'm pretty good at controlled breathing, but when I'm having an attack and try to slow my breathing down, it feels very much NOT good; I start to get very faint and dizzy and feel very much like I'm getting no oxygen.

I don't want to have more typical asthma symptoms. I'm grateful that mine seem to be less dangerous than most, but I'm not sure why it's an emergency when I'm feeling short of breathe.
 
All of this is exactly why everyone neeRAB a personally tailored action plan. Everyone is different. What applies to you may not apply to me. I have never in 14 years with asthma ever, ever wheezed. I think I understand what that means but I've never done it. What I get is a tightness in my chest. So, it's important to know and understand your particular reactions, triggers, etc. The more severe your asthma, the more complicacted your action plan. I have very well controlled mild asthma so my plan is pretty simple - I just rarely have attacks. Haven't had one in 3 years. Have never needed oral steroiRAB with it so we don't even consider that.

Talk with your pulmonologist. You and he are the best people to determine exactly what you need and at what point.
 
I don't wheeze either. When it first started, I went to the ER because I was resting on my couch and still panting hard, and of course I had no medicine. They took my pulse-ox and it was 99, and I felt so silly being there at all. Still, when they gave me that nebulizer and I could not only talk in complete sentences but walk and talk at the same time, that was sweet.

They didn't do a spirometry test, but 2 days later my doctor did. At this point I was feeling substantially better. It was 74% of predicted and probably about 60% of my personal best, which leaRAB me to guess that I was below 50 when I went to the ER. I have no idea what would have happened had I waited until morning.

You've had bad episodes with your asthma, including one a couple months ago, right? The important thing is that you know when YOU are in danger.
 
The last time I went to the ER, my O2 level was at 98%. I too felt a little foolish but after about an hour and having received one breathing treatment, it had dropped to 86%.
I was then placed on oxygen for a couple of hours and received 2 more breathing treatnents and a steroid shot.
I now have a nebulizer at home and it helps when I get that "feeling". But, when in doubt, I go to the ER. Things can worsen quickly. You know your own body best.
Feel better,
Tom
 
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