Is it Asthma or am I just out of shape?

[Hamilton92]

How can I tell if I have asthma or if I am just out of shape?
I have always been in fairly good health up to the last year or so. I have gained weight and I am on a mild exercise plan, light aerobics and walking to try to lose the excess pounRAB and get back in shape.
Sometimes I can exercise fine but yesterday it hit me again.
I was walking around a track with frienRAB and my chest began to tighten for no reason, it didn't get really tight where I felt I couldn't breath but it was an uncomfortable feeling.
I also have issues with anxiety so I don't know if its a panic attack or not.
I just don't want to be walking out in the middle of no where and have a full blown asthma attack if thats what this is. I don't want to stop exercising but now I'm scared to exercise. I wonder if I am just that out of shape or if its something more, .like asthma. I have a doctors appt to check for asthma but its not for 2 weeks.
Will my primary care doctor be able to diagnose asthma? What sorts of tests will he do during my appointment to check for asthma?
Thanks!

 

[Titchou]

Most likely he will not be able to test you for asthma. You would need to see a pulmonologist for that. They can do a pulmonary function test and other more sophisticated testing if that one is inconclusive. However, seeing your GP to rule out other things since you evidently have other issues that could cause the breathing problems is a good place to start.

 

[snowdrift]

I'm not sure it's all that clear-cut. I did get basic pulmonary function testing at my GP's office, and those results corabined with my symptoms led my doctor to prescribe a trial of asthma medications. Those were moderately effective, which is sometimes considered diagnostic in and of itself.

However, I was unable to get good asthma control despite trying a few different drugs and had a serious exacerbation, so I was referred to a pulmonologist. The wait for a pulmonologist can be long. In my area, it is rarely difficult to get an appointment with a specialist. Heck, three times now I've gone from initial referal to (non-urgent) surgery in under a month, and yet I waited over two months, if I recall correctly, for my first pulmonologist appointment. I have heard of people in areas with more doctor shortages waiting several months. You probably don't want to wait several months before try to exercise again, especially if you aren't experiencing severe symptoms.

You may be able to get some testing done in your GPs office, or you may not. He or she may not be very experienced in interpreting those results, and he or she may not be as skilled in listening for more subtle signs of constriction. Also, in many people with asthma, test results are completely normal except during an attack. Sometimes, in those case, a methacholine challenge test is done. If you have that test, you inhale a substance to induce symptoms and then a bronchodilator is used to help the symptoms subside. However, my pulmonologist advised against me doing a methacholine challenge. He felt that my good response to asthma medications was enough of an indication that my symptoms are due to asthma.

Sometimes it is possible to distinguish between discomfort due to asthma and discomfort due to being out of shape by the timing of the symptoms. If you're just out of shape, the symptoms usually go away when you stop or slow the activity. With asthma, symptoms may be more likely to persist or even begin after you've stopped the activity. I run a lot. When I first started, I had some chest tightness and discomfort even when I had premedicated with albuterol. It got better when I slowed down. I was out of shape.

However, if i don't premedicate and/or the weather is humid or very cold (two of my asthma triggers), I'll get tight and short of breath fifteen or twenty minutes in. When I get home, I will continue to have symptoms, sometimes for twenty minutes or so, sometimes until I use asthma medication. That's exercise induced asthma.

That is not a hard-and-fast rule, though.