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Thread: Pulmonologist doesn't think I have asthma, but isn't 100% - question about "wheeze"

  1. #1
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    Dec 2017
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    Pulmonologist doesn't think I have asthma, but isn't 100% - question about "wheeze"

    Basically here's what's happened. I'm 21 years old, generally quite healthy male (besides mild seasonal allergies) with no family or personal history of asthma. However, I do have significant family history of bad acid reflux - my Mom, sister, and Aunt all have it, and so do I. My reflux generally manifests as a burning feeling in the throat, regurgitation, burping, and a feeling like I can't get a good deep breath in. It's usually worst at night.

    A few months ago I had a cough that lingered for over a month with no other symptoms, besides some phlegm. My GP randomly suggested I get a complete PFT to check if I had asthma. Went in, did the test, and apparently it showed that I had (according to my GP) "slight asthma". He gave me albuterol and basically no more information. A few days later (without using the albuterol at all), the cough was completely gone.

    So, I saw a pulmonologist, as I'm a bit baffled in regards to the diagnosis, as I've never been remotely asthmatic in my life - my parents couldn't even believe it. I've had shortness of breath from anxiety, but that's about it. Pulmonologist thought I probably just had a case of bronchitis, which would account for the "slight" abnormalities on my PFT. He orders another Complete PFT w/bronchodilator, and this time my results are almost completely normal - the only thing that seemed off to him was my Residual Volume, which was apparently at 156%, whereas the normal "limit" for it is estimated to be around 120% (however, he did say this isn't fully agreed on and suspects it's possible that for me, it's just a normal variant). Pulmonologist says he really doubts I have asthma, but it's not impossible because of the RV reading, so keep my Albuterol around just in case. Didn't think a methacholine test was a great idea, as in his experience it produces a lot of false positives.

    Fast forward to about a week later. I notice when I exhale a certain way through my mouth, I can hear a wheeze that seems to come from my throat (don't feel it in chest at all). I'll do my best to explain. Basically, when I open my mouth and exhale a bit forcefully, I can hear a clear whistling noise - usually louder when I'm standing, a bit harder to do when I'm sitting. When I take a deep breath and then exhale, I don't hear it at all. When I breathe normally, I don't hear it at all. Nothing seems to make it worse (even fairly intense exercise, I feel great after) except for when my acid reflux/LPR is flaring up (like after eating hot wings), in that case it's more noticeable/louder when I do it, but still only when I exhale in that weird, awkward way to hear it. Here's the thing though - if I take a puff of Albuterol, I can barely make the sound at all, no matter how hard I try. I usually can still hear it a bit though. Does this sound like an asthma symptom? Also, if it was an asthma wheeze, wouldn't I also hear it through my nose? I can't make the noise at all no matter how I breathe through my nose. I'm assuming it is something to due with the combination of the awkward way I exhale through my mouth as well as the acid reflux/LPR. But if that's the case, would albuterol really diminish it so much? Also, does anyone know if bad LPR can lower your Peak Flow?

    Like I said, I can make myself do this stupid wheeze just about constantly, and I've started to worry it means that not only do I really have asthma, but it's severely out of control or something. I just don't know much about asthma. Does this sound like a symptom of it? Thanks so much.

  2. #2
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    Aug 2019
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    Re: Pulmonologist doesn't think I have asthma, but isn't 100% - question about "wheez

    Cyrus

    If this wheeze is only happening when you're forcefully testing it, then it isnt anything to worry about. Those with advanced asthma wheeze with the slightest exhalation. My advice is to trust your GP and Pulmonologist AND most importantly, stop forcefully exhaling in an awkward way. Self testing does more harm than good

    Best Wishes

  3. #3
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    Re: Pulmonologist doesn't think I have asthma, but isn't 100% - question about "wheez

    I have asthma and it does apparently go hand in hand with germ. Sometimes if I get reflux it affects my asthma and sometimes not. It’s very weird isn’t it, but on the advice of 2 specialists I would say you probably don’t have it.
    If you take the albuterol does it stop your forced wheeze?

  4. #4
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    Re: Pulmonologist doesn't think I have asthma, but isn't 100% - question about "wheez

    Reflux causes wheezing, it's because of mucus covering your irritated airways.

    Sounds like another case of trigger happy American health professional. They do love to medicate don't they!

  5. #5
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    Re: Pulmonologist doesn't think I have asthma, but isn't 100% - question about "wheez

    Quote Originally Posted by Scass View Post
    If you take the albuterol does it stop your forced wheeze?
    It greatly diminishes it, but I can still hear it if I try hard enough.

  6. #6
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    Re: Pulmonologist doesn't think I have asthma, but isn't 100% - question about "wheez

    You need to stop forcing the wheeze. You'll irritate your airways and keep perpetuating the wheeze.

    LPR can definitely cause wheezing, by irritating your upper airways and causing a mild bronchiospasm. Asthma medications can help with the bronchiospasm, which is why they sometimes help LPR. It took me quite a while to find out my problem was really LPR, because my doctor assumed I had cough variant asthma since my cough responded to Advair. It wasn't until I got the methacholine test that we discovered I didn't actually have asthma, at which point we had to go looking for the real source.

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