Diagnosing Asthma

There are alot of people who may have Asthma without even realising it. Perhaps they think they are out of shape, overweight, plagued by allergies or have sleep apnea. Or perhaps they just can't get a good diagnosis.

Part of the reason for this is that diagnosing asthma is as much of an art as it is a science. There is no blood test or x-ray that can pinpoint ashtma as is the case with diabetes or a slipped disk. In addition, all of the other COPDs (Emphysema, Chronic Bronchitis, etc) share symptoms with Asthma, as do congestive heart failure, a few types of cancer, cystic fibrosis, and persistent allergies. To further complicate things, especially with mild forms of Asthma, symptoms are are not constantly manifested. People have symptoms which are vague like fatigue, coughing after exercise, and wheezing at night (which may occur without the Asthmatic's knowledge). Therefore, when a patient makes an appointment with their doctor, they appear to be fine.

No matter how frustrating this may be, it is hard enough for a doctor to adequately diagnose Asthma. Untrained persons should never attempt to diagnose themselves - it can be extremely dangerous. I would hate to think one of you assumed you had asthma when you really had cancer or heart disease. If you cough frequently, have fatigue with no known cause, have chest tightness, wheeze or suffer shortness of breath, you should see a doctor for a thorough checkup and physical exam even if these symptoms occur occasionally. You can also seek treatment immediately when you are experiencing symptoms for a more accurate diagnosis. You might cough only at night...wheezing might only happen with vigorous activity...chest tightness may not be a constant thing...but even when they are sporadic, all these symptoms can indicate serious illness for which you need to be treated. Please do not fool around with your health!

If you have those symptoms or think you have Asthma, consider these facts when debating whether or not to discuss it with your doctor: Asthma sometimes runs in families - do you have family members with Asthma? There can be a link between Asthma and activity, seasonal changes or food. Do you experience any of these things? Do you frequently have rhinitis (nasal irritation/infection), hay fever or eczema? Asthma is common with those conditions. Most Asthmatics have sinus problems, many have a history of chest infections like pneumonia or bronchitis. An Asthmatic will have sensitive air passages which will be bothered by smoke or chemicals. Have you noticed any of these things in your life? Are your breathing patterns different to other people of a similar fitness (breathing faster, through the mouth or upper chest or too often)?

Before you do anything else, write down the above and then add when you get your symptoms: when exercising? At work? Home? Winter? Summer? Night? Morning?. Also note what your symptoms are...do you wheeze, cough, sneeze, have chest tightness? Make sure to write down anything, even if it is vague, like fatigue or sleeping problems. Then get on the phone and get an appointment for a physical.

When your appointment comes, your doctor will ask alot of questions in order to get an accurate diagnosis (If he does not, get another doctor. Even if the diagnosis is correct this person is not paying adequate attention to you and it may hurt you in the future). He will ask if there is a family history of asthma, as well as questions about your medical history, your social life and the symptoms that you experience. It is very important that you answer these accurately, and make sure to include all the information you wrote down and thought about before. This type of information can make up 90% of your diagnosis.

Your medical history is most necessary since linking triggers and symptoms is of critical importance. Your doctor will ask about the type of symptoms you have: Do you wheeze or cough, when do symptoms appear, do you have alot of mucus, do you have hay fever, allergies, eczema?

The doctor will do a physical and note the shape of your chest (asthmatics often have abnormally large chests), your breathing patterns and listen to your chest to see if you wheeze. He will also do a complete work up on other bodily functions such as your heart (congestive heart failure often has symptoms like asthma), your digestive system, and neurological systems. He should also have you blow into a flow meter, which will measure the rate at which the air comes out of your lungs. Sometimes the doctor will have you take it home to record it over a period of time, especially if you have a normal reading and all other indications point to Asthma.

Many doctors also use laboratory testing to assess the the extent of your condition. Usually he will use a spirometer to do pulmonary function tests to see how how quickly you exhale, the amount of air you put out and how air flow changes during use. The doctor may also administer a drug to open the airways and then take measurements again. A reversal of the obstruction indicates a possible diagnosis of asthma.

Some doctors test for allergens using Allergen inhalation and occupational exposure tests. These measure the response to specific triggers and do have the capability of producing an attack so they must be done only by a doctor. Do not try to take this test yourself.

Blood tests may be taken to check the immune system, for allergic factors or infections which may mimic Asthma. A high count of eosinophils indicate allergic reactions and inflammation in the airways and may mean you have allergic asthma. Skin tests for allergens may also be done.

Your doctor will most likely do x-rays to detect emphysema, lung cancer, obstructed airways or collapsed lungs, as all can have similar symptoms. Cystic Fibrosis tests like the sweat test may also be performed. Children with cystic fibrosis have more salt in their sweat than those without the disease. Additionally, sputum testing may be done, as could exercise testing with electronic monitoring. Sometimes the doctor will even the temperature of the test lab to see how it affects the patient.

A thorough, accurate physical is the key to an appropriate diagnosis of Asthma. Until you get an accurate physical, you may want to take some of the environmental and health suggestions and begin using them to see if they help you, but do not skip the medical exam. There are medications and therapies available which can help you and which will prevent lung damage which can occur with Asthma. This is your health, do not neglect to do the necessary upkeep.

Main Page
Back
Next Article

Click on the Bird to Email Lady Raven!