Asthma?

[Orange Peel]

Ok esteemed medical peeps. I'm an early forty something pilot who possibly has asthma, well perhaps :}

Since my child has started nursery my immune system has taken a battering. Last year the wife and I picked up colds that lasted ages and eventually went down into our chests. I was bringing up mucus for about a month every morning (nice :} ). Then I developed a wheeze whilst sitting on the couch in the evenings. It would disappear but occasionally I'd wake in the middle of the night with a wheezing.

I've never suffered from any allergy or asthma so I went to the local GP. Two different courses of steroids later he deduced it could be dust mite allergy and so gave me a course of hayfever type tablets for a month. No effect so he then deduced it was mild asthma. I was given a 2 week course on a puffer and told to stop and it disappeared never to rear its ugly head again, or so I thought. Until last month when I picked up another hefty cold which left me with the same symptoms.

I have starting doing cardio exercise again with no ill effects, I hoover the house with no ill effects and I mow the lawn with no ill effects. However I get bouts of clear mucus every now and again and this wheezing and a tightening of the chest which isn't severe but noticeable.

Searching on previous posts it seems chest conditions are easily misdiagnosed by GP's hence the reason for this post.....

What are you thoughts and implications for my class 1?!

[SassyPilotsWife]

Orange, While I'm no doc, I can only assist based on the level of care that I have training in. The first bit of advice, don't let any doc diagnose you with Asthma. Doing that puts a red flag on your medical record which then can move over to your aviation governing authority.

Here are some questions I would want to know.
1. How old is your house? When was the last time you had your ducts clean?
2. Did your little one get sick at all?

3. Where is the mucous coming from ? Nasal passage or is it a productive cough ( comes from your chest each time you cough)? If it is coming from your chest what color is it? Is it clear ?

4 Does the wheezing come on voluntarily or upon exertion ( you mentioned you would be sitting, just checking)

5. DO YOU SMOKE ??? Don't lie :)

6. Are you overweight? Do you feel these symptoms more at night? Are you awakened at night with the wheezing, coughing, mucous or wake up feeling like you are choking ? Are you having any back pain associated with the chest discomfort ? Have you had recent orthopedic surgery?

Alot of questions I know, but that is because it could be anything from allergies to Congestive Heart Failure to Cancer to a blood disorder and back to a simple cold. Hence why you need a full, detailed examination because all those answers can lead to the path a doc will want to take with determing what is going on. From this history, signs and symptoms, he will proceed further with more test. You also need a full lab workup. Pilots try to be alot of things, but having the ability to draw blood from your veins probably isn't one of them :) So leave it up to the medical professionals rather than posters on here ( no offense docs!!!). While I would not suspect CHF or Cancer ( again, I've not examined you or listened to your lungs), a PE or blood disorders, I think the signs and symptoms you're having are noticeable and worth seeing someone other than your GP.

Request a chest xray, 12 lead EKG and Echocardiogram. The good part is that you're not complaining of Shortness of Breath. You will also need to have a CT of your chest to rule out a possible airway obstruction. Not trying to scare you but 1. It's not going away, 2. You have a child and 3. You fly. Best of luck and keep us updated.

[Warrior2]

I also suffered the pain of asthma. (The pain being from the Irish CAA). I was unfortunate to be given a course of steroids too. Which the IAA told me that steroids were not accepted, and i would have to wait 5 years after i have taken steroids to get a class1!!

I would inform my doctor not to give steroids. There are lots of alternatives.

[SassyPilotsWife]

geeze Warrior. That is insane and a prime example of what I was saying. Good adviced you offered! I would also like to add that giving an inhaler will also red flag him. While it may bronchodialate, it can also cause an elevated heart rate which can in itself create the demand for more oxygen.

While airway is number and wheezing could justify one, I think less invasive treatments should always be used first. IF THE PATIENT IS NOT IN RESPIRATORY DISTRESS. If you treat the wheezing with an inhaler and send them on their way, you could be missing something and you could mask an underlying problem.

The same goes for medical professionals who listen and ascultate breath sounds and don't hear anything and make the mistake of noting they are "clear" when actually, they aren't because they aren't moving any air. It isn't until you do get them "opened up" where you will hear the wheezing, rales etc.

[Orange Peel]

Thanks for the replies....

To answer the questions:

1. House is 4 years old and no ducts as no air con! Cleaned once a week though....

2. My little one has a permanent green runny nose.

3. Last year when I had it first the mucus was from deep in the throat and a nice green colour, a really sticky blob every morning :} This time no real mucus once the cold had passed.

4. Wheezing comes on involuntary normally when slouching, lying, after a heavy meal or the occasional huge laughter session. I can do 30 min cardio, take my heart rate up to 160 and nothing.

5. Smoked when I was a student but that was over 20 years ago and only in the pub.

6. Slightly over weight, I was awakened this morning by it, no pain, just discomfort/tightening of the chest, light wheezing and a blocked nose which within minutes had turned into clear runny mucus. No back pain or orthopedic surgery. Did 30 min cardio with no symptoms.

Am off to the GP's this morning as we can't go directly to a specialist so will see what they say.

As an aside searching on here I've seen some people mention reflux as a cause. For the last two years I've had indigestion remedies in the bedroom as I lie in bed I occasionally (maybe once a week) get indigestion and occasionally get woken up by it and have to take a tablet.

[Rory Dixon]

Is the weezing in inspiration, in exspiration, or both?

[Orange Peel]

Rory, a good question, will have to wait until my next bout but I think it's mainly inhalation that I hear the wheeze.

Saw my GP and he looked through medical history and listened to my symptoms. Did a spirometry test and scored 600, last year it was 450.

From my symptoms he doesn't think I have asthma.

Got an inhaler to use for a couple of nights before sleeping and then as needed over a two week period. Got to keep a diary for those two weeks to monitor its usage.

So we'll see. :\

[Rory Dixon]

Inspiration, that is good news for you.
Asthma has typically an exspiratory stridor (wheezing), as the underlying dysfunction is a decreased stability of the wall of the small bronchi, therefore they (partially) collapse during exspiration, thus causing the wheezing.
For me it really doesn't sound like asthma. The easiest test to perform is measuring the FEV1. This will be massively reduced in asthma, normal values pretty much exclude asthma.
Nevertheless, you need to get your airways checked to find the underlying cause.

[merrick]

I have had asthma as a child and in the last five years it has come back to life. I use an inhaler in the morning and at night, do lots of cycling to help open up the lungs and never have any problems.
Dont worry about it too much, my advise is to do as your doc says and get on with it.
Worked for me ...

[gingernut]

Wheezing alone, shouldn't worry the authorities.

A diagnosis of asthma, backed up with a response from oral steroids may twitch them some what.

How has your quack recorded the diagnosis?

[SassyPilotsWife]

Sounds as if it is most likely just allergies.

Did u get a C xray? Hope it gets better for ya :)

[Bertie Thruster]

Might be worth getting your vitamin D level checked?

[Orange Peel]

Just a quick update. I've been using the inhaler before bed for 3 nights and not had any symptoms through the night. Last night I didn't use it and was fine but straight after my dinner this evening there was some very very light wheezing. I used the inhaler and things improved within 5 minutes.

Not so sure my wheezes are when inhaled, they maybe exhaled...:{

I'm keeping a record of when I need the inhaler for the GP, I have a follow up appointment in two weeks.

I didn't get a chest xray but I explained I was a pilot and he said to get a proper diagnosis I'd be sent to a specialist if required.

Thanks for all the input and advice.

[homonculus]

I f your peak flow is 600 it is unlikely you have asthma.

however wheezing is either asthma or some other airway obstruction

highly likely is that you have chronic sinusitis from your cold and have a post nasal drip where mucus is dripping into your lungs causing irritation

Ask for an ENT referral - this needs to be excluded if your symptoms have been going on so long. Asthma doesnt just happen like this

Best wishes

[Loose rivets]

What homonculus said. Several times in my life I've had what seemed like asthma, but dripping from sinuses seems to have been the main culprit. Mind you, killing bugs in these cavities is not as straightforward as one might imagine. Sinuses and flying can produce pain that's impossible to describe - unless you're Dante.

Came back to the UK this spring, and it wasn't long before I'd caught a bastard of a sore throat. Went to the lungs and got really nasty and I had an antibiotic. Coughed like hell for weeks then got another sore throat from wife who'd been looking after the London g-nippers.

'Coughed green' for six weeks in all. Total social outcast. Wife and several acquaintances all with the same symptoms. Oh, and one the GPs.

Long story short, normally a 740 puffer, I was in my sixth week of horrible sudden coughing spells and restricted breathing. (450) Sent for X-ray. Nowt.

Put on 3rd course of antibiotic, but suddenly felt better. Didn't take it. Back to lumbering my 72 year old 200 lbs around on me bike and fairly running up the 103 steps from the beach. So odd the way it just switched off.


When I was a kid, I had terrible allergic asthma. Just 'forgot' about it. Competitive at judo by 18. By the time I was having five year medicals I once gathered a crowd around the old cast-iron machine in Praed Street. The CAA bods called folk over to see the needle tilt off the edge of the (disc of) paper. Never quite managed to do it, but it speaks volumes (get it) for the accuracy of these peak flow machines. They really are consistent. If there's a change, it's likely the patient.

I was excused all sports at school, and I've always wondered if loooong nights of heaving for breath strengthened my wind-muscles.

[redsnail]

Oral steroids (ie pills etc) are a no go for a Class 1 medical.
However, a puffer is ok.

See JAR-FCL 3 for more info.

[Vortex5]

I'm almost in the same boat as you. I've been experiencing a slight wheeze and a cough of green but for months now. I lived in student accommodation got 'the freshers flu' then found mold spores in parts of the house! Moved out of that house back home with my parents but still have the symptoms. One doctor said I should take a mold test - spit in a cup - and they'll test it, but went to my GP today and he said mold is a irritant and the spores can't stay in your lungs and to him it sounds like ive got asthma and have been given a peak flow diary...:{
My mothers asthmatic and she told me to try her inhalers and they didn't seem to do anything..:uhoh:

For someone who's wanting to be a Pilot as soon as the Fleet Air Arm restart pilot entry, I'm at a cross road on what to do..
I've still to use the Peak Flow meter, but if 'mold in the lungs' gives the same symptoms as Asthma, and I get diagnosed as Asthma, would that be a misdiagnosis that will end a potential flying career before it began..

advice?

[datafox]

Have any of you with asthma or respiratory symptoms tried Buteyko?

Buteyko method - Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Buteyko_method)

It has worked wonders for me, allowed me to get off fairly strong asthma medications and thus keep my 1st class medical with ease.

Best of luck to you all & stay healthy!

[homonculus]

Vortex 5 - if you are coughing up green sputum you have an infection.

Period

your doctor needs to deal with this - I presume you are young and fit

If you continue to wheeze when the infec tion is sorted, masy be you have asthma but currently you have an infection!