Mr. Asthma

Question:

It’s possible to have a wheezing like noise come from the throat that can simulate asthma. Sometimes this happens due to anxiety states and is sometimes called vocal cord dysfunction or hysterical laryngospasm. Other times there’s something physically wrong with the focal cords such as an anatomical or nerve problem that causes abnormal movement/opening of the vocal cords. You can also have upper airway wheezing like noises from tracheal problems. The methacholine challenge test looks for airway hyperreactivity that is characteristically abnormal in asthmatics but wouldn’t be abnormal in some of the other problems that can cause wheezing. – Hide quoted text — Show quoted text – > I have one doctor who says I have asthma and another who says I don’t. > The doctor who says I don’t have asthma bases his diagnosis on the > fact that, although my symptoms look like asthma, a Methacholine > Challenge Test shows that I do not have asthma. > The doctor who says I do have asthma bases her diagnosis on my > symptoms, even though she knows that the Methacholine Challenge Test > came up negative. > One of things I have is wheezing/crackles. I feel that the > wheezing/crackles come from my throat. The doctor who says I do have > asthma has told me that the wheezing/crackles only feel as if they are > in my throat, but are really in my airways. > Does anyone know if wheezing/crackles in the throat (rather than > airways) are indicative of asthma or of something else? If something > else, what? And is it possible to have asthma even though the > Methacholine Challenge Test comes up negative? And if it’s not asthma, > what might it be? > I am getting ready to find a third doctor to see what he/she says, but > I was hoping I could get some ideas from this group. > Thanks, > Marly > To reply by e-mail, remove XY from my e-mail address.

Don Elton Columbia, SC http://www.midcarolina.org

Response:

> > One of things I have is wheezing/crackles. I feel that the > wheezing/crackles come from my throat. The doctor who says I do have > asthma has told me that the wheezing/crackles only feel as if they are > in my throat, but are really in my airways. > This is very similar to my situation.  I have laryngitis plus maybe > tracheitis (inflammation of the windpipe).  This is caused in turn by > stomach reflux, but can also be caused by sinusitis also.  You should be > evaluated for both conditions.

I had similar symptoms too, plus chest & back pain and tightness along with major shortness of breath. My Dr. put me on Prevacid for heartburn eventhough I didn’t feel like I had heartburn. I don’t know if it’s coincidence or not, but I’ve hardly had any breathing problems or chest tightness since going on the Prevacid. I haven’t had to use inhalers at all. Mary

Response:

- Hide quoted text — Show quoted text – > I have one doctor who says I have asthma and another who says I don’t. > The doctor who says I don’t have asthma bases his diagnosis on the > fact that, although my symptoms look like asthma, a Methacholine > Challenge Test shows that I do not have asthma. > The doctor who says I do have asthma bases her diagnosis on my > symptoms, even though she knows that the Methacholine Challenge Test > came up negative. > One of things I have is wheezing/crackles. I feel that the > wheezing/crackles come from my throat. The doctor who says I do have > asthma has told me that the wheezing/crackles only feel as if they are > in my throat, but are really in my airways.

This is very similar to my situation.  I have laryngitis plus maybe tracheitis (inflammation of the windpipe).  This is caused in turn by stomach reflux, but can also be caused by sinusitis also.  You should be evaluated for both conditions. — Steven D. Litvintchouk                   Disclaimer:  As far as I am aware, the opinions expressed herein             are not those of my employer.

Response:

>I have one doctor who says I have asthma and another who says I don’t. >To reply by e-mail, remove XY from my e-mail address.

My best advice to you is go to a pulmonary specialist. I  spent much time with internists and family doctors before consulting one who specializes in asthma problems. A simple change to maintenance medicine helped me.

Response:

- Hide quoted text — Show quoted text – > I have one doctor who says I have asthma and another who says I don’t. > The doctor who says I don’t have asthma bases his diagnosis on the > fact that, although my symptoms look like asthma, a Methacholine > Challenge Test shows that I do not have asthma. > The doctor who says I do have asthma bases her diagnosis on my > symptoms, even though she knows that the Methacholine Challenge Test > came up negative. > One of things I have is wheezing/crackles. I feel that the > wheezing/crackles come from my throat. The doctor who says I do have > asthma has told me that the wheezing/crackles only feel as if they are > in my throat, but are really in my airways. > Does anyone know if wheezing/crackles in the throat (rather than > airways) are indicative of asthma or of something else? If something > else, what? And is it possible to have asthma even though the > Methacholine Challenge Test comes up negative? And if it’s not asthma, > what might it be? > I am getting ready to find a third doctor to see what he/she says, but > I was hoping I could get some ideas from this group. > Marly

The purpose of a methacholine challenge test is to help diagnose difficult cases of suspected asthma. A negative result rules out asthma; a positive result indicates you may have asthma. Crackles can indicate fluid in the lungs. There are various look alike asthma lung conditions and a pulmonologist is the one qualified to make a diagnosis. Links: http://indy.radiology.uiowa.edu/Providers/ClinRef/FPHandbook/Chapter0… Pulmonary Medicine: Pulmonary Function Tests Excerpt: "IV.Interpreting Patterns of Abnormal Pulmonary Function Tests (PFT)             Patterns of abnormal PFTs 1.Obstructive disorders. Emphysema, chronic bronchitis, asthma  (Table 3-2). 2.Restrictive disorders.  a.Interstitial lung disorders. Sarcoidosis, environmental disease,  interstitial pneumonias, connective tissue disorders, pulmonary  vascular diseases.  b.Impairment of ventilation mechanics (bellows disorders). Obesity,  kyphoscoliosis, status post surgery, paralysis, ascites, pleuritis,  pleural effusion. " All contents copyright