Asthma/asthma

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Question
QUESTION: I am 23. I live in a small town. I do not have any pets. I am not on any medications. I work in an office building. I was always active until college. I am not overweight. Today I went hiking up a small mountain. My heart was pounding from lack of fitness, and about 20 min. in to the hike I was gasping for air. Suddenly it felt like I was trying to breathe through a straw and when I inhaled it sounded like high pitch noise. My chest felt tight.I also felt like I would throw up. I sat for a while and when I felt better I finished the hike. This only ever happened one other time on another hike a few months ago, but this hike was easier than the last one, but the symptoms were worse. I have never had asthma before and I played sports all through HS. I know you can not diagnose, but does this sound like asthma? Can a person get asthma as an adult?

ANSWER: Hi Katie,
   The symptoms you describe make me lean towards a diagnosis of "vocal cord dysfunction", especially in regards to a) your history, and b) the difficulty on inhaling. If you google the disorder, pick the description from National Jewish Hospital. It gives a great foundation and detail.
I'm on my iPhone, and it won't let me do a cut and paste for some reason.

If I'm correct on the diagnosis, the therapy is non-drug. It is working with a speech pathologist on breathing techniques.  
This condition is predominantly seen in girls starting in their teenage years. Once you've completed the therapy, you're finished. It's not like a long-term illness. It is best to locate a doctor who specializes in allergy/asthma, but has additional training in making this diagnosis.

If you care to come to Chicago, ha ha, I am well acquainted with an outstanding pulmonologist to teaches the subject.

I hope this helps you! If you've any further questions, feel free to get back to me. I apologize for the delay. I did not gets this letter until all experts contacted me directly.

Have a great day!

Sincerely,

Marc

---------- FOLLOW-UP ----------

QUESTION: So where do I start with this? I dont have any clue what type of doctor I need or if I need a referral or how any of this works. How do I know if they know anything about this?

Answer
Hello Katie,

 This evaluation should be done by either an allergist or a pulmonologist with training and experience in this disorder. To find a board certified allergist in your area, go to >

http://aaaai.execinc.com/edibo/FindAnAllergist

Specifically ask if they do this type of evaluation, or can refer you to a pulmonologist who does. Unfortunately, the pulmonary organizations do not offer a ZIP code referral reference for locating board certified practitioners.

A referral requirement depends upon the insurance you carry, which may also limit you to whom you may see. If there is an 800 number on your insurance card with a consultation line, they should be able to guide you to a properly trained specialist.

Since you state you really do not have any prior history, a test can be executed called a methacholine challenge. This can be done when normal spirometry (a lung function test) shows no abnormality. If the test is positive, it is an indicator of reactive lung disorder (asthma).

Asthma can develop in adults, and if no prior history, can be due to environmental factors, especially in the workplace or home: mold exposure, solvents (paint shops), dust, flour (like in a bakery), etc.
Allergies may also develop in adulthood which can lead to asthma also.

Let me know how this turns out.

Sincerely,

Marc

Asthma

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Marc Rubin, RPh Asthma Educator

Expertise

I have worked directly with patients as well as caregivers for over 30 years. Have made presentations throughout Illinois educating school nurses as well as the teaching and coaching staff of public schools about asthma, and how they should respond to these students needs. Presented a public education program on asthma through the US Department of Public Health. Specialize in helping guide asthmatic patients to take control of their disease in order to live a near-normal, fully active life.

Experience

Practicing pharmacist for 40 years, specializing in asthma and COPD for 12 years. Developed nationwide education to nurses, teachers and athletic coaches regarding asthma and exercise induced bronchospasm. In addition, and closer to home. my daughter has asthma, and my son has exercise induced bronchospasm. In addition, I serve on the boards and committees of a number of asthma organizations: Sports, Exercise and Fitness Committee of AAAAI, Population Health Committee and Sports Medicine Committee of ACAAI, Sports Medicine Committee of the World Allergy Association. Board of Directors of the Chicago Asthma Consortium, Board of Directors of the Christopher D. Redding Youth Asthma Foundation, as well as the advisory board of a medical education company, Emmi Solutions. Directly involved in the creation of public education programs for asthma, COPD and diabetes.

Organizations
American Academy of Allergy, Asthma and Immunology / Sports Medicine Committee, American College of Allergy, Asthma and Immunology / Population Health Committee and Sports Medicine, American College of Chest Physicians, American Thoracic Society. World Allergy Association, Chicago Asthma Consortium / Professional Development Committee, Christopher D. Redding Youth Asthma Foundation, and Respiratory Health Association of Metropolitan Chicago: Development Committee for AE-C prep class, and presenter.

Publications
AAAAI PowerPoint on the new guidelines for EIB (Exercise Induced Bronchospasm), AAAAI Powerpoint on Asthma in School Setting for Teachers and Coaches, Annals of Allergy, Asthma and Immunology: Transition guide for teens with food allergies or asthma going out of the home to live independantly.

Education/Credentials
BScPharm, RPh, (NAECB Certified asthma educator in 2002), NIPCO Certified Respiratory Care Pharmacist

Past/Present Clients
Emmi Solutions, Chicago Next Level Health, Chicago

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