Patient: Hi. I am a 21 year old female who is 5’5 and about 9 stone. For the past few months I have been suffering from difficulty breathing which particularly occurs in the evening. I do not feel wheezy or breathless but it is more like my airways feel tight and I feel it is more difficult for me to get oxygen into my lungs. I have been to the doctor who has performed tests such as a spirometry which was fine. She seems to think what I have is asthma so gave me a peak flow to monitor. I have quite a low peak reading (varies from 330-350) but this is always very consistent and has not varied much in the 4 weeks I have been monitoring it. I dont think it is asthma as I dont get ‘attacks’ and I thought asthma would cause the peak flow readings to vary a lot more? I was given an asthma inhaler(the blue kind) when I went to the hospital but that made me feel worse. I have now just been told to try a preventative inhaler but am not sure if this is going to help either? Please help.
Doctor: The diagnosis in your case is unlikely to be asthma, if full pulmonary function tests (spirometry) and reversibility stu dies, were all normal. Therefore the medications will have no effect on your symptoms if the diagnosis is inaccurate. The use of a diary to monitor your symptoms may be beneficial, recording duration of symptoms, what activities you are doing when the symptoms begin, the location you are in when the symptoms occur and anything that helps relieve your symptoms. Further investigations with a respirologist may be warranted if your symptoms are persisting, and if any time they become severe you should attend the Emergency Department.