Concerned about Tight Chest: Testing for asthma

I commented a little over a month ago saying I was having similar issues. All my lung testing looked pretty normal, but I went to a pulmonologist who said that based on my symptoms and the testing she had seen, it was probably either asthma (minor I guess, considering it wasn't really impeding with activity), or reactive airway disease. She put me on budesonide - a steroid inhaler - and that has made a big difference. I've got another week or so on that and then she will revisit, and there's some test that can definitively diagnose asthma - not sure if she'll recommend doing that, or what will be next. Again, Pulmonary Function Test was basically normal, chest x-ray normal, I can run around and exercise with no problem - it was just the chest tightness that was really bothering me.

Hi @emtaylor, diagnosing asthma can be a tedious, but necessary, journey. I included your posts to the Asthma & Allergy support group here: https://connect.mayoclinic.org/group/asthma/

Em, have you noticed any improvement with the chest tightness since starting budesonide, the steroid inhaler?

Thank you Colleen! Yes, I've noticed a major improvement, and am following up with my pulmonologist in a few weeks to see what's next.

Hi, @emtaylor - it sounds as though you've been through quite a bit of testing with the laryngoscopy, endoscopy, chest X-ray, pulmonary function test, many blood tests, plus taking allergy meds and a budesonide inhaler. I also have asthma. My symptoms were mostly coughing and chest tightening, which I later recognized with a physician's help as inaudible wheezing.

I took a lot of the same tests you mentioned, including spirometry, chest X-ray and body plethysmography (also called lung or pulmonary plethysmography). I also did a test for reflux medication, to see if that might affect my symptoms, which it didn't. Sounds like you did something similar. My allergist also trialed me on a maintenance inhaler plus a rescue inhaler. Since that worked effectively, I was determined to have asthma.

I'm glad to hear you've had major improvement of your chest tightness. That is a big relief, literally and figuratively.

You mentioned your pulmonologist said that based on my symptoms and the testing she had seen, you have asthma or reactive airway disease. Will you share more about which symptoms and results from your testing most made her feel you had one of these two diseases?

Thanks, Lisa - she said she wasn't sure based on what testing has been done so far. I can't remember exactly what she said, but it sounded like the next step would be a different test (maybe the spirometry) that could differentiate one from the other. Not sure whether the response to the inhaler would also factor in to figuring that out.

Tagging other members on Connect who've talked about asthma testing and/or chest tightness who might provide some support and insights, @emtaylor: @marioguye @jackiet @cwal @britelite @covidstinks2023 @lenchiksf. I also would like you to meet @sueinmn.

I have asthma, and Pulmonary Fibrosis. I can't use any nebulizer or inhalers because I react to the propellant. I have found a few things that help me manage the tightness.
My incentive Spirometer (voldyne 4000). Several times throughout the day for a few minutes.
Constricted muscles can really limit our ability to take a breath, and with a chronic condition we tend to adjust to that constriction.
Chest opening stretches are really helpful!! Massaging the upper chest, neck, shoulders and upper back is also really helpful!! I use an essential oil called Larch, mixed with a little carrier oil, which is soothing to the muscles, but that's just a bonus.
Warmest regards!

@emtaylor You would be wealthy indeed, if you could solve this issue.

My cardiologist is adamant that, with all heart issues well under control, my current issues are from asthma/allergies
. What relief to know this, but if shared 3-4 months ago, I could have begun to plan way before last week.

Hi, @rebeccabloch - thanks for the suggestions on therapy for chest tightness to be used instead of inhalers or nebulizers if they are not an option for a given person.

Will you share more about what your incentive spirometer does to help and how you use it? What stretches do you use for chest opening?