Question:
I was diagnosed with cough variant asthma by my physician, however, the recent pulmonary function test I took did not detect asthma. Does anyone know if you can have asthma and have a pulmonary function test be normal?
Response:
I was diagnosed with cough variant asthma by my physician, however, the recent pulmonary function test I took did not detect asthma. Does anyone know if you can have asthma and have a pulmonary function test be normal?
This is something that sometimes happens. Usually further tests (and a referral to an asthma specialist) will be necessary in order to determine if it really is asthma. "Keep looking below surface appearances. Don’t shrink from doing so (just) because you might not like what you find." General Colin Powell
Response:
I was diagnosed with cough variant asthma by my physician, however, the recent pulmonary function test I took did not detect asthma. Does anyone know if you can have asthma and have a pulmonary function test be normal?
Yes. It happens often with mild asthmatics. Asthma by definition is episodic. If you have the test on a good day it will be normal. If you were having symptoms and the test was normal then it might be time to reconsider the diagnosis and look for other reasons to cough. If there is really some doubt other tests can be done to try to stimulate and attack (methacholine challenge). — CBI, MD
Response:
I was diagnosed with cough variant asthma by my physician, however, the recent pulmonary function test I took did not detect asthma. Does anyone know if you can have asthma and have a pulmonary function test be normal?
The standard lung function test for asthma involves measuring lung function before and after administering a bronchodilator inhaler; substantial improvement in lung function post bronchodilator tends to indicate asthma. For difficult to diagnose cases, a methacholine challenge test can be administered. Lung function is measured as higher levels of methacholine inhalant are adminstered, looking for a 20% drop in lung function. If achieved, this indicates the possibility of asthma; if not, it rules out asthma. However most doctors would give a trial run of asthma drugs to see if they help. If so that tends to support the asthma diagnosis. [Whatever works, works.] A possible contributor to asthma is sinusitis or GE reflux. These need to be treated if they are present. Ellis
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What do people know about any interfering meds? I didn’t really test asthmatic at first, no change with meds, but had been on Beta blockers for 2 years ( scary isn’t it?) for constant migraines. I think the asthma was just so bad by then, that albuterol didn’t immediately help. I think I read once that Calcium channel blockers can cause a false neg on some challenge tests. Not sure how much this really factors in, but I know Beta Blockers are bad news for asthmatics. I am sure I wouldn’t test the same now, 8 years later. the peakflows look like yo-yos – Hide quoted text — Show quoted text – I was diagnosed with cough variant asthma by my physician, however, the recent pulmonary function test I took did not detect asthma. Does anyone know if you can have asthma and have a pulmonary function test be normal? Yes. It happens often with mild asthmatics. Asthma by definition is episodic. If you have the test on a good day it will be normal. If you were having symptoms and the test was normal then it might be time to reconsider the diagnosis and look for other reasons to cough. If there is really some doubt other tests can be done to try to stimulate and attack (methacholine challenge). — CBI, MD
Response:
I wouldn’t be too anxious to be diagosed with asthma. As I have found out, it plays hell with your ability to get any decent health insurance at all, regardless of high rates. If I knew then what I know now, I’d try to keep it off my record as long as possible. – Hide quoted text — Show quoted text – I was diagnosed with cough variant asthma by my physician, however, the recent pulmonary function test I took did not detect asthma. Does anyone know if you can have asthma and have a pulmonary function test be normal? The standard lung function test for asthma involves measuring lung function before and after administering a bronchodilator inhaler; substantial improvement in lung function post bronchodilator tends to indicate asthma. For difficult to diagnose cases, a methacholine challenge test can be administered. Lung function is measured as higher levels of methacholine inhalant are adminstered, looking for a 20% drop in lung function. If achieved, this indicates the possibility of asthma; if not, it rules out asthma. However most doctors would give a trial run of asthma drugs to see if they help. If so that tends to support the asthma diagnosis. [Whatever works, works.] A possible contributor to asthma is sinusitis or GE reflux. These need to be treated if they are present. Ellis
Sue M.
Response:
I wouldn’t be too anxious to be diagosed with asthma. As I have found out, it plays hell with your ability to get any decent health insurance at all, regardless of high rates. If I knew then what I know now, I’d try to keep it off my record as long as possible.
I sure have found that to be true! There is not a private insurance that will touch myself or my son. If we don’t have group insurance through a job, then the only recourse left is the State Health Insurance Pool, available to apply for if you have been denied by other insurance. Very high premiums, very high deductibles and out of pocket, etc. Not good news. Patrice
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You’re right – thanks for the tip!
Response:
Hi… I’m new to this group. I’m dealing with a severe flare up of Asthma after having been controlled for about 18 years (I’m 45). Control here meaning the attacks, when they happened, were more of an annoyance than a problem and quickly responded to a bronchodialator. Anyway… I too have problems with migraines and back when I was 27 and having big problems with both, they switched me from beta blockers to calcium channel blockers. The difference was remarkable. Better migraine control with greatly reduced bronchospasm. As for my current problems… I’m awaiting a call from my doctor. My last function test I tested clearly positive for asthma. Dan Rhea – Hide quoted text — Show quoted text – What do people know about any interfering meds? I didn’t really test asthmatic at first, no change with meds, but had been on Beta blockers for 2 years ( scary isn’t it?) for constant migraines. I think the asthma was just so bad by then, that albuterol didn’t immediately help. I think I read once that Calcium channel blockers can cause a false neg on some challenge tests. Not sure how much this really factors in, but I know Beta Blockers are bad news for asthmatics. I am sure I wouldn’t test the same now, 8 years later. the peakflows look like yo-yos I was diagnosed with cough variant asthma by my physician, however, the recent pulmonary function test I took did not detect asthma. Does anyone know if you can have asthma and have a pulmonary function test be normal? Yes. It happens often with mild asthmatics. Asthma by definition is episodic. If you have the test on a good day it will be normal. If you were having symptoms and the test was normal then it might be time to reconsider the diagnosis and look for other reasons to cough. If there is really some doubt other tests can be done to try to stimulate and attack (methacholine challenge). — CBI, MD
Response:
What is a pulmonary function test? I have adult onset bronchial asthma although I did have it when I was very young according to my mom. It disappeared until about 5 years ago. I’m 41now. I haven’t had much trouble with it until recently when I had to use an inhaled steroid (azmacort) and take Biaxin. Although I’ve completed the 30 days of the azmacort and the biaxin I still don’t feel well. No fever, and no green or yellow mucus. My dr. wants me to come in a take a pulmonary function test tomorrow and put me on some new medicine. Has anyone ever had this experience or know what might be going on here. What is a pulmonary function test. All this is really new to me. (My newsreader seems to be acting up again – everything above is quoted material.) A pulminory functions test is a detailed measurement of the airflow and capacities of your respratory system. Typically, you will sit in a telephone booth like device and, on command, inhale and exhale through a tube. The airflow through the tube is measured for different readings and the results are fed into a computer that provides a graphical or spreadsheet representation of your airflows. You will then use a bronchodilator, wait 10 minutes, then repeat this test. The ‘before’ and ‘after’ results are compared and this information is used by the doctor in his decision as to whether or not you have asthma.
Response:
What is a pulmonary function test. All this is really new to me.=20
I don’t have asthma,(I did, but grew out of it as a child too) but this is what I remember from when my daughter was diagnosed w/ it: A PFT determines whether you have asthma or not. The first step is for you to breathe into a machine and it will measure your lung function. Then you’ll be given some albuterol( broncodilator) and you’ll do the test again, and if there is a 20% or greater ( I think that’s the %) improvement, then they determine that the cause of your breathing problem is asthma. BTW, i just read a post recently that it’s common for childhood asthma to return around age 35. I think that my husbands childhood asthma is making a comeback now as well, he just turned 35. I’m 32 and hope mine doesn’t return! 3 asthmatics in one house? accckkkk!! good luck w/ your test, I hope that it determines it’s not asthma after all 
Donna
Response:
– Hide quoted text — Show quoted text – It sounds a bit dangerous to me, what exactly is methacholine? — It’s full name is Methacholine Chloride. For you chemists out there it is 1-propanaminium 2-(acetyloxy)-N-N-N-trimethyl-chloride. It is the beta-analog of acetylcholine and acts on the smooth muscle tissue of the bronchi through parasympathetic (cholinergic) innervation. Methacholine challenges are usually quite safe, much safer actually than many other routinely performed hospital procedures. There have been very few reported incidents reported from the use of methacholine for inhalation challenges (worldwide, not just the USA). My personal experience from performing about a thousand methacholine challenges over the last 20 years is that in all that time I have only had three or four patients ever have a serious asthma attack from methacholine. None of these patients required hospitalization and at most needed several nebulizer treatments with albuterol before leaving the PFT lab. In 99% of the cases I have dealt with, a couple of puffs of albuterol (from an MDI) are all that has been needed to reverse bronchconstriction in those people that do respond to methacholine (have a drop in FEV1 greater than 20 percent). In a very few cases, I have followed up with a couple of puffs of Atrovent (ipatromium bromide) which is a bronchodilator that is more specific to the cholinergic system. Methacholine challenges are one of the few ways that asthma can be diagnosed in people with equivocal pulmonary function test results. To my knowledge it is the ONLY test the US military will accept for recruits with suspected asthma (the US military no longer accepts recruits with asthma). Another way of diagnosing asthma that is even safer than a methacholine challenge is a Cold-Air Challenge. Many if not most asthmatics are sensitive to cold, dry air. I know of a few PFT labs that have cold air equipment to perform this kind of test. However, everybody I know that does cold air challenges does so ONLY for research, and not for diagnostics. One big reason for this is that there is no company that makes cold air challenge equipment – each lab has had to construct their own system. Here in Boston, the Asthma Research Center at Brigham and Women’s Hospital has cold air equipment (they are always looking for people with asthma for different studies – if you live in the Boston area and would like to be a subject in one or more studies on asthma contact them at 617-732-8201, they often pay research subjects and do a complete asthma work-up as well). I do not have cold air equipment in my PFT lab, mainly because it is hard to maintain. This kind of equipment requires a lot of attention (the temperature probes break all the time and are a b***h to re-build). Richard Johnston Supervisor, Pulmonary Function Lab Beth Israel Hospital of Boston I have done the methacholine challenge test. The preparation is nil,the
procedure is what takes the time. Methacholine is a drug that will induce an asthma attack in any one at certain levels. The test is the methacholine drug titrated to 5 different levels. They are all administered by a device similar to doing a breathing treatment. The first one is the smallest dosage the 5th is when most persons would have trouble. You will begin the test by the comuterized peak flow test , then take the treatmet and then take the peak flow test again. The same for each level. The lower the level of methacholine that induces your symptoms the worse your asthma. BTW,I never made it past the 2nd dose.My flow dropped 60% and then I had to do a "real " treatment. The only preparation is the knowledge that you might have an asthma attack,but remain as calm as possible as you will be in a secure setting and help is right there. It is my understanding that it is extremely accurate. The usual disclaimer.blah,blah,blah….. Just stay calm and you’ll soon know!! Let me kn ow how you make out Peace, Tish are the thoughts,you have hidden in your heart…….
Response:
It sounds a bit dangerous to me, what exactly is methacholine? —
It’s full name is Methacholine Chloride. For you chemists out there it is 1-propanaminium 2-(acetyloxy)-N-N-N-trimethyl-chloride. It is the beta-analog of acetylcholine and acts on the smooth muscle tissue of the bronchi through parasympathetic (cholinergic) innervation. Methacholine challenges are usually quite safe, much safer actually than many other routinely performed hospital procedures. There have been very few reported incidents reported from the use of methacholine for inhalation challenges (worldwide, not just the USA). My personal experience from performing about a thousand methacholine challenges over the last 20 years is that in all that time I have only had three or four patients ever have a serious asthma attack from methacholine. None of these patients required hospitalization and at most needed several nebulizer treatments with albuterol before leaving the PFT lab. In 99% of the cases I have dealt with, a couple of puffs of albuterol (from an MDI) are all that has been needed to reverse bronchconstriction in those people that do respond to methacholine (have a drop in FEV1 greater than 20 percent). In a very few cases, I have followed up with a couple of puffs of Atrovent (ipatromium bromide) which is a bronchodilator that is more specific to the cholinergic system. Methacholine challenges are one of the few ways that asthma can be diagnosed in people with equivocal pulmonary function test results. To my knowledge it is the ONLY test the US military will accept for recruits with suspected asthma (the US military no longer accepts recruits with asthma). Another way of diagnosing asthma that is even safer than a methacholine challenge is a Cold-Air Challenge. Many if not most asthmatics are sensitive to cold, dry air. I know of a few PFT labs that have cold air equipment to perform this kind of test. However, everybody I know that does cold air challenges does so ONLY for research, and not for diagnostics. One big reason for this is that there is no company that makes cold air challenge equipment – each lab has had to construct their own system. Here in Boston, the Asthma Research Center at Brigham and Women’s Hospital has cold air equipment (they are always looking for people with asthma for different studies – if you live in the Boston area and would like to be a subject in one or more studies on asthma contact them at 617-732-8201, they often pay research subjects and do a complete asthma work-up as well). I do not have cold air equipment in my PFT lab, mainly because it is hard to maintain. This kind of equipment requires a lot of attention (the temperature probes break all the time and are a b***h to re-build). Richard Johnston Supervisor, Pulmonary Function Lab Beth Israel Hospital of Boston
Response:
It sounds a bit dangerous to me, what exactly is methacholine? — Alex Matthews http://www.fen.bris.ac.uk/students/me3135/ – Hide quoted text — Show quoted text – writes: Recently I developed a serious allergy to Kiwi which caused my throat to swell and my breathing to become difficult. After a series of allergy tests, x-rays and pulmonary function tests, I have been asked to take one more test called the "Methacholine Challenge". I would like to hear from those people who have taken this test as I really have no idea what to expect outside of the fact that I am setting myself up for an asthma attack. This test is to take place at the hospital where oxygen and all the other good stuff is available if required. experiences. Thanks, Carol Hi Carol, the methacoline challenge test is a test that determines how "hyper-sensitive" your airways are, and is a good indication of how severe your asthma is. The test is relatively routine when regular pulmonary function tests seem to indicate the potential presence of asthma. Basically you will be exposed to various concentrations of methacholine followed by serial pulmonary function tests to determine the level at which your airways react. If you require more detailed information please let me know and I’ll try to type some more.. Cheers, Colya Kaminiarz Respiratory Therapist Vancouver Hospital and Health Science Centre Yes, some more info on this would be quite interesting. They canceled this on me after I totally flunked out on a treadmill test, going into an acute asthma attack. Fortunately they were suspicious that I might not do well and had a respiratory therapist and a pulmonary specialist standing by…… Sue whose asthma is triggered by almost everything
Response:
Hello, I am an asthmatic who has lived with asthma since childhood. Over the years my asthma has fluctuated from being almost non-existent to periods of lots of meds and breathing problems. Being pregnant was amazing as all allergies and asthma problems disappeared. Recently I developed a serious allergy to Kiwi which caused my throat to swell and my breathing to become difficult. After a series of allergy tests, x-rays and pulmonary function tests, I have been asked to take one more test called the "Methacholine Challenge". I would like to hear from those people who have taken this test as I really have no idea what to expect outside of the fact that I am setting myself up for an asthma attack. This test is to take place at the hospital where oxygen and all the other good stuff is available if required. Thanks, Carol
Response:
- Hide quoted text — Show quoted text – Recently I developed a serious allergy to Kiwi which caused my throat to swell and my breathing to become difficult. After a series of allergy tests, x-rays and pulmonary function tests, I have been asked to take one more test called the "Methacholine Challenge". I would like to hear from those people who have taken this test as I really have no idea what to expect outside of the fact that I am setting myself up for an asthma attack. This test is to take place at the hospital where oxygen and all the other good stuff is available if required. Thanks, Carol
Hi Carol, the methacoline challenge test is a test that determines how "hyper-sensitive" your airways are, and is a good indication of how severe your asthma is. The test is relatively routine when regular pulmonary function tests seem to indicate the potential presence of asthma. Basically you will be exposed to various concentrations of methacholine followed by serial pulmonary function tests to determine the level at which your airways react. If you require more detailed information please let me know and I’ll try to type some more.. Cheers, Colya Kaminiarz Respiratory Therapist Vancouver Hospital and Health Science Centre
Response:
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