Q. I have been having several breathing problems for about five years now. I get shortness of breath during running. When I am relaxing and experience a sudden change in the environmental temperature, I start coughing, wheezing, and getting chest congestion. Sometimes I get a recurring faint pain in the lower right side of my ribcage. My biggest concern is that at night, around 3-4 am, I usually wake up struggling to breathe. I do not have anybody in my family with asthmatic issues, and I never used to have these problems when I was young. I have visited many doctors and taken many medications, and I have been successfully managing the breathing difficulties with salbutamol inhaler. However, I’m looking for a permanent solution to this, so that I can stop depending on the inhaler.
A. Based on the information you have provided, your symptoms seem to be compatible with asthma that is not completely controlled. Asthma can present at any age.
While salbutamol is of benefit as a “rescue inhaler,” it should not be used on a daily or very frequent basis. Patients with frequent asthma symptoms generally need a “controller inhaler,” which includes an inhaled steroid. Asthma is a very controllable disease, but so far there is no “cure” for asthma.
Allergies can create airway inflammation in allergic patients and make patients more sensitive to other triggers such as cold air and running. However, not everyone with asthma has allergies.
Your allergist can assist to determine if you are allergic to inhalant allergens such as pollen or dust mites.
If a patient has inhaled allergen sensitivities, treatment with allergen immunotherapy (allergy shots) may help to relieve asthma symptoms. Allergen immunotherapy is the closest thing that we have to a cure for asthma.