Asthma and breathing problems
Breathlessness, wheeze and a cough that will not settle all deserve a proper look. Dr. James works out whether it is asthma, allergy, infection or something on the heart side, then treats the cause.
Who should see an internist about this
- You wheeze, cough or feel chest tightness in episodes.
- A cough has lasted more than three weeks.
- You get breathless on effort, on lying flat, or at night.
- You have been told you have asthma and your control is not good.
- You use a reliever inhaler more than twice a week.
What happens at your visit
Dr. James asks about the pattern: when symptoms started, what triggers them, night symptoms, smoke and dust exposure, and your medicines. He listens to your chest and may arrange spirometry (a breathing test) or a chest X-ray when needed.
The goal is a clear label for the problem: asthma, allergy-driven cough, post-viral cough, reflux-related cough or something else. Each has a different fix, so the label matters more than a quick prescription.
Preventer inhalers help many people control asthma when used as prescribed. Depending on the inhaler, side effects can include a sore mouth, hoarseness or tremor. Technique, dose and monitoring matter, and control varies. Do not change treatment without medical advice.
How to prepare
- Bring any inhalers or medicines you use, or photos of them.
- Bring old chest X-rays, scans or breathing test reports.
- Note when symptoms are worst: night, morning, exercise, dust, season.
After your visit
You leave with a written plan: what the problem is, how to use your inhalers correctly, which triggers to reduce, and what to do during a flare. Inhaler technique is checked at follow-up, because small mistakes are common and change the dose that reaches your lungs.
When to get help straight away
Breathlessness is an emergency when you cannot speak full sentences, your lips look blue, or a reliever inhaler is not helping. Go to the nearest emergency department immediately. Severe attacks can worsen quickly, so do not wait.
Common questions
How is asthma diagnosed?
From your story first: wheeze, cough, chest tightness or breathlessness that comes in episodes, often at night, with exercise, dust or cold air. An examination and a breathing test called spirometry then confirm how well air moves in and out of your lungs.
Can adults get asthma for the first time?
Yes. Asthma can appear in adulthood, sometimes after a bad chest infection, allergy exposure or reflux. The pattern of symptoms and the breathing test tell us whether it is asthma or something mimicking it, like a chronic cough from acid.
I only cough. Could that still be asthma?
Yes. A form called cough-variant asthma causes a persistent dry cough without obvious wheeze. Post-nasal drip and acid reflux cause similar coughs, so the visit sorts out which one you have before treatment starts.
Is my inhaler safe to use every day?
Preventer inhalers help many people control asthma when used as prescribed. Depending on the inhaler, side effects can include a sore mouth, hoarseness or tremor. Technique, dose and monitoring matter, and control varies. Do not change treatment without medical advice.
What are my asthma triggers likely to be?
Common ones are dust, air conditioning, smoke, perfumes, pets, weather changes, exercise and chest colds. Keeping a short note of when symptoms flare helps identify yours, and some people benefit from allergy assessment.
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