What is asthma? Can it be misdiagnosed?
According to the Centers for Disease Control, 8% of all Americans and 17% of poor, non-white children in the U.S. have asthma. A little known fact is that asthma can be misdiagnosed. Asthma, physiologically, is a condition where breathing out is affected by inflammation. Difficulty breathing IN can be associated with issues of “silent” or non-symptomatic acid reflux where the upper part of the larynx containing acid receptors get triggered and create an inflammatory response.
Dr. Jamie Koufman, author of The Chronic Cough Enigma, found in his 30 years of his medical practice that 80% of his patients did not have asthma but actually had silent acid reflux. The American College of Gastroenterology found that about 60 million Americans experience heartburn at least once a month and of these, about 15 million experience heartburn symptoms every day. Research confirms that GERD can trigger asthma symptoms and that it is more common in people with asthma than in the general population. Individuals whose asthma is difficult may have underlying GERD. The National Institutes of Health (NIH) reports that babies and young children may have silent GERD or not be diagnosed. Recent studies strongly suggest that GERD aggravates or may be the predominant cause of asthma symptoms in the very young. GERD affects as many as 89% of all patients with asthma, regardless of their age, sex, or ethnic background (American Academy of Allergy, Asthma and Immunology).
Some common asthma medications may promote gastric reflux. For example, research has found that prednisone and albuterol can possibly decrease the contracting abilities of the esophageal sphincter, thus allowing reflux. Other bronchodilators that relax the smooth muscles of the esophagus, can increase the possibility for gastric reflux as well. It is important to note that many patients who use those specific asthma medications regularly will not necessarily develop GERD or experience worsened symptoms (asthmaandallergies.org).
I believe that my personal experience with asthma may be similarly misdiagnosed or have a mixture of causative agents. I feel I may have silent acid reflux-related breathing constriction that is often combined with food sensitivities that lead to a severe allergic reaction. My intention is that in sharing my personal history, others may be more aware of a possible misdiagnosis and that there are more natural and effective options that may not only alleviate the symptoms but also can address the root issue of cause for this condition. I fully realize that my personal case is unique and individual to me and in no way would recommend that someone follow my story as a “treatment plan”. Instead, I would refer them to see an acupuncturist as well as an asthma specialist and/or gastroenterologist to design a course of action right for the individual and to determine the condition’s etiology that that specific person.
The medically accepted definition of asthma is very broad and possibly not complete. The Mayo Clinic definition: “Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath. For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack.”
The Mayo Clinic goes on to say: “Asthma can not be cured, but its symptoms can be controlled. Asthma signs and symptoms include:
- Shortness of breath
- Chest tightness or pain
- Trouble sleeping caused by shortness of breath, coughing or wheezing
- A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children)
- Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu”
I was diagnosed with allergy and exercise- induced asthma (EIA) when I was fourteen. When my throat started to constrict and air would not come into my body, I panicked and thought I was dying! In addition, my hands and ears would itch so badly I wished to tear them off. My eyes would also itch and swell as big as golf balls to the point of shutting. All of these symptoms point to anaphylaxis, which is life threatening. It was and remains to be one of the most scariest situation in my life. Tests determined I was allergic to near everything under the sun and I was put on steroid inhalers that I was told to take three times a day plus the usual albuterol to stop asthmatic attacks. I’ve always been somewhat of a rebel against pharma. I didn’t want to have anything to do with taking the inhalers and didn’t enjoy the “high” every time I took them either. So instead of taking the inhalers as directed, I eventually trained my lungs to expand whenever my breath started to get wheezy. I would concentrate on being calm instead of reacting to the wheezing and would take deep and long breaths in and out, holding the breath in between as long as I could. (Little did I know I was practicing the box breath which is actually a type of yogic pranayama!) This would slow down the constriction in my airways and if I stopped moving and meditated, the wheezing would go away. Overtime, I realized I had two different types of reactions. If my lungs were “touchy” and wheezy I could control my breath and stop the wheezing with pranayama and meditation. I never had any issues with breathing out so as long as I could calmly and slowly breathe in, I could resist taking my inhaler. For the past sixteen years, I have not been affected by this kind of breathing issue. The other type of situation is more severe and results in anaphylactic symptoms. This condition happened less frequently when I was young- maybe once every six months or so and now happens sometimes years apart. When I was young, I would stop the situation with the only things available to me at the time (inhalers and benedryl), and would feel completely drained for three days afterwards. To this day, I still use benedryl for these extreme situations but have been inhaler-free for sixteen years.
When I was 24, I was exposed to this amazing medicine called Traditional Chinese Medicine (TCM) which includes herbal medicine as well as acupuncture. Talk about a game changer! My teachers also confirmed that breathing IN is not actually asthma but can also be related to having weak kidney Qi (energy) which is responsible for pulling the diaphragm down when we breathe. There are other related etiologies that theorize a build-up of heat and/ or phlegm (likened to mucous) in other organs such as the lungs, liver, and stomach which ties into Dr. Jamie Koufman’s findings about acid reflux. Every individual must see an Acupuncturist to diagnose what pattern of organ disharmony is presenting for their unique body and situation.
TCM believes that the mind, body, and spirit are connected and that the spirit actually leads the mind-body. Therefore in TCM, emotions can often play a huge role in the development of conditions like asthma and allergies. We can literally be allergic to an emotionally toxic environment. Stress (triggered by a multitude of emotions) can cause inflammation and affects the immune system. I can very much relate to this as my living situation was emotionally stressful to me when I developed my symptoms suddenly at age fourteen. When I moved out of that living situation, my breathing issues and allergies began to improve. I notice even today that when I am stressed emotionally, my issues have a higher rate of re-appearing.
How to alleviate breathing issues with TCM
Although the symptoms of breathing issues can be alleviated with acupuncture, taking herbal medicine and addressing lifestyle (diet, environment, stress, exercise) is key to addressing the root issue and internal causative factors for breathing issues. The specific herbal formula must be prescribed by your local licensed Acupuncturist as there are various patterns that could be causing your condition. Acupuncture can aid in relieving the emotional stress and help guide excess heat/ inflammation from the organs which also helps boost the immune system. In addition to body points, I always keep ear seeds and needles on me for when I start to have symptoms of an attack. The itchiness for me is an early indicator and I apply either ear seeds or strong pressure (fingernails are best to the point when you feel pain in the points) to the highlighted energy points on the diagram:
Lifestyle for GERD related Asthma
Herbal medicine is very effective for GERD when treated before longterm use of strong medications. See a TCM practitioner for a prescription.
Diet: Physicians recommend that people with reflux problems avoid fatty and fried foods; caffeinated drinks; onions; garlic; tomato-based products; citrus fruits; pepper; chocolate; peppermint; and alcoholic beverages. Also, eat smaller meals.
Eliminate Tobacco which causes the esophageal sphincter to relax.
Yoga and Pranayama can relieve the stress causative factors and also helps to detoxify the organs so excess heat and toxins can be flushed out from the body.
Avoid eating too late. Eating right before bed can cause insomnia as well as cause acid to pull upwards when lying down. Have a three hour buffer period between eating and lying down.
Decrease Environmental Toxins: We live in a chemical world so reducing your exposure to harmful fluorocarbons and other irritants is extremely important. It is also incredibly wise to as much as possible decrease emotionally toxic conditions and find a sanctuary of peace at home and work.