After 9 years of blogging about life with severe asthma, I still get a lot of traffic from people searching the web for specific information about O2 saturation and how it relates to asthma or the severity of an asthma attack. So for those who might have missed my earlier posts, here’s a recap of that topic.

O2 saturation, by itself, IS NOT a good indicator of how severe an asthma flare is. There are many factors involved in assessing the severity of an attack, the biggest one being how well you respond to treatment, not your O2 sat readings! In fact, when it comes to gauging the severity of an attack, I would place O2 sat readings near the bottom of the list. While they’re useful as a rough guide to see which way you’re heading, they don’t paint the entire picture.

As with all vital sign monitoring, numbers that are higher or lower than normal usually get the most attention, and since breathing problems are often equated with oxygen levels, patients and medical staff alike tend to focus on the pulse ox reading and often place too much importance on it. But here’s the deal, you can be in the middle of a pretty nasty asthma attack and still have normal, or near normal O2 sat readings. How is this possible? Well, you have to remember that asthma is a disease of the airways, not the alveoli where gas exchange take place (such as the case with Emphysema). So unless your airways are completely blocked (which is rare unless you had some sort of massive anaphalatic reaction), or you have a secondary infection or a pneumonia going on, at least a little bit of air still gets through those tight lungs, and that little bit of air is usually enough to keep the blood oxygen level within the lower limits of the normal range. It’s usually not until you’ve been working really hard to breath over a period of several hours, or sometimes even days, that your body can no longer compensate and that’s when your O2 sats will start to drop.

So what’s a typical O2 saturation reading for someone experiencing a bad attack? Everyone is different, but based on my observations as an RT working in a hospital ER and also as a person with really severe asthma, Id say a pulse ox reading of 87-95% on room air or low flow oxygen is pretty common in the ER. As an example, you can see in the photo above, that even though I was in the middle of a pretty severe flare, I was still able to maintain my sat at 95% while breathing 40% oxygen).

Now, that doesn’t mean that if you’re sat is higher than 95%, that you’re not sick or not suffering, it just means that you’re still able to oxygenate your body. A super high saturation (99-100%) could also indicate some hyperventilaton, which btw almost always happens at the very beginning of an acute flare.
Naturally , if someone’s saturation is trending lower that’s a much bigger concern, as it could possibly indicate impending respiratory failure or full blown respiratory arrest. Thankfully in the vast majority of asthma attacks, that rarely happens.

Bottom line, if you’re an asthmatic having a difficult time breathing and it seems to be getting worse despite taking your medications, what you need to do is contact your doctor and/ or get to a hospital. Don’t waste time by fixating on your O2 sat numbers and trying to figure out if they’re too high to warrant a trip to the ER. Base your decision on how you feel, not your numbers.

Related Posts:

82 thoughts on “O2 sats and asthma attacks revisited

  1. SGBear98 says:

    I couldn’t agree more that the O2 sats, while certainly has its place of importance; in asthmatics – I think the overall picture truly needs to be assessed. My O2 sats were good, but I was teetering on respiratory failure as hard as I was working to breath and they seemed oblivious to it.

    I just recently was hospitalized with my asthma that hasn’t acted up in over 5 years. Odd thing – like a volcano that was domant…it is now active – wonderful. Anyway, I have cough variant asthma. I don’t wheeze, I cough – when they checked my lungs all they heard is just diminished breath sounds. I thank my luck stars that the ER physicians were cognizant enough to recognize how sick I was and admitted me. Despite the fact my O2 sats were darn near normal (94%), my heart rate was 150-170, I was sweating like I was running a marathon, working hard to breath and couldn’t say more than 2 words together without having to either have a coughing fit or try to gasp for air, I was using so much energy to just try and breath, I had no energy to stand or even lift my arms (they felt like lead weight)…but because my O2 sats were good they never placed me on oxygen until I was up on the floor and the respiratory therapist came in to give me a breathing treatment and noticed right away I was still in distress (God bless the respiratory therapists!!!). During my stay (and it was awhile) my O2 sats dropped as I tired out (even on oxygen), but never low enough to be considered critical (90%).

    My biggest question would be the charting vitals by the nursing staff. They come in and tell you to take a deep breath, then when the O2 sats go up ever so briefly, that is the number they record. Really? Why do that do that? To me that seems like they are trying to show numbers better then you actually are. I sat at 92% nearly all day on 4 liters O2, they tell me to take a deep breath – I “gasp” and get my O2 up to 96% – for like 4 seconds and then it promptly comes right back down to 92%…and yet 96% gets recorded. Not sure this paints an accurate picture of how I am truly fairing. I still received excellent care overall, I just don’t understand that particular practice.

    1. Haha, it’s a mystery. I think people ( ie nurses) just assume that difficulty breathing is associated with low oxygen levels. Well it is, but it isnt. In asthmatics, difficulty breathing occurs because the airways are narrowed, not because of lack of oxygen. O2 sats in asthmatics dont usually drop substantially until you’re in full blown resp failure or asphyxia occurs.

      Hope you’re recovering well :]

      1. Katherine says:

        Not all nurses some of us are actually good at nursing sorry if you have come across some that are not but I hate to be tarred as ie nurses I have met some Drs that I have told sats have no to very little baring in an asthmatic patient I have worked with fantastic nurses in ITU and the emergency unit whom are very well aware that a patient is looked at holistically and not as a set of numbers.

        1. Im lucky to receive my asthma care at University based medical center. The ER nurses and doctors are awesome. They deal with a lot of respiratory patients and really know their stuff. Sadly, it’s not the same at all hospitals, at least not in the US. There are still facilities with staff that base asthma severity on O2 sats and whether or not a person is wheezing.
          It’s getting better, but this problem still exists.

      2. Sascha says:

        Also I’m an asthmatic and a nurse and unless a nurse is asthmatic themselves they don’t understand the issue of asthmatics breathstacking and hyperinflation

      3. Judi Tucker says:

        I was having a severe asthma (?) attack one morning, ( question mark is I haven’t been officially diagnosed). My O2 sats were 98-100% on o2( not sure how much) Respiratory took o2 off and I remained at the same. As soon as i pulled my mask ( I do not have covid) my sats went down to 89% I continued to be in distress. My question is, why the fluctuation in O2 saturation? Follow up dr looked at VS including saturation said I was fine.(?)

        1. Sorry to hear about your desats. If you were on a Facemask instead of a cannula for your, this means that you needed a higher concentration of O2 or were breathing through your mouth. If thats the case, its not surprising that you would desat to 89%. It’s probably just your body adjusting to the lower level of O2. The main thing is that your sats come back up, even it takes a while. You bring up an important though, you need to get a definite diagnosis. So many things can cause your sats to drop. I hope they find out.

    2. Sarah says:

      My husbands dealing with a bad flair up right now. O2 stats fine m. He’s doing 1 hour long nebulizer and still feels tight. How did u get better?

      1. Paige says:

        Steroids!prednisone to keep the lungs from swelling. Thank me later. Good luck

      2. Sascha says:

        20 min burst nebs for 1 hour

  2. SGBear98 says:

    I’m having to learn all over again a world I thought I was very fortunate to have escaped, not exactly where I thought I would be years later.

    Recovering a lot slower than I could have ever imagined. Even on prednisone (40mg) and half a dozen other preventatives, inhalers and nebulizers – BUT – recovering none the less. Made it through Christmas with only one trip to the Urgent Care. (ok, and 4 asthma attacks treated at home, in the car, at a party, ect.) overall, Not bad I think.

    I hope you are doing better as well and have made it home.

  3. bottompage says:

    I agree with what you have said, Stephen, but still have a question – what do you do if you are in the ER or at an Urgent Care and ALL they are looking at is your oxygen sats. I’ve been sent home many times (without even a breathing treatment) because my oxygen sats were “too high” to be showing I was in distress or needed intervention. I even had my own pulmonologist (and no I don’t see here anymore) send me home with an oxygen sat of 91%. On a good day – I’m typically at 97 or 98%. So when I’m using all of my effort to breathe, and can’t say more than 2 words at a time, how do I convince the ER or Urgent Care doctor (who has never seen me before) that I am in distress?

    1. I can imagine your frustration. First of all, never ever go to an Urgent care center for an asthma attack. Even if the staff is experienced, they’re just not set up to treat a sick asthmatic. ALWAYS GO TO AN ER.

      Having said that, either the staff at that hospital are totally ignorant about the symptoms of asthma, or there is something else going on that I dont know about. The decision to treat and/or admit a patient to the hospital for asthma is based on all kinds of criteria, not just O2 sats. Some of it is based on the patients past medical history and some by how the patient looks and how their chest sounds. The fact that they wouldnt even give you a breathing treatment tells me that they dont believe that your symptoms are caused by asthma. A lot of conditions can mimic asthma, especially anxiety disorders.

      My advise to you is , whenever possible , is to contact your Pulmonologist or primary care doc and have them notify the ER that you’re coming in.
      I guarantee this will help.

      Good luck

    2. elaine moore says:

      I’m so glad someone explained high sats I’ve got such bad asthmatic my adrenal s have gone, but still they depend on sat
      s mine is always great But no one listens.

      1. Hi, Yes. it’s a shame that a lot of medical people dont understand how asthma affects O2 sats. The fact is, unless you are on the verge of respiratory failure, have anaphylaxis or pneumonia, it’s likely your O2 sats will remain in the 90’s. My best advise is to have your medical staff make a note in your chart, indicating that you tend have normal sats during asthma flares. They should not rely on your sat numbers when treating your asthma. I have gone to the ER many times for my asthma with my O2 sats 92-95 %, and then end up on a ventilator a few hours later. Best of luck to you!

        1. Lynda says:

          Sats 97 pulse100 continuous coughing wheezing!! Can’t sleep so tired wheeze stops stops any king of sleep even after neb!!

  4. Jan O'Leary says:

    I have struggled with this issue for the past twelve years. Some physicians and nurses give me looks suggesting I may be crazy. My saturation levels are never abnormal. I rarely wheeze. I cough, I have an elephant on my chest, I have difficulty saying more than a few words at a time, and because of reactive airways, I am hoarse. I thank you for posting this explanation: it was a relief to know there are others out there like me. I will carry copies of this article to give to care givers.

    1. Marion says:

      Your symptoms sound more like vocal cord dysfunction than asthma. Has that possibility been checked? It is possible to have both conditions but symptoms are slightly different and treatment is quite different. Just a thought

      1. Hi, No, I dont have VCD, but that’s a good observation. Thanks!

  5. Emma Dobson says:

    Thank you for posting this. This knowledge needs to be shared more widely with healthcare professionals. I literally want to cry with frustration when I go to the docs with a tight, silent chest, they check sats and seem very satisfied to show me that my O2 is 99%. That’s great but why do I still feel tight, itchy chin, coughing mucus, uneasy, irritable, exhausted and feel like an asthma attack is imminent? The other thing that I find worrying is when they listen to my chest on the breath in and no wheeze is evident. That’s because I wheeze on exhalation but they don’t seem to count that as a symptom of infection. It does make me feel like I don’t know what to do, am I imagining the severity of how I feel inside 🙁

    1. You’re welcome.

      Sorry to hear that you have asthma. Dont worry about your chest sounds. It’s actually normal to have wheezing on exhalation with asthma, not on inhalation. Wheezing is usually caused by bronchospasm and/or inflammation of the airways, which causes them to narrow and produces a wheeze. You can have asthma symptoms without an active infection. Lastly, O2 sats have nothing to do with asthma severity, unless you are critically ill. Take care!

      1. Sarah says:

        I’m in ER right now. My husband is having a bad flair up that is not going away. He’s had a shot of steroid numerous breathing treatments and even an hour long breathing treatment. He says he feels like heaviness on his chest. Dr seems annoyed that he doesn’t feel better. Is there anything u suggest

        1. GINNY FLOWERS says:

          What did they end up doing. I hate when docs seemed annoyed. Look at whole pic doc, look outside the box, we are all different

    2. ScorpioC says:

      I am with you on that one, Emma.

  6. Emma Dobson says:

    Hi again,
    I’ve just read some of your posts about your horrendous and life threatening experiences of asthma flare ups. I don’t know how you summed up the mental energy to articulate what you went through and the aftermath of recovery but full respect to you for doing it. Thank you for bravely sharing your experiences and I wish you all the very best in your continued management of your asthma.

    1. Thank you again. Blogging about my experiences with these bad flare ups actually helps me cope a little better. Ironically, it’s the high dose of steroids Im on during these bouts that gives me the clarity to write about them. Hopefully, it helps others as well.

  7. NaomiB says:

    Thanks for this explanation. I had an awful experience this week of severe cough and every breath felt like a hurculean effort. I did the right thing and called for an ambulance. When the ambulance arrived, I was very quickly dismissed because I had no wheeze and high oxygen sats.

    They tried to convince me not to go to hospital. I said I needed to go and at triage I was categorized as low risk due to them forwarding on this opinion, so I waited and waited. I finally got in a bed and on oxygen, medication etc and I felt 1,000% better. The doctors were actually surprised in the transformation.

    It would be great if this info was more well known, it would have saved me the stress of trying to convince someone to take me to hospital while I felt I was being sat on by an elephant.

    1. Thank you for the feedback, Im glad you found my explanation helpful.

  8. Casey says:

    Last night I waited two hours in the ER to see a doctor with high blood pressure, heart rate, and respiratory rate. Gave me 30 min nebulizer and sent me on my way. I was coughing and shaking because the “barking” coughs were so painful. They didn’t immediately send me back to the doctor with the initial checkup because my pulse ox was only 97.
    Now today, my BP has reached over 150/90, my heart is beating through my chest, my resp rate is 21-32, and I’m taking my albuterol every 30 to stop the wheezing.
    But am I going to the ER? No. Because they don’t take me seriously.
    I’m sick of it. I can’t even sleep right now. Sitting up in bed and writing this instead because Im struggling.

    1. This is an all too common problem in certain parts of the country. Im assuming you have cough variant asthma?

      If you don’t already, you need to be followed by a pulmonologist. If the ER docs know that you are being seen by a specialist, they’re more likely to take you seriously. In the meantime, if you dont get better, go to a different hospital.

    2. Angela Herrig says:

      I hear you. I am in the same boat right now. Been like this for 12 days. Spent 2 nights in the hospital, have had breathing treatments, steroids up to 100mg, antibiotics and inhaled budesonide. I am still breathing very hard although have some relief at times. I’m so exhausted. My 02 sats have been 86-93% although the average is going down to about 89% will ALL meds on board. Taking benedry to not suffer anymore. Sleep is bliss.

      I’ve been told i was having a panic attack in the ER right after I had COVID. I swore after that I would just die at home alone. Maybe in my sleep. Can’t imagine a second trip to the ER is going to help. But at least they were kind a few days ago and tried.

      Hoping to stay right side. But I feel my lungs may not be strong enough any more. Lifetime of asthma, horrible RSV virus and CoVid damaged lungs. Not a good combo.

  9. Jo says:

    Hi Stephen. Thank you so much for your information. My son is struggling with his breathing since having a viral infection 3 weeks ago. He has a reliever inhaler and has just started using Clenil Modulite. I have just spoke to our GP who has just argued that because my son has perfectly good SATs he cannot be having an asthma flare up. My son has a tight chest and is coughing in the day and finds going up stairs hard going. He is exhausted but the GP doesn’t think he is too bad because his SATs are fine and he is not wheezing. The Asthma UK nurse tells me that people do not always wheeze. I am so confused as to what is happening to my son and who is telling me the right information. The Asthma nurse thinks he needs steroid tablets to get things back under control. Do you think you can have asthma that is out of control but is not causing restless sleep and should it feel better lying down?

  10. Hello Jo,

    Sorry to hear about your son’s breathing problems. It’s sad in this day and age that some healthcare practitioners still believe that asthma flare ups are always associated with drops in O2 sat. That simply is not true. The only time that logic really applies, is when the person is suffering a severe life-threatening attack or if the person has a secondary infection, like a pneumonia. Mild to moderate asthma flare ups rarely result in O2 desaturation. The reason is because asthma is a disease of the airways, not the alveoli (air sacks) where oxygen exchange take place. Even when the lungs are tight, Oxygen manages to get through.

    The asthma UK folks are correct, not every asthmatic wheezes. Some cough a lot and dont wheeze, some wheeze a lot and dont cough at all. Sometimes the airways close so tight , that’s there’s not enough air moving around to make a wheezing sound.

    The most important indicator of an asthma flare, is how the person feels what their peaks are and how they respond to reliever meds. Steroid pills are only necessary when inhaled steroids arent working . There are lots of side effects from steroid pills.

    My recommendation, is that you find another doctor , preferably an asthma specialist ( I think you call them consultants in the UK). I would have the new doctor do a complete re-evaluation to make sure son actually has asthma and not something else that looks like asthma.

    Hope this helps.

    PS.. may I ask, how old is your son?

    1. Nicki says:

      September 17, 2016 at 12:16 pm
      Hi stephen. Sooo glad I found this site!! I’m an EMT and to be honest with you, I have always went with someones O2 sat when we get a call. Plus being asthmatic as well. I am always checking my O2 sat at home. I would consider my asthma to be very well under control. But when the pollen season or i come in contact with something, it will hit. Question for you. Sometimes I wonder if it’s anxiety or true asthma. I usually pre-treat everyday before I exercise. Other than that I hardly ever use my inhaler. Today was one of those days (haven’t had in in forever) that I get this weird feeling, i can feel my HR start to go up..I’m freaking out because I’m trying to hurry and do a treatment and when i’m doing it my HR is already out the roof so i’m wondering if that is making me worse or if true asthma makes you hyperventalate. My pulse was going 150-170. I finally finished my treatment but had to breathe in a bag to get my pulse down. Don’t know what trigger my symptons today. No wheezing, no coughing ever. No tighness in my chest. Just a change feeling. I have been checked for VCD. My fear is that I will hyperventalate to the point of passing out and not get all my neubilzer med in. Can you kinda help me out here. I have a great asthma-allergist dr. He goes by O2 just like everyone. But being an EMT , I am learning more what to check on a person besides their O2 sat!! Thanks

  11. g says:

    just discovered your site and I’m staying for a look around! I have asthma but wasn’t diagnosed until an adult as I rarely ever wheezed. My son rarely wheezes either, just gets a weird voice, is more breathless, and then vomits and gags. It took 5 years to get him diagnosed, how scary! Now my youngest has low-ish oxygen (93%) but “no wheezing so he is fine”… I’m taking precautions and monitoring him because wheezing is a decent sign of asthma but not guaranteed.

    1. Jody W says:

      Looking around and came across this article. This is an older post but could the son with voice change, breathlessness, etc have acid or gerd? Sometimes some of the symptoms overlap with asthma but would be different treatment.

      1. It most certainly could be GERD or even Vocal Cord Dysfunction. There are lots of conditions that either minic or go hand in hand with asthma. And Yes, the treatment would be different for each. The important thing is to get a proper diagnosis. The definitive test for asthma would be a PFT ( pulmonary function test) and a methacholine challenge test. For GERD, an esophageal Ph test. Vocal cord dysfunction ( VCD) might require evaluation from an ENT doc.

        Thank you for writing!

  12. Thanks for this article. I have cystic fibrosis as well as severe asthma ( which is mainly due to allergies) and was so confused by the contradictory reading. My O2 sats are pretty good (between 94-98) and seemed to have no correlation to the severity of the asthma attack. The info you provided has helped me clarify the situation! 🙂

    1. Thank you, Im glad I could help a little.

  13. Nicki says:

    Hi stephen. Sooo glad I found this site!! I’m an EMT and to be honest with you, I have always went with someones O2 sat when we get a call. Plus being asthmatic as well. I am always checking my O2 sat at home. I would consider my asthma to be very well under control. But when the pollen season or i come in contact with something, it will hit. Question for you. Sometimes I wonder if it’s anxiety or true asthma. I usually pre-treat everyday before I exercise. Other than that I hardly ever use my inhaler. Today was one of those days (haven’t had in in forever) that I get this weird feeling, i can feel my HR start to go up..I’m freaking out because I’m trying to hurry and do a treatment and when i’m doing it my HR is already out the roof so i’m wondering if that is making me worse or if true asthma makes you hyperventalate. My pulse was going 150-170. I finally finished my treatment but had to breathe in a bag to get my pulse down. Don’t know what trigger my symptons today. No wheezing, no coughing ever. No tighness in my chest. Just a change feeling. I have been checked for VCD. My fear is that I will hyperventalate to the point of passing out and not get all my neubilzer med in. Can you kinda help me out here. I have a great asthma-allergist dr. He goes by O2 just like everyone. But being an EMT , I am learning more what to check on a person besides their O2 sat!! Thanks

  14. Lynne says:

    Thank you for your article. I got asthma while serving in the U.S. Army from a different infection that was not treated correctly, for three months I had coughing fits, low ability to breath and recovery from a PT test was horrible. The doctor on sick call thought I was making things up. I wasn’t I was sick. I flew to Germany and while waiting in line for a flu shot the Major heard my coughing fit that would occur after saying a few words. Answer the phones for battalion s-1 was a nightmare. The doctor immediately pulled me from the line and had me taken to the hospital in Bremerhaven. I stayed there a few days and yep sure enough I had asthma. I never had asthma before, this was caused by doctor failure at my last duty station. Learning how to manage it and pay attention to warning signs became important to me. I know when it is an attack for me…coughing like I have clogged lungs but nothing coming up and the fits last for longer than 30 seconds to 1 minute, when I can’t talk except to end in a coughing fit that keeps coughing for some time seems like forever, walking to the bathroom or washing dishes is enough physical exertion I can handle we have a problem.

    Sadly people around me do not believe it is a serious thing, this asthma issue, it isn’t as life threatening as a heart attack it’s just needing to calm down and learn to control my breathing (this from my husband) who does not know about asthma or allergies. Give it time it will pass like any cold. Luckily, the ER staff is very good about believing me and they watch my coloration (i’ve learned not to wear makeup when I go to the ER so they can get good observations) the RT is really good about listening and double checking the nurses and this time when the nurse had a hard time listening to my lungs he actually helped her listen to what he found cause when he asked me to take a deep breath of course the coughing started. Their biggest concern though is that my blood pressure had sky rocketed to 160/85 before treatment. When he started treatment my blood pressure dropped to good levels again. Heart rate was high too. So at least they looked at all areas because even if it had been an anxiety attack…the BP and heart rates were alarming, after treatment everything went to breathing a sigh of relief.

    Actually I came across your blog today before I went to the ER cause I felt I couldn’t wait for a doctor’s appointment. I don’t know if your article gave me a wake up call or I decided to listen to my body I do not know, but yours was a big deciding factor to listen to my body not to my husband’s lack of knowledge on this subject. Thank you. I am sure things could have gotten worse if I hadn’t gone in.

    1. Hi and thank you for writing. Im sorry to hear that you’re having breathing problems.

      What is a PT test? Did you mean PFT ( pulmonary function test)?

      I understand your frustration. There many different types and severities of asthma, but unfortunately, we tend to get lumped all together under the heading of “Asthma” . If you dont fit text book example of a wheezing asthmatic, you’re either faking it or have some kind of anxiety problem.

      Because there are many conditions that mimic asthma, if you haven’t already, I would highly recommend that you see a Pulmonologist who specializes in asthma and get a firm diagnosis. At least then you’ll have a better idea of what’s going with your lungs.

      All the best to you,

      Steve G

      PS. There is such a thing as “cough-variant asthma”. The only symptom is coughing spells and shortness of breath.

  15. Colleen says:

    Hi Steve,
    I am hoping you will provide some much needed insight for me, as I have questioned my daughter’s doctors, Respitory therapists, nurses, and searched pubMed-and am still left with no answers. My 5 year old daughter was just released from the hospital after a six day stay with an acute asthma attack due to a respiratory virus. She has a complicated backstory. She was born at 35 weeks, and was exposed inutero throughout her birthmother’s pregnancy. We brought her home at 7 months. Since she was a toddler, every time she would get a cold, even a post nasal drip, she would begin to take “staccato breaths” yet lungs were clear. It was as if she was “afraid to breath”. This is my child that did not walk until she was 20 months, that was given a diagnosis of mild CP which was then dismissed, and has been determined to be one that is highly dramatic. As she has gotten older, her colds can be accompanied by a dry cough, and sometimes a throat wheeze. I have taken her to the doctor, and her lung sounds have always been clear. When she was recently hospitalized, her o2 seats never fell below 92%, and on subsequent follow-up visits have been 95-97%. My question to you is, given that she was a preemie, isn’t it possible that her normal o2 may be 97-98%, and or she may have some sort of weak upper respiratory musculature that may make her react to colds in this manner? I have scheduled an appointment with a pulmonologist for next month. I just find it unusual that there have been absolutely no other triggers for this child other than a cold, and her reactions are so atypical.

    1. Hi, Sorry to hear that you’re daughter is having problems.

      Did you mean she was born at 25 weeks? Low weight premies can have all sort of breathing issues as they get older, which are not well understood and aren’t necessarily related to asthma.. In fact, many are misdiagnosed with asthma. I would definitely follow up with someone who specializes in pediatric pulmonology.

      Wish I could be of more help.

      1. Colleen says:

        Hi Steve,
        Thanks so much for your quick reply. Could I ask your opinion as to what other possible causes besides asthma could attribute to her breathing issues? I’d love to do some research prior to the visit with the pulmonologist. Thanks again!

        1. Colleen says:

          P.s. I was a severe asthmatic as a child, and spent a great deal of time in the hospital. So much so, that my nickname became Bubbles :). I was surprised how much treatment has changed over the course of a few decades-much less steroid use, which is both good and bad.

  16. Sarah says:

    Hi Stephen,
    Glad I found this sites I’m going through a difficult bout with my asthma right now-same thing happened to me two years ago. Both in the winter and both after chest colds. Here’s what’s happens: the cold progresses from a productive cough to a dry cough. This is when things begin to get really rough-my breathing sounds normal (I listen to myself, I’m a trained nurse though I don’t work in the field) I sound normal, but it feels like there’s a ton of mucus in there-just stuck. My chest begins to get tight, I can’t take a full breath in. I blow around 400. I do my inhaler, I do my nebulizer but still cannot catch my breath (stairs are especially challenging). So it feels like all my airways are closing I can’t catch my breath and I go to the ER. They check my sat which is like 98/99 no O2 aid and listen to my lungs and say theres no way to admit me it’s fine I have anxiety….well yeah one would think it would be appropriate to be slightly anxious when you can’t breath. I’ve gone to pulmonologists and get allergy shots I’ve been to the ER. Everyone tells me it’s anxiety, but I take a klonipin when this happens and it does nothing for me. I’m 27 y/o fit girl w no lung sounds and a nearly perfect O2 sat, but these attacks make me feel as though I’m suffocating. Help?

  17. Shelley says:

    Stephen, I’ve been trying to solve a mystery. I had an episode of tachycardia that was improved with oxygen by about 30%. So, my heart rate was 150 without oxygen and it dropped to about 105 within one minute of oxygen therapy. My SaO2 during the time with and without oxygen remained at about 98 or 99%. If the oxygen was removed because the SaO2 looked good then my heart rate jumped right back up to 150 or higher. Obviously, my heart rate was compensating for something. Blood gases drawn at the same time showed severe hypoxia. How can the spirometer be 98%or 99% when the blood gases at the same time showed severe hypoxia? Have you ever heard of such a thing?

    1. Hi, To answer your specific question regarding the SPO2 and the miscorrelation with your blood gases, I would have to know the exact numbers on your blood gas results. You have to remember that PO2 ( the measurement of oxygen in your blood) is different than O2 saturation. It gets rather complicated, but under certain circumstances it’s possible to have a normal sat with a low O2. More important though, SPO2s measurements are only accurate if the devise is receiving a solid and stable pulse reading from your finger. If you’re tachycardic with a HR of 150, chances are the reading was probably false. I would disregard the pulse ox reading and go with the ABG results.

  18. Jacinthe Kitchur says:

    I so totally agree with this. Many times is or my husband have gone to the ER and and have been sent home sating we are fine without treatment cause our lod ox is normal. The worse time was when my husband was sick and his asthma was flaring really bad. I took him to our local ER. The nurse made him take that exhale test (sorry I can’t remember the name) and he could barely get out enough to push the little needle in the red zone, He for dizzy and almost past out while doing it. The nurse took note, his blood ox was in the 90s. Dr came in listened to his lungs looked at his blood of but not at the nurses notes and said “well your oxygen levels are fine and I dont hear wheezing (I was at the other end of the room and could hear the wheezing and he could take a deep breath without having a coughing fit) so you are fine and can go home” No treatment nothing. I ended up taking him to our Dr the next day had to be put on major steroids and still he didn’t fully recover for weeks. It’s so fustrating

    1. Sorry to hear about your experience in the ER. Unfortunately this is an all all to common problem for a lot of asthmatics. Physicians and staff need better education in this area.

  19. Debra farrell says:

    So glad i found this blog.

    Ive experienced the same frustration as many here.

    Im currently in hospital with urti induced asthma. Recently received adipose stems, with rapid af episode after taking panadeine forte, then onset of asthma like symptoms 2 days later.

    Id been virtually symptom free for many years aside from occasional flare during colds and drinking white wine.

    3 gp presentations and 4 emd presentations, with persistent chest tightness and sob, i was so totally fed up with being dismissed because i didnt have a wheeze and my sats had always been normal, i presented to emd, rang my choice of respiratory specialist and pleaded with him to admit me.

    He agreed. Im still not right, but he is the only dr so far who has acknowledged that not all asthmatics present in the same manner. Today, after reviewing me, he noted that my wheeze had improved. Wtf? i questioned him about the other 7 doctors misdagnosing me, and he replied by saying that maybe i didnt have a wheeze at that stage. Im so confused and worried about the future management of a condition that i thought was largely behind me.

    Im only anxious because of the severity of my symptoms, and getting tired of staff telling me to relax. Implying this is an anxiety issue.
    Im scared of being bumped out, because of how hard it was for me to be taken seriously in the first place.

    What are your thoughts on histamine intolerance and asthma?

    1. Sorry to hear you’re having all these problems. Unfortunately this is all to common for many asthmatics. Assuming that you were correctly diagnosed with asthma (which believe it or not up to 50% of people are not), you really need to see a respiratory doctor to specializes in asthma and discuss these issues with him. Maybe he can coordinated your care. Histamine is a potent asthma trigger not only in asthma, but also in hayfever. Best of luck to you!

      1. Michelle Smith says:

        So glad I found this blog. Currently in hospital after my asthma flaring up following a chest infection. Went to one hospital (I live in Australia). they treated me for my asthma and admitted me. that night, I had another pretty bad attack and it didn’t resolve with treatment and my o2 sats were okay for a period of time. The hospital I went to doesn’t have an ICU. So unfortunately when my sats did drop, there was minimal stuff they could do for me. By the time they got a medical team to transport me to a hospital with an ICU I was so tired from breathing I don’t even remember the transfer. 2 days later and I’m still in ICU, hoping to go home at the end of the week.

  20. Hope you’re starting to feel a little better!

  21. clark says:

    I have a wheezy non productive cough. Between exacerbation I am fine except with moderate exertion I will feel dyspneic. About every two-three weeks it will exacerbate and I get fits of coughing, dyspraxia, SOB and heavy chest feeling. I resort to and use xopenex, ventolin, atrovent with some success. Narcotic syrups work well but sedate too much. If I get a URI it always ends with cough, bronchitis that’s hard to get over without systemic steroids. Never had anxiety, so not worried about that as the issue. I do have mild GERD that’s well controlled with diet and Dexilant. I have food allergy to wheat, cow milk, peanuts, and eggs. My skin allergy test was positive to grasses, trees, molds, dust mites, cats, weeds… Cannot remember specific allergens. My Pre PFT shows moderate obstruction, Post PFT shows mild to moderate obstruction with 21% improvement from the pre PFT baseline. I’m a mid level provider that practices solo many days without a MD so I’m confident in diagnosing respiratory illnesses but I’m kinda stumped. I have a pronounced late upper expiration wheeze with these exacerbations too. Never heard it before on a patient except on myself. I’ve been in EMS 30 plus years as a Paramedic, 17 of those in the Professional Fire Service, RN for 22 years (ER and OR), and now full time CRNP (FNP) since 2011. I’m stumped and trying to see a Pulmonologist for definitive diagnosis. My sats on RA are 90-94 percent. Don’t improve much with updraft (best about 96%). Echo was low normal with minimal regurg of all the valves, worst being MVP/Regurg but I am 48 years old. LVF 59%. CT last week shows only small discoid actelactasis left lower base. EKG NSR with rate in 70’s. RSR in v1 but it’s normal from what I was always taught. RBB in v2-3 minimal. with no acute changes. CBC, CMP, Iron, and others normal. I did have rocky man fever last year, treated appropriately with 3 weeks of doxy 100 mg bid. I guess I’m done rambling but I’m just looking for ideas on maybe something simple I omitted. Any help is appreciated.

    1. What you’ve described sounds like asthma to me. Of course there could be other things going on as well, so I think it’s a good that you plan to see a pulmonologist.

  22. Racheal says:

    Hi, I have COPD but also suffer from what they call acute asthma. I am hospitalized around four times a year with my condition. My problem is too, that my Ox Sat levels are always so called good in their eyes. They sit between 96-98% but I struggle so hard when I have an attack. I have an audible wheeze and limited air flow but still get taken lightly because of my sat readings. I often end up on Bi Pap because of exhaustion but still get sent home the next day or two days later and am told I have panic attacks which don’t help. How can I not panic when they know I’m in distress but tell me my numbers are good and just to relax 🙁 frustrating! I have a great lung specialist but still don’t feel like I’m listened to. Thankyou so much for this blog, it helps to know I’m not mad when I try to say to my health professionals that my sats are always good but clearly I’m suffering acute severe asthma.

    1. Crystal Hoksbergen says:

      Exactly! I know too that the anxiety worsens the condition, I hyperventilated when I was a teenager & had an ER visit, ever since then I KNOW I have to control the anxiety & I work very hard at it when having an attack… but, you are right, how can you not be anxious especially when they don’t listen to you. YOU know your body, you know what is not normal.

  23. Crystal Hoksbergen says:

    Hi all, my name is Crystal. I have had SEVERE asthma since I was 2 years old. Normally I get treated pretty well, getting the meds I need & such….NOT the case this time. This asthma episode started about 2.5 weeks ago, I was swimming in a pool that had a chlorine boost for a pool party. I didn’t think anything of it until I was in the pool, in water over my head and started coughing uncontrollably. I immediately got my husband to help me out of the pool, get my inhaler & sucked in a couple puffs. Well the coughing stopped for a second & started again. Our daughter googled the nearest open urgent care, as it was right at 9 pm and we headed off… Upon arriving at the urgent care I was rushed to the back & put on nebulizer treatments, that’s the only thing that was helping the cough. They took it off for me to go get X-Rays, I coughed my fool head off the whole time. Of course X-Ray was clear, 2 doses (4 puffs) of albuterol inhaler and 3 breathing treatments later… I’m ambulanced to the local ER–on oxygen, shaking like a banchee because of all the albuterol…. The ambulance personnel told the nurses upon arrival that it was anxiety because my stats were good…. SO….now I’m being refused oxygen, I’m being told to calm down, all while I’m BEGGING FOR OXYGEN! The assigned nurse refused to give me anything until the doctor came see me, my husband had to go to the bathroom and wet a paper towel, put it in his pocket and bring to me, he said he had to smuggle it in, lol, meanwhile I’m getting even more anxious, restless, starting to cry, wondering what is wrong with this nurse, how could she be refusing an asthma patient oxygen, figuring she had to be new or at least inexperienced, you would think right? So I’m coughing so hard, I knew it was an asthma cough the minute it started in the pool, & NOTHING helped but, the oxygen/breathing treatment. I finally told my husband I want the charge nurse, so he goes to the nurses station and says I want the charge nurse, not my first rodeo at a hospital–NEVER have I asked for a charge nurse though! So a few minutes later a new nurse comes in & I find out that I had been dealing with the charge nurse, one of her co-workers had to come in & address the situation. Within a couple minutes I was on oxygen, calming down, had ice chips–which I was also refused by the “charge nurse”, and she went found the doctor! I have no doubt in my mind I would have died or come close to it had I not asked for the charge nurse. The doc LISTENED to me, gave me hydrocodan cough syrup to calm down my lungs, after about 1/2 hour or so the coughing stopped.

    Fast forward–a week later still having shortness of breath, tightness oxygen stats between 95/97 sometimes 98 after a treatment… I’m go back to my primary doc, who normally listens to me, got a steroid shot & was told—-no more than 2 breathing treatments a day, reduced prednisone to 5 mg a day…. I have made an appt with my pulmonologist in the meantime but, that won’t be for another 2 weeks. I was told that as long as my O2 sats are in the 90s I’m ok, not to worry, I questioned the nurse telling me this, are you sure? I don’t play with my asthma, it scares me.

    Fast Forward another week back in ER for another steroid shot. I explained that I don’t like taking all this medicine, I know the risks of it but, what am I supposed to do when I can’t breathe? The ER staff had me in the back & I had a steroid shot & a breathing treatment in like less than 5 minutes flat. Thank God!

    I’ve been reading your posts about O2 sats and WOW! I had been putting alot of emphasis on that number too, now I know that I have to be more careful, especially in a flare up that lasts weeks at a time. As a child I used to be in the hospital for weeks at a time, living in oxygen tents & having shot after shot, day after day…

    Concerned Asthmatic Patient

  24. Marta says:

    Hello there my name is Marta and I’m asthmatic. Ok, that little line done and over with and in all seriousness I have been a severe asthmatic synth age of three, I am now 53. Although I am a humble English teacher here in Madrid, Spain, I think I know asthma when I see it or better said when I have it. I have been reading some of the posts regarding the O2 readings. I have been to the health care center ( public and run by what I say is a well respected public health system ). I really do not go to these places unless I am feeling in a severe situation. My general practitioner always calls my attention about waiting too long before seeking help. She is a gem and knows me all too well. However, in my pointed health care center, the first thing they do is check my O2 level, when it reads an average of 97% they look at me with a “why are you wasting my time face” and tell me that I am not doing bad at all. Yes, tell that to my lungs… on another case, my O2 level was taken while I was being given oxygen, of course the appointed doctor proudly said, ” You see, you are doing so well now” while I could nearly manage a “no” by asking my face. I also have private health insurance thanks to my work and I have’ve also been attended to a private hospital’s ER. Again, they are just rely too much on their little O2 reading gadgets! ER staff, nursing staff should just learn to listen to their patients more and I say this with all due respect and knowing that they have my full admiration for all their years of studying and hard work, but like I once managed to say to am attendant at the ER: ” I am an expert teacher and I know how to do my job, but I always listen to my students, please listen to me, I CAN’T BREATHE !”
    I have also found out, the painful way, literally, that measuring the 02 levels through a blood test in the arteries ( not sure what this is called in English but here it’s called “gasometria” ) quite a painful test, proves to be a lot more accurate.
    Oh, well, just wanted to sympathize with all my fellow asthmatics out there, that the O2 gadgets ( and I bought one recently, oppps ) are not to be too relied on and that we, the ones with the sometimes blue lips and nails, should be listened to more.

    1. Marta says:

      I meant to say “asthmatic SINCE the age…”and ” by SHAKING my face ” Sorry, my bad.


  25. ScorpioC says:

    Last Friday I went through a really scary ordeal because I recognised that I was having an Asthma Attack. I live on my own and take care of two children. I thought that I would stay home through the night and go to the hospital once my children were settled in school. At the time of presentation, I was gasping for air and only saying one word at a time. I know that my stats were in the 99% in the afternoon but staff had me waiting in the ER waiting room for one and a half hours before giving me a lecture that I had panic attack disorder and sent me out the door. I arrived at the GP Clinic shortly afterwards and the same treatment was applied. I ended up going home wondering if I was going to die because payday was not until the next morning so I couldn’t save myself. I am okay now but I am feeling anxiety because if I was to have another Asthma Attack in the future, I am wondering who to turn to because in an event of a crisis nobody seems to believe. At this moment, I am not even sure if I would reach out for help again because it’s obvious that I don’t know the difference between Asthma Attack and Panic Attack.

  26. Erika Walid says:

    my mum who is 61 years old but 30 years old in her mind, has was diagnosed with severve copd, she was admitted into hospital in june 09 with an exberation of copd, she was hospitalized less than two months later and i must say alot lot worse, her sats dropped to 47 and me (her daughter) my brother and sister were called as things turned for the worse.she has to go home after a someone in the hospital recommended herbal clinic to us thankfully after three weeks and the shere determination of my mums will to live shes home, she was connected to oxygen 24hours a day, very tired,cant do things for herself. but shes alive!! this is a horrible condition for any human being to have to go thru but i can proudly say she is fully cure of COPD diease,for anyone in this condition must contact (totalcureherbalfoundation gmail com / https:// totalcureherbalfou . wixsite . com/ website)

  27. Amanda says:

    Wow thank you for the insight. I went to the urgent care this morning because I lost my last inhaler and was in near panic because of the severity of my asthma attack. I usually have pretty mild ones, but I’ve been slightly sick with a cold and it’s just irritated the crud out of my asthma. Anyway my oxygen levels were FINE (unless I coughed) so I thought it was in my head and felt rather embarrassed I’d decided to go to the urgent care. No one there explained that it didn’t matter. They did give me a treatment , a new inhaler , steroids and a cough surpresent. Also acknowledged they heard wheezing in my chest (and very obviously without the stethoscope lol).
    I feel I have more knowledge of my own condition now. I do wonder why this isn’t something they explain to patients!

  28. I think the reason they dont explain this to patients, is because many of them dont understand it themselves. Sad, but true.

  29. Bangie Burgos says:

    Hi ,I have had asthma my whole life as a little girl i wasn’t able to go outside and play at all due to my asthma ,doctor visits consists of them puncturing many holes in my arms to see what I was allergic to it which did not matter because medication was always the same albuterol Inhaler. As I got older my asthma was less severe. Than at the age of 24 I got a really bad cold after fighting it off a few days it got to the point where I was struggling to breath ,I went to the e.r where I waited hours to be seen finally I was admitted and given a 4 hour neb treatment along with i.v steriods. Once they realized that there efforts were not helping i was moved to icu at this point I was in full panic had the flu and my lungs were opening barely 1/2 in from all the mucus .My back was in severe pain from the struggle and the nurse moved her desk right in front of my room watching me all night .I couldn’t sleep and i couldn’t breath every effort to breath had tired my body out ,I was getting painful sticks in my wrist to check my o2 blood which wasnt good and i begged them to breath for me because i wanted to give up i didnt have energy the nurse refused as I begged and she said if we incubate you , you will not survive you will not wake up me being 24 years old with 2 little girls at home waiting for me i pushed myself every breath to live .After 2 weeks of being hospitalized I finally went home with a nebulizer machine and steriods Ann’s was told I will have to prevent myself from catching a cold .I followed up with the doctor who saved my life in the icu not once but twice and every year when November comes ,I am in the hospital fighting this asthma along with a sinus infection or flu .I am currently 39 years old the doctor has treated me with every preventive steroid that was out there and prednisone has become a daily vitamin .The only cotisteriod that has controlled my asthma is Symbicort high dose I take 2 puffs morning and night. Recently I left my job due to being exposed to sick people since I work in the medical field .I currently work partime and receive state medical benefits today I find myself struggling to breath fighting a cold and out of medication, I was told that my state insurance will not cover my symbicort and that they will need to find an alternative, there is no alternative .I called a physician I have only seen 1x and was told that i would not be able to be seen until next week imagine my anxiety while I am struggling to breath .My husband went to my prior doctor and begged for help. So he was kind enough to prescribe me antibiotics ,prednisone, inhaler. But still they say my inhalers are not covered and out of pocket will be 350.00 dollars. I do not want to go to e.r and wait hours for a 2 hour neb treatment that only works well for me in the hospital since its connected to oxygen unlike the neb treatments at home. I have broken down and cried where I couldn’t breath due to the lack of help for my illness .I was never given any tests to check what could be triggering it ,I have only seen a pulmonologist in the hospital and once for a check up he checked my pulse ox and that was it was told I was fine and to continue using inhaler .I am beyond frustrated with the lack of care and follow up.And then to be denied medication I have been on my whole life .I have begged my physician to prescribe oxygen for my home and he laughed and told me i was not a old person and that my pulse ox would need to be 65 and lower to be approved which makes no sense to me what so ever .I have struggled to keep a job due to constantly catching some type of virus or bacterial infection and fighting my asthma at the same time .And through this all I do not qualify for disability and still my asthma is not being taken care of urgently .I do not know what to do anymore and it is so frustrating being sick all the time and given medications that cause weight gain along with anxiety and sleepless nights because of all the steriods and on top of it all they refuse to give me something to help me sleep or calm my anxiety because according to them I can stop breathing in my sleep .So now im sleep deprived ,jittery, bloated, and still struggle to breath .I do not understand why asthma is not taken serious or why I have not been checked for other possible lung diseases.I felt I needed to share my struggle and that i completely understand all of yours.

    1. Hello, Im sorry to hear that youve had such a hard time with your asthma. Unfortunately , you’re story is a very common one. It’s sad, but the reality that is people who have limited financial resources usually receive inadequate health care. If you’re on steroids all the time and are taking lots of of neb treatments at home, your asthma would be considered severe and you need to have a pulmonologist involved in your care . Im not sure where you live or what hospital you go to, but I would try to make an appt or get a referral to go to a larger University medical center where they have a full staff of Pulmonologists who can do a full evaluation on you. Also, have you tried any of the other combo inhalers? There are many that do the dame thing that Symbicort does.

    2. David says:

      Have your DNA checked, extensive allergy tests and check for GERD. Stop eating all wheat, pasta and rice products and only eat fresh organic food that you aren’t allergic to.

      I’m finally on the road to recovery doing those things but its still touch and go depending on what allergen, bacteria or virus I get exposed to.

      Praying for you.

      1. Thank you for the advice. Ive been tested for most allergens, I eat mostly organic and virtually no gluten. I do however still eat rice, butnot very much. What would a DNA test tell me?
        Theyve actually collected blood to analyze my DNA and RNA for research purposes, though I dont know the results. Im happy to hear you’re doing better.

  30. cassie says:

    Hi. Thank you for your blog. I have asthma but I rarely wheeze. I also always exhale strongly; under normal circumstances I can blow 600-700. So when it’s bad and I blow 400 they think I’m fine. I also have GAD so I think the assumption is that I’m having anxiety. It’s so frustrating. Right now i feel like the lower half of my lungs are full and I can only get half breaths in. I am not even able to cough though I feel I need to. I have heard some wheezing which is weird for me. My inhaler isn’t hacking it so I’m using my neb sometimes. I don’t even want to go in because I’m sure I’ll be sent off. This has been ongoing for nearly 3 weeks. Anyway I’m just venting. Thanks again for all the info.

    1. Hello, Thank you for writing. Im sorry to hear about breathing problems. As far your peak flows go, if your baseline ( your green zone or personal best) is 600-700, but drops to 400 ( which would be your lower yellow zone), it’s not all in your head, your asthma is definitely acting up. It sounds like your doctors don’t understand how peak flow measurements work, or they are being bias because of your GAD, which ironically is all the more reason why you should be checking your peak flows. While the yellow zone is not considered an emergency, it does indicate a physical obstruction in your airways, ie bronchospasm, inflammation, air trapping, etc. I think its perfectly logical to take neb treatments and maybe even temporarily increase your steroid dose to get over the hump. In the long run, you need to find a pulmonologist ( or resp consultant if you’re in the UK) who understands your type of asthma and who you can build a good relationship with.

      Take care.

    2. David says:

      Same exact problem for me, 3 ER visits and from “nurse” to “doctor” they all snidely state my oxygen is at 100%. The last time they called security on me and had me and my mother escorted out before even waiting to get my Co2 artirial blood test back which showed I was in critical condition. Thanfully I was able to get the results and now have proof they where in violation of their oath.

      They should ALWAYS assume the patient is telling the truth. We KNOW the difference between anxiety and asthma. They choose to remain ignorant. Thank God CVA is now becoming a buzzword but why should it take YEARS and people like us suffereing for SO long for them to FINALLY do something about it?

      Som empathy would have went a long way in that and every ER visit where they ignorantly only rely on O2 sat.

  31. Kamari James says:

    Thank you so much for this post I just had the most scariest experience of my life. Me and my family went out to eat and I was having breathing problems that I thought I could fix with a treatment or an inhaler. I was wrong as we got to the car it only got worse I couldnt breath at all, my whole body was going numb I was on the verge of passing out and I felt like if I didn’t fight it I was going to die. We rush into the emergency room and the nurses said my oxygen level was 100. Me and my mother were shocked. Suddenly they were asking me if I ever had a panic attack before and I said no. The nurses were sweet but I felt like since my oxyen level was 100 they thought I was ok. Luckily the doctor who came in knew something was wrong and gave me medicine amd two hour long treatments. What ive learned from this is to not down play any form of discomfort and to seek help immediately because it could cost you your life.

  32. Angelica says:

    Hello Stephen, thank you for the information being provided here. During a recent trip to the ER (due to asthma) the Doctor told me that my lungs sounded fine, they also took some blood and there were no sings of infection. They said my heart showed signs of being enlarged possibly due to high blood pressure. My questions is whether blood test, oxygen levels check and or listening to the lungs are enough for the Doctor to know that one is having a asthma attack? I have the same problem as reported by others here . My CO2 levels get check and then becasue they are good my asthma is not being taking seriously. I will be following your recommendation and will be asking my pulmonologist for a letter that I can carry with me at all times . Again tank you for all the information I learned a lot and its was also very validating.

  33. Christina says:

    Thank you for this. I felt so bad despite use of my inhaler but then saw my sats at 99-100 when they are normally 97-98 that I went to urgent care thinking that something else had to be wrong with me and they didn’t say a word to disabuse me of that notion. They sent me to the ER because they were clueless. ER said asthma but I still couldn’t understand how. Now I know and understand. Thank you!

  34. Sorry for the delay in responding.
    Unfortunately, this is a very common problem. They assume because your sats are normal ( 94% or greater), that your asthma isnt bad. I think one of the reasons this happens is because there are a lot of other conditions that mimic asthma. The most common, is hyperventilation syndrome, ie panic attacks, anxiety ,etc. There are also upper airway disorders like vocal cord dysfunction. In most of these situations, O2 sats are normal, or even higher.
    My best advice, if you’ve been diagnosed with asthma and have a history of bad flares , is that you should always go to the ER, never Urgent care. Asthma can turn real bad, real quick and Urgent care centers arent equipped to deal with this. Also, you might want to have the ER staff make a note in your chart stating that you tend to have normal sats when you flare , and not to rely on those numbers when treating you.

    Best of luck to you

    Steve Xx.

  35. David says:

    Thank you SO much. It’s to the point now that I get so irritable from these severe asthma flares ups they call security to escort me out. It’s disgusting how the “health care” system treats us CVA’s.

  36. Iris says:

    Same story here, gasping for air suddenly never had it before. Am 49, a woman and a gardener. I was getting some bloods done at my Gp when it happened. Thankfully she realised that I wasn’t suffering from anxiety or panic attack. I just thought I’m short of breath because I had to walk fast and the mask I was wearing due to corona made me hyperventilate. My Gp didn’t trust it and send me to the er. All fine, no bloodcloth, clear xray, ecg perfect and oxygen 100 %. Good nothing serious I thought while still gasping/hyperventilating almost passing out and not able to talk for about 5 hours now. Their conclusion was ofcourse Panic attack which got me worried, because I knew that was not true and if they think that they wouldn’t look for the real cause. I was admitted for one night and send home the next day still gasping for air. Within 2 weeks I was admitted 3 more times. Same story again and again but the attacks got worse and worse 15 hours gasping for air. Couldn’t walk for 10 mtrs without gasping and got really desperate. In the hospital they never called a pulmonologist (very small local hospital with an arrogant consultant on the er) to see me since they were convinced I was panicking. My Gp had referred me to one by then and after the 4th time being send home she called him if I could be seen urgently because after 3 weeks almost constantly gasping for air and hyperventilating when walking or talking I couldn’t cope anymore. I was seen within a week and immediately he said that I most likely have asthma, something I’ve never even considered. He has put me on steroids, antibiotics and an inhaler and within 2 hours after the inhaler I could talk and walk again without gasping or hyperventilating. I have to take it for two weeks and then come back to evaluate and possibly lung function tests to get a definite diagnosis but that depends on the coronavirus if that’s possible at the moment. Have had a couple times shortness of breath and tightness in my chest after 2 hours working in the garden and was send to hospital again because the nebulizer that my gp gave me took a bit longer to work. And still in the hospital they don’t want to believe me that I most likely have asthma attacks even though they know the pulmonologist.

  37. Suz says:

    Thank you so much for posting this and explaining the physiology behind why O2 Sats may even go up initially with an attack. I have also had this dismissal happen to me several times. Now, if I have a flair before the weekend, I desperately try to get my doctor; who understands, as I have had many others who do not. Last time I had to call in for a phone appointment on the way home from a covering doctor’s appt because she said it wasn’t my asthma. Refused to listen to my husband or me. The advise nurse could not believe it as I could hardly talk or stop coughing. She got a doctor on the phone immediately. I do see that most the people here are like me and have cough variant asthma. Many medical staff are not familiar with this form and think that if they can’t hear you wheezing across the room you are not in distress and then they take you Oxygen Saturation. No it’s good must be here for the fun of it. Oh well, thanks again!

    1. Hard to believe in this day and age, that some medical people still equate asthma with O2 sats. Sorry youhad to deal with that. I think we all have at one time or another.

      Hope you’re doing better now.

      Steve G

  38. Kathy K says:

    I know this is an old conversation, but something happened to me this week that I couldn’t explain and I am hoping someone here understands and can relate. After recovering from a sinus infection and on Augmentin and prednisone, I finished the medication and soon after started feeling heaviness in my breathing. Not that I was actually breathing heavy, but the air felt thick and I would wake up at night feeling uncomfortable. I could breathe to the top and bottom without wheezing, but I felt like there was mucus deeper than I was breathing. It was just a sense and it was uncomfortable. I upped my steroid inhaler and used albuterol every 4-6 hours and no real change. I finally went to urgent care where they said my o2 was 100% and no wheezing and they did an EKG and no problem with my heart and were about to send me home and I asked could I possibly try a different medication for relief than albuterol. He had asked if I had a nebulizer early in the appointment, but never referred to it again. I USED to have a nebulizer but for years my asthma was not an issue so I gave it away. Anyway, after I asked about a different medication, he talked about using the nebulizer liquid that works a little differently. Then he prescribed me for that medication and tried to send a prescription for a nebulizer. Well long story short I picked up the medication and couldn’t get the nebulizer without a pre-approval from my doctor who moved to Texas and I am in the waiting period for my new doc appt. So a friend loaned me their nebulizer and I took a treatment that evening and I coughed up some thick white mucus and was able to rest for the first time in a long time. Today I used the nebulizer after waking up and feeling that same heavy feeling and I didn’t get quite the same relief but did some huff exhalations and produced some more of the white mucus. He started me on prednisone yesterday too, so I’m taking that (I just got off it, but I am hoping it will help and NOT open me up to anything unwanted)

    Here are my questions:

    1.Is this even possible that there is thick mucus way down in my lungs where it causes that heavy feeling when I breathe but there is no wheezing and my O2 stats are 100%? How could a doctor even know what is going on in that case? He kind of treated me like I was looking for medication and attention…which trust me I was missing work (self-employed so this will cost me), and visit the doctor once every 2 years or so because I despise the medical setting.

    2. How do I advocate for myself in this situation next time? What terms do I need to be familiar with? Are there tests I need to ask for? I did not ask for an EKG but I consented to and would have consented to anything they wanted to do for some hope of change.

    3. Do I need to be evaluated by a pulmonologist or is just an allergy/asthma doctor sufficient or are they the same?

    4. Is there a technique or exercise I can do regularly to avoid this happening again after an illness?

    Thank you in advance for any suggestions or even just commiseration.

Leave a Reply

Your email address will not be published. Required fields are marked *

WordPress Anti-Spam by WP-SpamShield