Asthma and Coughing

Previously posted at WEGO Health:

When my son was diagnosed with asthma, it was all new to me. No one I knew had asthma. My only experience with it was from what you see in movies and on TV. You know, how they portray the asthmatic as wheezing so loudly that the guy down the street could hear it? I never hear my son wheeze. He does, because the doctors can hear it with their stethoscopes. But I can't hear it. It's not that loud wheezing of the TV and movies. If we got to that point, he'd be in severe distress!!

Since he was diagnosed before he was two years old (only they called it R.A.D. [Reactive Airway Disease] ) and he was unable to speak and tell me how he felt, I had to look for clues that he was having trouble with his asthma (or R.A.D.). It wasn't easy. Yes, he got extremely fussy, but that could have been his allergies, or ear infections which he got every few weeks with no accompanying fever, or the asthma that had no wheezing. But what he did get with his asthma was coughing. It started out as a light cough and as his asthma got worse so did the cough. There would be nights we'd be up together until dawn and he would be coughing so hard that he would vomit. His albutrol nubulizer helped, but only for so long and then the coughing would start again.

My thought for this post came from a Twitter conversation that I was having today.

amyanaruk: Coughing, not wheezing is the #1 symptom of asthma. Exhibit A: RT @ __kerri Holy coughing spasm batman. Evidently I am late for symbicort. 1:52pm, Jul 08 from Web

chupieandjsmama: @amyanaruk My son doesn't wheeze until things are beyond severe. He's main, and for the most part only symptom, is coughing. 1:56pm, Jul 08 from HootSuite

amyanaruk: @chupieandjsmama Here, too. If we waited for wheezing, we'd be waiting on an ambulance.

__kerri: @chupieandjsmama @amyanaruk i wheeze neverrrr


As you can tell by the conversation, wheezing isn't a big symptom for anyone here. But most people think of wheezing as the one to watch for. If you are new to asthma, would you notice coughing as a symptom? Would you treat the "coughing" or wait for the "wheezing"?

According to WedMD the following are symptoms of an asthma attack:

Severe wheezing when breathing both in and out
Coughing with asthma that won't stop
Very rapid breathing
Chest pain or pressure
Tightened neck and chest muscles, called retractions
Difficulty talking
Feelings of anxiety or panic
Pale, sweaty face
Blue lips or fingernails
Or worsening symptoms despite use of your medications

All of the above ARE symptoms of an asthma attack. They can also be symptoms of a heart attack, stroke, or any number of other things. If you are a new asthma patient or are a new asthma care giver, these can be a bit vague. I know when my son first started having asthma attacks there were times I waited too long to treat because "I wasn't sure what the coughing meant". Now I don't wait. I treat it. And if he's still coughing with no other symptoms or no worsening symptoms, then I assume that the coughing isn't asthma and it's being caused by something else. If I treat it and the coughing gets better, then I know he's having trouble with his asthma and we need to keep an eye on things to make sure they keep improving and they don't get worse. And if they get worse? Call the doctor or head to the ER.

What is your main symptom of an asthma attack? Do you or your children wheeze, cough or both? Did you recognize your cough as an asthma symptom?

For more on asthma and coughing see:

Tips To Remember: Cough in Children from AAAAI

Calming Your Cough from Allergy and Asthma Network Mothers of Asthmatics

Chronic Coughing: on YouTube