Methacholine Test - Bronchial Challenge Asthma Test My Experience

Hi! Just for starters I am going to say that I am not a doctor, practitioner, therapist, nurse or any kind of medical professional and I'm not trying to be one here. I'm just sharing a personal medical experience.

Months ago I started have some trouble breathing. It was basically a constant cough. We tried all the antibiotics, rest, liquids, etc etc and nothing seemed to work. Eventually I went to see a specialist, pulmonary physician who gave me some breathing tests and asked me a zillion questions. Ultimately the pulmonary doctor suggested that I get an asthma test.

I was very skeptical of going for an asthma test. Honestly, there was no shortness of breath. I don't feel like Wilford T. Brimley doing the poll vault or Jonah Hill running. My lungs seem to function well other than the fact I cough more often than someone working in a cigar factory.

The doc reassured me that coughing alone can be a symptom of asthma and that the other indicators he saw leds him to believe that I should be tested.

Again, I'm not a doctor, I'm just writing about my own experience so don't treat this as medical advice. There are probably plenty of ways of testing someone for asthma. The test I took was called a methacholine test, which is also known as the bronchial challenge test.

I can only explain this through my experiences as a patient and from what was explained to me. Basically you go to the hospital and they have you breathe this stuff called methacholine. This stuff causes an asthmatic attack of sorts in people who have asthma. If you don't have asthma, the methacholine won't have much of an effect for you. If you do start to experience discomfort from asthma they can reverse the process and get you back to normal with albuterol or equivalent / latest drug out there that stops severe asthma symptoms fast.

OK, I'll take you through this from the beginning here are the steps I went through. Keep in mind this is not medical advice and I am not at all saying you will go through these same steps or experiencing things and better, worse or same as me. Everyone's illness is different and it is quite possible that your condition will be handled differently. Let's give it a shot anyway... here we go.....

OK, I start getting this cough and it lasts about a month. Some phlegm but mainly coughing multiple times an hour. I try just about every over the counter drug that I can think of for cough and cold. No other real symptoms other than cough and being tired.

Speaking of tired. My poor neighbors next store. I'm a non smoker but I coughed so much they must have though I was smoking the pipe on my car exhaust.

After a month of hacking like I've got tuberculosis or something, I go to the my primary care family doctor. They find no signs of infection so no antibiotics are prescribed but they do put me on some powerful prescription cough medicine.

If my wish was to fall into a deep coma-like sleep I'd say the prescribed cough medicine worked great. As far as stopping my cough, it didn't work at all. I'd hack all day like an old dog until the medicine made me so sleepy I'd fall asleep. If remembered my dreams I'd bet I was coughing in them.

I go back to the doctor and tell him that the prescription cough meds work fine if he wants me under a general anesthesia for open heart surgery. I convince him that the zombies in The Walking Dead have a higher brain function than I do while on this cough syrup.

He then puts me on a nasal inhaler.

It doesn't work.

OK, I visit the doctor again and writes me a script to get some chest X Rays done. I contact my local hospital, that accepts my insurance for an appointment in radiology.

If you go for X rays, remember to take your script, photo ID and some money for co-pay. I don't know much about radiology so I was wondering if I had to take off any clothes. I wore a pull over shirt and sweat pants for easy on, easy off just in case. For my chest X Ray I didn't have to disrobe like some Greek statue so you too should be able to wear whatever clothes you feel like without having to worry about ease of taking off them off and putting them on. If you want to wear that whale skin Eskimo coat, go for it.

They took X Rays and but do not provide the results there. My family doctor needed to do this. A few days later my doc calls and said the results were negative, negative, of course, meaning negative for any bad signs.... or put another way..... negative is good, negative is actually a positive thing, not a positive result.

Clear as mud for you? Negative means nothing looks abnormal in my lungs. (Positive would have been bad, go figure)

I still had constant cough and some wheezing. I decided to go with a different doctor since the previous one I was getting no relief from. Same doctors office, different doctor (actually I went from a D.O. to a physician's assistant... which apparently is the same thing as a doctor but I suspect they get paid less or something that causes them to have a less glorious title)

The physician's assistant puts me on prescription steroids to reduce any swelling in my breathing passages and some prescription pills to stop any cough spasms.

In short, the 'roids did nothing for me. I was hoping that my gym visits would result in me looking like Arnold in his prime but no such luck. The pills did nothing too.

Both doctors swore that I did not have a bacterial infection that would be remedied by antibiotics.

After asking them several times though, they showed me some mercy and put me on antibiotics anyway in case I really did have whooping cough or something bacterial.

I hate to say it, but they were right from the start. The antibiotics did nothing.

At this point I'm lost as to what to do. The family doctors some other drug induced ideas but I told them I'd really like to see a specialist. I wasn't sure what kind of specialist so they suggested going to a local pulmonary specialist and gave me a referral to do so.

Before visiting the pulmonary specialist, I contacted the hospital where I had the X Rays done and have them make a copy so I can take to my doctor. They tell me when I can pick it up. When I go, they give me a CD.

I also call my family physician and have them send my records to the pulmonary specialist.

I also, and I advise you to do this too, made up my own personal list of all the over the counter drugs I used as well as a list of all the prescription drugs.

Your experience might differ but when I went to the pulmonary doctor he asked me a ton of questions. This is where the list of meds I took came in real handy. He asked me what I was taking, when I was taking it etc. Anything I couldn't answer I just referred him to my records that I had transferred sitting in front of him. Again, be sure to make that list. From my experience, doctors always miss something in the official transcripts plus they can't possibly know any over the counter meds that you never reported.

I handed him my Xrays and he reconfirmed that they looked fine. No fluid, etc in the lungs.

They then gave me a breathing test. Basically I breathed normal into a tube that is attached to a hand held electronic devise that the nurse held. Then a breathed real hard until all the air escaped from my lungs.

I don't know much about this device but it basically measured my lung capacity which came in at a result that wasn't bad, but not great either.

The doctor feels that my breathing test reveals possible signs of asthma. It could be chronic bronchitis or other ailments but the only way was to get the asthma test at the hospital. So he wrote me a script for the Bronchial Challenge Test (aka Methacholine Choline Test)

He said this needs to be done at my participating (insured) hospital and that I would need to contact them for an appointment.

I contacted the hospital for an appointment for the methacholine bronchial challenge test. They were able to make an appointment that was a few weeks from the time I called. I suggest to you to call as soon as your doctor tells you too as you might have to wait a few weeks or more to get in depending on how busy the hospital is.

The hospital told me the test takes about 2 hours so be sure to leave yourself plenty of time. I took a half day off from work just to be safe but you might not have to do this.

I was told to bring my referral, my insurance ID card and photo ID.

They also told me NOT to take certain medications leading a few days up to the test. If you take certain medication prescription or over the counter it could prevent the test from giving accurate results. If they feel you've taken these meds they will send you home and you'll have to make a new appointment and start all over. I won't list the meds here but be sure to ask them about this and make note of what you can and can not do in preparation for the test.

Don't sweat the test... I've done it. Basically the bronchial challenge test will look like this..

Keep in mind that your experience might be different from mine. Unless the two of us are clones of one another, your body could experience a completely different reaction. Also, unless the hospital you go to and and the hospital I go to are completely identical, as if they are alternate realities with one another, the equipment you see might be completely different from the equipment they used on me.

So here we go......

When my turn came around a respiratory practitioner (also called respiratory therapist) came out and escorted me back to the testing area. She had me sit down in what looked like a little phone booth. If you are too young to know what a phone booth is, long before cell phones if you weren't at home you had to stuff yourself into a glass, booth, insert change into a dirty old phone and make a call. This booth is just like this only it is super clean and there's no phone :-)

Once in the room, the respiratory practitioner opened up a laptop computer beside me. She asked a bunch of questions about my symptoms and also if I had taken any certain drugs within certain periods of times (I'll keep the meds and times a secret.... I don't want to confuse my situation with whatever instructions they gave you when you made the appointment. Follow their instructions leading up to your test or they could send you home. Certain meds can cause your test results to come up wrong. I will give you one hint, don't take any caffeine, coffee, etc. Caffeine is bad. Lay off it this day)

Anyway, after the questions she had me first breath normally into a tube, then blow really hard into the same tube which measures my breathing. This tube measures your breathing and the results appear on that laptop I mentioned. She also contacted the hospital pharmacy and they delivered all these needles, you know, syringes, which she then proceeded to jam into my eye. Kidding, yes there are syringes but none of them were stuck into my eyes, arms, anywhere. The needles have methacholine in them which she injects into this device which you breath into. Using this device I breathed in the methacholine for a few minutes or thereabout and then she had me breath into that tube I mentioned again, first normally, then I had to blow really hard into it.

We kept repeating the process and each time she gave me a higher dose of methacholine. Each time I got a higher does of methacholine and breathed normal, then hard into the tube, the laptop computer screen recorded the decline of my lung function on a graph. I'll try to depict it from memory on the image I attached. Each triangle working from left to right was a higher and higher round of inhaling methacholine and then breathing into the tube for a result. As the triangles go down that slope, that indicates the methacholine is working and reducing my lung function (I believe by constricting them, though it sounds worse than it is). The orange line is the level that if you results fall below, it means you are positive for asthma (you have asthma). Someone without asthma, their results won't fall below this line.

That is essentially the purpose of the test, if you are asthmatic, the hospital puts you in a situation where you will experience an attack of sorts. Don't worry though, if you get shortness of breath or discomfort, they can reverse it right there.

At the end of the test they had me inhale stuff (I think it was albuterol) that brought my lungs back to normal. I guess they don't want me driving home while having difficulty breathing.

That was about it. Here are a couple answers to questions you might have. Again.... your case might be different from mine....

Not for me it didn't. No pain at all. No needles either.

For me it wasn't. I can't say you won't have the same luxury but hopefully not. Even when my lungs responded at their worst (when the triangles feel below that line) I pretty much just had shallow breathing and since I wasn't exerting myself just sitting there in the chair I was fine. Depending on your case, you might feel differently.

I'm not much of an athlete but I felt pretty good. I expected to be more exhausted due to the length of time and all the breathing exercises. They did warn me that I might feel a little lightheaded or have a sore throat from all the breathing but fortunately I was good. They said some people react much differently.

It definitely took a couple hours.

Yes, at least I did. Keep in mind my case of asthma was pretty mild. When they gave me the stuff in the end to make me feel better, I was instantly better. Again, you might have a different experience.

Sorry for the huge explanation but I hope this gives you an idea of what the test is like. Thanks for stopping by!

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