I've had shortness of breath problems for years - never very major, but always enough to be uncomfortable and very annoying. They tested me by spirometry (the breathing test to see how much lunch capacity you have among other things), saw that I was below average, and assumed that I had asthma. The doctor put me on albuterol as needed, and as the years went by Flovent and briefly Advair were added to the mix.
Earlier this spring, I got myself an appointment with an allergen/asthma specialist to get tested for allergies. While I was there, we talked a little bit about my breathing problems, and they tested me by spirometry again. The PA said that it looked like my asthma was under control, and I asked him if the test showed that I even needed the medications, because I was still having some problems that medication wasn't helping with. I told him that I had never officially been diagnosed with asthma, and he said it was probably a good idea to do so.
One diagnostic test for asthma is a methylcholine challenge. Methylcholine is an irritant to your lungs - people with asthma usually respond at lower doses than people without. They give you four doses, from low to high, and measure your breathing after each one.
It turns out that I didn't have asthma after all, just a touch of "reactive airway disease" - I'm a little more sensitive than most people, but I don't actually have asthma. But I still had problems with shortness of breath, coughing, etc. They tried me out on a medication, and lo and behold, it worked.
The medication? A heartburn drug! Why? There is a condition called vocal cord dysfunction, or VCD, for short. In asthma, the bronchioles of the lungs close up, making it hard to breathe. In VCD, its the vocal cords that close, but it results in the same general symptoms. VCD isn't usually helped by asthma drugs, which is why my symptoms never went away. A lot of the symptoms are identical to asthma though - shortness of breath, sometimes wheezing, coughing. Some people get tightness in the throat or chest, or feel like they can't get a full breath in. A lot of the time, its brought on by reflux - even in people who don't feel like they have reflux.
My triggers, apart from reflux, are the cold, and laughing too hard
. Turns out lots of people are diagnosed with asthma when they really have VCD.
Anyhow, get your doctor to give you a methylcholine test, or go to a specialist who will do one. I think that's one of the only ways to know that you really have asthma.