Now I have finally gotten the appointment for the Mannitol test at the hospital requested by the Norwegian Security system NAV. It is in two weeks. I have waited for this appointment for 6 months now. And before that 2 years to get word from NAV to do it. Since my asthma is an occupational asthma due to bad work environment in a former job I had, they require that I take the Mannitol test to determent that I got permanent damage to my health. (Not that one get healthy again from asthma in adult age though…) But NAV got their rules and ways and say I must take the test so that they can prove it is permanent damage. They need it documented.
A Mannitol test is very uncomfortable. I really do not look forward to it.
Firstly I am not allowed to take any medicines within 72 hours (3 days) before the test. This means I am not at all protected against what I get sick from. Secondly the test is really unpleasant. They let me breathe in a substance from a hose and a mask to provoke an asthma attack. They do this to measure the severeness of the asthma and the damage to my health. Being not protected by any medicine, this will be a really uncomfortable experience.
I have done it once before. I did not get any air. My lungs got so tight I could not breathe. It was scary. At least then I had taken medicines early the day before. But now I will be totally unprotected so I think this time it will be much worse.
What is a Mannitol test?
I found this about mannitol test on the internet.
JACI Highlights – November 2010
Airway hyperresponsiveness to mannitol diagnoses asthma with ongoing airway inflammation.
Bronchial challenge testing has a higher sensitivity for diagnosing asthma than spirometry or reversibility testing, but it is currently primarily recommended in patients with symptoms consistent with asthma – not a normal lung function. Direct bronchial challenge tests act directly on the smooth airway muscles and are sensitive in diagnosing asthma but have a relatively weak relationship with airway inflammation. Indirect challenge tests act via inflammatory cells in the airways and are generally more closely associated with airway inflammation. As reported in this issue of the JACI, Sverrild et al examined diagnostic characteristics of inhaled mannitol and methacholine in asthma in 238 unselected adolescents, who had their exhaled nitric oxide measured and were challenged with methacholine and inhaled dry powder mannitol. Methacholine had a fairly high sensitivity but considerably lower specificity in diagnosing asthma, whereas inhaled mannitol was highly specific but less sensitive. Furthermore, reactivity to mannitol, as opposed to methacholine, was associated with ongoing airway inflammation in terms of increased exhaled nitric oxide. Choosing the right test when measuring airway responsiveness in asthma depends on the diagnostic situation: The higher sensitivity of methacholine makes it suitable for ruling out asthma, whereas the higher specificity of mannitol makes it a more useful test for confirming asthma with ongoing airway inflammation.
“Airway hyperresponsiveness to mannitol and methacholine and exhaled nitric oxide – a random sample population study”
Remarks by Sverrild et al. (JACI November 2010 / Volume 126, No. 5)
The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.