Seeing pulmonologist Monday, but wondering if anyone has had asthma not respond

[luvwinnie]

To fairly high dose pred? ER sent me home with 60 mg for 4 days them taper down... But still not getting the relief I expected. Also using my rescue inhaler twice a day.

 

[Tiggeroo]

are you also using a nebulizer. When my asthma is in a major flare up it sometimes takes a couple of weeks to feel like I have good control. I will use my preventive inhaler, my rescue inhaler, nebulizer and steroids. I will also drink tons of clear fluids, hot tea, water with lemon... Spicy foods like onion soup with chili flakes and lots of garlic. I will also increase my allergy meds. Pulmonologists are the real experts here though.

 

[luvwinnie]

They gave me a nebulizer treatment in ER, but no script for it. It's always been mild before this.

 

[Jennasis]

Is it possible that your asthma is triggering a panic attack? My asthma and my anxiety/panic often go hand-in-hand. If I have an asthma attack (rare) or ANYTIME I feel like I can't breathe (even if I am suffering from a stuffy nose/chest cold and sometimes when I hold my breath underwater) I trigger a major panic attack. So if I have even a mild asthma flare, I immediately have a panic attack...which ofteen feels just like a major asthma attack. It's a nasty cycle.

I have Xanax now for those times.

 

[luvwinnie]

I don't think so....it's sporadic coughing, wheezing on exhale, heaviness...I don't feel panic at all. Every time I laugh it comes out as a wheeze.

 

[LuvtheMouse88]

Have you been tested for allergies? A lot of times allergens can trigger asthma symptoms and by getting your allergies under control will help with your asthma. Did they do a peak flow meter with you? I would ask about that. By monitoring your peak flow rate daily it can show you when your inhalers are not being as effective and you need to see a doctor. It has a green zone, yellow zone and red zone. You want to stay within the green zone.

 

[disfan07]

Yup. Many times.thats why I end up inpatient. I am on symbicort, pulmicort and xoponex daily. Plus Zyrtec, Benadryl, Zetonna nasal spray daily.

When I get a mild flare I do nebs every 4-6 hours. With a flare that leads to an ER visit I get IV solumedrol in the hospital, 80mg prednisone for 5 days, 60mg for 5 days, 40mg for 5 days, 20mg for 4 days and 10mg for 4 days. So I get prednisone for almost a month after an ER visit. In addition, I am also on nebs everyday for at least a week, sometimes two. And there are times where I have needed another round of prednisone afterwards.

If I end up inpatient, it is usually for 5-7 days. In the hospital I Usually get xoponex+atrovent nebs every 4 hours, IV solumedrol every 4 hours. Upon release it is the same thing as the ER visit. A month of prednisone plus a week or two of daily nebs.

Right now I am having a flare that is allergy based. I am on nebs three times a day plus rescue inhaler as needed and additional Benadryl.

 

[yeartolate]

To fairly high dose pred? ER sent me home with 60 mg for 4 days them taper down... But still not getting the relief I expected. Also using my rescue inhaler twice a day.

I have had a rough Winter. My "usual" is reactive airway disease. I can go months without having an issue. Up until this winter I only had proair and q var (steroid inhaler) Like I said, I could go many months without using them.

This winter I have been on 4 steroid tapers, antibiotics (which I probably did not need) and now have nebulizers and such. This last go around they started a high dose Dulera and Combivent. I have not used the nebulizer since. I was off work for about 4 weeks, My pulmonologist indicated it has been a rough winter for many and she has a lot of new patients.

What you should look for is probably an inhaled steroid (Q var is common) The prednisone will go away and if your lungs have not stabilized they will feel the steroid loss. Of course, talk to your doctor.

If they do order a steroid inhaler, be sure you use your bronchodilator (rescue inhaler or similar) first. Once your lungs have opened up with the bronchodilator, they will accept the steroid inhaler better,




Have you seen your Primary MD since the ER, it is real important to follow up, especially if you are not progressing as fast as you think you should.

 

[luvwinnie]

Thanks all. I am on a daily inhaled steroid...asmanex. I should have mentioned I have had a low grade fever off and on and primary started me on Levaquin last sat. I saw her again Wednesday night and SHE is the one who sent me to the ER. Yes, I also have allergies and take Zyrtec and singulair. She wanted a chest X-ray too to rule out pneumonia, which was ruled out.

 

[kellyg403]

Is it possible that your asthma is triggering a panic attack? My asthma and my anxiety/panic often go hand-in-hand. If I have an asthma attack (rare) or ANYTIME I feel like I can't breathe (even if I am suffering from a stuffy nose/chest cold and sometimes when I hold my breath underwater) I trigger a major panic attack. So if I have even a mild asthma flare, I immediately have a panic attack...which ofteen feels just like a major asthma attack. It's a nasty cycle.

I have Xanax now for those times.

I actually had this happen to me. Long story short, I ended up in the ER with an asthma attack after not having one for over 30 years. I had gotten to the point, the rescue inhaler I was using for a bronchitis disgnosis a few days before but it wasn't working and ended up with my son calling 911 because I did not have enough breathe to even get out of bed.

Anyway, once on meds and admitted, I still could not breathe normally. Was still gasping. I still was panicking from when I really couldn't breath. One does of Xanax and I was like a whole new person. I did spend 3 days in the hospital and coming home with several meds and a new inhaler, but it did take a full 7 days to not feel wheezy and out of breath. I presented in the ER with all 4 quandrants involved and a pulsox of 82%.

I think when you go a long time without having an attack or with a mild case that goes crazy, it is hard to not panick.

I wish you good luck. If you still do not feel well, I would definitely get in touch with your dr. I have a new respect for asthma. I had forgotten what it felt like to have an attack. It can be scary!

K

 

[figmentswife]

You should be taking the rescue meds every 4 hours not just 2 times a day. I know it is called rescue but when in a flare you need to keep it going for a few days.

 

[luvwinnie]

I have a Catch 22 with my rescue meds...I have a history of supra ventricular tachycardia so there is concern that the rescue med could trigger it... So I used it sparingly...to make matters worse, the standard med for treating the tachycardia can trigger a bronchospasm. Ironic,,huh?

 

[mommy2allgirls]

I don't think so....it's sporadic coughing, wheezing on exhale, heaviness...I don't feel panic at all. Every time I laugh it comes out as a wheeze.

I don't have asthma but I get panic when my chronic illness causes pain and this is exactly how I feel. I don't feel panic I feel these things and with Xanax I feel better

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[Mickey'snewestfan]

What rescue med are you taking? Is there a better option?

 

[luvwinnie]

Xyopenex...pretty sure they all have the ability to increase heart rate. Will talk to dr Monday.

 

[luvwinnie]

I don't have asthma but I get panic when my chronic illness causes pain and this is exactly how I feel. I don't feel panic I feel these things and with Xanax I feel better

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But a dr actually hears wheezing, congestion, etc?

 

[disfan07]

Does your cardiologist know that you are on a rescue inhaler?

I am on xoponex also and I have inappropriate sinus tachycardia with PVCs and my cardiologist and pulmonologist are always in contact to make sure things are okay.

And there are meds for tachycardia that are safe for asthmatics. I've been on them. The only thing that is contra indicated for asthmatics is beta blockers (at least that's what my cardiologist has told me) but there are other options. I've never been on a beta blocker but have been on a few other types of cardiac meds.

 

[leebee]

My sister was treated for chronic bronchitis and asthma for years... nebulizer at home, Q-var inhaler, prednisone tapers all the time, etc. She also has SVTs so it was always a balancing act, and she was always unwell and short of breath. I am not sure of the circumstances, but somebody investigated further and they discovered she has pretty serious gastric reflux. She is no longer taking any of the asthma meds, just meds for the reflux. She says it is amazing to be able to breathe all the time without congestion, constriction, and gasping for air. The change is pretty amazing!

 

[luvwinnie]

Does your cardiologist know that you are on a rescue inhaler?

I am on xoponex also and I have inappropriate sinus tachycardia with PVCs and my cardiologist and pulmonologist are always in contact to make sure things are okay.

And there are meds for tachycardia that are safe for asthmatics. I've been on them. The only thing that is contra indicated for asthmatics is beta blockers (at least that's what my cardiologist has told me) but there are other options. I've never been on a beta blocker but have been on a few other types of cardiac meds.

Yes. I'm lucky that I do not need meds as it has not been frequent. Thank you for info!

 

[luvwinnie]

My sister was treated for chronic bronchitis and asthma for years... nebulizer at home, Q-var inhaler, prednisone tapers all the time, etc. She also has SVTs so it was always a balancing act, and she was always unwell and short of breath. I am not sure of the circumstances, but somebody investigated further and they discovered she has pretty serious gastric reflux. She is no longer taking any of the asthma meds, just meds for the reflux. She says it is amazing to be able to breathe all the time without congestion, constriction, and gasping for air. The change is pretty amazing!

Interesting. I was supposed to have an endoscopy and colonoscopy this week (for other reasons) but have to reschedule because I can't be sedated in a flare. I don't have GERD symptoms ( other than one small bout of heartburn about a month ago) but we will see what the tests show.