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Old 06-01-2008, 05:38 PM   #1
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Asthma w/ GERD and Swallowing Disorder?

So I had my first appointment with a Pulmonologist a few weeks ago. I have been diagnosed with asthma since January 2002 and am on a regimine of Advair 500/50, Singulair, Albuterol, Tessalon Perle and an EpiPen for emergencies. I still have problems with cold and polluted air, but during warm weather my asthma seems under control.

A little over 2 years ago, I had an extreme flare-up with a chronic cough (the kind where you can't catch your breath) for about 4 months. My asthma medication dosages were increased. I also went through testing (24hr PH and monometry) and discovered I also had reflux with no symptoms other than the cough. After a few attempts with a couple meds, I found that a twice daily dose of Prevacid and diet modification got it under control. I have followed this routine for the last couple years.

During this past winter, my asthma flared up and was out of control. With the extreme cold air and air pollution, my asthma symptoms changed from just being a cough to also including chest tightness and extreme difficulty catching a breath. I ended up needing emergency treatment in January. I asked for a referral to a Pulmonologist. It took me over 4 months to get an appointment. Of course, by now the air has warmed and my asthma is under control. I haven't needed my Albuterol for about 7 weeks. The Pulmonologist confirmed my asthma and had me go for some testing. This testing inculded a Modified Barium Swallow and Esophagram. My Pulmonologist called today (on Sunday?) to tell me that the testing confirmed that I have a swallowing disorder. He said that until I get the swallowing disorder under control, I will NEVER have my asthma under control.

I will be going back to my GI doc for follow-up on this latest testing. I guess what frustrates me is that I currently have NO symptoms. My asthma is currently under control since the things that usually trigger it aren't present right now. I don't have any GERD/LPR symptoms. I have never noticed any swallowing problems. I will visit with my GI doc, but how will I ever know when I have things under control if I don't even have any symptoms at all until things flare up? This winter my asthma problems really scared me.

Also, since I have been on a reflux diet and medication for years, I worry that I will be facing surgery to correct a reflux/swallowing problem that I don't even feel symptoms of just to get control of my asthma.

 
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Old 06-03-2008, 01:44 PM   #2
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Re: Asthma w/ GERD and Swallowing Disorder?

Wow! I am glad you are getting yours figured out. I don't know what I have going on now. A little bit of everything. Guck in my throat due to allergies, the other night I had a tight chest and I was dizzy, breathing was labored and scared me. UGH! throat feels tight and swollen. My allergist thinks I have a passing virus, (i bed to differ) Allegra and sudafed help but I still feel like I have acid reflex and a touch of asthma coming on. Which doctor will help best?? Family doc? Allergist? Ears nose and throat? Any other ones you can think of?? I don't know where to start. I am so frustrated. UGH!

 
Old 06-03-2008, 05:39 PM   #3
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Re: Asthma w/ GERD and Swallowing Disorder?

TEdwards,
If it is a virus, it will get better within a couple weeks. If it lasts longer, chances are it is the allergies.

A good PCP is invaluable. I started off years ago with a PCP and a doc at an allergy/asthma clinic. I did well with this while I had a caring PCP. She left the practice though and I haven't found one that I am happy with yet. I have now set up my own team of an ENT who also treats allergies (for allergies and sinuses), a Pulmonologist (for the reflux), and a Gastroenterologist (reflux and now possible swallowing disorder). I have been having all my tests sent to all three doctors to help with coordination. I also have my reports sent to the clinic I have been going to for many years and I hope to find a good PCP there one of these days.

I do have severe allergies and get sinus infections at least 4 times a year. I am on my second round of immunotherapy. I also use Allegra, Singulair, Flonase, Astelin and Zaditor. I also use saline sprays and do saline nasal washes. I had to stop using the decongestants regularly due to increasing blood pressure.

I also read up on the homeopathic things I could do to help with the sinus/allergy/asthma problems. I can't do everything they recommend, but the information was really helpful.

 
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