So I have had an asthma flare-up for the last 8 days. Typically I have major asthma problems in the winter. In the past, I have only had asthma problems in the summer when the air quality was bad from wildfires. Right now, our air quality is OK- no fires. I know humidity can play a role, but we have only been averaging around 18-20% humidity here.
I am frustrated right now because I am not sure what my triggers are for this attack so I can help get it under control.
Here are my suspects- either individually or in some combination:
Allergens: I do have year-round and seasonal allergies, but I have never had allergy induced asthma. So far this spring and summer, my allergy meds and immunotherapy have kept me from really having severe allergies. I've actually felt better this allergy season than I have for many many years.
Dry hot air: We haven't had rain for over a month. My doc thinks this flare-up may be as a result of particulates that may be hanging low in the air because there hasn't been any rain to clear it out.
Acid reflux: I do have reflux. I was on Prevacid 2x/day for years. In May, I went to the Pulmonologist for my asthma. He ran some tests and found I still have some acid coming up and aggrevating my asthma. I have been working with my GI doc to find a new medication to help control the acid. My problem here is that I don't feel any acid symptoms so it is hard to know if it is causing problems at any given point and time. (My acid symptom is typically a cough.) I tried Nexium a month ago and it was horrible. I have been on Aciphex for the last couple weeks.
Current treatment regimine for this flare-up: Asthma- Advair 500/50, Singulair, Albuterol, Prednisone; Allergies- Allegra, Flonase, Astelin, immunotherapy, Saline rinses; Reflux- Aciphex 2x/day, Gaviscon. I'm also beginning Avelox for the next 5 days, just for the heck of it to see if I have some sort of infection.
Anyone out there have any thoughts on what I may be able to help get my asthma back under control? If so, they would be much appreciated.
I don't know if this helps but I had a similar experience last summer in Lake Tahoe - I can't be sure but my pulmonologist thought that it was probably a combination of the dry air and some irritants in the air from fires that were burning on the West Coast of California 150+ miles away).
It sounds like you're doing about everything possible - hope you can get it back under control and keep it there.
My asthma cough has gotten worse instead of better this week. I finished a round of Prednisone yesterday and I am already loaded down with the other meds I am taking for this. I have been relying on my Albuterol every 4 hours for the last 9 days. My voice has really gotten hoarse. The doctor put me on antibiotics in case I have some sort of infection that is aggrevating my asthma, but I'm not sure it is doing much. I just don't know what else I should be doing.
To make matters worse, our air quality changed today. We are under red air quality alerts for the near future and our humidity is 9%. I just don't see any relief in sight.
Aside from just hoping I don't have a serious attack that needs emergency care, I feel like my options are limited. This is really wearing me out.
I'm up the road from you---in Idaho.
I have intermittent asthma...finally found out that it accompanied sinus infections.
I had real bad problems for more than a year---and a new and much better pcp did a ct scan of my sinuses which showed that I was up to my hip boots in infection.
Do you happen to have thyroid disease?
Thyroid disease can make you more susceptible to asthma problems---and it can also make your voice hoarse.
Just a thought. Can you go in for a breathing treatment or get a nebulizer???? I've had times when that's what it took for me to get rid of my problems.
I usually use the nebulizer when we get forest fires or inversions.
You don't have to go to the ER---some doctors will let you have a treatment in their office---but if you're bad---and it sounds like you are----definitely see someone.
One ex-doctor accused me of smoking 'cause I smelled like smoke when I went into see him.
I guess he forgot that the forest fire smoke was so thick you could hardly see.
I think the California wildfires are causing problems for all of us around here...
PS: I got put on Levaquin---for 40 days---it nearly killed me---but it did take care of the sinus infection.
14 days now of asthma coughing. I think it is a combination of the bad air quality, dry air and acid reflux. It's really starting to wear on me. Right now, there is no end in sight in the forcast for our bad air quality so I know I am in for a long haul.
My GI doc has had me on a new medication the last two weeks. It is better than the one I was on the month before, but it still isn't very effective. I check back with him on Tuesday. I am running out of PPI's to take. Over the years, I have been on Prilosec, Protonix, Nexium, Prevacid (I had fewest symptoms on this one, but still had it affecting my asthma), Nexium and Aciphex. My Pulmonologist says he can't do much more for me until I get the acid under control. I feel like I am going around in circles.
Meanwhile, I have finished a round of Prednisone and Avelox. I'm not as wheezy, but the coughing has increased.
T4T3Hell- Thanks for your response. I do have sinus problems at times. I had a CT scan last year. For now, my ENT has me on immunotherapy before he will consider any surgery. While I had frequent infections this past year, I don't have an infection currently. Fall-Spring are my worst times. I have had breathing treatments, and once an epi-shot for my asthma at my PCP's. It is cheaper than the emergency room so I like to try it first. I think the hoarseness was from frequent coughing and Albuterol use. 40 days on Levaquin is really intense. It must have been a doozy of an infection.
Last edited by MountainReader; 07-13-2008 at 09:24 PM.
You sound like I did last summer - I spent 4 miserable months with an asthma flare up (VERY unusual for me), and it turned out to be 95% caused by my acid reflux. Thank goodness I changed allergists in the middle of the whole ordeal because his new perspective on my situation was key to getting the acid reflux sorted out (he re-tested me, found that none of my allergies were severe enough or prevalent enough to be causing my symptoms and started looking for other potential causes).
I know you tried Nexium and it didn't agree with you - that was what did it for me (and it only took about a week for me to notice significant improvement once I got the acid reflux under control).
Hopefully your gastroenterologist will be able to figure something out quickly - the prednisone can make the acid reflux much worse so maybe getting that behind you will help with the reflux.
I got a call back from the nurse at the GI docs office today. I go in for an Endoscopy next week. I had one two years ago that came back normal, but they want to see if there are any changes or anything noticable that is causing the flare-up. I went through this cough thing a couple years ago and it took 4 months then to get it under control. I have to get both the acid and asthma under control at the same time. Hard to do when the air is bad too.
I had an Esophagram and Modified Barium Swallow a couple months ago. That is what started the change in my reflux treatment. (Been on PPI's for 6 years.) Even though I wasn't feeling any symptoms on the Prevacid at the time, the tests showed I was refluxing quite a bit. I have been having my asthma problems since then. Unfortunately, my main asthma and reflux symptoms are both a cough. What a hassle. The coughing really can wear you out.
Thanks for your support. It is nice to have someone else to relate with sometimes.
Last edited by MountainReader; 07-14-2008 at 06:41 PM.
I have verified it is the acid flaring up my asthma cough. They changed me to Aciphex twice a day for the next few weeks.
I ended up having to go to my PCP last week because the cough was so bad. Ended up being prescribed a cough syrup. I assumed it would just be one with codine in it when the doc said not to drive. Instead, when I picked it up I found it had hydrocodone in it. It worked wonders on my cough. I know I can only take it short-term and it is only masking the symptoms, but a couple days without coughing really helped me feel better.
I go back to the GI doc in two weeks to see where we go from here. By then, I will have spend the entire summer with this flare-up...bummer since winter is my bad time for asthma.
My asthma is flared up AGAIN. I went on another round of Prednisone yesterday. I think this is the 5th time I have been on it since last fall... the second time this summer since July 3. I typically get some weight gain and sometimes some facial puffiness when I take the Prednisone. Today I woke up with the puffiness, an upset stomach and redness on my face and chest.
Have any of you had a Prednisone reaction with facial and chest redness, or some sort of rash, before? This one is new to me? I'm not sure if I should be concerned or not. If I have it tomorrow, I might call the dr's office.
By the way, I am already on Advair 500/50, Singulair and Albuterol for the Asthma so I am pretty maxed out on other asthma medications.
I go back to my GI doc on Monday to discuss the acid that has been flaring my asthma this year also. This particular attack was caused by bad air though.
I've never had a rash or redness from prednisone. It's actually used to treat rashes but I guess you can have an allergic reaction to anything. I hate to say this, but you should probably call the doctor if it's still there in the morning.
So, I am 5 days into a 9 day burst of Prednisone and my cough is already back. (Sigh!) This is with frequent use of Albuterol and daily doses of Advair 500/50 and Singulair.
I had another follow-up with my GI doc today. I just know it is my acid that is flaring up my asthma cough this summer. He verified that my EGD I had two weeks ago was just fine. I have been on Aciphex 2x/day for the last 5 weeks and I have had to go to my PCP 3 times for my chronic cough. He is switching me to Zegrid. Basically this is my last hope since I haven't had luck with Prilosec, Protonix, Nexium, Prevacid or Aciphex and all of my other tests verify that I have "serious" acid. I know it has the same medicine as the Prilosec, but it is supposed to be a bit more effective. I also have to go back for another Manometry and 24 hr PH. My last ones were 2 years ago. Depending on how the Zegrid and test results are, I think I am seriously looking at having the Nissen Fundoplication surgery for my reflux. They are running out of other medical interventions to help. I can't continue forever with my asthma out of control. I am getting scared for fall and winter that are fast approaching. In past years, the summer has been my "safe" time from my asthma since the cold air & winter inversions are my worst triggers. I can't imagine my asthma worse than what it has been this summer.
By the way, my Prednisone "flush" on my face, neck and chest just lasted 2 days. I found on a website that it is a "lesser" side effect. I will definitely let my PCP know next time I go in.
One of the crummy things about the prednisone is that it can aggravate the acid reflux while helping knock down some of the other symptoms. Sounds like you're stuck in a really crummy cycle. I don't know much about the surgery but at this point it sounds like it could be better than what you're dealing with.
Before you have any operation of any kind, please look up Digestinol on your computer. It is VERY strong aloe vera. My acid reflux was SO bad that I was on a pill two times a day and I found all it did was numb that area for a certain. Got on to Digestinol and I am MUCH better. Can even drink coffee. Hope this is of some help!!
Frustrated and miserable here. 82 days for this asthma flare-up with almost nonstop coughing. I have been to my PCP's 7 times, specialists (Pulmonology and GI) 4 times with two more appointments scheduled, had various testing done, had 2 rounds of antibiotics and 2 rounds of Prednisone and I am still using my Albuterol several times a day. I am on Advair 500 and Singulair, PPI's, allergy meds and immunotherapy.
I am stuck in the acid reflux-asthma cycle. I'm not sure if it is the acid triggering the reflux or the reflux triggering the acid, but we've been trying various treatments to get both controlled at the same time. NOTHING is working. The thing is that I am not seeing any end in site. On top of that, winter is approaching and the cold air is a MAJOR asthma trigger for me. Winter is usually when I need emergency care for my asthma.
While the doctors I go to are highly recommended and seem to kow what they are doing, I have scheduled an appointment with a local university medical center doctor who is supposed to be the best in the state. That appointment if still 6 weeks out though.
I'm on zegerid. It is working well for me. But, then, protonix worked ok, too. Do you have, or could you get a nebulizer for home use? My DS (10) has allergies, asthma, reflux, chronic sinusitis. When he flares up, the neb works much better than the inhaler. We'll usually do back to back treatments (wait 15-20 min in between). The first treatment will make his cough worse because it causes his sinuses to drain. The second treatment will relieve the cough and he'll *usually* be good for a couple hours.
Other than that, my only other suggestion is to try a different asthma med. Symbicort is similiar to advair except the long-acting bronchodilator is foradil and the inhaled steroid portion is pulmicort. Have they checked a WBC to make sure you don't have an infection?
Or, maybe you need a round of IV solumedrol (steroids) to kick the cough??
Last edited by sunshinemommy23; 08-21-2008 at 10:33 AM.