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Old 08-31-2008, 04:44 PM   #1
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After all your options are used up, what else can you do?

I am really sorry for posting so many times; I don't know what to do. I posted about the side effects of the nebulized albuterol yesterday, and thanks for the response--today I've used it three times, and haven't had too much trouble with side effects.

My asthma just sort of appeared several weeks ago. Not gradually, just one day I started coughing and the next I was having coughing fits and chest pains. Since then, it's getting much, much worse. I've had several bad asthma attacks since it first started.

I've got an at-home nebulizer now, and I've had to use it three times today. About an hour ago, I had a really bad scare. The worst asthma attack yet. I was breathing heavy and coughing for a few minutes, and then I just couldn't breathe. I started getting dizzy, my chest and ribs were killing me, and I felt like I needed to cough but I just didn't have the breath. I tried walking and I nearly passed out--everything was fuzzy and my vision kept getting black around the edges. All I could do was hunch over and try to get some air.

My mom and her friend got me to sit down near the air conditioner, and when I tried to ask my mom to get the nebulizer, I couldn't even talk. Every time I tried, I was gasping for breath. I've never been more scared in my life. All I could do was point and finally say "nebulizer" after several failed attempts. I had to get up and go get it, though I nearly collapsed when I stood back up. I felt a lot better after the nebulizer treatment, but it's still not quite enough. I'm not struggling to breathe, now, but it is VERY uncomfortable--normal breaths hurt, coughing hurts, I'm still dizzy from that episode earlier, and I feel like just moving in general is only going to exacerbate it.

My question is this: what else is there to do? What else CAN I do? I'm on symbicort day and night, the nebulizer treatments when I need them, and I'm on prednisone right now to get rid of the inflammation. What's the next step? Every doctor I've seen has only gotten this far--nebulizer treatment, prednisone, send me home. Isn't there anything further that can be done? It's unbearable. I never thought asthma could be such torture.

 
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Old 08-31-2008, 07:30 PM   #2
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Re: After all your options are used up, what else can you do?

I am so sorry you are struggling so much. I've never had an attack as severe as you talked about but I can imagine how bad it must feel because my moderate attacks feel pretty bad to me. I wish I had some advice for you but I really don't know what can be done when asthma is really severe. All I know is that if you have an attack and if after using your inhaler/nebulizer rescue medicine you still are struggling then you need to go to the ER right away. At least they can assess you better there and you are in the safety of the hospital if it worsens. I'm probably stating the obvious here but call your doctor ASAP on Tuesday. Like if they open at 8 a.m. then call at 8:01 and keep calling until they get someone to talk to you.

 
Old 08-31-2008, 09:09 PM   #3
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Re: After all your options are used up, what else can you do?

Serious asthma attacks can be scary. They are nothing to play around with. Go to the ER if you have a serious attack and the meds are not working. When you get to the point that you can't talk, that is serious.

That said, when I have asthma flare-ups that aren't taken care of with my maintainence items, I typically end up on a round or two of Prednisone. That is really the only thing that gets things back under control. (I am on Singulair, Advair 500/50 and Albuterol). I also carry an Epi-pen prescribed by my doctor for a serious asthma attack. It is to be used to give me time to get to an ER when the Albuterol doesn't work.

You should also work with your doctor or an asthma specialist to put an asthma plan in place. It will give you some direction on what action to take when you have asthma problems of different types.

It would also be useful to determine what some of your asthma "triggers" are. Then, if possible, you can work to avoid them or make lifestyle changes. That is often easier said than done though.

 
Old 09-01-2008, 05:15 AM   #4
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Re: After all your options are used up, what else can you do?

I agree with the written plan. If you aren't seeing a pulmonologist or at least an asthma specialist, you need to find one. I also agree with finding out what your triggers are so you can manage them. Next, you may not be on the best meds for you. You may have to try several daily meds to find one that works best for you.
Good luck!

 
Old 09-12-2008, 01:40 PM   #5
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Re: After all your options are used up, what else can you do?

This might be a little bit of a long shot as you have had the asthma a relatively short time. You mentioned you are taking Symbicort. It is a combination therapy which contains a steroid component to keep lung inflammation in check and a long lasting bronchodialator similar to the albuterol but lasts 12 hours. I had some problems with Advair which is a similar combo medicine from another company. Advair is generally a good drug. However in a small number of people (myself included) it can actually make asthma worse, especially with someone who often uses Albuterol (usual component in the nebulizer) as I did before every bike ride. I didn't have attacks nearly as bad as you but after 5 or 6 months I had trouble riding 15 miles flat when I could easily ride 50 miles with hills before. I would ask your doctor about this. Unfortunately many doctors refuse to acknowledge this. Mind does and I stopped taking Advair on my own. My very next bike ride without any medicine was much better although not quite as good when I first used the Advair when it worked well. I would suggest your doctor prescribe another steroid, without the long lasting bronchodialator and maybe add something like Singular which is a type of anti inflamitory drug that works in a different way. The goal is to keep inflammation in your lungs to a minimum where your triggers don't create an asthma attack. I would also try to figure out what your triggers are and try to avoid them.

 
Old 09-12-2008, 01:48 PM   #6
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Re: After all your options are used up, what else can you do?

After re-reading your post the pregnizone should be enough to reduce the inflamation although adding an inhaled steroid might help which is what your doctor added with the Symbicort. This leads me even more to believe that may be the long lasting beta agonist in the Symbicort that is causing the problem. Since you are taking the pregnizone I would call your doctor to see if you can try stopping the Symbicort and add Pulmicort which has the same steroid component in Symbicort without the beta agonist. If my theory is correct you should know in a day or so as the long lasting beta agonist should wear off before 24 hours.

 
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