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Old 10-26-2009, 12:57 AM   #1
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Questionable diagnosis of adult-onset asthma?

OK, so my doctor diagnosed me with "adult-onset" asthma in December 2008. I'm questioning this diagnosis. I'm also questioning my doctor's choice of treatments, as I seem to have been prescribed some powerful drugs to treat relatively mild symptoms. These may have been causing some terrible side effects and withdrawal symptoms.

Here is my story:

I have never had any breathing problems before Dec 2008. I have recently quit smoking after 18 years, and I have been smoke-free for 6 months. Even though my GP is adamant about his diagnosis of asthma, I just can't rule out the correlation of 18 years of smoking and asthma-like symptoms.

I have been put on progressively stronger medications for the last 10 months. Here is the timeline:

Dec 2008 - Started on Asmanex
Apr 2009 - Switched to Advair, discontinued Asmanex
Aug 2009 - Switched to Symbicort, discontinued Advair

Sep 2008: At this point I was beginning to have some VERY strange health problems, the likes of which I had never experienced before. It scared me. It started with nausea 3-4 times a week always after dinner. Then I started having insomnia problems, possibly due to upset stomach. I also started having tiredness all day (even when I had no insomnia), blurred vision, leg cramps, anxiety at night. I had a voracious appetite and have put on 40 pounds on 10 months, which is fairly unusual for me. I can only attribute these to side effects of the medications, all of which are common side effects of corticosteriods.

Needless to say, i have stopped all corticosteriod treatment effective 2 weeks ago. Ironically, my "asthma" has been fine. I have only used my Proventil fast acting inhaler twice, and those attacks were relatively minor. This reinforces my theory that the "asthma-like" symptoms are from quitting smoking and not because I actually have asthma.

However, I fear that I may be experiencing some withdrawal symptoms from the corticosteroids. The nausea has subsided (thank god!), but I'm still having problems with insomnia, although not as bad. Keep i mind that I am lucky to have a VERY strong stomach. I have been "physically sick" maybe 5-10 times in my entire life, and I'm 34. I have also never had sleeping problems until recently. These symptoms are very, very unusual.

So these are my questions:

Do I really have asthma or am I just recovering from 18 years of smoking?

Am I experiencing withdrawal from 10+ months of corticosteriod treatment?

If so, can anyone tell me how long I can expect to be in withdrawal from the corticosteroids?

Last edited by Eric J; 10-26-2009 at 01:22 AM.

 
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Old 10-26-2009, 10:15 AM   #2
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Re: Questionable adult-onset asthma?

Quote:
ven though my GP is adamant about his diagnosis of asthma, I just can't rule out the correlation of 18 years of smoking and asthma-like symptoms.
First of all, you really shouldn't be relying on a GP to make a diagnosis of asthma. You should see a pulmonologist for an asthma evaluation. There's no easy way to diagnose asthma without a pulmonary function test and N2O test.

Quote:
I have been put on progressively stronger medications for the last 10 months. Here is the timeline:

Dec 2008 - Started on Asmanex
Apr 2009 - Switched to Advair, discontinued Asmanex
Aug 2009 - Switched to Symbicort, discontinued Advair
Just as an FYI, those really aren't "progressively stronger" medications, they're just different versions of the same medication. In some ways, Advair and Symbicort are stronger than Asmanex because they contain multiple medications, but they are very similar overall.

Quote:
I can only attribute these to side effects of the medications, all of which are common side effects of corticosteriods.
Actually, the things you list aren't that common with inhaled corticosteroids except at extremely high doses (or in people who are extremely sensitive to them). Weight gain, in particular, is fairly unusual because the amount that reaches the blood stream is very low.

Quote:
Do I really have asthma or am I just recovering from 18 years of smoking?

Am I experiencing withdrawal from 10+ months of corticosteriod treatment?

If so, can anyone tell me how long I can expect to be in withdrawal from the corticosteroids?
You really need to see a pulmonologist to answer the first question.

As for the second and third questions, it's very unlikely that what you're experiencing is the result of withdrawal from the inhaled corticosteroids. It only takes a 24-48 hours for the medication to be excreted from your body so the effects of the inhaled corticosteroids are almost certainly behind you at this point. Again, I think you should probably see a pulmonologist to try to get your questions answered.

 
Old 10-26-2009, 11:13 AM   #3
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Re: Questionable adult-onset asthma?

Excellent, thank you, thats good advice. I got a recommendation for a pulmonologist today, so I'll be seeing about making an appointment this week. I hope I can get it sorted.

 
Old 11-11-2009, 03:01 PM   #4
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Re: Questionable adult-onset asthma?

What exactly are the testing procedures to determine asthma? I am having adult onset asthma symptoms which may be allergy induced, I saw my ENT yesterday, but they insist that allergy injections would not bring on my symptoms, however, I believe different...you mention testing, is this the same as the flow meter? N20? what is that? I am feeling like the ENT office can't handle my symptoms and want to go to the proper doctor......thanks for any advice

 
Old 11-11-2009, 07:14 PM   #5
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Re: Questionable adult-onset asthma?

No, it is not the flow meter. There are several they can do but you do need to see a pulmonologist for that. And no, the injections would not bring on an asthma attack but it can be allergy induced, caused by the allergy itself which is not totally under control.

 
Old 11-15-2009, 01:11 PM   #6
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Re: Questionable adult-onset asthma?

Is the amount of the allergen injected so small that it would not make any asthma symptoms worse? they suggested getting 2 shots a week broken up, instead of all three at one time....has anyone ever done this that may be reading this? if so, did it help? I am confused by what is happening to me and how to manage it....I am going to ask for a referral to a pulmonary dr tomorrow ... I had another shortness of breath today and had to use the inhaler...it was while driving through a heavily wooded area with loads of leaves all over....we had a Nor'easter with three days of rain, I am thinking mold spores count....but have no real idea of what brings this stuff on..thanks for the info

 
Old 11-15-2009, 02:07 PM   #7
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Re: Questionable adult-onset asthma?

When I was on the shots I had two vials that could not be mixed so I had to get separate shots each time. And I went twice a week for 4 shots a week int he begnning to build up to maintenance faster. Never had any problems with my asthma as a result...but it's not set off easily by most of my allergies and was - and continues to be -very well controlled also.

 
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