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Old 05-06-2012, 05:14 PM   #1
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Need Help with my Asthma Action Plan

I am a fairly healthy 71 year old female who joined the Health Boards about a year ago to work through some acid reflux and migraine headache issues . . . the GERD forum was very helpful. I walk several miles per day, and exercise one or two days a week at a gym. Every month or two I have been having trouble breathing and have been put on a CPAP machine at night (Apnea Board forum also very helpful!). Recently diagnosed with Asthma, and my GP prescribes the following each time I start with symptoms (congestion, etc), and progress up this medication ladder: Singular one 10 mg tab at night; Symbacort 2 puffs twice a day; ProAir (albuterol sulfate) 2 puffs 4 times a day. If symptoms continue to get even worse (SOB, wheezing, etc) I then start using my Hand Held Nebulizer with Ipatroprium & Albuterol, and have ended up on Prednizone a couple of times (which I really dislike the side effects). I have already learned a lot from your website, and now realize that I have had tell-tale symptoms which should have served as an early warning system. I have two basic questions: (1) Should I be doing a peak flow test every day? and (2) Is there a med that I should be taking every day (e.g., the Singular tabs or any of the inhalers) as a preventive measure, especially prior to exercise? Thanks in advance for your help!

Gwen

 
Old 05-06-2012, 05:22 PM   #2
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Re: Need Help with my Asthma Action Plan

I am so sorry you are going thru this. If you indeed have asthma - and GERD symptoms are often assumed to be asthma - then you need to be on these meds EVERY DAY - not just when an attack occurs. Normally, you would start on the steroid inhaler (symbicort) twice per day and the singulair once per day. The ProAir is for attacks and for premedicating before cardio = 2 puffs, 6 seconds apart, 15-20 minutes before cardio. My suggestion at this point is to see a pulmonologist for a proper work up and medication and personal action plan. Hope that you sort it out.

Last edited by Titchou; 05-06-2012 at 06:37 PM.

 
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Old 05-06-2012, 05:45 PM   #3
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Re: Need Help with my Asthma Action Plan

Thank you so much!! I thought my GP was leaving me without a complete plan of action!

 
Old 05-06-2012, 06:41 PM   #4
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Re: Need Help with my Asthma Action Plan

Well, GPs really aren't the place to be for asthma. Mine told me that up front and told me who was the best guy in town to see. You need the extra insight. Hope you find someone good...btw, I'm 66 and a jogger and work out with a trainer 2 days a week. I also dance a good bit so controlling my asthma is very important to me!

Keep us posted.

 
Old 05-06-2012, 07:05 PM   #5
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Re: Need Help with my Asthma Action Plan

Thanks again. I am sure I can get a referra lto a good pulmomologist, because we have good insurance. However, I might first try an allergist who worked me up some time ago (pollen, etc does start the sinus symptoms rolling) . . . . this was before I knew I might have asthma. I know he personally is asthmatic, so he should be in a good position to fine-tune my action plan!

 
Old 05-07-2012, 03:41 AM   #6
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Re: Need Help with my Asthma Action Plan

He very well may be able to help. Keep in mind though that not all allergists have the equipment to test you for asthma in their offices. I'm thinking you need to be sure that it's asthma and not a side effect of your GERD. A friend's doctor treated her for asthma and she did not get better. Finally sent her to my asthma doc and she doesn't have asthma - it was her GERD. Changed meds and now all is fine. Keep that in mind as well. Keep us posted.

 
Old 05-07-2012, 06:31 AM   #7
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Re: Need Help with my Asthma Action Plan

Verrrrry interesting! I feel sure I have GERD, and I feel sure I have Asthma . . . . but this is an interesting possibility worth pursuing to get my doctors to settle on one or both!!

 
Old 05-07-2012, 07:27 AM   #8
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Re: Need Help with my Asthma Action Plan

I have both GERD and allergic asthma. My GERD could not be adequately controlled with diet or medication, so I had surgery, which reduced it about 90%.

There's been a dramatic improvement in my asthma. Most days are symptom-free or nearly symptom free, and I only have issues when the pollen is particularly bad outside.

 
Old 05-07-2012, 08:14 AM   #9
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Re: Need Help with my Asthma Action Plan

I am hoping to avoid surgery for the GERD, because my GP and Gastro both recommend against it . . . . how did you get away from the medical folks? Heavy pollen season (like this year in Maryland) really kicks off the Asthma . . . . and I was not even taking the Singulair on a daily basis, as it was just prescribed for the first time as my congestion/wheezing got worse this Spring! I plan to take a Singulair tab every nite even if there are no symptoms. Should I use any inhalers on a daily basis, or only when symptoms sneak up on me?

 
Old 05-07-2012, 08:24 AM   #10
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Re: Need Help with my Asthma Action Plan

Use the symbicort every day. The ProAir only when you have an attack or as I indicated before cardio. I have asthma and have to premedicate before I jog.

 
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Old 05-07-2012, 12:18 PM   #11
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Re: Need Help with my Asthma Action Plan

Definitely, Symbicort is meant to be taken every day. Do be aware, though, that for some people the LABAs such as Fomoterol, one of the ingredients in Symbicort, can actually make reflux worse. If this seems to be happening to you, ask your doctor to switch you to a plain inhaled steroid without LABA.

My GI and family doctor both endorsed my decision to have reflux surgery, but only after I'd tried multiple treatments, including high-dose PPIs. I do recommend the procedure, but only to someone who's had a thorough workup, given medical and nonmedical treatments a good long trial, and still has major issues.

 
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