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Old 06-07-2012, 03:02 PM   #1
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trying to stay off prednisone

I have been having breathing problems due to asthma off and on for almost
2 weeks. My family doc wants me to try and stay off the prednisone because
I have have been on it so many times and primarily because of all the side effects.

I am just so tired from being short of breath.

It is hard to function when my asthma is out of control.

Can anyone relate?

I am already on so many medications. It has been better in the last year but the last 2 months it is giving me more problems.

 
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Old 06-07-2012, 03:49 PM   #2
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Re: trying to stay off prednisone

WHat does your pulmonologist say?

 
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Old 06-07-2012, 03:55 PM   #3
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Re: trying to stay off prednisone

My asthma doctor says the same thing to try to stay off prednisone.

 
Old 06-07-2012, 03:59 PM   #4
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Re: trying to stay off prednisone

It is hard sometimes. Have you changed your inhalers around? Added, taken away? What does your action plan say? Are you sticking with it? Do allergies have anything to do with this? Taking antihistamines - doing allergy shots?

 
Old 06-07-2012, 04:41 PM   #5
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Re: trying to stay off prednisone

Yes, I have added atrovent plus extra alvesco according to my action plan. My daily medications are alvesco, zenhale and spriva plus my rescue inhaler when needed.. Allergies are a big component of my asthma and I have been taking reactine for that.

I do not take allergy shots but I have in the past. The last time I did I ended up in the hospital from reactions from them.
I am also on xolair which I started Feb 2011.

I just find my asthma just wears me out. I have so many triggers that it is impossible to avoid everything.

 
Old 06-07-2012, 11:13 PM   #6
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Re: trying to stay off prednisone

Do you use a nebulizer? If not, it might be worth asking about to help you get your medication into your lungs better.
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Old 06-08-2012, 08:25 AM   #7
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Re: trying to stay off prednisone

Yes, I do have a nebulizer. I just find it so much easier to grab an inhaler.
When I am short of breath the more I do the worse I feel.

 
Old 06-08-2012, 10:28 AM   #8
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Re: trying to stay off prednisone

Quote:
Originally Posted by klynn1960 View Post
I have been having breathing problems due to asthma off and on for almost 2 weeks.
I really sympathize with your asthma misery. I've got heart failure, permanent atrial fibrillation, insulin resistance and asthma, all of which can cause breathing problems. I can take just about any nasty symptoms, but breathing problems drive me NUTS! Fortunately, most of the time I do not have breathing problems.

Years back, when I had more problems with Asthma, I'd have more problems with my asthma when I was inside my home. When I would go out, my breathing problems would improve. I bought a bunch of air filters. They didn't help too much. I thought that the problem could be air conditioner mold. That wasn't it. I eventually removed all of the wall to wall carpeting, and any wood product that had an odor, including wall cabinets and furniture, which led to a significant improvement in my asthma. My asthma also improved after our dog passed away and we did not get a new pet.

Now, instead of suffering asthma symptoms when inside my home, if I go out on a high pollen day, I'll sometimes notice tightening in my chest, either immediately, or later on in the day. So, in essence, I feel better in my home and once in a while I'll have asthma problems outside my home.

How many years have you suffered with asthma? Do you suffer breathing problems 24 hours per day, or are the times during the day or night when your asthma is worse? Do you feel better when outside your home, or inside? Are there times when you go more than one day without any breathing problems at all?

Perhaps, with a little more information, the very knowledgeable members of the Asthma Topic will be able to offer some additional input or suggestions.
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Old 06-08-2012, 12:34 PM   #9
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Re: trying to stay off prednisone

Wow, you have your hands full what you mentioned you have.

I have had asthma for 16 years and it has been better in the last year. I started xolair injections last Feb and I get 3 every 2 weeks. They have reduced my prednisone use and the severity of my asthma attacks.

However, the last 2 months I have been having more shortness of breath.
I still have asthma symptoms pretty much everyday. They are mostly caused by the many allergies that I have and if I do too much or catch a cold. Right now, I am coughing alot and that just makes the breathing worse.

I find it hard to deal with being short of breath so much.

My asthma affects me inside and outside my house.

 
Old 06-08-2012, 03:13 PM   #10
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Re: trying to stay off prednisone

This is my first time to post, so bear with me, but I believe we're talking about Prednisone. I HATE Prednisone. I already have a weight problem, and when my doctor places me on this, there is not enough food in sight. I get so hungry, but it does help me breathe better. I take Symbicort (2 puffs in a.m. & p.m.), Ventolin inhaler 6 to 8 times a day, and a Singular tablet before bed. I feel for you if your doctor has you on Prednisone for a long period of time. Mine really doesn't like to put me on Prednisone, only as a last resort when the medications above don't work. In the last 6 months, I've been on the Prednisone 4 times, but my doctor only has be on them for 5 days at a time. I don't like how I feel when taking Prednisone, and it's not only the eating, but I seem to get quite aggressive.

 
Old 06-08-2012, 10:37 PM   #11
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Re: trying to stay off prednisone

Hi klynn1960,

I can totally relate to what you're going through right now. I had very bad asthma for 15 years (1980 to about 1995). I had to be on very high doses of prednisone for LONG periods of time early on because my asthma was so out of control. (I had a life threatening episode in 1985 and was on a respirator for FOUR DAYS!!)

However, things started getting better for me in 1988 when I had to switch pulmonary doctors because the one who saved my life in 1985, quit his practice to go into research instead. My new pulmonary doctor has been WONDERFUL in helping me get into COMPLETE REMISSION the last 15 YEARS, both physically and psychologically!

Though I DO still have to take a small (6 mg/day) dose of Prednisone for the rest of my life due to total adrenal insufficiency, the side effects of the higher doses really did bother me. Prednisone is a double edged sword drug - it really brings your asthma under control with short term "burst doses", but it has a LOT of side effects long term. One, as I say, is total adrenal insufficiency where my adrenal glands no longer put out ANY cortisone on their own which is why I need the low dose every day. (A healthy person's adrenals normally put out 25 mg. of cortisol daily to help fight infections and just keep your body working normally.) Another serious long term effect of taking high doses of Prednisone is the development of osteoporosis in your back and hips. (I have it in both, but cannot take ANY of the drugs to treat osteoporosis because I also have acid reflux disease AND, in 2009, to avoid the oral drugs adversely affecting my esophagus, I tried that new I.V. drug Reclast, but had a severe temporary kidney failure reaction to the Reclast! Thankfully, they caught it in time and there was no permanent kidney damage.) So now, I can no longer take ANY drug that contains components of the drug family called Zoledronic acids. (I could not even try Synvisc for my osteoarthritic knees because it is in the zoleldronic acid family. Besides, my knees were so bad that I had to have total knee replacements in both, one year apart - 4/5/11 and 3/23/12. TKRs have a 90% proven success rate long term. Synvisc doesn't have the proven track record yet and most insurance companies would rather pay for the $50,000 knee replacement surgery for this reason. I'm pretty much done with re-hab for my left TKR from this past March and both new knees feel great and should last me the rest of my life since I'm not an uber athlete!) But, I digress.

I know the side effects of long term high doses of Prednisone can be very uncomfortable, but if you are having asthma symptoms right now, let your doctor put you on a short term "burst" of Prednisone and wean you down over a few weeks time to not having to take it at all. See if it gets your asthma under control again.

Also, ask him to put you on Singulair (10 mg./day) as a maintenance asthma drug with little or no unpleasant side effects. I have been on it since it first came on the market and it's been an absolute Godsend! You might also ask for either Advair or Flovent inhalers (one or the other but not both!). They are also long acting asthma control maintenance drugs. Advair contains a steroid component to reduce the inflammation of an asthma flare-up combined with a beta-agonist component for fast acting results. HOWEVER, if you have any heart problems or have too fast a heart rate, ask the doctor for the Flovent. It works the same as Advair but without the beta-agonist component that can adversely affect your heart rate. Both Advair and Flovent are taken twice a day. The Advair is one puff twice a day and the Flovent is 2 puffs twice daily. There are different dose levels of each so whichever one your doctor puts you on, ask for the LOWEST dose one first to see if it's enough to bring your asthma under good control and KEEP it there!

Hope this info was helpful. Don't lose hope! I'm a walking example of a true asthma success story! As a matter of fact, I participate with one of my pulmonary doctor's group colleagues in a presentation every April for the 2nd year Pharmacology med students at NY Medical College. The doctor and I have a Q & A session first - he asks me certain questions about my asthma history and how the asthma meds I take affect me. Then we open the floor to questions from the medical students. This way, they get a valuable understanding of asthma from a patient's perspective a year before they start their clinical clerkships going on rounds with senior attending physicians, and teaches them how to have compassion for what the patient is going through. I've been doing this (volunteer basis) for about 10 years and really look forward to it. And the students seem to appreciate my being there to answer their questions because they always thank me as we all walk out of the lecture hall. Some even have stayed to privately ask me questions that they might have been too shy to ask out loud with their classmates there.

Hope this info helps and you ask your doctor about the medications I've mentioned here that he could put you on in order to get you off the Prednisone and still keep your asthma under good control.

Let me know what happens. I care because I've "been there, done that" IN SPADES!!

Regards,
******* (Carol)

 
Old 06-09-2012, 10:22 AM   #12
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Re: trying to stay off prednisone

Hi Carol
You have been through alot. I am glad your asthma has improved.

I have tried advair and singulair. I siwtched from advair to zenhale which I am not sure is working as well or not. I have tried singulair twice without any success. I think it helps some people and not others.
Along with zenhale, I take alvesco and spriva daily. I also use my rescue inhaler when needed and take flonase and reactine for allergies.

I take medications for acid reflux too. I started xolair injections last Feb which have improved things. I am just having a bad 2 months probably due to allergies.

I prefer not to take prednisone if I do not need too. I know I can go back to my doctor or one of his colleagues.

I am feeling better today but I just have to watch I don't do too much.

Thanks for all your ideas and suggestions.

 
Old 06-09-2012, 10:55 AM   #13
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Re: trying to stay off prednisone

Hi klynn1960,

Yeah, it HAS been a very tough roller coaster ride the last 30+ years with first the asthma, then the GERD and finally the osteoarthritis that required the double knee replacement surgeries! But I've learned a lot about health care because as I was going through all these crises, I made it my business to learn everything I could about my conditions.

Matter of fact, a nurse friend of mine suggested I take a program or class to get certified as a Medical Coder/Biller which is much in demand and a recession proof job. (Also, it can be done from home via the internet.) I just got approval from the NY State Dept. of Labor to take this class at my local BOCES school! (Board of Cooperative Educational Services). The Dept. of Labor is paying my way in FULL!!!

Since I've been out of work since January of 2011 due to my knee replacement surgeries a year apart, I realized the corporate world wasn't for me anymore. Been there, done that! So I was thrilled when my friend suggested the medical billing/coding profession for me. (The class starts in Sept. but I am going to start looking for a job in that profession that doesn't require certification right away. Now that I know I will be taking the course, I can mention that in an interview and maybe they'll hire me knowing that I'm pursuing certification.)

I digress.

You are right about the Singulair. For some reason the experts are not sure why, it doesn't work for every asthma patient. I have a high school classmate who lives in Arizona and she tried it a few years ago but said it didn't work for her.

Luckily for me, as I mentioned in my first post to you, Singulair has been one of my Godsend medications to keep my asthma in remission!

I understand how you feel about the Prednisone issue, but if you are REALLY having frequent and bad asthma attacks, don't refuse a short term "burst" course of its use to get you back under control. Your doctor will know how to wean you off it quickly once it does its job of getting you back under control.

The other thing you might ask your doctor to prescribe for you so you can treat your attacks without going to the E.R. is a nebulizer machine and albuterol with saline to use instead of your rescue inhaler when you are at home. (They also have portable nebulizer machines that run on batteries so you can keep it in your car should you need a neb treatment.) I have NEVER had to use the portable one - it's somewhere in a box in the back of my SUV! And I don't remember the last time I had to use the electric one at home since I've been in complete remission for years!

Just another tip for you to try.

Hope this helps.

Regards,
Carol

Last edited by ldy12; 06-09-2012 at 10:58 AM. Reason: punctuation correction

 
Old 06-09-2012, 01:14 PM   #14
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Re: trying to stay off prednisone

I was on a month of Prednisone after the allergy season came around. I'm getting off it now. The goal is to replace systemic steroids (prednisone) with inhaled steroids.

Inhaled steroids have very low systemic bioavailability, meaning they won't cause side-effects on the rest of your body.

Alvesco didn't really cut it for me, I started on Symbicort which helped a lot. While I was tapering off the prednisone my doc also added a once a day Budesonide nebulization.

Symbicort contains two medications. A long-acting Brocho-dilator (formoterol fumarate) and an inhaled steroid (budesonide).

Just double up on the budesonide and it'll help you stay off the prednisone. Again remember inhaled steroids aren't as bad as systemic steroids. granted they do have side effects, but they are usually confined to your lungs/throat/mouth as opposed to affecting your whole body.

Tell your doc to up your inhaled steroids for a while, possibly a month, and then it should all calm down.
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Old 06-09-2012, 01:55 PM   #15
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Re: trying to stay off prednisone

Hi kenanali - I want to point out that what you said in your next to last paragraph about "doubling up" the budesinide dose on your own is NOT recommended! You can cause cardiac problems if you take more than the recommended dose. A lot of asthmatics have a tendency to think that "if one puff of their inhaler is good, than two must be better." NOT TRUE!! And especially with a long acting time released beta agonist containing inhaler like Symbacort! It is intended for ONLY ONCE A DAY DOSING FOR A REASON!

Patients SHOULD NEVER take more than the recommended dose of these drugs on their own WITHOUT FIRST CONSULTING THEIR DOCTOR!! It can have very SERIOUS AND DANGEROUS CONSEQUENCES IF NOT TAKEN AS DIRECTED!!! Suggestion: Next time you see a commercial for Symbacort, listen EXTREMELY CLOSELY to the part that describes the potentially dangerous side effects and who should or should NOT take the drug!!!

Even though, after many years of living with asthma and being very medically sophisticated as I have become, I STILL CONSULT MY PULMONARY DOCTOR about any changes to my medication regimen, especially my Prednisone dosing!! (He knows I know how to taper it - though I'm in remission and haven't had to go up on my daily maintenance dose for years - but for special circumstances such as my total knee replacement surgeries last April and this year's March, I had to ask him how much extra to take the night before my surgery. Then my surgeon took over in Pre-op and ordered IV stress dosing during the surgery because I am totally immune suppressed.)

klynn1960 should follow her doctor's dosing instructions and NOT take more than the recommended dose of ANY of her asthma drugs on her own!!! It could cause a serious adverse cardiac reaction if she does that!

******* (Carol)

 
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