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Old 10-29-2012, 08:48 PM   #1
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Had to start Singular

I have been on symbicort 200/6, two puffs twice daily for a year and a half. I only realized I had CVA when I started a steroid inhaler last year, although looking back I've periodically been symptomatic for years. I would have described my symptoms as mild intermittent so am shocked that I haven't been able to wean off the symbicort. I start coughing if I even cut back to three puffs a day from four. In the last month I've been having a hacking cough that worsens with allergy exposures so my doctor has added singular to my treatment (I also use reactine and nasonex). I'm frustrated because I really thought I would be off meds once I settled the inflammation down last year and seem to be more symptomatic than before.
What is your experience with singular? Have you been able to wean off singular/symbicort once you've started them? Is anyone just using singular? I am in my forties and am trying to figure out what to expect with this.

 
Old 10-29-2012, 09:17 PM   #2
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Re: Had to start Singular

Once you have asthma, you will continue to have asthma. The question is how much you can get the symptoms under control and what it will take to do so.

I added Singulair to my Advair 500/50 years ago. I stayed on those for a very long time. Last year, I had some very good control of my asthma and weaned off of the Singulair first, then down off of the Advair. Unfortunately, we had some really really bad air that hit here a couple months ago and really flared my asthma so I had to go back on the meds. I just added the Singulair back about a week ago. I didn't find Singulair very effective by itself, but in conjunction with the Advair (Dulera now) I did find it very helpful.
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Old 11-21-2012, 05:51 AM   #3
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Re: Had to start Singular

I personally have never been on symbicort so I have no advice on that the singular I had a really bad reaction to though that involved me having tremors for 2 weeks straight... I had no problems the minute I came of it though but while on it it did help my asthma.

 
Old 11-21-2012, 06:06 AM   #4
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Re: Had to start Singular

I was originally put on just Singulair 3 years ago and it helped me a lot. My allergies were causing me to wheeze at night and the Singulair took care of it completely. Looking back I know now I had mild asthma back then, although I hadn't been diagnosed yet. Fast forward to last year, a bad case of bronchitis upgraded me to a much worse case of asthma and I was finally diagnosed accordingly. That is when I started taking Flovent in addition to the Singulair. I was hoping to be able to wean off some of my meds by now (they thought maybe my asthma was intermittent) but at this point I expect to be on both indefinitely. My asthma is not intermittent, it seems.

On the plus side, Singulair is now generic! It's free with my insurance.

 
Old 11-23-2012, 09:49 PM   #5
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Re: Had to start Singular

My symptoms have started to settle down. I'm finally at a point where I'm not carrying my ventolin with me everywhere I go. I'm still very aware of when the symbicort wears off and notice a difference if I take it late. I still feel like I'm coughing more now than I did before this all started last year, but maybe I'm just more aware of my cough.
I'm supposed to see my doctor in a few weeks to reassess the plan, but may wait a little longer to make sure I don't have any symptoms. My doctor had mentioned leaving me on the singular and weaning the symbicort, but the sources I've read don't recommend singular on it's own for asthma. I would like to not be on any meds but it seems like, between allergy and cold seasons I don't have a huge window to wean off meds. I've got my fingers crossed for next year though (consider it a New Year's Resolution). I also realized that my triggers include strong emotions. I felt myself getting tight and choked up when I was upset over something this week, but managed to calm myself down before things got too bad.

 
Old 11-24-2012, 06:07 AM   #6
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Re: Had to start Singular

I was also diagnosed with cough variant asthma in my 40's. It might take awhile before you finally get a grip on things and gain better control. In your quest to get off meds, it will help a lot if you can figure out what sets you off. You mention allergies, for me this was my main trigger, which would get my asthma going, and then once it was out of control, just about everything would make it worse. It took me some years to finally start stepping down my meds. I was on advair 500/50, singular, and then clarinex and nasacort for the allergies. Allergy shots for me were what eventually helped me get things under control enough to start stepping down the meds. I got down to advair 250, then 100, then down to flovent. The singular I don't take normally during seasons that dont cause me any problems (basically winter) Singulair was a huge help to me when added to the advair. It was key in stopping me having to stop after almost every syllable when talking to cough or try to supress a cough. I think it's all about finding the right combination for you. If you can get over the irritation over having to take so many meds, and having everyone at the pharmacy call you by name, and just focus on feeling better and getting the asthma under control, things will be better. The most important thing is to get the asthma under good control, where you are feeling normal for an extended period of time before decreasing your meds. Hope you feel better!

 
Old 11-24-2012, 08:52 PM   #7
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Re: Had to start Singular

Thanks,
I know I need to let go of weaning off meds, but easier said than done. I'm not the best patient and find it easier to give than to take advice. I keep thinking that I'm not as bad off as others who are taking the same meds or fewer meds than me, so logically (in my head, not in reality) I shouldn't be on the meds I'm on. I do think I ended up needing singular because I kept trying to wean the symbicort, so I am working hard to not toy with my meds for a few months and to speak to my doctor before I change anything. My problem is, as soon as the symptoms settle I think I've overreacted and exagerated my symptoms. However, this last flare has taken some time to get under control (even with perfect med compliance) so obviously I'm not being overtreated and just need to do what I've been told to do. Before all this, I believed that it wasn't asthma unless you wheezed, so think I'm still working to undo that belief. It has definitely taken me time to come to terms with this and I've only started to tell people I have asthma in the last couple of months.

 
Old 11-24-2012, 09:00 PM   #8
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Re: Had to start Singular

Quote:
Originally Posted by ProbCVA View Post
My symptoms have started to settle down. I'm finally at a point where I'm not carrying my ventolin with me everywhere I go. I'm still very aware of when the symbicort wears off and notice a difference if I take it late. I still feel like I'm coughing more now than I did before this all started last year, but maybe I'm just more aware of my cough.
I'm supposed to see my doctor in a few weeks to reassess the plan, but may wait a little longer to make sure I don't have any symptoms. My doctor had mentioned leaving me on the singular and weaning the symbicort, but the sources I've read don't recommend singular on it's own for asthma. I would like to not be on any meds but it seems like, between allergy and cold seasons I don't have a huge window to wean off meds. I've got my fingers crossed for next year though (consider it a New Year's Resolution). I also realized that my triggers include strong emotions. I felt myself getting tight and choked up when I was upset over something this week, but managed to calm myself down before things got too bad.
It seems strange that your Dr would want you to wean off the Symbicort and stick to just the Singulair. Unless your asthma is really mild, Singulair won't cut it on its own. Are you seeing your regular Dr, or a Pulmo? You might want to consider a Pulmonologist or Allergist if you haven't already. Your PCP doesn't always know a lot about asthma.

 
Old 11-24-2012, 09:03 PM   #9
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Re: Had to start Singular

Quote:
Originally Posted by ProbCVA View Post
Thanks,
I know I need to let go of weaning off meds, but easier said than done. I'm not the best patient and find it easier to give than to take advice. I keep thinking that I'm not as bad off as others who are taking the same meds or fewer meds than me, so logically (in my head, not in reality) I shouldn't be on the meds I'm on. I do think I ended up needing singular because I kept trying to wean the symbicort, so I am working hard to not toy with my meds for a few months and to speak to my doctor before I change anything. My problem is, as soon as the symptoms settle I think I've overreacted and exagerated my symptoms. However, this last flare has taken some time to get under control (even with perfect med compliance) so obviously I'm not being overtreated and just need to do what I've been told to do. Before all this, I believed that it wasn't asthma unless you wheezed, so think I'm still working to undo that belief. It has definitely taken me time to come to terms with this and I've only started to tell people I have asthma in the last couple of months.
I think a lot of us were in denial at first. I had convinced myself that I would be able to wean off my meds eventually, but it's been over a year and that's certainly not happening. It's hard to accept you have a chronic condition for which there is no cure, trust me. It took many months for me to accept it. The most important thing is to take care of yourself and listen to your body- even when it's telling you something you don't want to hear.

 
Old 11-25-2012, 08:48 AM   #10
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Re: Had to start Singular

Yes, I think it's funny my doc suggested singulair alone. I've read up on it and it is definitely not the standard. Considering that I can feel when the symbicort has worn off, I don't think I'm a candidate for being on singulair alone. I'm seeing my family doc, who has been giving good advice. I think she suggested the singulair on it's own because I've expressed interest in being off the symbicort. At this point, I think the first thing I would want to stop is the singulair though.
Denial is a funny thing. For me, I always thought that my cough was normal. Reading and hearing other's stories is helping me understand all of this and is helping me deal with my asthma. Things could definitely be worse, but I'm realizing a little prevention is much easier than trying to manage flares. I can't believe how long it can take to get things back under control once things flare. Will definitely take things a little more seriously now.

 
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Old 11-25-2012, 05:44 PM   #11
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Re: Had to start Singular

I would strongly suggest seeing a pulmonologist. I know that is a step towards fully accepting the asthma but I really think that would be helpful for you.

 
Old 11-27-2012, 06:32 AM   #12
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Re: Had to start Singular

I agree, I think you should consider seeing a specialist. It will give you more information about your condition. They do tests that your regular Dr can't and can give you more insight into what is going on. My primary care physician had me over medicated and I was able to work with a Pulmonologist to adjust my meds.

For me, it took a trip to the ER to take my asthma seriously and see a Pulmonologist. I wish I hadn't waited that long!

 
Old 11-27-2012, 05:42 PM   #13
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Re: Had to start Singular

Thanks,
I will talk to my doctor about seeing a pulmonologist next time I'm in her office. My plan is to get things stabilized for a few months then assess the plan with her at that time. I forgot to take my symbicort yesterday morning (slept in, rush to work) and can feel the effects of that missed dose, so obviously not keen on stopping that anytime soon.

Is it realistic to expect to be symptom free on these meds, or is it more realistic to have controlled symptoms? Right now I feel a little (just a little) tight but it's not enough to affect my activity or make me feel short of breath. Also I do cough once in a while (couple of times a day), but the cough never gets out of control and doesn't last long. I've had slow improvement of symptoms since starting the singulair, but still don't feel like I'm back to normal.

 
Old 11-28-2012, 12:11 PM   #14
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Re: Had to start Singular

It is reasonable to expect to be symptom free most of the time, but that can take a long time to accomplish. It was some years for me, med tweaks, allergy shots, etc. I am having some problems right at the moment, but otherwise I have been pretty much symptom free for most of the past 2 years. You really really have to be patient, and don't give up! I was lucky enough to have an allergist who kept telling me that I would eventually go back to feeling the way I had felt before I had the problems, and that really helped me keep going, but it was a hard time for me, feeling good for a few days and then feeling lousy again. Keep in close contact with your dr about your symptoms, it can really help if you write down each time you experience symptoms so that when you talk to your dr they will have an accurate picture.

 
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