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question about asthma and meds


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Old 06-02-2003, 06:12 PM   #1
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Post question about asthma and meds

I'm "new" to asthma, and posted a few questions last week. People were very helpful. I've checked out 7 books on asthma from the library that are written recently to try to learn more about asthma. I'm still baffled, because ALL these books mention that asthma is a condition that is always in your lungs, but they mention having "attacks" that require meds. And if you start having them often, they put you on long-term medications. I find no reference to just having mild shortness of breath all the time. No cough, no wheeze. But the methacholine challenge test was positive for asthma, so the doc put me on Foradil and Pulmicort. I actually still do not know WHY. I don't doubt that I have asthma, but I'm wondering if that is the problem causing the shortness of breath. Does ANYBODY out there have only that symptom? No "attacks", no wheezing, no cough. I've been on these for one week now, and I find that my chest is a bit sore. Sort of like putting alcohol on a cut (just a little). I'm wondering if these meds are irritating my lungs. Is this normal for when you first start taking them? I also notice a bit of hoarseness to my voice, but I read about that on the internet, so I guess that is common. I did find out from reading these books that in the 90's, doctors changed their thinking on asthma. Instead of just treating you when you have an asthma attack, they like to put people on long-term medications to prevent the inflammation and possibly prevent attacks. They don't want permanent damage to your lungs because of asthma. So maybe my doc is just trying to be "pro-active". But if anybody has a comment about the meds making my lungs a bit sore, I'd like to know more about that. And what about the hoarse voice, does that go away?

 
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Old 06-02-2003, 10:02 PM   #2
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I had shortness of breath with my asthma, but also had tightness in my chest. There are many different types of asthma - some people have 'attacks' but are fine in-between, others cough, others wheeze, other like us simply have an on-going uncomfortableness with no 'attacks' to speak of. You tested positive but you may not be responding to the inhalers your doctor put you on. Many times it's a trial and error to find what works best for each individual. Some people get the hoarseness you have, but a different inhaler may not do that to you. I would suggest you call your doctor and have him try you on something else that may work better.

Good luck.

 
Old 06-02-2003, 10:18 PM   #3
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kellie2, thanks so much for your reply. So have you ever had an actual "attack" or just ongoing shortness of breath? According to my father, when I was very young (under 4) I used to wheeze real badly and they had to give me medicine to breathe. Was probably asthma. Then whenever I got sick as a young child and teenager, it was bronchitis. But then for 30 years, I didn't have much problem with my lungs. Then 3-4 months ago, I realized I just had a constant shortness of breath. So this is not at all what I would have considered asthma. My subconscious keeps thinking, "Yes, I believe I have asthma, but I don't think that is the problem right now." I'd love to hear from others who have basically this same story.

 
Old 06-03-2003, 10:08 PM   #4
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Yes, that IS the problem right now. You had asthma as a child, it's very common to come back when you're older. Fortunately the only symptom you have is shortness of breath. And trust me, THAT is asthma. And if you don't treat it, in a very short period of time you may find out just what all those books are talking about, because it's very common for mild asthma, which is what you have, to suddenly become moderate or severe and needing a whole lot of treatment. Don't try to talk yourself out of what is wrong at the risk of losing what good health you do have. There are many people with atypical asthma, meaning they don't fit into any book, or into that nice little cubby-hole that some writer says all asthmatics are in. Atypical is just that - NOT typical. Yes, your 'typical, common, everyday' asthma will have attacks so to speak. No, I did not have 'attacks', I had a constant shortness of breath and a tightness in my chest, and they went away with treatment. You have to remember that adult asthma is not going to be like children's asthma, which is very often attacks like what you're asking about. Asthma encompasses so many diverse symptoms, and not every one is going to be struck with the same ones. If you tested positive for asthma, which is something you already had anyway (from when you were little), than accept it and treat it, or believe me, you WILL get worse. If you are really intent on not accepting you have asthma again, then you may want to consider the other lung disease that will also cause shortness of breath - emphysema. And if your doctor didn't check you for that, you may want to ask him to.

 
Old 06-04-2003, 05:45 AM   #5
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Kellie, Thanks again for taking the time to reply to my questions. It is great to know that someone else has symptoms just like mine. You mentioned “not fitting in a nice little cubbyhole” and I had to laugh. That’s exactly what I said to my daughter! You said you underwent treatment and the symptoms went away. Are you still on a daily regimen of medications for this? About emphysema: when I went to this pulmonary doctor, I took my x-rays which my general doctor had ordered. The radiologist report noted “slightly hyperinflated lung fields and a flat diaphragm.” When the pulmonary doctor put the x-ray on his light box, he immediately said, “You have the lungs of a smoker. That is what emphysema looks like. Your lungs are too big for your body. And your heart is enlarged. It’s only supposed to be the size of your fist.” So I put my fist up to the x-ray and was trying to compare size. He sort of mumbled and turned off the light and took the x-rays down. He never mentioned the heart again. After they did the pft, he left a message on my answering machine saying it indicates “early stages of adult-onset asthma.” So I called him back. He finally returned my call 2 days later. I specifically asked if asthma would cause large lungs and he said no. I asked if allergies would do that and he said no. He again used the word “emphysema” and I was totally freaked. He said, “I’m not saying you have emphysema.” So the phone call left me with more questions than answers. After taking the methacholine challenge test the following week, I had another appointment with him. The lady who does the testing must have mentioned to him that I was upset about our lack of communication, because he was very terse when he came in. Like he was MAD at ME for something! He whisked through the appointment as fast as he could, barely answered my questions (and left me with more questions than answers). He basically said “You have asthma, take these 2 drugs and come back in 3 months.” No information, no reassurance, no explanation of WHY I’m taking the drugs and the expected outcome, etc. That’s why I’m out here on the internet begging for information and checking out library books trying to find out everything I can. And as you said, I’m not fitting into a neat little “cubbyhole”, so it leaves me with more questions!! By the way, I’ve never smoked, so he did order the alpha-trypsin blood test which shows if you have a genetic kind of “non-smoker’s emphysema” and it came back negative. I’ve been on these drugs (pulmicort and foradil) for 9 days so far, and don’t notice any difference. I’ve read that it can take several weeks for the steroid to make a difference, so I’m being optimistic. But I keep thinking about the “hyperinflated lungs”. When your lungs are large, they expand into the space your diaphragm is supposed to have to move up and down. I mostly feel like I just can’t take deep breaths. So maybe the hyperinflated lungs cause me to feel this way, and what is the cause of the hyperinflated lungs? I wish the doctor had addressed this issue, but he didn’t. This sure turned into a long posting!! Please let me know how long you were on meds before you noticed your breathing was normal, and what your current regimen is. And thanks again for your replies.

 
Old 06-04-2003, 08:50 PM   #6
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Quote:
I mostly feel like I just can’t take deep breaths. So maybe the hyperinflated lungs cause me to feel this way, and what is the cause of the hyperinflated lungs? Please let me know how long you were on meds before you noticed your breathing was normal, and what your current regimen is.[/B]
Oh boy, you really do have alot of questions. But what's strange is that, your symptoms and x-rays are identical to mine. First, not being able to take a deep breath is a common asthma symptom in adult-onset asthma. But because it's not your 'typical' symptom, many people who feel like this have trouble accepting the asthma diagnosis. I couldn't take a deep breath either, and I would find myself yawning alot just to try and get more air in. Very frustrating. In fact, I had this symptom linger longer than the chest tightness. I would also find myself sighing alot because I felt like I needed that extra oxygen. This was probably the last symptom to go. The chest tightness went, then the shortness of breath started easing off, then the sighing gradually went away, in that order. Honestly, it was months before I finally felt like my old self again. The initial chest tightness and panicky feelings started going away after a couple of months, but the others were there off and on probably for another 3-4 months. It takes awhile to get it under control so you have to be patient. I only use Advair twice a day, no rescue inhaler, and I'm on the lowest dose, 100/50. If you don't feel like you're getting any better, call your doctor and ask to be put on Advair for awhile and see if that helps. It's what my doctor calls the 'cadillac of inhalers', and it's been out now for maybe a couple of years, and almost everyone I know who has asthma is on it and is doing better than they ever did on anything else. But you may want to go back to your regular doctor as your respiratory doctor doesn't seem to be doing much for you. And any doctor can prescribe it.
As for your lungs, mine showed to look exactly like yours on x-ray - hyperinflated and flattened diaphram. And yes, when he said emphysema, it scared the hell out of me. But I smoked years ago and that's probably when it started, but it hasn't gotten any worse because I quit so it's not an issue. And no, that isn't what causes my breathing trouble, and it has nothing to do with yours, either. It's just 'there'. As to what would cause yours, I haven't a clue if you never smoked. Did you live with a smoker, or do some kind of work in your life that would have caused you to be breathing in something on a regular basis? If not, your doctor should have also said that you don't have to smoke to get emphysema, just like you don't have to smoke to get lung cancer. Anyone can get either of these, but smoking does raise your risk. You may simply be one of those who has it without being a smoker. But just because they see this in your lungs doesn't mean you're gonna be on oxygen next year They see the beginnings of it, it's there, it could have been there for years, and it may never get any worse. Even smokers who are diagnosed with it and then quit can pretty much halt it or slow its progression down to where they live just as normal of a life as anyone else for the remainder of their life. So please, don't let that x-ray scare you. If you like, you can always go back in every couple of years and have another breathing test done to see if it's maybe gotten worse or if it's the same as always. Your PFT will show this and would put your mind at ease.
Well, I hope I've helped you some. I know when I was diagnosed, I hit every website I could find to find out as much as I could about it. But I was also fortunate enough to find myself a wonderful pulmonologist with a bed-side manner you don't often see in doctors anymore. I just love him, and he has taken excellent care of me. In fact, when I first went to him, his goal in life was to make me better. And he did. You'll get better too, but you may need a different doctor to help you do that. Think about trying the Advair and see if it helps.

Let me know how you are, ok?

 
Old 06-04-2003, 09:46 PM   #7
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Kellie, I really appreciate your responding to my questions. We DO sound identical! You mentioned several things that I totally relate to: the yawning and sighing. I had never heard of “sighing” until the lady doing my pft mentioned it. She said every so often, EVERYBODY takes a deep breath called a “sigh” and it is perfectly normal. She noticed that I was doing it a lot. And I know what you mean about the yawning!! I do that! It makes you feel like you’ve taken a nice, deep breath! Also anxiety, boy do I relate to that. Almost 2 years ago, because of changes in my husband’s job, I got anxiety real bad. I would shake uncontrollably and couldn’t concentrate. I didn’t realize it was panic. The doctor put me in Paxil (an anti-depressant, but they found it works great on anxiety) and Buspar (an anxiety med). A few months ago, I decided on my own to wean myself off the meds and was pretty much down to a tiny sliver of Paxil and 1/6 the amount of Buspar I was supposed to take. I’m sure it was so little they weren’t doing anything. After my first appointment with the lung doc, I lay in bed that night shaking again. The thought of that awful anxiety coming back made me as anxious as the whole breathing thing!! When I went back the next week for the second doctor appointment, I mentioned this to him. He looked me right in the eye and said snidely, “There are doctors for that, you know. They’re called psychiatrists. Not that I’m saying you’re crazy.” What a totally insensitive clod! On the opposite end of the spectrum from your great doctor. This is a huge pulmonary practice with at least 10 doctors, so I asked the testing technician to please tell me which doctor is sympathetic and treats you like a person. She whispered the name of one of the other doctors, so that is who I will see from now on. I am so happy to hear that it took you several months to get back to normal. Here I am feeling anxious after 10 days wondering why this isn’t gone!! It is encouraging to hear from someone who has been there and come out fine. Now I have another question for you (are you surprised?). You said your doctor also mentioned emphysema. From what I read on the net and books, emphysema is when you actually start getting “holes” in your lungs. The only way to really see this is on a CT scan. Did you have that? Or was your doctor just referring to the overinflated lungs and flat diaphragm? And I wonder if the inflammation of asthma could cause them to be hyperinflated, and if they might get smaller once the inflammation is cleared up. Did you ever have another xray after your meds started working? How long ago did all this start for you?

 
Old 06-05-2003, 11:10 AM   #8
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<Emphysema is when you actually start getting “holes” in your lungs. The only way to really see this is on a CT scan. Did you have that? Or was your doctor just referring to the overinflated lungs and flat diaphragm? And I wonder if the inflammation of asthma could cause them to be hyperinflated, and if they might get smaller once the inflammation is cleared up. Did you ever have another xray after your meds started working? How long ago did all this start for you?>

My doctor only saw overinflated lungs and flat diaphragm on my x-rays, and what you also see are 'air pockets'. Is this what you're referring to as holes?

Yes, I had two CT scans - one was just a regular one, the other was a high intensity one, but they were looking for blood clots so if anything else was seen, they didn't tell me. I've also thought, as you do, that the over-inflated lungs could be from the asthma and the extra effort exerted to breathe for 2-3 months, as that's what actually causes the overinflation in emphysema patients - they struggle to get in more air and the muscles they use to do this, that's why so many of them have what is called a barrel chest. I'm not questioning my doctor on seeing it on my x-rays, but it's not what is causing my problem or yours, as emphysema is a disease with symptoms that begin so slowly that the patient doesn't know what's happening until they get worse. In other words, we wouldn't 'suddenly' start being short of breath all the time, it would start slowly like when you're doing something physical, you may notice that whoa, I'm a little out of breath. But even then, the disease has progressed quite a bit to even notice that. I've also read that it's a disease that usually starts in the 50's with symptoms so so mild that the person isn't aware there's something wrong. And then it progresses over the years if the person continues to smoke. But remember, the key word here is 'slowly'. The shortness of breath comes on so gradual that pateints don't know it's there until the disease has advanced. What you and I are experiencing is asthma shortness of breath, which is very different and not connected. And yes, our x-rays may show some changes in our lungs that are seen in the beginnings of emphysema, but geez, so does my sister's, so do a couple of my friends, so I'm not really concerned about it and please, don't you be, either. And no, I didn't have any more x-rays or CT scans done after I got better because there was no reason to, and I don't think it's good to be exposed to that much radiation. I was diagnosed with all of this a year ago, and I had all these x-rays and CT scans done within a 6 week period, so I'm none too anxious to have any more

 
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