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    Old 04-27-2005, 10:41 AM   #1
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    Finding a GOOD asthma/lung/allergy doctor

    I need some help in the area of finding new, GOOD doctors. The ones i go to, for whatever issue I have, don't seem to do much but talk, and prescribe medicine.

    This all started last year in May when I went to the ER for chest tightness and pain, they said I had bronchitis. They gave me albuterol and antibiotic, said to follow up with the regular doctor. I did, and by that time it was cleared up, but I decided to go to an allergiest too because I had suspected for sometime that I have allergies. He gave me a scratch test, determined that I'm allergic to grass, pollen, trees, dust, and mold spores (4 out of 5). This seemed to explain a lot of my issues, because my chest tightness would be mostly around on hot, humidy, and rainy days. But on dry days, I had issues too, so I guess those days it's more the pollen/dust.

    I've taken all the meds they prescribed...Allegra, Singulair, Nasacort. I tried Zyrtec for a few days too, but that didn't seem to make any difference one way or the other. I also was tested for GERD, which that doc determined I had, and HE put me on Protonix. I take all of this stuff daily, the albuterol "as needed" and STILL some days need to take Sudafed, tylenonl, whatever I think will work at the time.

    Basically, I kind of feel like all these allergy treatments have made me WORSE. I never had all these breathing issues that I do now...since that after the bronchitis. I wonder sometimes, what if I didn't go to the allergist, would I have gotten worse? Or have all these meds somehow made me worse? It sure seems that way to me.

    The thing that concerns me most is the asthma. The allergist doctor said I had it just based on my symptoms, but isn't there a way to TEST for it? I decided on my own to go to the lung doctor, to have a PFT. I told him my allergy issues, he scheduled the test. When I took it, I thought I did horribly, but when I spoke to the doc, he said it seemed pretty "normal" and that I should come back in August for a follow up, and do the PFT again next year. SO, I figured that meant my asthma wasn't all that bad. But then when I think about it, he didn't actually TEST for asthma either...or did he?

    Also, I've asked both the allergy doc and the lung doc about the peak flow meter thing. They both said they don't believe in it. Yet all I read about on the boards and every site I find, talks about how important that is. Why are these docs so against it? It seems like a reasonable way to test how you're doing.

    It's just so frustrating because I don't feel well 90% of the time, one day it's sinus issues, another day I'm clearing my throat all day, and other days I can't take a good deep breath. When I use the albuterol, it doesn't seem to work right away, and a lot of times I feel like it makes it worse before better. And the more doctors I go to, the more medicines I get, with no real answers or solutions.

    Last edited by Rain820; 04-27-2005 at 10:46 AM.

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    Old 04-27-2005, 12:55 PM   #2
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    Re: Finding a GOOD asthma/lung/allergy doctor

    I'd find a good need to sort all this out. If you need the sudafed, why not seitch to Alelgra D? Then you'll just have the one to take. And none of the precription stuff is a pain medication like the Tylenol is so that's a different issue altogether...why do you take it? Just for sinus headache? And the PFT is an ashtma test. If you had asthma, he'd have you on an inhaler daily so he evidently doesn't think you have it...that's a good thing. And allergies can make you short of breath so I wouldn't worry too much...he is a pulmonologist, right? You said "lung doctor" so I'm just trying to clarify. And if the albuterol doesn't work, then I would think it isn't asthma causing your problems...I know I'm rambling here but am trying to make sense out of it all.

    Old 04-27-2005, 01:42 PM   #3
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    Re: Finding a GOOD asthma/lung/allergy doctor

    That's OK I tend to ramble too...thanks for the response!

    I forgot to add that the lung doctor did put me on a daily inhaler, Qvar. He didn't think Singulair was good enough, but then when I went back to allergist, he seemed to think the Singulair was important too. So I'm doing both of those, two puffs of Qvar in the morning, and one Singulair at night before bed. That was another issue I had, why am I on two types of "preventive" asthma medicine, and STILL having days when I have issues?

    I mean, it makes sense to say that becuase I'm allergic to so many different things, that on any given day, things will affect me. One day it' sthe molds, another day it's the pollen, and yet another it's something else. It's hard to pinpoint exactly what is affecting me because how can you do that? I can't control the enviroment to say, "OK today I wasn't around any grass, so if I have issues, it must be mold. Or maybe, dust?" You know what I'm saying, I can't eliminate each thing completely to see if that helps, then add it back one by one, to see what affects me. Unless I seal myself off in a bubble for a few weeks, then let in some dust, grow some plants, haha. That sounds kinda fun, actually.

    Anyway, I realize that it's such a vast field, having allergies and asthma, but I just wonder sometimes if I should be trying different doctors and different meds.

    Oh yeah and the lung doctor is a pulmonary specialist. And the tylenol I mentioned because before I took sudafed, I would take Tylenol sinus for my head pressure, but then my sister said why bother taking that when Sudafed is just for the sinsus issues.

    Last edited by Rain820; 04-27-2005 at 01:44 PM.

    Old 04-28-2005, 09:19 AM   #4
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    Re: Finding a GOOD asthma/lung/allergy doctor

    The PFT doesn't test for asthma, but decreased lung function. The idea is if your lungs aren't functioning at their best, and you're asthmatic, the albuterol will help and your lung function will increase. I would ask for a copy of the PFT. The number most looked at is the FEV1, or air you can force out in a second. I would recommend going to a pulmonologist who works with asthma, if you want a good lung doc. Not a lot of asthmatics really need to be seen by pulmonologists, and a lot of pulmos work with people who have like cystic fibrosis and emphysema and other types of lung issues. There are people out there who specialize in asthma. I see one. :-D

    The gold standard test for asthma is a methacholine challenge. This is where they give you increasing doses of a substance (methacholine) that irritates asthmatics lungs. If you respond, your lungs are considered to be hyperresponsive.

    The two preventative medications you're taking are two different types of medications. Qvar works at the underlying inflammation in asthmatics lungs. Singulair works by targeting something called lukotrienes. Lukotrienes can cause trouble breathing and even allergy issues. Singulair is a medication for both asthma and allergies. The Nasonex decreases underlying inflammation in your nasal passages. Those with allergies sometimes have a condition called allergic rhinitis. This is what causes you to have nasal issues with your allergies. Allegra is your basic antihistimine.

    If you have sinus issues you may try a sinus rinse. The brand I like is NeilMed, but there are others out there (waterpik, etc). What these do is just rinses out your sinuses and gets all the junk outta' there. Since I've done these, I haven't had sinus issues. It's like gargling salt water when you've got a sore throat. Helps immensely sometimes.

    If your allergies are a really big issue you might think about immunology, or more commonly called allergy shots. They just put a bit of your allergen at a time in your arm and it can desensitize you to your allergies. (I had to go twice a week.) If that doesn't work, and you're still having issues, there is Xolair, which is a brand new medication. It's injected too. But right now it's expensive, and used for those with moderate to severe allergic asthma. Costs about ten thousand a year.

    Old 05-01-2005, 12:47 PM   #5
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    Re: Finding a GOOD asthma/lung/allergy doctor

    My asthma/allergy doctors have been getting better over the years (I've moved a few times, and I know what I am looking for in one now). Asthma and allergy specialists (with immunology, too) are usually the best. The one I have now is willing to listen to what I have to say during appointments, which is important, too. Singulair DOES make a difference for me. I can tell the next day when I have forgotten to take it the next day.

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