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ProbCVA 10-05-2012 05:25 PM

Trying to wean symbicort for cough variant asthma
I have a probable diagnosis of cough variant asthma and have been on symbicort for a year and a half. What are other's experience with weaning off (or at least down on) symbicort?

I have always been prone to prolonged cough after I get a cold. Before last year I had been treated once with Flovent for cough but had been fine for several years. I have allergies and take reactine and nasonex year round. Last year, I caught a cold during the worst of allergy season and ended up with a terrible cough. It was worse at night and would get so bad I would throw up. I've had this cough before and it is usually triggered by a viral illness. The cough was really harsh and would not settle so I convinced an after hours doc to start me on Flovent (which he wasn't convinced I needed). Usually when I get a cough it will last for weeks, but once it settles I won't have problems for a long time. After a month on Flovent my symptoms improved but I was still using ventolin almost daily. My doctor then put me on symbicort 200/6 2 puffs twice daily. I had PFTs done once my symptoms settled and they were normal. I haven't had a methacholine challenge so don't know for sure that this is asthma.

My problem is that I can't wean myself off the symbicort. I've tried going to one puff twice daily but always start coughing again. I'm surprised I can't get off the inhalers a I have always been fine between episodes before. I don't know if I just got used to feeling a bit tight and now that I know what it's like to not have the feeling I have no tolerance for feeling tight. I did notice that exercise was easier after starting the inhaler and even noticed that I had longer breaths during yoga. What is the experience of others with CVA?

tmwccs 10-06-2012 04:47 AM

Re: Trying to wean symbicort for cough variant asthma
I do have cough variant asthma and am on Spiriva and symbycort. I was told I might never be off them!

ProbCVA 10-06-2012 04:51 PM

Re: Trying to wean symbicort for cough variant asthma
I think I'm struggling a bit with this. I went from not needing any inhalers to not being able to function without inhalers in one step. It is especially hard because my PFTs are normal so I feel like I should be fine without the symbicort. I sometimes think I'm just being a hypochondriac and try to ignore the symptoms. Like today, I had a cough all day (to be honest I've been coughing for a couple of weeks but was trying to ignore it) and felt a little tight but I ignored it until I got home. I didn't think ventolin would help but took it when I got home just to see and I'm amazed what a difference it made. I'm not even sure when I should use the rescue inhaler. Do people use it for any symptoms or only when the symptoms start to interfere with life?
I'm starting to think I should go back to my doctor to ask about this.

tmwccs 10-06-2012 05:27 PM

Re: Trying to wean symbicort for cough variant asthma
The rescue inhaler should be used only when you need quick help with your breathing or congestion. The main reason for taking things like symicort and the like is so that you don't have to depend on your rescue inhaler. You shouldn't be using your rescue inhaler as a routine.

Also, the weed and grass pollen count has been nuts, especially here in the Midwest. This pollen is my main asthma trigger. You may find your cough getting better now that the pollen is lower.

When you see a pulmonologist they will set you up with an "plan" to help with the asthma attacks. Asthma is something you may never get rid of, so don't ignore breathing and coughing problems.

I feel much better now that I take daily medications to help. I almost never use my albuterol.

Good luck to you and know that there are many of us out here with the same problems.

ProbCVA 10-07-2012 04:32 PM

Re: Trying to wean symbicort for cough variant asthma
Thanks. Another question. When do people use their rescue inhalers. Since I don't wheeze I don't have a clear sense of whether there is a tolerable level of symptoms that don't need a rescue inhaler? For example coughing occasionally through the day. Right now my symptoms seem to be ramping up a bit but are still mild. I feel a little short of breath walking but it settles when I stop. As well I cough frequently but not uncontrollably through the day and don't have nighttime symptoms. I am taking my symbicort but don't really use the ventolin. Do others use their rescue inhaler for mild CVA symptoms?

tmwccs 10-07-2012 07:55 PM

Re: Trying to wean symbicort for cough variant asthma
Your pulmonologist will go over this in some detail. I use mine when I feel like I have something stuck in my throat that I can't cough up. I've never had a shortness of breath problem so you would have to get advice from someone else.

CVA can vary from having a tickle in your throat that wont go away to feeling like you have something in your throat that you can't cough out. I also have considerable hoarseness when I have an attack.

The rescue inhaler also helps to break up the heavy mucous in my throat besides helping breathing.

Capttom48 10-08-2012 10:05 PM

Re: Trying to wean symbicort for cough variant asthma
I also have cough variant asthma. Sometimes my coughing has caused me to black out briefly. The symbicort has made me much less sensitive to my triggers. Colds, smoke, fragrances and extreme heat or cold weather can set me off.

ProbCVA 10-09-2012 05:03 PM

Re: Trying to wean symbicort for cough variant asthma
Obviously I'm still trying to get a handle on this. At times I don't feel like I really have asthma because I don't have the traditional symptoms. This has lead to me ignoring changes in my cough. I've had increasing cough over the last few weeks but didn't think too much of it. Today however I noticed my chest felt different, kind of like my lungs vibrating (I don't know how else to describe it). I haven't felt this way since I started symbicort. I decided to be more liberal with the ventolin and couldn't believe how much mucus I started to cough up. I'm realizing I'm going to have to pay more attention to my symptoms to avoid a real flare. Unfortunately I can't get into my doctor this week (I'm out of town for the next few days) but will be trying to get in next week. I'm hoping this will settle down soon.

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