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  • How much more meds to control my asthma?

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    Old 02-17-2010, 09:02 AM   #1
    pljohns
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    How much more meds to control my asthma?

    I'm pretty new to the board and have been really struggling-in more ways than one. I've NEVER had any health problems other than migraines and now asthma. I'm having a pretty terrible time getting it under control because I've had such terrible allergic (literally life threatening) reactions to so many meds we've tried.

    I'm currently on TONS of meds and am finally making some progress, but I was curious if anyone else was on so many meds. Here's the growing list-
    Singulair tabs every morning
    Protonix every morning
    Alvesco inhaler twice daily
    Spiriva every morning
    Brovana neb twice a day

    I add Xopenex 30 min. before exercise and keep Ventolin as a rescue inhaler.

    They tried me on Advair and Symbacort-both with severe reactions. Thankfully I manage a dr. office and he was able to get me through both reactions with injections of epi and some oxygen for a while. It wasn't pretty.

    Before we added the Brovana, I was always right on the edge of a flair up and the least little thing sent me down to the point it too a medrol pack to get me back. At least with the Brovara, my peak flows are up almost 60 points and I don't seem to flair up nearly as often.

    I've had allergy testing and everything comes back clear. I keep a daily diary to find some of my triggers, which has been very helpful. I learned to do this with my migraines and just added the asthma to it. Cold weather and dust seem to be my biggest two.

    Is anyone else on this many meds? I"m just having a hard time dealing with all of this. I had enough over the weekend and just stopped taking everything. I know better, but I was fed up. Lessons learned-won't make that mistake again!

    Any feedback would be greatly appreciated.
    Lynn

     
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    Old 02-17-2010, 11:29 AM   #2
    Titchou
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    Re: How much more meds to control my asthma?

    Sorry you are having these issues. Do you also have GERD or acid reflux or a related condition? I am assuming that's what the Protonix is for. Has it been determined that these flare ups are not gastric related, since that seems to be in the mix?

    Can you drop the Xoponex or Ventolin and just use one for both situations? I use Albuterol for both jogging and rescue.

    Since you are in Birmingham where I live, are you seeing someone in the Pulmonary Clinic at Kirklin? My doctor is there and he is excellent - the one they always go to for info for TV and the paper when we have bad weather (back when we had the 2 weeks of 100 degree weather that Augst 2 years ago). He's also the one all the docs at UAB go to....

    Just some random thoughts...

     
    Old 02-18-2010, 09:07 AM   #3
    pljohns
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    Re: How much more meds to control my asthma?

    Thanks for the reply-I didn't realize you were in Birmingham also.

    The Protonix is for GERD. I have no symptoms of GERD, but my doc explained that you can have "vapor acid reflux" and not know it. He's throwing everything he can at my asthma and then we will back off of things one at a time. I'm only on the Protonix for 2 months-I hope.

    I can't use the Xopenex or Ventolin only-I've tried. The xopenex takes almost 30 min. to work on me-not good for a rescue inhaler! However, the ventolin takes less than 5, but doesn't last nearly as long for me as the xopenex. My karate class is 2.5 hours, so I need something that's going to last a while. That's why we do the xopenex as a pre-med and keep the ventolin for rescues.

    I don't currently see a pulmonologist. My GP said if this doesn't get it under control, then that's the next step. I've had an allergy screen done and it came back clear. The big problem is all of my drug allergies. Most of the time if I have a problem with a drug, it hits my lungs with bronchial spasma-not great with asthma! It's been trial and error for most of the meds we've found to work. What I have seems to work really well. Once the Brovana was added, my peak flows went from 470's to 560's. Since 450 seems to be my thresh hold for problems, that's a huge improvement. It's just a pain having to use a neb twice a day.
    Lynn

     
    Old 02-18-2010, 10:09 AM   #4
    Titchou
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    Re: How much more meds to control my asthma?

    In my never to be humble opinion, GP's just aren't trained for asthma - esp one that isn't easy to control. I see a great internist (on the Birmingham Magazine list of the best ones) but he didn't do much for mine and told me to go see someone else. At the time, I was married to a PhD on the UAB med school faculty and he found my current doc at Kirklin - Jim Bonner in the Pulmonary and Allergy Clinic there. I recommend him highly! I am allergic to everything they test for, have asthma and have a long haired cat. The cat sleeps with me now....and everything is under control. What more could I want?

     
    Old 02-18-2010, 09:12 PM   #5
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    Re: How much more meds to control my asthma?

    I'm on lots of asthma meds. I second the need to see a good Pulmonologist. When my asthma was first diagnosed and much more mild, my PCP was able to really help, but as it got worse, my Pulmonologist really helped. He also had me go back to my Gastroenterologist as well.

    I have asthma with environmental triggers that "typical" treatments usually get back into control when it flares. I learned after months of suffering that my "silent" reflux was triggering my asthma. Reflux can cause sthma and asthma-like symptoms by aspiration and by irritation. It took a significant increase and lifestyle changes to get my reflux back under control. In my case, the asthma and asthma cough are my only reflux symptoms. It took having several tests to convince me of this. My Pulmonologist had me do a Modified Barium Swallow and Esophagram which showed I was refluxing and they could see it hitting the lungs. I also had a 24 hr pH that showed my number and duration of of refluxing incidents. They did a Manometry also that showed my Lower Esophageal Sphincter wasn't closing properly and allowing the acid up.

    Even if you don't feel you have reflux, it is certainly worth looking further into, especially if you don't have any allergic triggers.

     
    Old 02-19-2010, 07:46 PM   #6
    KVC1
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    Smile Re: How much more meds to control my asthma?

    Hi Lynn
    I have been diagnosed with asthma then COPD with Emphysema and Seritide,{fluticasone propionate and Salmeterol} was prescribed as a preventer.
    after much thought and looking back on my symptoms I thought I was worse of using Seritide than I should be so I stopped using it and low and behold my symptoms went away. I am now breathing a lot easier and getting better every day.
    My peak flow is slowly going up where as before it was in reverse.
    What alerted me to my reaction to Seritide was the fact that each time I went to the USA I forgot my Seritide and only had my Ventolin with me. I found I never had to use the Ventolin while there.
    On my return to Australia I would start using Seritide again and I was short of breath again.
    This last time I went to the US,2008 summer, I took my Seritide with me and ended up in the ER of the local hospital with severe bronchitis.
    I researched the side effects online and bronchitis can be a side effect.
    As with your Alvesco it has the side effect of shortness of breath ,maybe try stopping the use of that for a few days and see how you feel.
    I still use my Spireva to relax my airways and have had no adverse reaction at this stage.

    Last edited by KVC1; 02-19-2010 at 07:49 PM.

     
    Old 05-26-2010, 09:15 PM   #7
    Wellok
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    Re: How much more meds to control my asthma?

    I've never had any medical problems, always said I was perfectly healthy. I too was diagnosed with migraine 6 moths ago and was diagnosed with mild asthma last week. I haven't had any symptoms since I quit smoking 4 years ago. My diagnosis was based off spirometry results. I take: ALvesco 80 mcg BID, Prilosec 20 mg daily, Omnaris 200 mcg once daily(this is the nasal form of Alvesco) and ALbuterol 30 minutes before excercise or acute attacks. Do not stop taking Alvesco abruptly. I missed a couple of doses and almost ended up in the ER due to chest tightnness. You are on a lot of meds. The Singulair I understand and the Alvesco I don't know why you are taking Spiriva too I think it does the same thing as Alvesco. You might want to ask your doctor to see if some of those can be tapered off it doesnt seem to be doing you much good. Also since you keep having all of those attacks with that medicine it seems like something is setting it off. It would be good to try and remeber if you were eating or exposed to something during that time. It sounds like you have an allergen or irritant setting you off all the time. I sincerely hope you get to feeling better!

     
    Old 05-27-2010, 11:32 AM   #8
    pljohns
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    Re: How much more meds to control my asthma?

    Thanks for the info and suggestions. I have now been to a pulmonologist who did a full pulmonary function test, looked at my labs and allergy panel and promptly announced that I have asthma. Great-tell me something I DIDN'T know! He agreed with all of my meds given my reaction to the combo drugs like Advair and Symbacort and sent my PCM a consult note that he agreed with the meds/dosage and that I should follow up with the PCM if I have any issues. Totally wasted afternoon and co-pay. I do know that from the allergy panel I'm not allergic to anything and it's now confirmed that I have moderate to severe asthma, so my meds need to stay the same.

    My PCM and I spent the month of April tweeking my meds just to see what I could and couldn't do without and promptly found out that the "coctail" that I'm on now seems to be what I need along with the dosage I"m currently on. We haven't tweeked anything since the end of April and aside from getting pneumonia, I've had a wonderful May. No major flair ups and am doing anything I want to. I think we've found the right meds now all we have to do is leave them alone.

    I too have missed a dose here and there of Alvesco and have problems. I've had more problems with the actuator on the Alvesco inhaler not working properly than anything. At least things are going well right now and we're going to leave them at that.

    Thanks for the info and help!
    Lynn

     
    Old 06-07-2010, 11:45 AM   #9
    My3sons5
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    Re: How much more meds to control my asthma?

    I am shocked that the pulmonologist sent you back to your PCM!!! Mine wanted to see me every month until I was well under control and then every 6 months when I had no flare ups what so ever. Get another specialist. If you have asthma you need to have a specialist around. Asthma does not just disappear and you will be shocked at the amount of times you will have nothing happen then you get slammed with problems. The specialist will know your history to help you the best!!

    Pulmonologists are good. Can also look for an asthma/allergy doc. That is who I have now, but had a pulmonologist for years before an insurance change.

    Last edited by My3sons5; 06-07-2010 at 11:52 AM.

     
    Old 06-07-2010, 02:27 PM   #10
    pljohns
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    Re: How much more meds to control my asthma?

    Well, after the un-eventful pulmonologist visit, I headed out to an allergy/asthma specialist. I didn't care for her much, but she helped me more than anyone has. I now have an action plan at least.

    Her asthma educator spent ab out 30 min. with me working out a plan for karate so I can return to it July 1. She put me on some new meds-Zycor or Zyflow-something like that. Anyway, it made me sick as all get out. After 3 doses, I quit and am feeling MUCH better again. I called her office today to let her know I got nailed with the side effects of nausea/vomiting and body aches. She also doubled my inhaled steroid dose and that has made a HUGE difference. The new meds were $606/month on top of my already almost $2000/mo bill. Not an option even if it hadn't made me sick.

    She wants to see me back in a month and I will have returned to karate by then so hopefully we can see how the plan works. All in all, I got more info from that visit than anywhere else. I also found out that she is with the group my PCM almost joined last year. No wonder he was so good to get me on the meds so quickly-his subspecialty is allergy/asthma. Anyway, we'll see how it goes.

    Lynn

     
    Old 06-16-2010, 09:05 AM   #11
    ruth988
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    Re: How much more meds to control my asthma?

    three meds, soup A, soup B, and lc balancer, and you will order in herbhealthon.

     
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