Question:

Earlier I typed: No one knows.  I’ve even been tested for pertussis (neg) as one MD thought my son’s baby shots may have had something to do with this. Re-test for pertussis came back positive.  Finally, they can put a label on this horrific cough.  Thank you for all your very helpful and supportive emails!  I just hope no major damage has been done as a result of not being properly treated. Finally, finally, finally!   Now what to do with my closet FULL of various drugs?  Yard sale?  ;- Ruth, not losing her mind after all, CM

Congratulations on finally getting the correct diagnosis. Especially when a retest was required to diagnose the pertussis; most adult cases go undiagnosed. See: http://www.abcnews.com/sections/living/DailyNews/whooping0310.html Whooping Cough Explosion Excerpt: "Mistaken Identity In an effort to see just how common pertussis is, Guris and others have been studying people with coughs lasting longer than two weeks. Their research shows that as many as 90 percent of all whooping cough illnesses go undetected. In other words, up to 500,000 Americans could have the infection right now, but think it’s just a bad cold. "This is an enormous incidence rate that’s unrecognized," says Kaiser Permanente’s Shinefield, whose own study in 1996 had similar results. "There are more cases now than there were in 1945, before we had the vaccine." Part of the problem is that whooping cough in adults isn’t usually accompanied by the characteristic "whoop" that you hear at the end of the cough in children. The only symptom in teens and adults may be a cough that simply won’t go away. Whooping cough is easily treated with antibiotics. But all too often, doctors send patients home to wait out their "cold." That can pose a serious danger to infants, who are hit hardest by whooping cough because of their fragile immune systems."

Response:

Bill Ellis Fleenor: <snip You said you asked your doctors about allergies, what did they say?

Skin tests revealed, as the allergist called it, "A cheap response to dog" (not a concern in my house) and nothing else significant. <snip If not allergic asthma, then you shouldn’t be on antihistamines.

Yes, that makes sense. GERD (gastroesophageal reflux) is implicated in many cases of asthma. As a precaution, I elevate the head of my bed 6" with wood blocks and no meal withing 3 hr of going to bed. Severe cases of GERD also require drugs.

I’ve always had a very "strong" stomach.  Never any signs of heartburn or indigestion.  I mentioned it to the MD and he very quickly dismissed it.  He said, "No this does not sound like a GERD type of cough" (whatever that means) No one knows.  I’ve even been tested for pertussis (neg) as one MD thought my son’s baby shots may have had something to do with this. The pulmonologist and the asthma specialist both told me this was not asthma.  I still have a bunch of referrals to an ENT, and Infectious Disease MD (which seems silly considering normal bloods), orders for CAT scans, some sort of different lung diffusion test, more chest x-rays.  <sigh Very frustrating when no one can tell you what’s wrong with you. <snip Thank you very much for the info. Be well, Ruth CM – Hide quoted text — Show quoted text -Ellis

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Earlier I typed: No one knows.  I’ve even been tested for pertussis (neg) as one MD thought my son’s baby shots may have had something to do with this.

Re-test for pertussis came back positive.  Finally, they can put a label on this horrific cough.  Thank you for all your very helpful and supportive emails!  I just hope no major damage has been done as a result of not being properly treated. Finally, finally, finally!   Now what to do with my closet FULL of various drugs?  Yard sale?  ;- Ruth, not losing her mind after all, CM

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: Earlier I typed: : No one knows.  I’ve even been tested for pertussis : (neg) as one MD thought my son’s baby shots may : have had something to do with this. : Re-test for pertussis came back positive.  Finally, they : can put a label on this horrific cough.  Thank you for all : your very helpful and supportive emails!  I just hope no major : damage has been done as a result of not being properly : treated. : Finally, finally, finally! That is great news.  Good luck. : Now what to do with my closet FULL : of various drugs?  Yard sale?  ;- I believe the standard procedure is to dispose of all the medicines that have been partially used, and not needed* in the waste disposal.  There may be places which take donations for unused, unopened medicines (I have no idea where, though), otherwise, it would be safest that they go in the bin too. *make sure they are no longer needed first, though! Cheers, Kin Hoong

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- Hide quoted text — Show quoted text – I’m 36 years old and have just been diagnosed with asthma.  This all seemed to start after a bad head cold in March and I’ve been coughing ever since.  I’ve been to many different MDs and I have a closet full of medications all of which have had little or no effect in relieving this chronic cough, (with wheezing).  The cough seems to be aggravated by humidity. I had my first child in Oct ‘97.  I was just wondering if there could be a connection between the pregnancy and asthma. I had a C-section with an epidural.  The MDs have dismissed  my questions concerning any connections between pregnancy/hormones and the cough. I’ve taken Zithromax,  Cefzil, Augmentin, Biaxin, Prednisone,  (twice), albuterol, Nasacort, Vanceril, Vancenase, Atrovent, Serevent, Pulmicort Turbuhaler, Allegra-D, Benzonatate, Duratuss-DM, Tussionex, Triacin-C, Promethazine w/Codeine, and 7 nebulizer treatments.  All  since March ‘98.  With no real improvement. I’ve also asked if the cough could be related to: allergies, gastroesophageal reflux, (no signs of heartburn), bronchitus. CBCs have been normal.  Breathing tests have not clearly revealed asthma. I do have a history of sinus infections and post nasal drip, but, I have never had a cough for more than a couple weeks. Any suggestions?  Please email responses as I don’t read this newsgroup often. TIA, Ruth CM

If you’re not pregnant now I doubt there’s a direct connection with asthma. More likely the ‘cold’ you suffered in March was acute bronchitis and caused some lung damage leading to adult onset asthma. This happens fairly commonly. Postnasal drip from Sinusitis can lead to Cough Variant asthma; so the sinusitis would need to be controlled before the asthma would be. Irrigation of the sinuses daily with a saline solution can help to keep them clear. You said you asked your doctors about allergies, what did they say? You should be referred to an Allergist specialist to determine allergies; you were on promethazine, an antihistamine, so what ever doctor prescribed that must have thought you had allergies. Knowing what you are allergic to, if anything, can help you avoid it. If not allergic asthma, then you shouldn’t be on antihistamines. GERD (gastroesophageal reflux) is implicated in many cases of asthma. As a precaution, I elevate the head of my bed 6" with wood blocks and no meal withing 3 hr of going to bed. Severe cases of GERD also require drugs. You mentioned that ‘breathing tests’ do not clearly diagnose asthma. This indicates the need for more comprehensive breathing tests; the methacholine challenge test is the one to try. See: http://www.ama-assn.org/sci-pubs/journals/archive/inte/vol_157/no_17/… Interpretation of Positive Results of a Methacholine Inhalation Challenge and 1 Week of Inhaled Bronchodilator Use in Diagnosing and Treating Cough-Variant Asthma Asthma is a chronic disease that needs to be treated with asthma meds like Serevent and Pulmicort Turbuhaler, both of which you have been on. It sounds like you would benefit from learning more about asthma, and finding a good asthma doctor. A good book is ‘The Asthma Sourcebook’, Francis Adams, MD The local American Lung Assoc. has information, and in some cases can refer you to an asthma support group. Your ISP seems to be in the Rochester, NY area. Here is an asthma link: http://www.eznet.net/aarrc/ Allergy & Asthma Resource Center http://www.eznet.net/aarrc/services.htm Services for Rochester Community For Patients and Families (call 716-223-2880) There are lots of asthma/allergy links at www.njc.org and www.aaaai.org Ellis

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I’m 36 years old and have just been diagnosed with asthma.  This all seemed to start after a bad head cold in March and I’ve been coughing ever since.  I’ve been to many different MDs and I have a closet full of medications all of which have had little or no effect in relieving this chronic cough, (with wheezing).  The cough seems to be aggravated by humidity. I had my first child in Oct ‘97.  I was just wondering if there could be a connection between the pregnancy and asthma. I had a C-section with an epidural.  The MDs have dismissed  my questions concerning any connections between pregnancy/hormones and the cough. I’ve taken Zithromax,  Cefzil, Augmentin, Biaxin, Prednisone,  (twice), albuterol, Nasacort, Vanceril, Vancenase, Atrovent, Serevent, Pulmicort Turbuhaler, Allegra-D, Benzonatate, Duratuss-DM, Tussionex, Triacin-C, Promethazine w/Codeine, and 7 nebulizer treatments.  All  since March ‘98.  With no real improvement. I’ve also asked if the cough could be related to: allergies, gastroesophageal reflux, (no signs of heartburn), bronchitus. CBCs have been normal.  Breathing tests have not clearly revealed asthma. I do have a history of sinus infections and post nasal drip, but, I have never had a cough for more than a couple weeks. Any suggestions?  Please email responses as I don’t read this newsgroup often. TIA, Ruth CM

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Question:

It could be a mild case of asthma. Adult onset asthma following bronchitis is fairly common. Wheezing on exhale tends to indicate asthma. It comes and goes. Does it ever go away?

Assuming you have asthma, it’s probably the lowest category designated as ‘Mild Intermittent Asthma’. This can come and go depending on factors like air quality, and exposure to asthma triggers like allergens and irritants, viruses, cold dry air, etc. Adult onset asthma tends to persist. However I know a lady who came down with asthma following surgery with general anesthesia; her asthma went away after a couple of years. So time will tell. Ellis

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It could be a mild case of asthma. Adult onset asthma following bronchitis is fairly common. Wheezing on exhale tends to indicate asthma.

It comes and goes. Does it ever go away?

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Is there such a thing as an allergy which doesn’t respond to Benadryl? I had symptoms of bronchitis a few weeks ago which went away with an antibiotic. I was left with an occasional slight wheezing or whistling and a slight cough. I have clear lungs, and it feels like there is something with the bronchial area. The whistling/wheezing comes and goes, and only on a deep exhale, when I "force" it, and have a quick cough. Sometimes I don’t have it at all. I feel no obstructions, and xray shows everything clear. Benadryl didn’t do anything. Is this some asthma or what?

It could be a mild case of asthma. Adult onset asthma following bronchitis is fairly common. Wheezing on exhale tends to indicate asthma. I x-posted to alt.support.asthma Benedryl would not be used to treat asthma. Mild cases of asthma are treated with bronchodilators, like Ventolin inhalers. Moderate and Severe cases are treated with steroid inhalers and other drugs. Asthma is diagnosed using lung function tests. Lung function is measured using a spirometer, a bronchodilator like Ventolin is administered, lung function is remeasured. A 15-20% improvement tends to support the asthma diagnosis. X-rays are used to rule out TB and other lung diseases, not diagnose asthma. Ellis

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Question:

- Hide quoted text — Show quoted text – Recently have been having steadily worsening problems with my breathing, can barely catch a breath at most times, chest is *severely* tightand heart pounds strongly for no reason. Have been using bronchodilator (Ventilon) and steroid (Vanceril) combo for asthma prescribed two years ago by my Dr., but the benefits of these have been declining or haven’t worked at all lately.  Am going to see my MD at my HMO next week. What I’d like to know is what I should ask for in terms of a full cardio-pulmonary checkup, I’m not too knowledgable about this area. Last visit he mentioned getting a chest Xray which is fine, but I want to know what else I should ask for. I’d like to have my pulmonary output and oxygen/CO2 levels checked as well as possibly my heart in general, what tests are appropriate and might be suggested and which aren’t? I’d like to be as knowledgeable as possible so I can get the necessary testing done all at once and not have to keep going back if the problem increases, with the HMO cost-cutting I’m not sure they’ll automatically do the full complement of tests if I don’t ask for them. Thanks for any replies.

Short-acting bronchodilators like Ventolin are no longer recommended to be used on a regular basis for maintenance; only for ‘rescue’ or exercise. If you are using your Ventolin puffer more than once/day it indicates the need for more long-acting preventor drugs, in your case the Vanceril inhaler. Ventolin can cause heart palpitations in some. Vanceril is now available in a double strength version, Vanceril DS, which is what most people on this drug should be using, even for Mild asthma. For Severe asthma, even stronger steroid inhalers, Pulmicort and Flovent 220, are available. Sounds like you need a referral to a good asthma doctor; an allergist or pulmonologist specializing in asthma. And lung function tests to properly diagnose your lung condition, and rule out look-alike conditions. A spirometer lung function test would be the minimum to diagnose asthma; with lung function measured before and after administering a bronchodilator. A 15% improvement tends to confirm asthma. Also if you have allergies these should be evaluated so you can take avoidance measures. Lung function tests in a pulmonary function lab could be more definitive. Also recommended for most asthmatics is a Peak Flow Meter to monitor lung function at home, and an Action Plan to adjust meds based on Peak Flows. You might also need a referral to a cardiologist; and a treadmill test to rule out heart conditions. Ellis

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: x-no-archive: yes : Recently have been having steadily worsening problems with my breathing, can : barely catch a breath at most times, chest is *severely* tightand heart pounds : strongly for no reason. Have been using bronchodilator (Ventilon) and steroid : (Vanceril) combo for asthma prescribed two years ago by my Dr., but the : benefits of these have been declining or haven’t worked at all lately. Not sure if any of this is helpful… not even sure if it is 100% accurate, but… if your chest is severely tight, it is likely that your asthma is not well-controlled and it would be advisable to go see your doctor ASAP.  As for the heart pounding, well there are many causes for that, including the ventolin if you use too much and even (?) just the heart attempting to correct the oxygen shortage in your system.  Best to ask your doctor. :  Am going to see my MD at my HMO next week. What I’d like to know is what I : should ask for in terms of a full cardio-pulmonary checkup, I’m not too : knowledgable about this area. Last visit he mentioned getting a chest Xray : which is fine, but I want to know what else I should ask for. I’d like to have I really don’t know if asking for a full cardio-pulmonary checkup is a good or a bad idea, but you might want to ask about a peak-flow meter, if you have not got one already, assuming that you are not one of those people for whom these things are not useful.  Of course, if you want a full check-up, it might be an idea to get a referral to a good pulmonologist*.  You might want to know if you have any allergies too. As for the X-ray, I believe that it is generally used to rule out things which are not asthma, like TB. Cheers, Kin Hooong *Yes, yes, more expense, but then the pulmonologist specialises in lungs.

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Question:

Will I always have to use the inhalers if they find a particular allergin??

No, you will not necessarily have to use the inhalers.  You might, but it’s not a fact of life.  Thankfully, after some 5 years of treatment with Intal, and Albuterol, my asthma has seemed to go into remission. I wake up now with no problems, and don’t have any problems most days. Strong climate changes (like airplane trips etc…) will cause a slight problem for a day or two, then it settles down again. (albuterol usage less than once per week.) I really don’t know how long this will last, hopefully if I stay healthy, quite a while.  (Bronchitis set it off 6 years ago.)  I am still going to be seeing my doctor, to keep my prescription for albuterol going in case I need it, but boy is it a relief…  It’s been like this for a couple of months now, knock on wood… brian moffet  ( I can breathe again! — Brian. D. Moffet, speaking for myself. But you should know that

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- Hide quoted text — Show quoted text – Just found out today that this chronic cough I have had for a year is in fact Asthma.  It began last August after helping a friend clean a rental house using chemical cleaners.  Soon a cough developed that wouldn’t go away.  It was nearly every day but worse sometimes than others.  Slight shortness of breath on occasion.  The Dr. was pretty much baffled until I did some tests (pulmonary I belive it was) that showed percentages that led them to diagnose Asthma.  I am not using two inhalers—Proventil and Vanceril 2 puffs 4 times a day.  So far it is helping. My question is–would allergy testing do any good at this time?  Will I always have to use the inhalers if they find a particular allergin?? I hope that I will get used to using these inhalers as it does take time to wait the 1 min between puffs and then having to rinse and gargle. as I am using a non-spam return address above. Thanks so much,  Lynn Eberle

Note that Proventil (albuterol, short acting bronchodilator) is no longer recommended for use on a daily basis, only for rescue or exercise. Often a long-acting bronchodilaor is prescribed, either Serevent inhaler or theophylline sustained-release tablets (Theo-Dur). Allergy testing would usually only be done on a person with a history of allergies, eg hayfever, hives, eczema, allergic dermatitis. However consulting an allergist can be worthwhile, even if not allergic, as they generally know more about asthma than a GP. BTW, under my HMO, the way I got referred to an allergist was to indicate I wanted to take allergy shots. Allergists in general are better informed on asthma, both the allergic type and the nonallergic type. You could simplify your inhalation routine by switching to the new steroid inhaler Flovent 44, 2 puffs twice a day would replace your Vanceril 2 puffs x4. The reason for rinsing after using a steroid inhaler is to prevent a yeast infection in the mouth or throat. Ellis

Response:

Just found out today that this chronic cough I have had for a year is in fact Asthma.  It began last August after helping a friend clean a rental house using chemical cleaners.  Soon a cough developed that wouldn’t go away.  It was nearly every day but worse sometimes than others.  Slight shortness of breath on occasion.  The Dr. was pretty much baffled until I did some tests (pulmonary I belive it was) that showed percentages that led them to diagnose Asthma.  I am not using two inhalers—Proventil and Vanceril 2 puffs 4 times a day.  So far it is helping. My question is–would allergy testing do any good at this time?  Will I always have to use the inhalers if they find a particular allergin??

Allergy tests from a Specialist are warranted. I have allergic asthma to our cat. I am also allergic to dust, horses, dogs, and feathers. But the cat was the biggie. The cat is now gone. I keep improving everyday. The Doc says I may even be able to get off inhalers by September. Call a Specialist!

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My question is–would allergy testing do any good at this time?  Will I always have to use the inhalers if they find a particular allergin?? I hope that I will get used to using these inhalers as it does take time to wait the 1 min between puffs and then having to rinse and gargle.

My general attitude towards the allergy testing is that it can’t hurt and might help.  If you do identify a specefic allergen you can reduce your inhaler usage by simply avoiding that substance (this is easier for some things than others of course). ‘Reply to’ address changed to foil email spammers.

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Just found out today that this chronic cough I have had for a year is in fact Asthma.  It began last August after helping a friend clean a rental house using chemical cleaners.  Soon a cough developed that wouldn’t go away.  It was nearly every day but worse sometimes than others.  Slight shortness of breath on occasion.  The Dr. was pretty much baffled until I did some tests (pulmonary I belive it was) that showed percentages that led them to diagnose Asthma.  I am not using two inhalers—Proventil and Vanceril 2 puffs 4 times a day.  So far it is helping.   My question is–would allergy testing do any good at this time?  Will I always have to use the inhalers if they find a particular allergin?? I hope that I will get used to using these inhalers as it does take time to wait the 1 min between puffs and then having to rinse and gargle. as I am using a non-spam return address above.   Thanks so much,  Lynn Eberle

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Question:

A large part of my asthma consists of bronchial spasms.  These spasms are often painful and many times cause a dry, hoarse cough.  They seem to be worse in one area of my lungs.  Infections and allergies seem to trigger these spasms.  It does happen, but it’s always best to check with your doctor to eliminate any other possibilities.

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<snip Furthermore, the doctor upon a chest examination, has found a considerable amount of wheezing on my right side, but not my left. I seem to have all the other symptoms of asthma, ie. hard to breath, heaviness in my chest, alot of white, sticky phlegm coughed up. My inhilator works for about 4 hours, but then I have to take it again. However, I DON’T HAVE NOTICEABLE WHEEZING that I can detect when I breath (although the doctor can hear it with her stethascope). Can asthma be only one sided??? Oh, she has also taken a series of x-rays that have not shown anything abnormal. I am confused, any info. would be appreciated. You can e-mail me back if you’d like.

My son rarely wheezes when he’s having severe asthma problems. Once he’s in the hospital and getting better, the doctors start hearing wheezing with a stethoscope (as the airflow gets better). They can pinpoint specific trouble spots as he recovers — with the stethoscope and by seeing retractions between his ribs at those spots. His right lung always takes longer to recover. X-rays are usually done to rule out other problems. Asthma doesn’t show up at all in x-rays. Mary

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Jo, See if you can get some guaifenisen for thinning down the secrections.  It is the main ingredient in plain Robitussin cough syrup, but more potent in prescribed tablets (easier to go down too).  It is taken with lots of water, which alone may be of some help too.  I had pains that I thought were pneumonia, but the Fenesin (generic) took care of it.  Your doc should have offered it to you, Hope it helps you. <<Hi, My doctor has been preforming a number of tests to determine if I have allergy related asthma (pollen etc). However, I am sure as to whether I really do have this condition as I am experiencing terrible, sharp, stabbing pains on the right side of my chest as well as pain underneath my right shoulder blade. I have not experienced this pain on the left, (the pain is associated with breathing). Friends who have asthma have told me that they do not experience this sharp, stabbing pain and I was wondering if anyone else there has experienced this with their asthma??? Furthermore, the doctor upon a chest examination, has found a considerable amount of wheezing on my right side, but not my left. I seem to have all the other symptoms of asthma, ie. hard to breath, heaviness in my chest, alot of white, sticky phlegm coughed up. My inhilator works for about 4 hours, but then I have to take it again. However, I DON’T HAVE NOTICEABLE WHEEZING that I can detect when I breath (although the doctor can hear it with her stethascope). Can asthma be only one sided??? Oh, she has also taken a series of x-rays that have not shown anything abnormal. I am confused, any info. would be appreciated. You can e-mail me back if you’d like. Thanks, Jo Sue M.

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- Hide quoted text — Show quoted text – My doctor has been preforming a number of tests to determine if I have allergy related asthma (pollen etc). However, I am sure as to whether I really do have this condition as I am experiencing terrible, sharp, stabbing pains on the right side of my chest as well as pain underneath my right shoulder blade. I have not experienced this pain on the left, (the pain is associated with breathing). Friends who have asthma have told me that they do not experience this sharp, stabbing pain and I was wondering if anyone else there has experienced this with their asthma??? Furthermore, the doctor upon a chest examination, has found a considerable amount of wheezing on my right side, but not my left. I seem to have all the other symptoms of asthma, ie. hard to breath, heaviness in my chest, alot of white, sticky phlegm coughed up. My inhilator works for about 4 hours, but then I have to take it again. However, I DON’T HAVE NOTICEABLE WHEEZING that I can detect when I breath (although the doctor can hear it with her stethascope). Can asthma be only one sided??? Oh, she has also taken a series of x-rays that have not shown anything abnormal. I am confused, any info. would be appreciated. You can e-mail me back if you’d like. Thanks, Jo

There are 2 kinds of asthma; allergic asthma, and nonallergic asthma; plus some people have a combination of the 2 (I am one). Adult onset asthma is most commonly the nonallergic variety. Asthma is diagnosed using a spirometer; lung function is measured before and after using a bronchodilator, an improvent of 15-20% tends to indicate asthma. An asthma doctor can also use the shape of the flow curve to help make the diagnosis. Asthma usually involves wheezing or coughing (if mild you may not hear wheezing) The pain in the right chest does not sound like a typical symptom of asthma. Could it be stress related? If you have asthma and are using a bronchodilator inhaler, like Ventolin every 4 hours, you need to have long-term preventor meds prescribed. The primary drug for asthma is inhaled steroids; like Vanceril, Azmacort, Flovent. Asthma is an inflammatory disease, steroids reduce the inflammation of the bronchial tubes. You may benefit from being referred to a specialist, a pulmonologist or asthma doctor; difficult to diagnose asthma may require a visit to a pulmonogy lab for tests. Ellis

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Hi, My doctor has been preforming a number of tests to determine if I have allergy related asthma (pollen etc). However, I am sure as to whether I really do have this condition as I am experiencing terrible, sharp, stabbing pains on the right side of my chest as well as pain underneath my right shoulder blade. I have not experienced this pain on the left, (the pain is associated with breathing). Friends who have asthma have told me that they do not experience this sharp, stabbing pain and I was wondering if anyone else there has experienced this with their asthma???

Yes!  I have had nearly identical symptoms (except I have audible wheezing)– right down to the pain underneath my right shoulder blade. (the doctors I have seen have not put much credence in my "right side only" discomfort, btw) I have experienced a lot of relief from accolate and using proventil as needed — asthmacort actually seemed to make it worse.   I have had allergy tests which were all negative.  X rays showed nothing, unless my congestion gets so bad that it leads to pneumonia. My asthma seems to be triggered by exercise and stress (the hot weather doesn’t help) and has gotten worse over the last several years after a second bout of pneumonia)  My peak flow is usually normal, again except when the congestion is really bad.

Response:

Hi, My doctor has been preforming a number of tests to determine if I have allergy related asthma (pollen etc). However, I am sure as to whether I really do have this condition as I am experiencing terrible, sharp, stabbing pains on the right side of my chest as well as pain underneath my right shoulder blade. I have not experienced this pain on the left, (the pain is associated with breathing). Friends who have asthma have told me that they do not experience this sharp, stabbing pain and I was wondering if anyone else there has experienced this with their asthma??? Furthermore, the doctor upon a chest examination, has found a considerable amount of wheezing on my right side, but not my left. I seem to have all the other symptoms of asthma, ie. hard to breath, heaviness in my chest, alot of white, sticky phlegm coughed up. My inhilator works for about 4 hours, but then I have to take it again. However, I DON’T HAVE NOTICEABLE WHEEZING that I can detect when I breath (although the doctor can hear it with her stethascope). Can asthma be only one sided??? Oh, she has also taken a series of x-rays that have not shown anything abnormal. I am confused, any info. would be appreciated. You can e-mail me back if you’d like. Thanks, Jo

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Question:

I use Ventolin and Asthmacort and have been for several years.  For the past year, nothing seems to keep my asthma under control.  At the least, I always feel a tightness while breathing.  Every other night I wake up either early unable to breathe well, or just wake up at the regular time unable to breathe well.  So far, all my doc has done is suggesting more numerous puffs of the asthmacort.  It hasn’t helped.  I find myself waking up unable to take a large enough puff of Ventolin thus needing to take something like Primatene just to clear the breathing enough to take the ventolin and then the asthmacort.  This scares me as Primatene should not be combined with ventolin.  Usually, when I get to the doctor, he listens to my chest (remember I had to medicate just to make it to the doc) and says – doesn’t sound too bad and prescribes me some prednisone (which doesn’t help me much – and makes me feel depressed and emotional). Anyone else been thru this and found a solution? Yana

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Stop the Primatene mist immediately it is very unsafe. Stop the athsmacort and switch to flovent which can be described as a newer Asthmacort. Then you need to start the Flonase, Zyflo, and accolate. Also I would consider a 1000 or more miligrams of Slobid a day. That should help you. Adam Miller – Hide quoted text — Show quoted text -I use Ventolin and Asthmacort and have been for several years.  For the past year, nothing seems to keep my asthma under control.  At the least, I always feel a tightness while breathing.  Every other night I wake up either early unable to breathe well, or just wake up at the regular time unable to breathe well.  So far, all my doc has done is suggesting more numerous puffs of the asthmacort.  It hasn’t helped.  I find myself waking up unable to take a large enough puff of Ventolin thus needing to take something like Primatene just to clear the breathing enough to take the ventolin and then the asthmacort.  This scares me as Primatene should not be combined with ventolin.  Usually, when I get to the doctor, he listens to my chest (remember I had to medicate just to make it to the doc) and says – doesn’t sound too bad and prescribes me some prednisone (which doesn’t help me much – and makes me feel depressed and emotional). Anyone else been thru this and found a solution? Yana

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Hello.  I went through something similar.  I was up to 16 puffs a day of Azmacort, which helped, but not totally. I switched to Beclovent, 16 puffs a day which seems to work much better. I also started taking Intal, 8 puffs a day, and that was also a great help.  I now use my Ventolin about 5 puffs a week, sometimes none. Sometimes a switch in meds makes a difference.  The Intal was really what put me over the edge. One thing to remember is that these meds need time to work, like a good 6 to 8 weeks.  And you must take them religiously.  Now after several months I’m beginning to slowly taper off on the doses. Hope this helps.   Jim

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I had the same problem. I was going through a primatine inhaler ever 2 weeks since that was the only way I could get relief when I was not on high doses of prednisone. A few months ago, after some persistant requsts to my HMO, I was sent to a specialist who put me on Serevent, other day. I havent needed a rescue inhaler since and within a month had improved my breath tests from 35% of normal to 85%. I would suggest that you demand better medication until your asthma is under control. – Hide quoted text — Show quoted text – I use Ventolin and Asthmacort and have been for several years.  For the past year, nothing seems to keep my asthma under control.  At the least, I always feel a tightness while breathing.  Every other night I wake up either early unable to breathe well, or just wake up at the regular time unable to breathe well.  So far, all my doc has done is suggesting more numerous puffs of the asthmacort.  It hasn’t helped.  I find myself waking up unable to take a large enough puff of Ventolin thus needing to take something like Primatene just to clear the breathing enough to take the ventolin and then the asthmacort.  This scares me as Primatene should not be combined with ventolin.  Usually, when I get to the doctor, he listens to my chest (remember I had to medicate just to make it to the doc) and says – doesn’t sound too bad and prescribes me some prednisone (which doesn’t help me much – and makes me feel depressed and emotional). Anyone else been thru this and found a solution? Yana

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- Hide quoted text — Show quoted text – I use Ventolin and Asthmacort and have been for several years.  For the past year, nothing seems to keep my asthma under control.  At the least, I always feel a tightness while breathing.  Every other night I wake up either early unable to breathe well, or just wake up at the regular time unable to breathe well.  So far, all my doc has done is suggesting more numerous puffs of the asthmacort.  It hasn’t helped.  I find myself waking up unable to take a large enough puff of Ventolin thus needing to take something like Primatene just to clear the breathing enough to take the ventolin and then the asthmacort.  This scares me as Primatene should not be combined with ventolin.  Usually, when I get to the doctor, he listens to my chest (remember I had to medicate just to make it to the doc) and says – doesn’t sound too bad and prescribes me some prednisone (which doesn’t help me much – and makes me feel depressed and emotional). Anyone else been thru this and found a solution? Yana

It sounds like you have nocturnal asthma, and your asthma is poorly controlled. If Ventolin & Azmacort are your only meds, it sounds like your doc is out of date. The 1997 Expert Panel Guidelines II recommend the use of a long acting bronchodilator like Serevent or theophylline. Ventolin should only be used for ‘rescue’ or exercise. Also there are several other steroid inhalers which could be tried in place of the Azmacort, I would recommend Flovent (fluticasone). The Guidelines also recommend the use of a Peak Flow meter by the asthmatic at home, to monitor lung function; and an Action Plan for increase of medication when peak flows drop below 80% of personal best into yellow or red zone. This is all described in the book ‘The Asthma Sourcebook’ by Francis Adams, c96. Try another doctor, preferably an asthma doctor. Your lung function should be measured in the doctor’s office using a spirometer to verify asthma. (Spirometer plots flow versus time, shape of curve helps diagnose asthma) Regarding prednisone, going on it makes most people feel exhilarated, going off it is a downer. Its powerful stuff with bad side effects. Many people can stave off an attack using the new more powerful steroid inhalers like Flovent 220. The inhaler is still a steroid like prednisone, but the dose required is over a factor of 10 lower since it goes directly to the lungs.

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I use Ventolin and Asthmacort and have been for several years.  For the past year, nothing seems to keep my asthma under control.  At the least, I always feel a tightness while breathing.  Every other night I wake up either early unable to breathe well, or just wake up at the regular time unable to breathe well.  So far, all my doc has done is suggesting more numerous puffs of the asthmacort.

Azmacort seems to be a popular medicne when something stronger isn’t needed.  You need to talk to your doctor about getting your meds changed.  In fact you might think about talking to a different doctor. ‘Reply to’ address changed to foil email spammers.

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Thanks for all the advice I got.  I went to a new doctor today and he has put me on Serevent and is switching me over slowly to Accolate.  It was great!  He actually listened to me.  Anyway, he said that I just have to let him know if I am still having difficulties at night and we can try some other things or add another thing. All your advice was great.  It helped me tell him what I wanted to do. THANK YOU EVERYONE!!! Yana God laughing me into existence, and you, too, a joke to remember Haiku? by Ralph Wright

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Thanks for all the advice I got.  I went to a new doctor today and he has put me on Serevent and is switching me over slowly to Accolate.  It was great!  He actually listened to me.  Anyway, he said that I just have to let him know if I am still having difficulties at night and we can try some other things or add another thing.

You might also want to look at environmental factors.  I had problems until we cleaned the carpets (cat dander was in the carpet), and I also got some relief with a pillow cover and a HEPA filter.  The good side to these "treatments" is that they don’t require more medication, the bad side is that they only help somewhat (and only if you have allergy-induced asthma.) Good luck… Scott T

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Dear Yana: I am having accupuncture treatments and I don’t know it is that or the natural combo of supplements I am taking…but I have been using my inhaler less not in the height of allergy season.   Angel – Hide quoted text — Show quoted text – I use Ventolin and Asthmacort and have been for several years.  For the past year, nothing seems to keep my asthma under control.  At the least, I always feel a tightness while breathing.  Every other night I wake up either early unable to breathe well, or just wake up at the regular time unable to breathe well.  So far, all my doc has done is suggesting more numerous puffs of the asthmacort.  It hasn’t helped.  I find myself waking up unable to take a large enough puff of Ventolin thus needing to take something like Primatene just to clear the breathing enough to take the ventolin and then the asthmacort.  This scares me as Primatene should not be combined with ventolin.  Usually, when I get to the doctor, he listens to my chest (remember I had to medicate just to make it to the doc) and says – doesn’t sound too bad and prescribes me some prednisone (which doesn’t help me much – and makes me feel depressed and emotional). Anyone else been thru this and found a solution? Yana

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Question:

I have severy friends that have had Asthma all their lives.  They have told me about a whole food supplement made from Fruits and Veggies that has allowed them for the first time in their life to be free from meds and breathing equipment.  

If you are that confident in your product I expect that you will be happy to explain 1) what the ingredients are and 2) the theory behing how they work (unless of course the primary function of your herbs is to transfer money into your wallet). ‘Reply to’ address changed to foil email spammers.

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test

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I have severy friends that have had Asthma all their lives.  They have told me about a whole food supplement made from Fruits and Veggies that has allowed them for the first time in their life to be free from meds and breathing equipment.   I thought I would share this information with you.  You can call a 24 hour hotline number – 1800-624-7671 select option number 4 (I think) just list to the menu.  Acutally all the options are good.  Lots of information, If you are interested in any of the products or want information sent to you – call Natural Health Solutions at 1-800-484-2808 enter security code:  2255 when prompted.  Good Luck and have a happy and healthy life. Dee-St. Louis, MO

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- Hide quoted text — Show quoted text – Ive hade no side affects with Flovent 220 (8 puffs a day) though I have occational tremers from the Serevent. Question…I just started Serevent and Albuterol yesterday.(Just diagosed with asthma).  I noticed my hands shaking. Now I just read this note.  Is this a side effect of the Serevent?  Do I just accept it or notify my doctor? Beta 2 agonists (bronchodilators) like Serevent & albuterol can cause this but many people find that this side effect goes away after 2-4 weeks. Note, Serevent(slow acting) is used 2 puffs twice a day, no more, no less. Albuterol(fast acting) is used on an as needed basis for ‘rescue’ & exercise, probably no more than 1 or 2 puffs a day. You should also be using a steroid inhaler like Flovent 44, Vanceril, Aerobid, Azmacort, for long term control. "My doctor" that’s another problem.  I had Pulmonary Function Testing last week because of frequent boughts of bronchitis, which showed I have asthma.  However my doctor says that since she has never seen me gasping for air in her office, that I can only have very mild asthma and therefore should basically ignore it.Asthma is often much worse at night when the doctor’s office isn’t open. Some asthmatics don’t gasp or wheeze. The doctor should at least have a Peak Flow Meter in his office (ideally a spirometer) to test lung function.   She only gave me the meds because I pushed her.  The technician who took the tests said I should see a pulmonologist.  I have been taking Peak Flow Readings all week (before going to her about the test results), and I am consistantly in the yellow zone (middle to high). If you are in the yellow zone, you need to increase you puffs of the steroid inhaler, which controls the bronchial swelling.Its important to stay in the green zone.   She laughed at me and says this doesn’t matter and I shouldn’t even bother with the peak flow readings because they are useless. Actually she didn’t even know what the zones were about. She wouldn’t give me a referral to a pulmonologist because she says she can handle my "mild" asthma. From what I have read, her attitude is incorrect.  So what do I do? I have suffered from chronic bronchitis all my life. I KNOW that certain things bring on what I always thought was bronchitis.  Probably this has always been asthma.  She has never treated the bronchitis with much care either.  I want to change GPs, but how do I know I’ll get anyone any better?Your GP is definetly below average in her understanding of asthma plus she has a bad attitude. Try another GP, you could hardly do worse.   Am I just overreacting? NO  Is she right? NO Give me some feedback please.  Those who have been here before, give me your opinions. Christine (shihtzumom) You seem to be fairly well informed for somebody just diagnosed with asthma. Actually if you become well enough informed and have a doctor who will prescribe what you ask, it is possible to get by with a less than optimum doctor, not that I recommend this. The best book on the subject I have found is ‘The Asthma Sourcebook’ by Francis Adams, MD (a NY pulmonogist specialing in asthma), c96, Lowell House The book gives complete guidelines and medications for different levels of asthma (mild, moderate, severe) If you have allergies you could ask for a referral to an allergist, they generally know a lot about asthma. Also if you want to be tested for your allergies (so you would know what to avoid) and consider allergy shots, you should see an allergist. The 1997 ‘Expert Panel Report II: Guidelines for the Diagnosis & Management of Asthma’ (downloadable from the NIH web site) classifies asthma into 4 categories–Step 1 Mild Intermittent, Step 2 Mild Persistent, Step 3 Moderate Persistent, Step 4 Severe Persistent. If untreated you have symptoms <1 time/day, it is Mild, if you have daily symptoms, if is moderate or severe. Doctors in the US are advised to use these guidelines, your doctor is not up to date.

I received more info from Christine: " Hmmmm, now I’m confused again.  I finally talked my doctor into sending  me to a pulmonologist.  And I got the same treatment there. According to  him, my peak flow readings are just fine! Maybe I’m crazy.  The peak flow meter’s documentation says the peak flow for a 44 year old woman should be 463.  My readings are always under 370.  Anywhere from  300-370.  These are all yellow zone readings.  I have only reached 400 once in the past 2 weeks." Each person has a ‘personal best’ peak flow, depends on age, sex, height, race, etc. The table I have shows an average woman, age 45, has a peak flow of ", ", ", ", 75". The important number is ‘personal best’, not what a chart shows. You measure peak flow by blowing strongly 3 times, use the highest value. I can see why your doctor’s are skeptical, since your numbers could be in the normal range.Also peak flow numbers vary from one peak flow meter manufacturer to another. The point here is peak flow meters should not be used for diagnostic purposes. A spirometer should be used, you blow into it until all the air is out of your lungs & it plots the curve.An asthma doctor uses this to help diagnose asthma. Assuming 400 is your personal best, you don’t reach the yellow zone til you drop 20% to 320.   "I am only on serevent and albuterol." Usually an inhaled steroid, like Vanceril, would be prescribe with the Serevent. Asthma is an inflammatory disease, Vanceril directly treats the inflammation. Per Fig 1-3 Classification of Asthma Severity of the Expert Panel Report II, You would fit in the STEP 2 Mild Persistent or Step 3 Moderate Persistent category, actually more likely the latter. Quoting "Consultation with an asthma specialist may be considered because the therapeutic options at this juncture pose a number of challenging risk/benefit outcomes. There are at least 3 options for initiating step 3 therapy: *Increase steroid inhaler to medium dose, OR The short answer is get your doctor to prescribe a steroid inhaler like Vanceril, 2 puffs 3 or 4 times a day, or Flovent 44, 2 puffs twice a day are examples. " I was so disgusted with this doctor too that I finally walked out of his office. Oh, yeah, I kept my appointment with this pulmonologist even  though I have a bad case of bronchitis right now. I thought he might be  able to help me. According to him it is perfectly normal for all people to get bronchitis twice a year.  "Everyone gets it twice a year" according to this pulmonologist.  I’m sorry, but everyone does not get  bronchitis twice a year (or else what I have been getting all my life IS NOT bronchitis).  This is not "NORMAL". I cough until I puke…my ribs ache, my  throat hurts from all the coughing.  I cough and cough. Sometimes I think I’ll never get another breath I’m coughing so much.  I was so upset after seeing this "EXPERT" that I decided to stop taking everything.  If it’s "just me", then I don’t need these chemicals in my  system for nothing. My family doctor gave me Biaxin and Safetussin over the phone for the bronchitis, even though she was too busy to see me in the office.  The  Safetussin tastes like poison and does absolutely nothing.  So I’m spending a lot of time in bed trying to get my breath between coughing  spells.  Today was a little better, so I thought I’d check up on my e-mail….136 messages to download. Wow. Sorry for going on, but I feel totally frustrated. Thanks for your reply, maybe I’ll keep on checking it out.  Thanks for the info about the book too.  Christine (shihtzumom)  Shihtzumom SUMMARY 1. Try a steroid inhaler. 2. Buy ‘The Asthma Sourcebook" 3. Try to get a referral to an asthma doctor, usually your best bet here is an allergist rather than a pulmonary specialist. Sounds like you have ‘Cough variant asthma’ (no wheezing). See the Nat’l Jewish C. web page on Bronchitis at  http://www.njc.org/MFhtml/URI_MF.html

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I agree, find another Dr. ….try an asthma & allergy specialist. Sometimes even when I’m in ER with trouble breathing, the Dr says my lungs sound pretty clear (and I’m gasping for air). – Hide quoted text — Show quoted text – "My doctor" that’s another problem.  I had Pulmonary Function Testing last week because of frequent boughts of bronchitis, which showed I have asthma.  However my doctor says that since she has never seen me gasping for air in her office, that I can only have very mild asthma and therefore should basically ignore it. You need to change doctors.  You need to research a doctor and find one that specializes in asthma.  There are still doctors out there that believe that asthma is all in your head.  I am a severe asthmatic that doesnt experience wheeaing until I get below 275.  Until then I cough, my doctor doesnt hear me wheeze too often but that doesnt mean that I dont have asthma.

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Question…I just started Serevent and Albuterol yesterday.(Just diagosed with asthma).  I noticed my hands shaking. Now I just read this note.  Is this a side effect of the Serevent?  Do I just accept it or notify my doctor?

Let your doctor know _immedeatly_ if you suspect side-effects from any of your meds.  BTW, most people on Serevent are also on an inhaled steroid.  Serevent is a long-acting bronchiodialator, if you need this you should also be on an antiinflamitory med (please note that I am an asthma patient, _not_ a doctor – so talk to your Dr. about this). "My doctor" that’s another problem.  I had Pulmonary Function Testing last week because of frequent boughts of bronchitis, which showed I have asthma.  However my doctor says that since she has never seen me gasping for air in her office, that I can only have very mild asthma and therefore should basically ignore it.  She only gave me the meds because I pushed her.  The technician who took the tests said I should see a pulmonologist.  I have been taking Peak Flow Readings all week (before going to her about the test results), and I am consistantly in the yellow zone (middle to high).  She laughed at me and says this doesn’t matter and I shouldn’t even bother with the peak flow readings because they are useless. Actually she didn’t even know what the zones were about. She wouldn’t give me a referral to a pulmonologist because she says she can handle my "mild" asthma.

I don’t know your situation, but I suggest that you find another doctor.  If nothing else she should afree to allow you to get a second opinion. ‘Reply to’ address changed to foil email spammers.

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Ive hade no side affects with Flovent 220 (8 puffs a day) though I have occational tremers from the Serevent. Question…I just started Serevent and Albuterol yesterday.(Just diagosed with asthma).  I noticed my hands shaking. Now I just read this note.  Is this a side effect of the Serevent?  Do I just accept it or notify my doctor?

Beta 2 agonists (bronchodilators) like Serevent & albuterol can cause this but many people find that this side effect goes away after 2-4 weeks. Note, Serevent(slow acting) is used 2 puffs twice a day, no more, no less. Albuterol(fast acting) is used on an as needed basis for ‘rescue’ & exercise, probably no more than 1 or 2 puffs a day. You should also be using a steroid inhaler like Flovent 44, Vanceril, Aerobid, Azmacort, for long term control. "My doctor" that’s another problem.  I had Pulmonary Function Testing last week because of frequent boughts of bronchitis, which showed I have asthma.  However my doctor says that since she has never seen me gasping for air in her office, that I can only have very mild asthma and therefore should basically ignore it.Asthma is often much worse at night when the doctor’s office isn’t open.

Some asthmatics don’t gasp or wheeze. The doctor should at least have a Peak Flow Meter in his office (ideally a spirometer) to test lung function.   She only gave me the meds because I pushed her.  The technician who took the tests said I should see a pulmonologist.  I have been taking Peak Flow Readings all week (before going to her about the test results), and I am consistantly in the yellow zone (middle to high).

If you are in the yellow zone, you need to increase you puffs of the steroid inhaler, which controls the bronchial swelling.Its important to stay in the green zone.   She laughed at me and says this doesn’t matter and I shouldn’t even bother with the peak flow readings because they are useless. Actually she didn’t even know what the zones were about. She wouldn’t give me a referral to a pulmonologist because she says she can handle my "mild" asthma. From what I have read, her attitude is incorrect.  So what do I do? I have suffered from chronic bronchitis all my life. I KNOW that certain things bring on what I always thought was bronchitis.  Probably this has always been asthma.  She has never treated the bronchitis with much care either.  I want to change GPs, but how do I know I’ll get anyone any better?Your GP is definetly below average in her understanding of asthma plus

she has a bad attitude. Try another GP, you could hardly do worse.   Am I just overreacting? NO  Is she right? NO Give me some feedback please.  Those who have been here before, give me your opinions. Christine (shihtzumom) You seem to be fairly well informed for somebody just diagnosed with

asthma. Actually if you become well enough informed and have a doctor who will prescribe what you ask, it is possible to get by with a less than optimum doctor, not that I recommend this. The best book on the subject I have found is ‘The Asthma Sourcebook’ by Francis Adams, MD (a NY pulmonogist specialing in asthma), c96, Lowell House The book gives complete guidelines and medications for different levels of asthma (mild, moderate, severe) If you have allergies you could ask for a referral to an allergist, they generally know a lot about asthma. Also if you want to be tested for your allergies (so you would know what to avoid) and consider allergy shots, you should see an allergist. The 1997 ‘Expert Panel Report II: Guidelines for the Diagnosis & Management of Asthma’ (downloadable from the NIH web site) classifies asthma into 4 categories–Step 1 Mild Intermittent, Step 2 Mild Persistent, Step 3 Moderate Persistent, Step 4 Severe Persistent. If untreated you have symptoms <1 time/day, it is Mild, if you have daily symptoms, if is moderate or severe. Doctors in the US are advised to use these guidelines, your doctor is not up to date.

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I have been taking Peak Flow Readings all week (before going to her about the test results), and I am consistantly in the yellow zone (middle to high).  She laughed at me and says this doesn’t matter and I shouldn’t even bother with the peak flow readings because they are useless. Actually she didn’t even know what the zones were about. She wouldn’t give me a referral to a pulmonologist because she says she can handle my "mild" asthma.

Christine I’m pretty new to this chatgroup stuff and also to asthma self-management. I have been battling myself and the doctors to submit to all this medication. Thank God, the doctors I was led to at least were trying to figure out what was going on, and one even knew something about managing this. Of all the doctors I did go to, an internist, a pulmonologist, and an allergist, it was the allergist who was most knowledgeable and effective in treating my condition. I was in hospital for about 4 days in winter ‘95, that care being handled by the internist and the pulmonologist. It was the allergist who finally got me stabilized after about 2 months of being "sick" and not realizing it was asthma. Anyway, point is, lack of expertise in a given area is understandable, however.for your doctor to "laugh at you" over a life-threatening, potentially fatal condition, is outrageaous. I would suggest that you find a doctor who will at least take you seriously, as well as your condition. Your insurance should have some source through which you can change your primary care doctor. It shouldn’t have to get to this, but if need be, you can advise your ‘doctor’ that if you are making note of her indifference and lack of attention to a situation about which you are very concerned and if you do end up in hospital because of her refusal to adequately address these concerns, you will be holding her personally accountable for your condition, and you will be advising your estate of the same. She should be a little more cooperative after that. And like anything else, be an informed consumer. You can interview a doctor to see what experience s/he has had dealing with asthma. You have every right to ask the doctor questions about their training. And most important, see if s/he will listen to you, when you talk. By the way, my allergist swears by the Peak Flow Meter. And FYI, Serevent can make you ‘nerve-y’(it may also make you want to urinate more too -read those package inserts). A couple months ago, I passed out after taking 2 puffs of Serevent -complete black-out for several minutes. I had been on it for about 1 year. I told my allergist and he had me stop it. These medications are not for fooling around with, and definitely need close medical supervision, but they can also be the difference between life & death for an unstable asthmatic. The key is, be informed. Some of these news/chat groups can give you some pretty good info too. Anyway, I pray the Lord will lead you to the right doctor for you. Karen

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I would start looking for a new GP.  You may try contacting the local American Lung Association and see if they know of any docs in your area.  Good luck. — "Be good, and you will be lonesome.",   Mark Twain Michael A. Pease                                        

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"My doctor" that’s another problem.  I had Pulmonary Function Testing last week because of frequent boughts of bronchitis, which showed I have asthma.  However my doctor says that since she has never seen me gasping for air in her office, that I can only have very mild asthma and therefore should basically ignore it.

You need to change doctors.  You need to research a doctor and find one that specializes in asthma.  There are still doctors out there that believe that asthma is all in your head.  I am a severe asthmatic that doesnt experience wheeaing until I get below 275.  Until then I cough, my doctor doesnt hear me wheeze too often but that doesnt mean that I dont have asthma.

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"My doctor" that’s another problem.  I had Pulmonary Function Testing last week because of frequent boughts of bronchitis, which showed I have asthma.  However my doctor says that since she has never seen me gasping for air in her office, that I can only have very mild asthma and therefore should basically ignore it.

Not necessarily.  Virtually all my bad asthma attacks occur at night, usually between 10 PM and 4 AM.  So my primary care physician never gets to see me when I’m in real trouble, but my family has, and so has the local emergency room at the local hospital.  At one point, I even told my PCP I would be willing to get a camcorder and videotape one of my nighttime asthma attacks, just so he could see what is going on. Fortunately, I ended up finding another PCP instead who understands that asthma attacks can occur randomly, and often not when the doctor is around.   If your physician has any doubts, ask about having a methycholine challenge test.  That should bring on an attack while the doctor can see it. — Steven D. Litvintchouk                  "There seems to be no mainframe Disclaimer:  As far as I am aware,       in which we’re living." the opinions expressed herein                 — President Bill Clinton are not those of my employer.

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- Hide quoted text — Show quoted text -Current prescription medication:     Albuterol, Beconase AQ, Claritin, Flovent 44mcg, Nystatin, Tilade. Previous prescribed (1996) medication:     Accolate, Aerobid M, Beconase, cough medicine(!),     Flovent 220mcg, Flovent 110mcg, nothing(!) Why are you taking Nystatin?? It is an anti-fungal drug/ Please get a second or third (or more) opinion about your asthma. Michael J. Lim United States, Hawaii, Kaneohe

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Question…I just started Serevent and Albuterol yesterday.(Just diagosed with asthma)….   "My doctor" that’s another problem.  I had Pulmonary Function Testing last week because of frequent boughts of bronchitis, which showed I have asthma.  However my doctor says that since she has never seen me gasping for air in her office, that I can only have very mild asthma and therefore should basically ignore it.  She only gave me the meds because I pushed her.  The technician who took the tests said I should see a pulmonologist….  

Definitely GET ANOTHER G.P.   I had a similar problem that since I never wheezed in the office my (much better than yours) GP undertreated my asthma.  In my heart I knew this but hated to deal with another dr.  Since I did it has made all the difference.    Just because you don’t wheeze in the office does NOT mean your lung function isn’t seriously limited and does NOT mean your asthma is mild.    Also, if she were well-informed she wouldn’t have prescribed Serevent in all likelihood without ALSO prescribing an inhaled steroid drug.     Yes, if you are stuck with an HMO you will have to deal with some GP but though they do have a tendency to undertreat asthma I am sure that despite the hassle you can find a better one, even if it takes a couple of tries, than that!     You owe it to yourself, you can improve your life a whole lot.                                         Anne Peticolas                                         & Nicolette

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Question…I just started Serevent and Albuterol yesterday.(Just diagosed with asthma).  I noticed my hands shaking. Now I just read this note.  Is this a side effect of the Serevent? I pushed her. <snip The technician who took the tests said I should see a pulmonologist. always been asthma.  She has never treated the bronchitis with much care either.  I want to change GPs, but how do I know I’ll get anyone any better?  Am I just overreacting?  Is she right? Give me some feedback please.  Those who have been here before, give me your opinions.

http://www.snip.net/cbm/home.htm  Your hand shaking is a common side affect of both Albuterol and Serevent. With the questionable diognosis you should go to a pulmonologist for your own peace of mind and to verify your receiving the best medications for your situation.

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Ive hade no side affects with Flovent 220 (8 puffs a day) though I have occational tremers from the Serevent. Question…I just started Serevent and Albuterol yesterday.(Just diagosed with asthma).  I noticed my hands shaking. Now I just read this note.  Is this a side effect of the Serevent?  Do I just accept it or notify my doctor?

It could be a side effect, but it never hurts to keep your dr. informed so they can figure out side effects. "My doctor" that’s another problem.  I had Pulmonary Function Testing last week because of frequent boughts of bronchitis, which showed I have asthma.  However my doctor says that since she has never seen me gasping for air in her office, that I can only have very mild asthma and therefore should basically ignore it.  She only gave me the meds because I pushed her.   [cut] … Actually she didn’t even know what the zones were about. She wouldn’t give me a referral to a pulmonologist because she says she can handle my "mild" asthma. From what I have read, her attitude is incorrect.  So what do I do?

I’ve never heard such a pathetic bedside manner (even the doctor from "Voyager" was better).  You probably want a second opinion (that sounds less permanent than "changing doctors", and might be more acceptable to your HMO.)  You may only have a mild case of asthma, but any doctor who laughs at you when you present them with hard evidence of a problem has room for doubt. either.  I want to change GPs, but how do I know I’ll get anyone any better?  Am I just overreacting?  Is she right?  

You’d be hard pressed to find someone worse, and you have nothing to lose except some time and money if you switch, or your health if you stay with a doctor that doesn’t listen. Your call.  Good luck! Scott T.

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Okay, here’s a weird question. I am of course, an asthma suffer and I have been wondering if a person with asthma who has a lower PFT than the general population, let’s say 50% or 60% range, will reach anaerobic exercise levels sooner (at a lower than normal heart rate) than someone with normal PFT. Here’s my rationale. If my PFT is 50% I am basically using one lung to support my blood’s need for oxygen. This means that my heart will pump that much harder to deliver the same amount of oxygen. In turn, does this make it harder for people with asthma to burn fat when they exercise? A few years ago when I was running 20 miles a week my PFTs were in the 90s and I was thin. Now my PFTs are in the upper 40s and I am 20 pounds heavier and although I have been getting back to the gym a few times a week, and of course watching the diet, I am finding that the weight is not coming off very well. Could the two be linked? And will an increased PFT (see note on flovent) make it easier for me to burn fat when I do exercise? I suppose this is a question for an exercise physiologist, but I think it’s an interesting one. Any ideas?

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I am a personal trainer with asthma, and I really don’t think that there is any relation to the two.  I would look for dietary changes, and any medication that may cause weight gain.  Oral steroids cause weight gain, that is for sure.  What I would do is to monitor my calorie intake and check out what else could be different this time, than last.  I will ask my Doctor about this. val

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- Hide quoted text — Show quoted text – Okay, here’s a weird question. I am of course, an asthma suffer and I have been wondering if a person with asthma who has a lower PFT than the general population, let’s say 50% or 60% range, will reach anaerobic exercise levels sooner (at a lower than normal heart rate) than someone with normal PFT. , I am finding that the weight is not coming off very well. Could the two be linked? And will an increased PFT (see note on flovent) make it easier for me to burn fat when I do exercise? <snip

Im on Serevent, Flovent and Accolade and undergoing a similar temporary (one month) treatment for the same reason ( to improvwe my FEVs) however, my HMO prescribed the cheaper Sulfa and Deltasone for this purpose. Ive hade no side affects with Flovent 220 (8 puffs a day) though I have occational tremers from the Serevent. I also experience weight gain when on predisone, 20# so far, even though Im able to exercise more. I think the reason for this has to do with fluid retention and a change in medabolic rate.  In the past I’ve found it’s difficult to loose the extra weight, even by dieting, probably do to the high does of inhaled steroid. The added weight has always eventually come off, however. Fred   Fred

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This has probably nothing to do with your question but….to start with, I am not asthmatic, my daughter is, but while I was pregnant with her, I was taking ventolin orally, to stop premature contractions.  I found that I was eating  a lot, on bed rest (all the time) but I didn’t gain any weight.  I found that the ventolin made me really jumpy and on edge, and extremely hungry.  My daughter prognessed and gained weight but I gained about a pound during my entire bed rest situation. ( I ate a lot…it was over Christmas, and I can remember eating many boxes of chocolate…normally all I have to do is look at chocolate and I gain weight.)  Now that I no longer take ventolin, I have normal weight gain…to bad. Like I said, this probably doesn’t have much to do with your question, but you may find interesting, then again, maybe not! – Hide quoted text — Show quoted text – Okay, here’s a weird question. I am of course, an asthma suffer and I have been wondering if a person with asthma who has a lower PFT than the general population, let’s say 50% or 60% range, will reach anaerobic exercise levels sooner (at a lower than normal heart rate) than someone with normal PFT. Here’s my rationale. If my PFT is 50% I am basically using one lung to support my blood’s need for oxygen. This means that my heart will pump that much harder to deliver the same amount of oxygen. In turn, does this make it harder for people with asthma to burn fat when they exercise? A few years ago when I was running 20 miles a week my PFTs were in the 90s and I was thin. Now my PFTs are in the upper 40s and I am 20 pounds heavier and although I have been getting back to the gym a few times a week, and of course watching the diet, I am finding that the weight is not coming off very well. Could the two be linked? And will an increased PFT (see note on flovent) make it easier for me to burn fat when I do exercise? I suppose this is a question for an exercise physiologist, but I think it’s an interesting one. Any ideas?

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Ive hade no side affects with Flovent 220 (8 puffs a day) though I have occational tremers from the Serevent.

Question…I just started Serevent and Albuterol yesterday.(Just diagosed with asthma).  I noticed my hands shaking. Now I just read this note.  Is this a side effect of the Serevent?  Do I just accept it or notify my doctor? "My doctor" that’s another problem.  I had Pulmonary Function Testing last week because of frequent boughts of bronchitis, which showed I have asthma.  However my doctor says that since she has never seen me gasping for air in her office, that I can only have very mild asthma and therefore should basically ignore it.  She only gave me the meds because I pushed her.  The technician who took the tests said I should see a pulmonologist.  I have been taking Peak Flow Readings all week (before going to her about the test results), and I am consistantly in the yellow zone (middle to high).  She laughed at me and says this doesn’t matter and I shouldn’t even bother with the peak flow readings because they are useless. Actually she didn’t even know what the zones were about. She wouldn’t give me a referral to a pulmonologist because she says she can handle my "mild" asthma. From what I have read, her attitude is incorrect.  So what do I do? I have suffered from chronic bronchitis all my life. I KNOW that certain things bring on what I always thought was bronchitis.  Probably this has always been asthma.  She has never treated the bronchitis with much care either.  I want to change GPs, but how do I know I’ll get anyone any better?  Am I just overreacting?  Is she right?   Give me some feedback please.  Those who have been here before, give me your opinions. Christine (shihtzumom) — "At ease, Ensign, before you sprain something" — Janeway (Caretaker) Shihtzumom http://www.snip.net/cbm/home.htm

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Question:

Evidently, asthmatics can’t do scuba diving but then he asked if I already had my scuba certificate.  Evidently, if I did have it I could but since I don’t I can’t. A friend was told she couldn’t scuba dive either but she could do research on a ‘deep’ diving submarine. Does anyone on the list with asthma scuba dive?  Does anyone know anything about this?  Is the difference breathing through the tube, the air mixture, or something else?  Any references/reading material that I could refer to?

This seems really weird to me.  Are you being told asthmatics can’t (physically) scuba dive or is it a legal issue in that people hesitate to issue you certificatation to scuba dive? — Kathie Sindt

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: This seems really weird to me.  Are you being told asthmatics : can’t (physically) scuba dive or is it a legal issue in that : people hesitate to issue you certificatation to scuba dive? It is a medical/physical safety issue. <please see my previous post on the subject.  Liability may enter ito it in terms of certification, but it is fundamentally a safety issue. SW.

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I find this diving discussion quite interesting as I tried to get into Scuba training last year and was turned down by three different schools – However, one school agreed and said that I would be placed on one-to-one supervision during all my classes in the pool with a group (with the rest of the diving students being supervised by two instructors ).  They still, however, required a physician (specializing in diving certification) to give an okay – guess what ! He refused and called the school to ensure that I was not permitted into any diving classes due to my asthma (I must admit that my asthma is relatively severe so it may be different for mild asthmatics ?) : : This seems really weird to me.  Are you being told asthmatics : : can’t (physically) scuba dive or is it a legal issue in that : : people hesitate to issue you certificatation to scuba dive? : It is a medical/physical safety issue. <please see my previous post on the : subject.  Liability may enter ito it in terms of certification, but it is : fundamentally a safety issue. Few schools will be willing to accept responsibility for asthmatic divers – there is simply too much that can go wrong. That has been my experience anyway, Amber

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        I run a Pulmonary Function lab and have used cold, dry air (the same as you’ll get from a scuba tank) to diagnose asthma.  Cold, dry air will cause bronchoconstriction in most asthmatics (medical literature implies 85% of asthmatics will respond.  A doctor I work with uses cold air challenges almost exclusively to charactarize responses to different asthma medications/treatments).  This is a good reason not to scuba dive if you know you have asthma. I was an avid diver until I had an asthma attack 85 feet down.If it hadn’t

been for my husband being on the alert and recognizing that something was wrong,I would most likely be dead.My pulmonologist said that if I continued to dive,that I risked pneumothorax(blowing your lungs out).For me it is not worth the risk. Colleen the respirtory therapist and fellow asthma sufferer.

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        I run a Pulmonary Function lab and have used cold, dry air (the same as you’ll get from a scuba tank) to diagnose asthma.  Cold, dry air will cause bronchoconstriction in most asthmatics (medical literature implies 85% of asthmatics will respond.  A doctor I work with uses cold air challenges almost exclusively to charactarize responses to different asthma medications/treatments).  This is a good reason not to scuba dive if you know you have asthma.

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Hi, I just talked to my doctor about the possibility of scuba diving and now I’m confused.  I’m borderline asthmatic with allergies (I haven’t taken the ?? challenge test because I just can’t face having a full blown attack just to be sure.) Evidently, asthmatics can’t do scuba diving but then he asked if I already had my scuba certificate.  Evidently, if I did have it I could but since I don’t I can’t. A friend was told she couldn’t scuba dive either but she could do research on a ‘deep’ diving submarine. Does anyone on the list with asthma scuba dive?  Does anyone know anything about this?  Is the difference breathing through the tube, the air mixture, or something else?  Any references/reading material that I could refer to? Gayle Providence, RI 02912

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: Evidently, asthmatics can’t do scuba diving but then he : asked if I already had my scuba certificate.  Evidently, : if I did have it I could but since I don’t I can’t. A : friend was told she couldn’t scuba dive either but she : could do research on a ‘deep’ diving submarine. Most diver certification programs prohibit asthmatics form going through the course as they are not medically cleared to do so [automatic disualification; just as you can never be a pilot...].  Asthmatics who are already certifie are not SUPPOSED to dive, but once you are certified you are certified and there is nobody to take the certification away from you…  I.e. chances are nobody can stop you so it;s your choice. : Does anyone on the list with asthma scuba dive?  Does : anyone know anything about this?  Is the difference : breathing through the tube, the air mixture, or something : else?  Any references/reading material that I could : refer to? There are multiple problems.  One is, if you are down and have an attack you are in trouble — you can’t take meds an to take meds means you have to come upto the surface; depending how far down you are you may ot be able to do with quickly.  Also, asthmatics tend to have a problem with trapping air — in severe attacks this can often be seen on X-rays — and trapped air on ascent can lead to all kinds of dangerous medical conditioan,s and CAN be fatal.  For some of the same reasons that people with colds are not supposed to dive, nor are asthmatics.  <remember that as you go down air compresses and as you go up it expands, trapped air will expand as you come up, often with VERY nasty consequences. Also, you in an attack at depth is a danger to your dive buddy and the others who are in your group; not only will they have to care for YOU, but you won’t be able to help THEM if something goes wrong. The next problem has to do with breathing compressed air — it is cold and dry.  If you know anything about Exercise-Induced Asthma, you will know that for EIA the theory is that the cooling or the drying of air is what results in EIA attacks.  Scuba diving is physically intensive exercise, and when you then breath dry cold air, you are setting yourself up for the posibility of an EIA or otherwise attack. Next problem:  with allergies, one often ends up getting fluid in their ears.  In my cae, it got severe enough that my eustachian tubes collapsed; as someone with a cold I would not have been wise to dive with fluid in my ears, but with collapsed eustachian tubes I had a further problem — I was unable to equalize the pressure in my middle ear; while this is normally rather painful, while diving it could become excruciatingly so, and could also lead to a ruptures eardrum.  As it was, I had to have tubes placed through my eardrum in order to drain teh fliu so I woudl stop having midle ear infections and so that the eustachian tube woudl hopefully heal and stopbeing collapsed.  So, depnding on how severe and what the symptoms are of your allergies, you may have problems witha ht too. So, in short, just as one with a coldshouldnotbe diving, one with certain alergy symptoms and asthma should not be [the virus causing the cold is not the problem, the ear problems, sinus and chest congestion, coughing, etc ARE].  While people with cods have sucessfully dived before, so have people with old died because they dove while ill.   Unfortuantely allergies and asthma are often not predictable — you COULD have a flarup at any time; hence, as those with some other medical conditions, asthmatics have been deemed ineligible to take scuba certification classes. Note: being on a submarine is a whole otehr issue; you aren’tbreathing from a tank of air, you can take medication and be medically treated while at depth [i.e. immediately], and the attack can be often fully treated at depth with no need to ascend.  Some subs have better medical facilitie then the best hospitals do [albeit on a smaller scale] and you’d probably get better treatment in a sub then you would in many ERs!!. SW.

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