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Another asthma flare- I'm getting frustrated.

Thanks Jane,

I've never had problems like this with Prednisone before. I've been careful to take the Prednisone with food. Part of the problem is that I've had trouble keeping food down most mornings when I'm constantly coughing. My GI doc said it is because I'm squeezing my stomach with the coughing and pushing the food up. It was crazy, I've had a lot of bad insomnia, headaches and "zoning" out for the last 4 days. I cut back my dosage today. I didn't "zone" as much, but still had the headache, we'll see if I can sleep tonight. I'll try to make sure I'm eating more often throughout the day to help.

I'm not sure if my lungs are doing better or not. I'm still coughing, but not all the time, just frequently. Walking, talking, laughing, showering, etc... all trigger the coughing. I have stepped up my use of my nebulizer vs. the inhaler this last week though. Ironically, my breathing has felt better for a couple weeks now. I'm concerned about over-using the albuterol. My doctor is encougaging me to still use it frequently though.

Another asthma flare- I'm getting frustrated.

Have you tried a cough suppressant - like codeine cough syrup? Sometimes the cough just becomes automatic after the underlying cause is gone. I got a dry hacking cough two weeks ago and tried everything to get rid of it. Nothing worked. I wasn't sick just had the darned cough. Finally gave in and took codiene cough syrup one night and that took care of it. (Of course, since codiene winRAB me up instead of makign me sleepy, I had to take a benedryl to sleep). You might just try treating the cough and ignoring the cause.

Another asthma flare- I'm getting frustrated.

Almost 11 weeks and I'm still coughing. I occassionally have some short perioRAB without coughing, but then have hours with multiple attacks. I keep hearing from the doctors that the primary causes of a chronic cough are asthma, allergies/PND and acid reflux.

My primary care doc upped my treatment of all three with no real success. I'm feeling like I'm medicating myself and doing more harm than good.

While I had a true asthma flare in early august, I'm questioning whether or not it is still asthma at this point. I've been on two rounRAB of Prednisone. The first was a short course for my flare and apparently worked. The second was a high-dose longer course that I had side-effects from and didn't make any noticable difference in the cough. I'm still on Singulair and at Advair 250/50 in addition to Xolair shots.

For the allergies, I'm on immunotherapy, Allegra, Singulair and Nasonex. Right now, I'm not feeling any congestion or PND at all. My allergies are mostly just itchy, gritty eyes.

For the acid reflux, I had a Nissen Fundoplication 2 years ago. I have had a Barium Swallow that showed no sign of reflux and that my fundoplication was intact. I also had another Endoscopy that showed no evidence of reflux. My ENT is going to do another pH test on me next week, but neither of us expect to find any signs of reflux. I'm also still taking Dexilant (never went off after surgery), Pepcid, sleeping on a slant and watching what I eat and drink. I haven't noticed any increase in coughing after I eat. Mornings are bad though.

My Primary Care doc told me he couldn't do any more for me.

My GI doc said he didn't think the cough was GI related. I did have an Endoscopy last week and they did a couple biopsies to check for H. Pylori and Celiac, but everything looked good.

I went to my ENT/Allergist today on the advice of my PCP. He did a scope and said my vocal corRAB are red. He said the redness could be from the coughing or from reflux. (Big surprise!!) I'm going to have pH testing to rule out the reflux. As for the coughing, he doesn't see a need to adjust my allergy or asthma treatments at this time. He said that some people just have a chronic cough that remains undiagnosed or that is a "habit". He said the habit isn't a couscious thing, but that the inflammed vocal corRAB trigger the need to cough which keeps the vocal corRAB inflammed. I asked him about the possibility of environmental triggers and he just listed the ones I already know about.

I go see my Pulmonologist next week, but he didn't do anything for me last winter when I had the cough for 4 mos so I'm not too hopeful.

I'm really worn out from this. It is affecting my work performance. I can't multitask like I used to be able to do and keep getting further and further behind. I also can't work the long hours I used to at times to get the job done either. I'm beginning to worry for my job which I've had for many years.

I'm frustrated with having to seek out answers myself and hitting roadblocks at every turn. While several docs seem sympathetic, none of them have helped me seek out the answer beyond the obvious. They just pass me off to another. I'm spending a huge amount of money and getting no answers

I would welcome any suggestions anyone on this board may have. Your support helps keep me going.

Thanks,
MountainReader

Another asthma flare- I'm getting frustrated.

I've actually dropped back down to Advair 100 for the last couple weeks. I haven't needed the Albuterol for weeks now either. I've cut back some on my allergy meRAB also. I do worry about when the cold air really hits though. That is my worst asthma offender.

They basically told me that there just isn't anything to keep the acid down and that I'm overproducing the acid.

Another asthma flare- I'm getting frustrated.

MountainReader, regarding your comments on humidifiers & humidity, here are 2 experiences I had:

Last year during a severe asthma period, my pulmonoligist said to start using a humidifier at night. When I saw my asthma doctor a week later, she said to stop using it because the minor benefit from more humid air in my airways was more that oRABet by the greater risk of small amounts of mold or mildew developing in my bedroom from the humidifier. I stopped using it because of her concern plus the humidifier didn't seem to help and I didn't like the gurgling sound it made.

I was in NYC in May and one day was in the high 90's with high humidity. As soon as I stepped outside asthma flared & I couldn't stay outside for more than 5 minutes. As soon as I stepped back into an air conditioned building, the asthma ended. This happened every time I tried to go outside that day.

Another asthma flare- I'm getting frustrated.

Last time I had prednisone I kinda went crazy for a few hours. I've found that eating constantly helps. Doesn't have to be much food (shouldn't be!) but just never letting the stomach really empty.

Is it settling down your lungs at all?

Another asthma flare- I'm getting frustrated.

Thanks for your support everyone. I really needed it. When it gets to the point that the asthma is really physically draining you and treatments just aren't working as they usually do, it is easy to let it emotionally drain you.

I've been able to do pretty well with the allergies and avoidance/ treatment this spring and summer. It was going out of town that just threw my system off. I was at UCLA for a fellowship for 12 14-hour days of class. The corabination of allergies, air quality and long days finally cought up with me (and my allergies and asthma) by the end. Now, triggers that I had under control and weren't affecting me before are easily triggering me. I can't hold a good conversation or walk up or down the stairs or hallway. I'm coughing almost nonstop from the moment I wake for a couple hours in the am before I can leave the house. I've even switched to the nebulizer in the am and pm. Also, things like walking by a smoker who isn't even somking, cleaning on the other end of my building, laughing, etc... trigger coughing jags.

If I thought they would have been able to do much for me, I would have gone back to the doc today. I was just very miserable and uncomfortable. I'm not at the point of needing the emergency room or my epi-pen, but I'm not sure what else I can do right now.

I'll try to relax more. I've been doing PT, chiro and massage regularly for the last 3 months so that has helped some as well. It is a hectic time at work though so there is no avoiding everything there right now. I know I stress myself about what others think, but I've had to take a lot of time off for appointments this summer. (I've had weekly visits to the ENT/Allergist for a couple types of shots, regular visits to my TMJ specialist as I just started splint therapy, PT, Chiro, specialists, PCP. They all add up quickly when it comes to time off work.) I am going out of town for a few days soon though so hopefully that will help.

Again, thanks for your support. I know this too will pass, but I have to get through the bad time first. Hopefully it won't last as long as last time.

MountainReader.

Another asthma flare- I'm getting frustrated.

Thanks for your response. I have looked into other Pulmonologists twice now and the waits for them were even longer. Last year when I was really really bad, I called his office almost daily/weekly until I got in as soon as I did. They kept telling me to go to my PCP until I had my appointment. I kept telling them I had been in almost once a week for a couple months. I'm considering going to a University hospital. Problem is that it is over an hour away and I'm already taking off work a ton to visit my TMJ dentist, PT, Chiro & ENT/Allergist.

My ENT has also been trying to help some with the asthma. I'm in his office weekly for immunotherapy and once a month for Xolair (allergic asthma) shots. He worked for 6 mos this year to get insurance approval for the Xolair. I was repeatedly denied. He finally got me connected with a foundation who gave me a 1 year grant for the shots. The cost for 1 year of monthly shot medication is $10,000. I won't be able to do a second year, but I'm hopeful the Xolair will help me out this winter. So far I've had 3 shots.

I hurt my back Monday from all the coughing I'm doing. Went to the Chiro today who said it was common and also said to see him when my coughing is bad because of the affects it has on the body. The lungs are tied to the spine as well. I also keep throwing off my first rib. I go back next week for an adjustment and laser therapy. Hoping it will help.

I have a massage therapist who will work my asthma and sinus points as well, but I haven't been able to schedule with him lately due to my work schedule.

Frustrating thing is that I had great control for 4 months. My Pulmonologist does give me a standing prescription for antibiotics and steroiRAB. I'm reluctant to use them though because I don't want to take them unless I truly have a problem. I usually go to my PCP so he can listen to my lungs.

Today was a smidge better than yesterday with the coughing. I'm hopeful for tomorrow.

Thanks for your support.

Another asthma flare- I'm getting frustrated.

In that case, taking leave might be your best option. Just getting away from stress and environmental triggers might be a big help.

Biggest problem for me is, my problems trigger each other, yes, but the treatments for each problem trigger the other problems, too, so more treatment is not the solution. I think I may have found the ideal balance between benefit and side effect as far as the asthma meRAB go, with Syrabicort in the morning and a plain steroid at night. Syrabicort twice a day would probably work even better, but then I'd never sleep.

Another asthma flare- I'm getting frustrated.

Still coughing, but not as frequently thank goodness. It's been over a month between my sinus infection and asthma flare.

I'm not sure why my cough is starting to get better though. I started a 10 day course of Avelox last Sunday on the off chance my original infection hadn't totally cleared up and was a factor even though aside from the coughing I haven't had other indications of an infection. I've also been to the Chiropractor 3 times now. He has been working on a couple lurabar areas that influence the lungs. He has also been working the lower back that I tweaked with all the coughing. I go back next week for another visit. I've also been for several sessions of PT. Not sure if it is influencing the cough treatment though. She is working on my hips/lower back/ shoulder & first rib/ neck and mouth (the orofacial releases hurt like crazy, but I feel better after) for TMJ & Myofacial pain. Seems that so many things are connected, who knows.

On the plus side, despite the continual coughing, my breathing has been better and I've been able to cut back on the Albuterol/nebulizer treatments. Still taking the Advair 500 for a few more days though before bumping down to the 250.