Another asthma flare- I'm getting frustrated.

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janewhite1

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Yeah, I had a weeklong flare a couple weeks ago, and it really messed with my acid reflux. I wasn't using bronchiodilators (because this was after I'd figured out my inhaler was poisoning me and before I could get to the doctor for a new one) and I wasn't coughing much. The stomach problems were just from the straining to breathe all day and night, because the diaphragm is not designed to work that hard.

Sometimes I find protein shakes go better than actual food. Or Farina with milk, which is sort of like food but not really.
 
I've been having the same thing lately, whether it's from a hot sticky day, shower or another cause. As soon as I start breathing air that's very high in humidity, (like literally from the first breath) I start feeling bad. But as soon as I get into drier air, I start feeling better.
 
Uggggg!!! Just finished (almost) a round of antibiotics to see if I had an underlying infection, also dealing with unexpected side effects of the antibiotics so I stopped taking them at day 9. Still coughing.

Been going to PT and a chiropractor to help with the cough and tweaked back from coughing.

To make matters worse, for the last couple days, we've had red air quality days with elevated ozone and particles from a fire in Idaho. They also started construction this week on my work facility. Although they are behind a barrier, the air particles were bad today. I ended up putting on a face mask we keep for emergencies. I was the only one in the building, other than the contractors, who was wearing a mask and kept getting teased, but my coughing had gotten so bad I couldn't function. I'm dealing with the same thing again tomorrow.

Unfortunately, I can't miss any more work. I missed a couple days already due to my IBS and side effects from the antibiotics.

I'm about 6 weeks into this flare and really really tired of it. I don't think my doctors know what else to do for me at this point either. My asthma appears to be better and under fair control right now. My allergies appear to be under control. I haven't had signs of reflux or PND. Still that URI and asthma flare I had in July triggered this chronic cough that is playing havoc with my life. I've been to tons of specialists and I'm not sure where to go from here. Winter is my "bad" time and I'm dreading the upcoming months. I wish I knew what to do.
 
Just feeling a need for a bit of support right now.

For those of you who know me, I've had asthma for about 8 years now officially. I usually have major triggers in the winter with the cold air and pollution. Occassionally wildfire season in the summer will get to me. I'm more environmentally triggered, but I did start taking Xolair shots a couple months ago for allergic asthma. I'm also a couple years into immunotherapy. I had a really really rough winter last year with a flare that lasted about 4 months. I do have a pretty solid asthma action plan in place and am diligent about following it.

Here is my frustration. I went out of state for about 2 1/2 weeks at the beginning of July. I hit my last leg of my journey with a sinus infection & fever. I got my doc to call in an antibiotic to the nearest pharmacy to where I was staying. I returned home and finished my Augmentin and my sinuses felt better, but I developed a cough. It has gotten much worse over the last week. I get a cough as a symptom for allergies, PND, asthma and sometimes as residual from the sinus infections. Trouble is that I can't always tell the trigger. I hate to take too much asthma medication if it really isn't an asthma flare. Thus, I ended up at my docs again today. He could tell it was asthma from talking to me and said my lungs were extremely "tight" and wheezy. I'm on yet another round of steroiRAB in addition to Advair, Singulair and my albuterol inhaler & nebulizer. I've upped the Advair as well.

In addition to the frustration of being in another asthma flare, I'm frustrated because summer is my "good" and fairly "safe" time. Our humidity is low and the pollens are fairly moderate/low right now. We do have a bit of bad air quality here, but we've been on mostly green days and yellow days which is good. I just don't want to face going into the fall/winter season with flared asthma. I'm hoping the steroiRAB work, but so far, the albuterol hasn't totally been doing the job very well.

I just don't know how much more I can do to get my asthma under control long-term. It has really worn me out over the last several years, both physically and mentally. At this point, moving would probably be a best option so I'm away from the cold, but I will just end up with new allergy triggers so is it really the best? Also, I need a job that pays a livable wage and has good insurance because I certainly have a lot of doctor's visits over the course of a year.

Most of the people around me were very understanding when I first got the asthma, but after so many years of this, I think they aren't so sympathetic/empathetic anymore. They don't understand how draining asthma can be. I get the impression that because I'm not in the hospital with it, it must be OK and that I'm just exaggerating. Prior to my asthma diagnosis, I'd never taken a day of sick leave in school or in my work life. Even the first few years of asthma, I rarely took off. The last couple years, I've taken some days here and there trying to take care of myself, but for the most part, I plug through at work and crash at night. It is harder to deal with all this when most around me just don't understand anymore.

Thanks for listening.
MountainReader
 
Los Angeles in July? Ick. Yeah, that would be BAD.

Hang in there. Do what you need to do, and don't feel compelled to return to your normal activity level the minute you start feeling better.
 
For the cough directly, I've tried Tessalon Perle, Promethazine syrup and Cheratussin AC Syrup (a corabination of codeine and guaifenesin). The last one does make me sleepy so I can't use it during the day. While I wake coughing like crazy, I don't wake up at night coughing. I've taken it periodically though when I need a really good rest though.

I'm considering taking some leave from work so I can just rest all I need. It's a tough decision though.
 
Hopefully the prednisone will settle things down again!

When is the CT scan supposed to be?
 
I'm curious about the humidity thing too. I developed my asthma after I moved to Utah and developed major allergies. Right now we have 14% humidity. I also live in a high altitude area in the Rocky's. We do get quite a bit of winter snow, but the humidity stays fairly low still in the winters though.

When I went to CA last month, they were in the miRABt of their "June Gloom" still. The first week I was there, I had asthma problems. I associated it with the air quality and not the humidity. It is also at sea level. 3 factors I hadn't all considered.

I typically do OK in Las Vegas which is a lot lower in humidity that my home environment. I've been there twice in the last two months with no asthma problems other than what I arrived with. In fact, it was in the 110's during my July visit and I didn't have problems with the heat. Granted, I didn't spend extended time outside though.

I haven't spent extended time in the high humidity of the midwest or south that I grew up in for years. I wonder how that would affect me? For some reason, I imagine that the hot humid air I grew up in would would make it hard for me to breathe now since my body is no longer aclimated.

I do have humidifiers I use here. Typically during the winters because the indoor air is so dry. Problem is that I go through them at about one or two a year and it gets expensive. No matter what I try they eventually build up pretty badly with calcifications. It is too expensive to keep buying water to fill them with. I do use a Brita pitcher, but it doesn't do the job completely and eventually the calcification builRAB. Even using the humidifier cleaners. I should probably pull it out again. Hadn't thought about it.

Interestingly enough, neither my PCP, ENT or nor my Pulmonologist have talked to me about use of a humidifier with the asthma. I'll have to ask next time I have an appointment.

Certainly something worth thinking about.
 
Just one more hurdle to healing. Pollens are on the rise again and our air quailty has gone back up to yellow (unhealthy for those who are sensitive) and may be red before the end of the week. A few miles to the south of me, it will already be red air quality tomorrow. If I didn't need to work so badly, I'd be taking off away from this for a while. How do you avoid breathing the bad air when you are living in it? Masks only do so much. I'm about ready to pull mine out though.

Had another appointment with my Chiropractor today. He seems to think a couple more visits should help with the cough. I'm not sure how much I believe that, but at this point I feel it is worth a try.
 
Still don't have this thing kicked. Went back to the clinic today because my cough is still really intense. I'm on another round of antibiotics--Avelox this time, to see if I still have an underlying URI. I'm continuing the Advair 500, Singulair and Albuterol as well. He gave me a prescription for a codeine cough syrup to try to help me get some rest from the coughing.

It is really wearing me down mentally and physically. I keep pulling my messing with my back when I cough this time. Went to the chiro this week and going back on Monday. Keep pulling muscles too. I really really hate that I can't get things under control when I'm doing all the "right" things and carefully following my asthma plan.

Thanks for listening.

MountainReader
 
I definitely know what it's like to dread going back to work!

Is there any way you can work in a different spot? Maybe a different area of the building?
 
Thanks for the suggestion on the Farina. I haven't done protein shakes, but I have been trying Instant Breakfast with soy/ almond milk. I haven't done much dairy in years. I'll see what kinRAB I can find in my local stores.

I found out today that my Hemoglobin is at 7.0. My doc said I should be at 15.0. When I look up anemia symptoms, it mentions difficulty breathing as a symptom. I'm not sure if that can be connected with the coughing at all or not. Based upon my internet research, It looks like that is an extremely low score. They will be doing some biopsies on me in a couple weeks during an Endoscopy.

I got my chest CT scan results today. The good news is that it came back normal. (Just very expensive.) The nurse who called asked if the Prednisone was working. I told her it made me sick and that I'm still coughing a lot. She said he would want me to follow-up, but left it up to me on when. I still have 10/16 days left on this Prednisone prescription, but I've completed taking my upper level dosages already and am tapering down so I'm not sure I should wait. I just don't know where to go from here. There are 2 PA's who have been working with me and both have told me to come back as needed. I haven't been able to get an appointment with an MD in a timely manner so I've just been seeing them instead. Do I want to get another Primary Care doctor involved? I went to my Pulmonologist last spring and he didn't do much even after I'd been coughing for 4 months. Since my asthma appears to be under control and my breathing isn't bad right now, I'm not sure how much he would do. It is a "mystery" cough and since I'm not sure why I still have it, so it makes it difficult to know who to go to. What to do...what to do... :confused:
 
Mountain, my symptoms are worse in summer because of the AC's in buildings being turned so low, that the cold air always causes a reaction...I was just given a methacholine challenge and did very well on the test, and the tester said I had a small reaction, but, get me in cold AC and my reaction turns bad....they didn't test me for the cold air....or did they?

I am new to the asthma issue, but I can relate to much of what you say...to me, it feels like I am not comfortable around people other than my husband when this problem hits me....I am not sure if people do understand asthma, even those who have it sometimes seem like you should have it the way they did...

I had a bad one today and still not sure whether it was the vocal cord dysfunction the doctor said was probably giving me trouble as well, or acid reflux which can aggravate the vocal corRAB and asthma...

I wonder about moving away from your state, I was told that once a person has asthma they always have it, it is just controlled better....and if your luck is like mine, it would get worse...that's what happened to me when I moved to another area in my own state just 25 minutes away from where I lived all my life....just the types of trees here and the wooded setting was like walking into a nightmare...I had no clue....

Of course, I probably always had it, just nothing ever triggered it to the degree it is now...bothers me to go out in cold night air in the winter and AC air in the summer...but I deal with it better in the winter, because I can put a scarf over my mouth and nose, in the summer, it is harder to control, I can control my AC but others...and people don't understand, not even my kiRAB....or husband really....but I had to make some changes to how I dealt with their opinions, and figured, until they walk in my shoes, they need to leave me to deal with it the way I have to....

My husband is supportive, but still I get the feeling that he doesn't completely get the whole thing....to that I say....Tuff....it's my life, like it or leave it
 
Just a thought here--is it possible one of your meRAB is actually making things worse? My rescue inhaler helps in the short run, but I tend to feel worse a couple hours after using it when the side effects kick in. My friend can only use Proventol because the generic inhaler makes her throat tighten.
 
Well, it really comes down to whether taking the leave will put your job at risk, or whether continuing to work with slipping performance would be worse.

Right now I'm still dealing with a sore throat. Can't figure out how much of it is the reflux, how much is the steroiRAB, and how much is the asthmatic cough, I know all three are part of it.

Is it possible the steroiRAB are irritating your throat? Does that happen to you?
 
I've been on the steroiRAB for years and never noticed a problem. I've always tried to be careful to rinse afterwarRAB. I did switch up types of steroiRAB last winter with no real change. Who knows?

Actually, taking leave under the FMLA law will protect my job legally. It's tough. I have tons of responsibilities and keep up with most, but haven't been able to keep up with everything. I keep finding things I've let slip. I never used to have those problems before. Nobody's job is totally safe in these economic times though. I do know I have over 3 months of sick leave accrued though along with another 6 weeks annual so I can afford to take off. I think I'm just worn out mentally and physically. I think the emotional piece is there also.

I certainly know frustration plays a key part when you can't find an answer.
I'm tired of dealing with this year after year. My last flare was from last Nov-mid-February. I know it is probably a corabination of things, but right now the allergies, asthma and reflux all appear to be under control. Heaven knows I've gone overboard trying to address all of these issues in the last 3 months.

As for your struggles, I know it took using the multi-prong approach in treating all at the same time to get things under control. One always seems to trigger the others if I don't. It's worked for me in the past, just not this time. I think a good Pulmonologist is probably your best bet. The trick is finding a really good one and getting an appointment.

Thanks for conversing with me about this. It does get lonely.
 
Thanks Jane. I really hate going on such a high dose of Prednisone, but at this point, I'm willing to take more aggressive approaches.

My CT scan is Wednesday evening. The radiologist at the hospital also received a copy of my x-rays for a second reading. I figure it will be about a week after that before I get all my results.

All the antibiotics also threw off my IBS. I've also been throwing up with all the coughing pushing things up because it squeezes my stomach. I went to see my GI doc last Monday. He did some labs. They called me on Wednesday to come in for more labs. Turns out I'm now anemic as well. I really wasn't expecting that. Not sure if it has any connection with the cough at all. I'm awaiting the results from my second labs. I go in for an Endoscopy in about 3 weeks. I really hope it doesn't show anything. I had major problems with acid reflux triggering my asthma a couple years ago. I had surgery to prevent the reflux. If it shows any acid coming up, there really aren't any other treatment options left to me. (I never went off my PPI's and sleep on an incline and watch my diet still.)
 
Yeah, that's rough. Is there anything more you can do to reduce your exposure to triggers?

I've only been at this a few months, but I've firmly decided that the fatigue is the worst part. Last May, I'd get done with work and be too tired to talk coherently. I'd get home, shower, and just sit in my chair, too worn out to even raise my arms.

And yes, that's the other problem with this, that people get tired of being understanding and patient. They expect you to get better and stay better, and sometimes it's just not that simple.
 
Hang in Mountainreader, Are you drinking warm liquiRAB? Warm tea or coffee, usually help with the lungs, or just putting a towel over your head and breathing in warm air. Put some vicks in warm water and put your towel over your head and breath it in. I know it is a very old remedy, but it works.

Sunny
 
Thanks for your responses.

I have talked to my doctor again this week about the possibility my meRAB are having an effect on my cough. I know the allergy meRAB can have that side effect. I've tried switching meRAB up over the years when I've had flares with no luck. I tend to come back to the ones I'm currently on because they seem to be the most effective.

I haven't tried the warm approach this time. I usually have more troubles in winter when I am drinking lots of hot. Hadn't thought of it as hot as its been. I'll give it a try. I typically avoid caffeine. I'll give it a try. I do know that my coughing is horrible after getting out of a warm shower.
 
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