Coping with Severe Asthma

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  Jan 10, 2008 10:02 AM GMT

  Hi Guys,
  
  I would like to hear from any guys who are trying to cope with (relatively) severe asthma. I've had it all my life (incl. hospitalisation as a child) but it cleared up during my teens. Suddenly it's back with a vengeance.
  
  I can usually manage it with Flixotide, but when I wake up in the morning with that tightness in my chest I just don't want to go anywhere near the gym. A ten minute run can leave me hardly able to breath and dizzy for 15-20 mins.
  
  What do you guys do? Am I right just forgetting exercise for the day? I REALLY hate missing out on my work out. Should I, for example, just skip my warm up? It's at the point when the attacks are so bad I'm scared to experiment.
  
  ANY ADVICE???
  
  Thanks
  
  William

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  Jan 10, 2008 5:14 PM GMT

  Do you have a good allergist? that's the person you should be talking to! It sounds like you're just taking a cortocisteroid and no bronchiodilator. You might need both for good asthma management.
  
  I have moderate/sever asthma since I was a very young child. Just last year, my allergist switched me to Advair 250/50. It has done wonders for me. and I only need to take 1 inhalation twice a day.
  
  It's a combo of fluticasone and salmeterol and I find it works much better than having 2 separate inhalers (1 steroid and 1 bronchiodilator). Before Advair, I was using Azmacort (steroid) up to 8 puffs a day, and Serevent 1 puff twice a day.
  
  Most important...TALK TO YOUR DOCTOR about your options.

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  Jan 10, 2008 6:03 PM GMT

  My cousin has not had an attack since he cut out all processed sugar and milk. Apparently ice cream after diner was the worse thing he could do. Also processed sugar or processed carbohydrates after 6:00pm.

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• cowboyathlete
  
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  Jan 10, 2008 6:07 PM GMT

  medfordguy saidDo you have a good allergist? that's the person you should be talking to! It sounds like you're just taking a cortocisteroid and no bronchiodilator. You might need both for good asthma management.
  
  I have moderate/sever asthma since I was a very young child. Just last year, my allergist switched me to Advair 250/50. It has done wonders for me. and I only need to take 1 inhalation twice a day.
  
  It's a combo of fluticasone and salmeterol and I find it works much better than having 2 separate inhalers (1 steroid and 1 bronchiodilator). Before Advair, I was using Azmacort (steroid) up to 8 puffs a day, and Serevent 1 puff twice a day.
  
  Most important...TALK TO YOUR DOCTOR about your options.

  
  I agree and sympathize on all counts. I have to take the 500/50 dosage of Advair, plus a generic version of Allegra. On top of that, I highly recommend that anyone with asthma or breathing problems keep their living quarters free of dust and mold. A HEPA unit can do wonders in that regard, mine has been a lifesaver in allowing me to keep working out and keep cycling.

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• cowboyathlete
  
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  Jan 10, 2008 6:11 PM GMT

  I Googled Flixotide. In the United States, I believe it is called Flovent. Advair (that some of us have spoken about) is a combination of Flovent and Serevent. Seretide is the parallel name for what we are suggesting you check out:
  
  http://www.seretide.co.nz/

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  Jan 10, 2008 7:10 PM GMT

  Life-long asthma sufferer here, so I can tell you what might help...
  
  You may want to cut out/down on milk/dairy products as the chemical (caesin?) causes an expansion of mucus which can block your air pathways and trigger symptoms. Same for cold-weather exercises which can contribute to your symptoms (if you must go in the cold, cover up). Incorporating herbs and spices from the mint family will help you a lot, as well as incorporating more peppers into your diet. Studies have shown that people who consume kiwis on a regular basis have decreased asthma symptoms over a long period of time. Same for apples, actually. Just a few things, hope that helps.

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  Jan 12, 2008 7:55 PM GMT

  Hey guys, thanks for all your responses. I'm also incredibly impressed at the lengths that you went to researching for me! I'm going to go see a new doctor now so hopefully that'll work for me ;-)
  Thanks once again,
  William

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  Jan 12, 2008 8:31 PM GMT

  I use the 500/50 Advair with the usual albuterol. Note that some pharmacies only carry the HFA (CFC free)albuterol inhalers now and some of the formulations out there are better than others. I recommend going with the ventolin over the other HFA albuterols out there. My doctors have told me many people haven't responded well to the new HFA proventil compared to the HFA ventolin. In my own experience, the HFA proventil did not work at all. If you're still able to get a hold of the CFC stuff it shouldn't matter what brand name or generic it is. The Ventolin also has a counter that counts down from 200 inhalations so it's easier to gauge when to call in a refill.
  
  Asthma is common enough that most general practitioners have a pretty good handle on it, but if the situation doesn't resolve with basic treatment you should see a respiratory specialist or an allergist as some have suggested earlier in this thread.

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  Jan 12, 2008 8:49 PM GMT

  William,
  
  I'm glad you got some good advice here. I've been living with asthma since early childhood and the recent advances in medication have been fantastic. About 10 years ago, i let my asthma get out of control, relying heavily on my rescue inhaler. Hell, I was getting winded going up a single flight of stairs, and I wasn't overweight. Within weeks of getting a medication regime from my doctor, i had things under control.
  
  There is no reason for asthma to slow down your physical activity. Find a good doctor and you'll have everything under control in short order. Make sure to talk about what you can do besides medication to control your asthma. Even something like a hypo-allergenic pillow cover can make a difference.
  
  Good luck.

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  Jan 12, 2008 8:55 PM GMT

  I had regular asthma attacks until I was 23. I actually missed most of ninth grade due to asthma.
  
  And then it vanished. I am 50 and it has not been back.
  
  I don't understand. I am grateful but I don't really understand it.

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• medic
  
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  Jan 13, 2008 12:29 AM GMT

  Lots of good advice given already. A couple points.
  
  I try to inform patients that asthma is an immune system problem manifested in the lungs primarily. It consists of an inflammatory pathway and bronchoconstriction.
  
  First you need medication for the inflammatory pathway. Inhaled corticosteroids are the mainstay for this treatment but there are some new drugs; leukotriene inhibitors (like Singulair) or anticholinergics, which can be added and may help.
  
  Second you must treat the bronchoconstriciton with a long-acting bronchodilator such as Serevent. If you have break-thru wheezing or tightness, you use your albuterol rescue inhaler like medfordguy mentioned. This use has to be regulated.
  
  There are several other drug combinations that have helped in complex asthma cases.
  
  This disease is one that has been notoriously under treated in the States and numerous Federal Programs have pushed better Guidelines since 1992. Do not assume your medical provider is utilizing best treatment but ask! Teaching centers can be very helpful if you are not getting better. Here is some light reading. lol http://www.nhlbi.nih.gov/guidelines/asthma/asthsumm.pdf
  
  The allergy avoidance already mentioned can be crucial if you have allergic triggers.
  
  One final point. There are patients who have physical triggers such as cold air exposure or heavy breathing. (not that kind you guys, This is called exercise induced or exertional asthma. Albuterol used 15 minutes before exercise can avoid this.
  
  Sorry about the long post but in my decade of ER experience I saw tragic results of poor management. Best of luck.
  

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• gr8hands4you
  
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  Jan 14, 2008 6:10 PM GMT

  My compliments to all the suggestions. I would also get a consult with a pulmonologist. They are better for severe asthma than an allergist.

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